Vital Signs Blog

Blog: Virginia Mason crosses the pond to teach Lean cost and quality methods

Gary Kaplan Virginia Mason Kaplan
The Virginia Mason Institute in Seattle announced Thursday that it has won a five-year, $13 million contract to improve patient safety and control costs at five acute-care hospital trusts that are part of England's National Health Service Trust Development Authority.

The institute, which is the educational arm of Virginia Mason Medical Center, will train NHS staff in the Virginia Mason Production System. The Lean management system was inspired by the Toyota Production System, and was designed to standardize tools and procedures, eliminate waste, prevent errors and sustain continuous improvement.

The Lean system, led by Virginia Mason CEO Dr. Gary Kaplan, has built a reputation for Virginia Mason as one of the nation's top hospitals, as recognized by the Leapfrog Group coalition of large employers. The Washington Health Alliance has also found Virginia Mason to be the lowest-priced hospital by admission type in the Seattle market.

Kaplan said the institute's staff plans to address cultural challenges that may emerge in getting U.K. physicians to adopt Lean concepts such as standardization.

“We share many of the same problems, and we have 15 years of experience in culture change, coupled with a management system that is designed to improve quality and safety,” Kaplan said.

He added that the health system has had a long relationship with the NHS. The United Kingdom Secretary of State for Health Jeremy Hunt visited Virginia Mason in March 2014, and announced the NHS' intent to reduce incidents of avoidable patient harm by half.

Other health systems, such as the Cleveland Clinic, Geisinger Health System and the Mayo Clinic have also developed business arms to disseminate their operating methodology, but Kaplan said Virginia Mason has been doing it the longest—since 2008.

Kaplan added that 5,000 people from 20 countries have attended Virginia Mason Institute programs. He wouldn't say whether the NHS contract will lead to adding more staff, but said the contract “will accelerate” the institute's growth.

The NHS will send senior leadership to Seattle this fall for training. Virginia Mason will then train staff at the hospital trusts in the U.K.

Kaplan said the five trusts will comprise the following hospitals and their affiliated outpatient physicians: University Hospitals Coventry and Warwickshire NHS Trust; the Shrewsbury and Telford Hospital NHS Trust; Barking, Havering and Redbridge University Hospitals NHS Trust; the Leeds Teaching Hospitals NHS Trust; and Surrey and Sussex Healthcare NHS Trust. Those trained will share what they learn with other hospitals.

One lesson that will be imparted is that the “pathway to lower costs" is the same as the road to better quality, Kaplan said.

“Like healthcare everywhere, they have a cost problem, with healthcare eating up a large part of the national economy,” he said. “Every citizen is covered by the NHS, and this brings with it opportunities and challenges. Cost is an issue everywhere and we have the moral obligation to be wise stewards of our precious resources.”

Kaplan's philosophy has earned him a spot on Modern Healthcare's 50 Most Influential Physician Executives and Leaders list ten times. He came in at No. 10 this year.

Kaplan also chaired the Institute of Medicine committee that wrote the report Transforming Health Care Scheduling and Access: Getting to Now, which was released June 29.


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