Virginia Mason Medical Center

Virginia Mason Medical Center is an award-winning, private, not-for-profit organization offering a network of primary and specialty care clinics throughout the Puget Sound region and a hospital in Seattle, WA. Six years ago, however, the health system was struggling. The 336-bed hospital faced a slew of problems including quality concerns, a three percent defect rate, an increase in cost of care, low morale among employees, an aging workforce and budget constraints due to inefficiency. In fact, Virginia Mason calculated they wasted 2.5 hours a day simply searching for things in their hospital.

By 2002, Virginia Mason’s board demanded a new strategic plan—a plan that was efficient, calculated, reliable and proven to generate results. For inspiration, they turned to one of the most efficient corporations in the world: Toyota. With a new strategic plan in place, Virginia Mason took action. In 2002, the hospital sent several senior executives to Japan to work in and learn from a Toyota manufacturing plant. By experiencing the Japanese management method first hand, the board hoped that these leaders would apply their learned principles to the hospital setting. Nine leadership trips later as of June, 2008, Virginia Mason is indeed seeing real results.

The Toyota management method is simple. The company is passionate about quality, safety, staff engagement and, most importantly, customer satisfaction. In addition, they have waged a “war on wastes,” which Virginia Mason now applies to its daily operations. Whereas Toyota avoids the waste of overproduction, now Virginia Mason avoids the waste of unnecessary or repeated lab tests. And whereas Toyota avoids the waste of motion, Virginia Mason now has a system in place to decrease the waste of searching for patient charts.

Virginia Mason has also adopted Toyota’s method of “stopping the line.” When any Toyota employee, whether an executive or a service line worker, sees a problem with a car on the line, he or she has complete autonomy to stop production. This method is both empowering and effective in making each and every employee an integral member of a team. By implementing the stopping the line system at Virginia Mason, now every employee within the health system has the authority to create a patient safety alert that shuts down the entire hospital.

With a more efficient system in place, Virginia Mason has enhanced their health information technology capabilities, making them one of the most integrated health systems in the country. In fact, since 2001, the health system has implemented clinical messaging, computerized physician order entry, ambulatory prescribing, surgery scheduling and much more.

Virginia Mason has also teamed up with Starbucks, one of Washington’s largest employers, and their health plan provider, Aetna, to combat back pain, the number one healthcare expenditure for the famous coffee company. Upon investigation, Virginia Mason found that 45 percent of Starbucks employees received an unnecessary MRI after one week of back pain. To combat this issue, Virginia Mason along with Starbucks and Aetna designed a model where patients receive same day appointments with a physiatrist and physical therapist to assess the situation. Since this protocol has been in place, many MRIs have been deemed unnecessary, and MRI usage has decreased, which in turn is leading to better care at a lower cost.

Results

• By utilizing the Toyota LEAN method, Virginia Mason now uses only one-half of the human effort, space and equipment that they did in years past.
• Since September of 2002, the health system has had over 900 patient safety alerts resulting in improved care and better outcomes.

***Submitted byGary S. Kaplan, M.D., Chairman & CEO Virginia Mason Medical Center

Published: January 26, 2009