Virginia Mason Health System in Seattle was among the industry’s earliest adopters of Lean, a management process based on Toyota’s production system that focuses on identifying areas of waste to improve quality and efficiency at an organization.
Yet Dr. Gary Kaplan, the longtime CEO of Virginia Mason, shies away from using the term when describing the system’s 18-year-old management system.
Rather than calling it Lean, Kaplan prefers to describe it as the Virginia Mason Production System. “The reason I don’t like the word Lean is it implies it’s a toolkit (rather than a production system) and to some people it’s misinterpreted” as a way to cut costs, Kaplan said.
The Lean management system has gained a bad reputation in the two decades since it first made a splash in healthcare, causing its most long-term supporters to run away from the term while still standing by the philosophy.
The approach, which is described by advocates as a holistic management system reliant on a culture of continuous improvement to drive out waste and inefficiency, has evolved into a bureaucratic, cost-cutting strategy for many hospitals and health systems.
“There is a negative connotation associated with it, the connotation that Lean is mean,” said Dr. John Toussaint, an expert on Lean and chairman of education institute Catalysis. Toussaint also doesn’t like using the word Lean anymore and prefers calling it organizational excellence.
“There has been a lot of talk recently that Lean is being used to make people more efficient and to get staffing numbers down,” Toussaint said, “and that is just absolutely not what Lean is.”