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Patient safety lessons from LEAN manufacturing

Posted May 02 2013 9:55am

by Diane Miller

How does "production" apply to healthcare? Patients are not cars, of course. Yet both manufacturing and healthcare are filled with complex production processes.

In healthcare, these include admitting a patient, scheduling a clinic visit or undergoing surgery. All these processes should embrace the concepts of quality, safety, customer satisfaction, staff satisfaction and cost effectiveness.

For example, at Virginia Mason Health System in Seattle, in much the same way that Toyota employees are empowered to "stop the line" when they encounter a problem on the assembly line, we used the Virginia Mason Production System (VMPS) to develop a patient safety alert (PSA) system.

Our PSA system requires all 5,500 Virginia Mason staff members who encounter a situation likely to harm a patient to make an immediate report and cease any activity that could cause further harm.

If the safety of a patient is indeed at risk, an investigation is immediately launched to correct the problem. Most reports are processed within 24 hours--a significant improvement from when reports took up to 18 months to resolve. Patient safety at Virginia Mason has increased and professional liability claims have dropped.

Thousands of people from 17 different countries have come to Virginia Mason during the last several years to learn about VMPS and tour our facilities. Many have learned how to create their own brand of VMPS with the help of the Virginia Mason Institute , established in 2008 in response to the rising number of requests for Virginia Mason staff to share their experience and knowledge in applying lean principles to healthcare.

Lean concepts and proven resources are numerous, ranging from simple (i.e., department production boards) to robust (i.e., the "5S" process for sorting, simplifying, sweeping and standardizing workflow, and setting expectations for the self-discipline necessary to sustain new efficiencies.) Lean can benefit any organization that is genuinely committed to becoming less wasteful and more efficient. Transformation is a journey, however. It requires galvanized management support and determination.

Imagine how much more efficient and effective your healthcare organization could become by embracing the principles of lean to enhance safety, establish goals, organize work flow and streamline steps that do not add value. Imagine, too, that your front-line staff not only do great work on their assigned jobs, but also feel empowered to generate ideas to increase efficiency by making small improvements within their control.

Could lean be the way to transform everyday work at your organization?

Diane Miller is vice president of Virginia Mason Medical Center and Executive Director of the Virginia Mason Institute in Seattle. She can be reached at

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