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Shingo Research Award
Healthcare Kaizen has been named a recipient of a Shingo Professional Publication and Research Award, in May 2013. Read more about this award.
From the Foreword and Introduction
I believe that Kaizen is essentially a “human business.” Management must meet diversified requirements of its employees, customers, stakeholders, suppliers, and its community. In this sense, the healthcare profession can probably best benefit from Kaizen because its central task is people. I am honored to write a foreword to this book by Mark Graban and Joseph Swartz.
Author of KAIZEN and Gemba Kaizen
To get started with Kaizen, you should do the following. First, read this book. Second, ask your employees to read the book. Third, ask your employees to begin a Kaizen system. It is just that simple. You just ask, and you will get what you ask for. Just do it and learn from the process.
Author of How to do Kaizen
From the Team at Franciscan St. Francis Health
I hope you will discover, as we have, the incredible creativity that can be derived by engaging and supporting each and every employee in improvements that they themselves lead.
Robert J. (Bob) Brody
CEO, Franciscan St. Francis Health
Kaizen has been a key differentiator for us. Besides contributing many benefits to our staff, customers and organization, it has vitally contributed to developing our workforce’s capacity and capability for continuous improvement and change.
Sr. VP & COO, Franciscan St. Francis Health
Kaizen has marvelously engaged so many of our staff and enabled them to improve the world around them to the benefit of staff, patients and community.
Paul Strange, MD
Corporate VP of Quality, Franciscan Alliance
Kaizen is an easy, no-pressure way for people who do the work to improve the process of the work.
India Owens, RN, MSN, CEN, NE-BC
Director, Emergency Services & EMS Operations, Franciscan St. Francis Health
I don’t know why all of healthcare hasn’t gone to this!
Michael A. Russell, MD, FACEP
Assistant Clinical Professor, Dept. Emergency Medicine, Indiana University School of Medicine
Vice President, Emergency Physicians of Indianapolis
Filled with practical examples of improvements initiated by employees at all levels, this book vividly demonstrates how to tap into the creativity of all employees to ensure healthcare remains a mission that serves all.
Chuck Dietzen, MD
Founder and President, Timmy Global Health
Chief Medical Officer, iSalus Healthcare
Kaizen is exactly what healthcare needs – with ever increasing change coming at us – Kaizen gives all our employees the opportunity to continually reassess and communicate differences to improve our outcomes and improve our ability to change more rapidly.
Robin Eads MSN, RN, ACNS-BC, CEN
Clinical Nurse Specialist – Emergency Department
Franciscan St. Francis Hospital
Outside Endorsements for Healthcare Kaizen
At a time when many hospitals and health systems have relegated Lean to the “Project of the Month Club”, Graban and Swartz remind us of the fundamentals that help organizations keep their Lean initiatives alive and thriving. I hope everyone reads this book and recommits to the fundamentals of Lean, particularly the involvement of frontline staff in process redesign.
Chief Operating Officer, Avera Health
Unleashing the energy and creativity of every employee to solve problems everyday should be the sole focus of every healthcare leader. Unfortunately, there are only a handful of examples where this is happening. Healthcare Kaizen provides examples of front line staff coming up with solutions to problems on their own and implementing them. Healthcare leaders need to read this book to understand that their management role must radically change to one of supporting daily kaizen if quality safety and cost are to improve in healthcare.
John Toussaint, MD
CEO, ThedaCare Center for Healthcare Value
Author, On the Mend and Potent Medicine
In Healthcare Kaizen, Mark Graban and Joseph Swartz show us that Kaizen is more than a set of tools. What we have learned through our application of the Virginia Mason Production System is that Kaizen is a management methodology of continuous improvement that must permeate the fabric of the entire organization. Front line staff must know, understand, embrace and drive Kaizen and its tools to achieve incremental and continuous improvements. This book will help health care organizations around the world begin and advance their journey.
Gary Kaplan, MD, FACP, FACMPE, FACPE
Chairman and CEO, Virginia Mason Medical Center
The healthcare industry is in the midst of truly fundamental change, and those organizations that engage their front line staff in developing the strategies for improving care, enhancing satisfaction, and streamlining processes to reduce unnecessary variation and expense will be well positioned to thrive in a post-reform environment. In their book Healthcare Kaizen, Graban and Swartz create a roadmap for using incremental, staff driven changes to inculcate performance improvement into the culture of an organization in a sustainable manner. This book represents a wonderful resource for healthcare leaders looking to foster innovation at all levels.
Brett D. Lee, Ph.D., FACHE
CEO, Lake Pointe Health Network
Healthcare Kaizen is a practical guide for healthcare leaders aspiring to engage frontline staff in true continuous improvement. Graban and Swartz skillfully illustrate how to foster and support daily continuous improvement in health care settings. Health systems struggle to move beyond improvement work being extra work done in “special projects” facilitated by experts. This book can guide organizational transformation so that continuous improvement becomes part of the daily work of frontline staff.
John E. Billi, M.D.
Associate Vice President for Medical Affairs, University of Michigan
When healthcare organizations take initial steps on their Lean journey, they often focus very heavily on tools and grand solutions, which may create new barriers to innovation. In Healthcare Kaizen, Mark and Joe remind us of the great power of daily problem solving. Their examples reinforce that learning is a result of the repeated tests of changes that are often small and simple, and less often by hitting the home runs of improvement. The story of Franciscan St. Francis Health is compelling, where leaders created the opportunity for great people at the frontline making great improvements for patient care.
Michel Tétreault, MD President and CEO
Bruce Roe, MD, Chief Medical Officer
St. Boniface Hospital, Winnipeg, Canada
In the last decade, implementation of the lean production model in a healthcare setting has produced remarkable outcomes and revolutionized the way we deliver care. Using examples from Franciscan Health and other forward-thinking medical groups, the book contains valuable strategies for organization-wide cultural transformation to create an more efficient, patient-centered healthcare system dedicated to continuous quality improvement.
Donald W. Fisher, Ph.D.
President and CEO, American Medical Group Association
We are challenged with improving the health of individuals and populations while reducing costs. Mark and Joe provide real-life examples of how those who do the work provide ideas for small changes that add up to BIG results. Healthcare Kaizen is a must for leaders whose focus is the patient and how to effectively and efficiently deliver quality and safety with improved outcomes. The methods shared are foundational in changing our healthcare system for the better.
Betty Brown, MBA MSN RN CPHQ FNAHQ
President, National Association for Healthcare Quality
For the past 7 years I have been leading a successful lean healthcare transformation at Chugachmiut, the non-profit organization I lead in Alaska. During that time, I have learned that respect for the people who work for you is key to any transformation. Mark Graban and Joseph Swartz do a great job of capturing this truth in their book, Healthcare Kaizen: Engaging Front-Line Staff in Sustainable Continuous Improvements. Every employee can learn the tools of lean, and improve processes as a result. However, sustaining a lean transformation and resisting entropy requires engaging front line employees in a long term vision for serving their customers and in true continuous improvement. Employees who work in a culture that removes blame and shame, operates on facts and seeks improvement continuously have great leadership and will respond with incredible results. This book is a long needed addition to my growing lean healthcare library. (Read his more detailed review)
Executive Director, Chugachmiut
Successful practitioners recognize Lean as a method for comprehensive and widespread continuous improvement, not just a set of tools for isolated project improvements. Everyone in the organization has an active and intentional role to play in this journey. Through description and example, Mark Graban and Joseph Swartz present a clear pathway for successful Lean practice in Healthcare Kaizen. This should be on every healthcare systems reading list.
Dave Munch, MD
Senior Vice President and Chief Clinical Officer, Healthcare Performance Partners
Simple and actionable, “Healthcare Kaizen” is filled with practical information, great examples, and is an inspiring read. Improving quality and decreasing costs can be daunting and seemingly impossible when you look at trying to solve the problem in one stroke. Once you understand that every single person can be a part of the solution, the problem becomes manageable and feasible. Kaizen is a big part of the solution, a very big part, and this book will give you the nuts a bolts of how everyone can be part of the solution.
Gregory Jacobson, MD
The term ‘kaizen’ has been interpreted in many ways since we learned of the Toyota Production System in healthcare. Mark and Joe demystify the term, help us understand its real meaning, and help us see how using kaizen can help us improve in healthcare and, frankly, how we can use kaizen to save lives. The philosophy, tools and techniques discussed in the book work, and work well, in any environment. We in healthcare must improve – we owe it to our patients and communities – and Mark and Joe are helping to show us the way.
Lean Improvement Advisor, Iowa Healthcare Collaborative
In their book Healthcare Kaizen, Mark Graban and Joseph Swartz use real-life examples and easy-to-understand verbiage to demystify kaizen. Continuous process improvement led by front-line staff is imperative to having a lean culture. Mark and Joseph give the reader a fresh understanding of what it means to lead, and how to transform an organization into one focused on engaging staff and operational excellence. For the leader, it is a great roadmap; for the employee, it will help to understand the bigger (lean) picture. Whatever your place in the organization, this book will give you a robust understanding of how to effectively carry out kaizen, thus improving care for all your patients.
Jody Crane, MD, MBA
Co-Author, The Definitive Guide to Emergency Department Operational Improvement
At Beth Israel Deaconess Medical Center, everybody improving every day is a critical aspect of our Lean and quality improvement efforts. Healthcare Kaizen, is full of relatable examples as well as practical ideas that will inspire staff, clinicians and leaders at all levels.
Vice President, Business Transformation, Beth Israel Deaconess Medical Center
The healthcare industry has long struggled to tap one of the biggest sources available to it for ideas to improve outcomes and reduce costs – its front-line staff. Healthcare Kaizen lays out a step-by-step approach that any healthcare organization can use to get the dramatic results that come when its workforce is fully engaged in kaizen activities on a daily basis. This inspirational book is packed with examples and is informed by the authors’ years of experience on the “front-lines” themselves, helping leading healthcare organizations around the world to build successful kaizen programs.
Alan G. Robinson, PhD
Professor, Isenberg School of Management at the University of Massachusetts
Co-author, Ideas Are Free and Corporate Creativity
What Mark Graban and Joseph Swartz have done in Healthcare Kaizen is to bring hope and light to a part of our society that is facing increasing challenges. Full of examples and illustrations from hospitals and healthcare professionals leading the way in the journey to patient-centered, error-free care delivery, this book makes it easy to connect with this very powerful concept of kaizen. By putting kaizen within the broader tradition of quality improvement, shedding light on its historical development and pointing out potential pitfalls in its application in healthcare, the authors provide a great service to the healthcare community. I was especially impressed by the authors’ important insights on what a kaizen culture feels like, and how people at all levels can and must engage in daily improvement. Healthcare Kaizen will be a reference on the subject for many years to come.
CEO, Kaizen Institute
At last, a crystal clear description of Kaizen as a philosophy and a work culture, not another top-down tool. Graban and Swartz show, in unequivocal detail, that Kaizen need not be viewed as a formal, five-day event, requiring X, Y, and Z participants, components, and steps. The compelling examples from Franciscan Health and others paint a picture of a hospital culture steeped in respect for people and continuous improvement—the very elements of Lean, Kaizen, and scientific inquiry. By busting the myth of the five-day “event,” the authors show the true, sweeping potential of Kaizen in the healthcare workplace.
Co-author, Lean-Led Hospital Design: Creating the Efficient Hospital of the Future
Author, The Pittsburgh Way to Efficient Healthcare
Years ago, an elderly Japanese gentleman asked, “How will you engage team members, Pascal-san?” This engagement is arguably the leader’s greatest challenge. Fixing health care may be our generation’s great test. We’ll need to engage all the good people who currently work in broken systems. Mark and Joe have helped to show us how.
Lean Pathways, Inc.
Author, The Remedy and Andy & Me
The vision of a world in which our healthcare institutions operate with a universal discipline of relentless, patient-centered improvement remains a vitally important yet distant dream. In Healthcare Kaizen, Mark Graban and Joseph E. Swartz illustrate just how to make that dream a reality.
Matthew E. May
Author of The Elegant Solution and The Laws of Subtraction
Unfortunately the lean movement has too often turned into a race to implement as many of the tools of lean in as many places as possible. This is totally alien to the spirit of kaizen or the purpose of the Toyota Production System. The purpose is to create a culture of continuous improvement with people at all levels thinking deeply about their ideal vision for the people and process, and purposefully taking steps to achieve the vision. The vision should be for the good of the enterprise, not to check the box for the lean folks who are auditing 5S and visual management.
Mark and Joe have a deep understanding of the purpose of TPS and what is needed in healthcare to raise this from a program to a true culture that can tackle all the difficult challenges that face modern medicine. They have been steeped in the healthcare field for years and has great examples to illustrate kaizen, both small and big changes. In this book, they take on the challenge of driving kaizen down to the level of every work group–truly the deepest meaning of kaizen. This takes exceptional leadership, a second nature understanding of the tools, and always working at the gemba to solve the real problems. Hopefully this book will become a blueprint for healthcare organizations everywhere that truly want to be great!
Professor of Industrial and Operations Engineering, University of Michigan
Author of The Toyota Way
One of the greatest leadership and cultural challenges when embarking on a Lean transformation is the shift that MUST occur where the frontlines have the skills for and are authorized to make daily improvement. This shift not only accelerates results, but it fully engages the workforce, a precondition for achieving organizational excellence. Graban and Swartz present the kaizen philosophy in the most accessible way I’ve seen yet. They present a powerful model for preparing managers for their new role as improvement coaches and the frontlines for taking a far more active role in delivering greater value to the healthcare industry’s various customers. THIS is the missing link in healthcare reform.
Author, The Outstanding Organization and The Kaizen Event Planner