Story of Going Lean in Healthcare: On the Mend

This past weekend I finished up reading On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry. I started the book one morning over a cup of coffee and it was either a large cup of coffee or a very engaging book. I noticed a craving for a 2^nd cup after 75 pages. I also noticed that it was actually a work day and I needed to start my day, the perils of having an office at home. The book reads similar to other business novels such as The Goal or The Gold Mine: A Novel of Lean Turnaround except for the fact it is true. This is Thedacare’s story and the authors discuss successes and failures in the same voice. It was quite interesting and this might be a stretch but at times it felt like the drama was unfolding. The book truly represents an organization’s Lean Journey and I would recommend it for any organization as an overview of what that journey may entail.

I was disappointed at first that it was as short as it was 150 pages. However, I found myself this past week starting to go back and have to admit that referencing and rereading parts of it was much easier. The subtle attention to detail and the preciseness of the statements made for a true Lean Learning experience. For example, I had gained additional insights on finding Change Agents within an organization. Actually in review, Change Agents were only mentioned on 3 pages. On a broader perspective, the book was about change and the authors illustrated the 5 Stages of Change with a similar diagram:

The difficult steps that you can imagine in taking a Healthcare facility of this size and character through a Lean Journey were well documented. It started at Why they began and ended with choosing a successor to continue the journey. They also gave an outline on how Lean can be applied in Healthcare from a broad industry perspective.

A description of the book from the publisher: Lean Enterprise Institute:

- In On the Mend, John Toussaint, MD, former CEO of ThedaCare, and Roger A. Gerard, PhD, its chief learning officer, candidly describe the triumphs and stumbles of a seven-year journey to lean healthcare, an effort that continues today and that has slashed medical errors, improved patient outcomes, raised staff morale, and saved $27 million dollars in costs without layoffs. Find out:
- How lean techniques of value-stream-mapping and rapid improvement events cut the average “door-to-balloon” time for heart attack patients at two hospitals from 90 minutes to 37.
- What ThedaCare leaders did to replace medicine’s “shame and blame” culture with a lean culture based on continuous improvement and respect for people.How the lean principle of “building in quality at the source” broke down divisions among medical specialties allowing teams to develop patient care plans faster.
- Why traditional modern management is the single biggest impediment to lean healthcare.
- How the plan-do-study-act cycle coupled with rapid improvement events cut the wait time at a robotic radiosurgery unit from 26 days to six.
- How the lean concept of “one piece flow” saved time in treating ischemic stroke patients, increasing the number of patients receiving a CT scan within 25 minutes from 51% to 89%.
- How senior leaders at other healthcare organizations can begin their own lean transformations using a nine-step action plan based on what ThedaCare did — and what it would do differently.

P.S. Actually, it was just fun reading and I even noticed the type of paper the book was printed on.