When Virginia Mason Health System's clinic in Kirkland, Wash., relocated to new office space in February, the staff left the waiting room behind—permanently.
Thanks to a new office-visit process, patients no longer wait for clinicians to take care of them.
When patients check in at a reception area, they are given a tracking device and sent to an exam room. The device alerts staff members that a patient is ready. The average amount of time a patient sits in the room before a medical assistant shows up is just five seconds.
“It is about synchronizing the steps of the visit from the moment the patient gets off the elevator to the moment they get back on the elevator,” explains Gary Kaplan, M.D., 58, chairman and CEO of Virginia Mason Health System, Seattle.
“Patients are loving it. In fact one of my patients today said, ‘It is really efficient. I don't feel any kind of wait anymore,' ” recalls Kaplan, an internist who sees patients two mornings a week.
Pediatrics and sports medicine clinics at the main campus in Seattle also operate without waiting rooms.
The drive to eliminate waiting rooms is but one example of Kaplan's commitment to improving healthcare. For all his accomplishments, the Medical Group Management Association presented Kaplan with the Harry J. Harwick Lifetime Achievement Award on Oct. 12 during the group's annual meeting in Denver.
It is Kaplan's second, national award this year. In May 2009, he was ranked 16th in Modern Physician's 50 Most Powerful Physician Executives in Healthcare.
In addition to his work at Virginia Mason, Kaplan has served in national positions in healthcare. He has been on the board of the National Patient Safety Foundation, Boston, since 1997 and the Institute for Healthcare Improvement, Cambridge, Mass., since 2007. He has also held a variety of leadership posts at the MGMA, Denver; and American Medical Group Association, Alexandria, Va.
“It seems to me that Gary always has the patient in the front of his mind. He is really dedicated to the well-being of the patient,” says Donald Berwick, M.D., president and CEO of the Institute for Healthcare Improvement.
Kaplan joined the staff of Virginia Mason in 1978 as a medical resident and then moved up the clinical and management ranks, assuming the job of chairman and CEO in 2000.
Since then, he has pushed employees to become as patient-centric as he is. He wants employees to “change the way we do work everywhere,” so the needs of patients always come first. To accomplish that goal, he set out in 2000 to find a management method that could be used throughout the health system. He personally visited many major hospitals but didn't find what he wanted.
“Then, almost serendipitously, we learned about the Toyota production system from our colleagues at Boeing,” Kaplan says. In 2002, Kaplan and a group of Virginia Mason executives went to Japan for a two-week introduction to the method, which focuses on continually eliminating wasteful steps in a process until there are zero defects in the final product or service. They not only spent time in classrooms but also observed the principles in action on production lines at Hitachi and Toyota factories.
“We got home, and said, ‘This is our management system,' ” Kaplan says.
He hasn't wavered in his commitment to what is known as the Virginia Mason Production System, although it hasn't been easy. “The cultural change is really hard,” says Carolyn Corvi, chairwoman of Virginia Mason's board of directors and a retired executive from the Boeing Co. who is schooled in Toyota's methods. “Some doctors chose to leave.” But Kaplan “really stuck with it,” she says.
Since the first trip to Japan, Kaplan has taken at least one group a year there. Virginia Mason now has 140 certified experts in the Virginia Mason Production System.
The effort has paid off in both improved efficiency and higher quality. For example, Virginia Mason implemented a safety-alert system in 2002, giving employees a standard way to report any situation that could cause patients harm, ranging from medication errors and near-misses to slippery floors.
A total of 13,166 patient-safety alerts were logged from 2002 through the second quarter of 2009. Each time a safety alert is issued, managers analyze the problem and fix it.
Concern for patient safety also was the reason why Virginia Mason implemented a policy in 2005, requiring all 5,000 employees to get a flu shot or wear a mask at work during flu season. In 2008, 99.5% of employees got the shot.
“When some of the sickest people in our community, the most vulnerable, come within our walls, we want them to be safe,” Kaplan says.
Linda Wilson is a freelance writer for Modern Physician based in McHenry, Ill. She can be reached at [email protected].
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