Lean Leadership for Healthcare

The second edition of this Shingo Prize-winning book builds and expands on the first edition. When originally published over ten years ago, there was a need to understand how to lead process and cultural transformation within the healthcare industry. The perfect storm of rising costs, decreasing reimbursements, substandard quality, a shortage of resources, and a new run of better technology and electronic health systems requires leadership to navigate in a different environment. Since the original book, lean improvements have been made to the governance of process and quality improvement programs, and to the management of operations using the daily management system. The core of the book remains the same; however, the results have been updated and made more current, given access to better data and enhanced use of the electronic health record. Extraordinarily good advice is given throughout this book on best practices of what to do and what not to do in leading large-scale change based on another ten years of hands-on experience of the author working in large and small healthcare systems across the country, including case studies that share the time-tested insights of healthcare team members and leaders. The book outlines a management system for sustaining lean improvements and provides the lean leadership approaches, thoughts, and visual tools needed to guide organizations along the path toward world-class healthcare performance. It walks the reader through developing an improvement strategy, laying out a detailed transformation roadmap for initiating, accelerating, and sustaining lean improvements and delivering world-class improvement of outcomes and culture, discussing leadership behaviors necessary for success, and closes with actions that can be used to mitigate risk. It reviews the fundamentals of lean and explains how to link a strategy of continuous improvement to corporate strategy to achieve operational excellence. The book also describes how to mitigate the risk of failure when undergoing large-scale corporate change, including what can go wrong and how to prevent these failures. Updated and refreshed, Lean Leadership for Healthcare remains the gold standard for end-to-end delivery of lean transformation in healthcare. This book is ideal for leaders in the healthcare industry looking to initiate or accelerate lean improvements to clinical and non-clinical processes. Ronald G. Bercaw is the President of Breakthrough Horizons, LTD, a management consulting company specializing in World-Class Improvement through the application of the Toyota Business System, or "lean." With over 38 years of experience in operations, his hands-on, lean management experience was gained through multiple enterprise transformations in different industries including custom packaging, power reliability electronics assembly, and test and measurement products. Educated at Purdue University, he learned the details and disciplined applications of lean principles, habits, and tools from both the Shingijutsu Sensei and their first-generation disciples. Since leaving industry, Ron has consulting experience in the healthcare sector (U.S. and Canada health systems including primary care, acute care, and community applications of both clinical and back shop operations), the commercial sector (administration, manufacturing, distribution, supply chain, and engineering), and the public sector (U.S. Army, U.S. Navy, U.S. Air Force including Depot Repair Operations, the Pentagon, and Surgeon General Assignments). Ron is also a recognized author with the release of four books, including Shingo award-winners entitled Taking Improvement from the Assembly Line to Healthcare, and Lean Leadership for Healthcare. He is a co-author of The Lean Electronic Health Record, along with Susan Snedaker and Kurt Knoth, as part of the HIMSS book series.

Ronald (Ron) Bercaw is the president of Breakthrough Horizons, LTD, a management consulting company specializing in delivering world-class improvement through the application of the Toyota Production System more commonly known as "Lean." With over 35 years of experience in operations, his lean management experience was gained through multiple enterprise transformations in different industries including packaging, electronic power reliability assembly, test and measurement products, and agriculture. Educated at Purdue University, Bercaw learned the details and disciplined applications of lean principles, habits, tools, and applications from the Shingijutsu Sensei and their first-generation disciples. Working in shop floor, engineering, and administrative areas, he vigorously strived to remove waste from organizations through the involvement and ideas of the world's greatest experts, those people doing the work. Bercaw has consulting experience in the healthcare sector (U.S. and Canadian health systems including primary care, specialty, care, acute care, and community applications of both clinical and administrative improvement), the commercial sector (administration, manufacturing, distribution, supply chain, engineering, sales, marketing, finance, etc.), and the public sector (U.S. Army, U.S. Navy, U.S. Air Force) including maintenance, repair, and overhaul (MRO) assignments, Pentagon, and Surgeon General assignments, the Veteran's Health Administration including central office administration and medical center clinical and administrative processes and Public Health. He is also the author of four previous books including Taking Improvement from the Assembly Line to Healthcare, first and second editions, and Lean Leadership for Healthcare, first edition, and The Lean Electronic Medical Record. Bercaw is a two-time recipient of the Shingo Research and Professional Publication award for advancing the body of lean improvement knowledge.

Foreword Preface Acknowledgements About the Author Chapter 1: Lean at a Glance Chapter 2: Creating and Deploying a Lean Strategy Chapter 3: Leading Change - The Transformation Roadmap and Phase 1: Getting Ready to Transform Chapter 4: The Transformation Roadmap - Phase 2: The Acceleration Phase (Improve, Sustain, and Spread) Chapter 5: The Transformation Roadmap - Phase 3: Make Organizational Improvement the "New" Culture Chapter 6: Leadership Behaviors and Actions for Success Chapter 7: Mitigating Transformation Risk and Avoiding Common Mistakes Chapter 8: Closing Thoughts Glossary of Lean Terms