WWW Iowa Healthcare Collaborative

Lean in Health Care



Case for Change

Waste, redundancies, errors, and escalating costs are pervasive in many industries. The Japan-based Toyota Corporation developed the Toyota Production System (TPS) to tackle these problems within its organization. The tools and principles of the TPS helped increase efficiency, decrease resource waste, and improve quality. Eventually, American manufacturers began to utilize TPS to improve their own organizations. TPS, today better known as Lean, revolutionized the way manufacturers did business. Lean also reduces overhead costs, eliminates waste, and increases patient and staff satisfaction, by improving the processes by which an organization carries out its activities.

Others industries took notice of these rapid improvements in manufacturing and considered implementation within their sectors. Health care, in particular, lent itself well to Lean techniques. Implementation of Lean allowed providers to lower cost and improve the quality of care delivered to patients. One of the early adopters, Virginia Mason Medical Center in Seattle, reaped Lean benefits immediately after its 2002 implementation. The 350-bed hospital saved $6 million in planned capital investment, freed 13,000 square feet of space, cut inventory costs by over $350,000, reduced staff travel time around the hospital, and decreased infection rates. At the same time, the hospital greatly improved patient satisfaction.

The Iowa Healthcare Collaborative (IHC) recognizes that many health care providers in Iowa have successfully implemented Lean process improvement within their organizations. These providers have many success stories of more efficient care delivery and better resource allocation. IHC hopes to encourage more Iowa health care providers to implement Lean, and has a goal of expanding the number of hospitals using Lean for improvement.

IHC would like its efforts to create greater awareness of Lean in the Iowa health care community. Additionally, IHC hopes that these process improvement tools will spark meaningful, lasting dialogue among the state's providers. This communication should successfully link those new to Lean and other process improvement techniques and those who have successfully implemented them within their organizations. IHC hopes this sharing of ideas will stretch beyond this project and into other meaningful arenas.

This toolkit will:
  • Provide numerous educational materials about Lean
  • Provide a list of Iowa contacts who have implemented Lean in their organizations
  • Provide success stories from Iowa hospitals who have applied Lean tools for improved outcomes
Sources:
  1. Connolly, C. "Toyota Assembly Line Inspired Improvements at Hospital." Washington Post, June 3, 2005, p A01.
  2. Institute for Healthcare Improvement. "Going Lean in Health Care." 2005. Available at www.ihi.org.



Tool Kit

Education and Tools

Lean Presentations
2007 Annual Lean Conference Speaker Handouts
  • Creating a Culture of Improvement at Mercy Medical Center-Des Moines
    Dan Varnum, MBA, Vice President of Performance Improvement, Mercy Medical Center – Des Moines
    This presentation will walk you through how Mercy Medical Center – Des Moines had continued to develop its culture of process improvement, and share successes and lessons learned.

  • Improving Processes to Decrease Cost and Improve Service
    Jay Christensen, Administrator; and Les Martin, Director of Continuous Improvement, Mahaska Health Partnership, Oskaloosa
    This presentation illustrates how the Mahaska Health Partnership decreased costs and improved customer service through simple organizational changes.
  • Lean Basics
    Dean Bliss, Director of Lean Improvement, St. Luke's Hospital, Cedar Rapids
    This presentation provides a basic understanding of the Lean methodology, including terminology and acronyms.

  • Non Healthcare Approach to Lean
    Teresa Hay McMahon, Performance Results Director, Iowa Department of Management, Des Moines
    Jeff Ruiter, Director of Demand Distribution, EDS, Des Moines
    These two presentations describe how Lean methodology has been successful in non-health care environments in reducing costs, increasing productivity and achieving greater customer and employee satisfaction.

  • Reinventing Health Care: Improving Quality as a Determinant for Reducing Cost
    Karen Wolk Feinstein, PhD, President/CEO, Jewish Healthcare Foundation and Pitts burgh Regional Health Initiative, Pittsburgh, PA
    This presentation examines the way in which quality improvement leads to cost reduction and the innovative way in which health care institutions in Pennsylvania are using process engineering to achieve improvements.



Articles

New Articles
Old Articles



Websites



Books

5S for Service

5S for Service Organizations and Offices: A Lean Look at Improvements
Author: Debashis Sarkar

ISBN-10: 0873896777

A3 Problem Solving for Healthcare

A3 Problem Solving for Healthcare: A Practical Method for Eliminating Waste
Author: Cindy LeDuc Jimmerson.

ISBN-10: 1563273586

A Lean Guide to Transforming Healthcare

A Lean Guide to Transforming Healthcare: How to Implement Lean Principles in Hospitals, Medical Offices, Clinics, and Other Healthcare Organizations
Author: Thomas G. Zidel

ISBN-10: 0873897013

Becoming Lean

Becoming Lean: Inside Stories of U.S. Manufacturers
Author: Jeffrey Liker.

ISBN-10: 1563271737

Leading Change

Leading Change
Author: John P. Kotter.

ISBN-10: 0875847471

Lean For Dummies

Lean For Dummies
Authors: Natalie J Sayer and Bruce Williams

ISBN-10: 0470099313

The Lean Healthcare Pocket Guide

The Lean Healthcare Pocket Guide
Authors: Debra Hadfield & Shelagh Holmes.

ISBN-10: 0977072029

Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction

Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction
Author: Mark Graban

ISBN-10: 1420083805

Lean - Six Sigma for Healthcare

Lean - Six Sigma for Healthcare: A Senior Leader Guide to Improving Cost and Throughput
Authors: Chip Caldwell, Jim Brexler & Tom Gillem.

ISBN-10: 0873896475

Lean Six Sigma for Service

Lean Six Sigma for Service: How to Use Lean Speed and Six Sigma Quality to Improve Services and Transactions
Author: Michael L. George.

ISBN-10: 0071418210

Lean Six Sigma

Lean Six Sigma: Combining Six Sigma Quality with Lean Speed
Author: Michael L. George.

ISBN-10: 0071385215

Lean Solutions

Lean Solutions: How Companies and Customers Can Create Value and Wealth Together
Authors: James Womack and Daniel Jones.

ISBN-10: 0743277783

Learning to See

Learning to See: Version 1.3
Authors: Mike Rother, John Shook, Jim Womack, & Dan Jones.

ISBN-10: 0966784308

Lean Thinking

Lean Thinking: Banish Waste and Create Wealth in Your Corporation
Authors: James Womack & Daniel Jones. Free

ISBN-10: 0743249275

The Machine that Changed the World

The Machine that Changed the World: The Story of Lean Production
Authors: James Womack, Daniel Jones, Daniel Roos, & Donna Sammons Carpenter.

ISBN-10: 0060974176

The Pittsburgh Way to Efficient Healthcare

The Pittsburgh Way to Efficient Healthcare: Improving Patient Care Using Toyota Based Methods
Author: Naida Grunden

ISBN-10: 1563273675

Stop Rising Healthcare Costs

Stop Rising Healthcare Costs Using Toyota Lean Production Methods: 38 Steps for Improvement
Author: Robert Chalice.

ISBN-10: 0873897137

The Toyota Way

The Toyota Way: 14 Management Principles from the World's Greatest Manufacturer
Author: Jeffrey Liker.

ISBN-10: 0071392319

The Toyota Way Fieldbook

The Toyota Way Fieldbook
Authors: Jeffrey Liker & David Meier. McGraw-Hill, 2005.

ISBN-10: 0071448934

Winning Score

Winning Score: How to Design and Implement Organizational Scorecards
Author: Mark Graham Brown

ISBN-10: 1563272237



Iowa Contact Information

Iowa Healthcare Contacts

Spencer Hospital
Linda Moore
Director – Quality Services
moore@spencerhospital.org
712-264-6410

 

Mercy Medical Center
Cedar Rapids
Kathy Berry
Lean Coordinator
kberry@mercycare.org
319-221-8780

University of Iowa Healthcare
Sabi Singh
Assistant Vice Present for Operations, Excellence, Quality & Safety
sabi-singh@uiowa.edu
319-353-7202

 

Iowa Health - Des Moines
Gayle Culbertson
culbergd@ihs.org
515-241-6859

Skiff Medical Center – Newton
Bob Campbell
Director of Quality Management & Risk Management bcampbell@skiffmed.com
641-791-4347

 

Jennie Edmundson Hospital
Council Bluffs
Steven Baumert
CEO & President
stevebaumert@nmhs.org
712-396-6239

Iowa Health System
Dean Bliss
Lean Improvement Specialist
blissd2@crstlukes.com
515-979-9413

 

Pella Regional Health Center – Pella
Sarah Cottington, BS, RHIT
Performance Improvement & Service Excellence Coordinator
scottington@pellahealth.org
641-628-6683

Mercy Medical Center
Dan Varnum
VP of Performance Improvement
dvarnum@mercydesmoines.org
515-643-8746

 

Mahaska County Health Partnership
Dan Nikkel
Director of Continuous Improvement
dnikkel@mahaskahospital.com
641-672-3300

Mercy Medical Center
Cedar Rapids
Kathy Krusie
VP of Human Resources
KKrusie@mercycare.org
319-398-6451

 

Jefferson County Hospital – Fairfield
Staci Worley
Education Coordinator
SWorley@jchospital.org
641-469-4232

Iowa Industry Contacts

Alliant Energy
Ron Hellweg
Project Manager Office Deployment Leader
RonaldHellweg@alliantenergy.com
319-786-4668

 

John Deere Public Affairs
Mara Sovey
State Public Affairs Manager
SoveyMaraL@JohnDeere.com
515-267-4432

Pella Corporation
Gina Singer
GMSinger@Pella.com
641-621-1000

 

Rockwell-Collins
Tom Hobson
trhobson@rockwellcollinis.com
319-295-1000

Vermeer Manufacturing Co
Louis Norton
Continuous Improvement Manager – Business Process
lnorton@vermeermfg.com
641-621-7715

 

 
Iowa Government Contact

Iowa Department of Natural Resources
Teresa Hay McMahon
Executive Officer
515-281-0110



Iowa Community College Contacts

The reVIEW© training program, originating from Lean Healthcare West, "teaches simple, proven tools for Lean implementation that are immediately practiced on real issues in your workplace." The following individuals have been trained to bring the reVIEW© program to organizations.

For general information contact:
Collette Saylor
Executive Director
515-964-6267
casaylor@dmacc.edu
www.iacct.com
www.leanhealthcarewest.com



Lean Consultants

Breakthrough Management Group
1921 Corporate Center Circle
Longmont , CO 80501
303-827-0010
1-800-46-SIGMA
moreinfo@bmgi.com
www.bmgi.com

 

Kenagy & Associates
625 Mt. Auburn St.
Cambridge, MA 02138
617-491-1476
query@kenagyassociates.com
www.kenagyassociates.com

Gemba Research, LLC
13000 Beverly Park Rd. Suite B
Mukilteo, Washington 98275
888-464-3622
425-356-3150
info@gemba.com
www.gemba.com

 

Lean Advisors, Inc.
613-821-4545
506-849-2668
www.leanadvisors.com

Guidon Performance Solutions
2550 N Thunderbird Circle
Suite 317
Mesa, AZ 85281
866-986-4414
www.guidonps.com

 

Simpler
2814 Oak Meadow Drive
Suite 201
Ottumwa, IA 52501
1-888-532-6888
carrolld@simpler.com
www.simpler.com

HPK Group, LLC
PO Box 1974
Windemere, FL 34786-1974
407-808-4785
www.hpkgroupllc.com

 

TBM Consulting Group
Corporate Office
4400 Ben Franklin Blvd.
Durham, NC 27704
1-800-438-5535
tbm@tbmcg.com
www.tbmcg.com





Success Stories

Below are Process Improvement Success Stories from St. Luke's Hospital – Cedar Rapids, Mercy Medical Centers in Cedar Rapids and Des Moines, and the University of Iowa Hospitals and Clinics.

Spencer Hospital – Spencer

St. Luke's – Cedar Rapids

St. Luke's Hospital – Cedar Rapids

Mercy Medical Center – Cedar Rapids

Mercy Medical Center – Cedar Rapids

Mercy Medical Center – Des Moines

University of Iowa Hospitals and Clinics

Pella Regional Health Center - Pella

Allen Hospital - Waterloo



Mentor Hospitals

We would like to thank those individuals and organizations who have shared their materials and who have agreed to serve as mentors. Please contact IHC if your organization would like to contribute materials to this toolkit.



IHC would like to thank the Lean Steering Committee:

Vicki Baum Indian Hills Community College
Kathy Berry Mercy Medical Center, Cedar Rapids
Dean Bliss Iowa Health System, Des Moines
Tom Evans, MD Iowa Healthcare Collaborative
Randy Fry University of Iowa Hospitals and Clinics, Iowa City
Jeff Jutting Mercy Medical Center, Des Moines
Kyla Kiester Iowa Healthcare Collaborative
Perry Meyer Iowa Hospital Association
Sarah Pavelka Iowa Quality Center, Marion
Mike Rohlf Iowa Department of Management



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    This process improvement method can help providers deliver more efficient care that saves resources and improves quality.

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    Details on the principles and components of a patient centered medical home, including the business case and how to become one.

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