Business901 Podcast Transcription
Implementing Lean Marketing Systems
Transforming Healthcare thru Lean
Guest was John S. Toussaint, MD, is CEO emeritus of
ThedaCare, and CEO of the ThedaCare Center
for Healthcare Value
Related Podcast:
Transforming Healthcare thru Lean
Transforming Healthcare thru Lean
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Implementing Lean Marketing Systems
John S. Toussaint, MD, is CEO emeritus of ThedaCare,
and CEO of the ThedaCare Center for Healthcare Value.
During his tenure at ThedaCare, he intro-duced the
ThedaCare Improve-ment System, which is based on the
Toyota Production System. Toussaint was the founding
chairman of the board of directors of the Wisconsin
Health Information Organization and has served as the
chairman of the Wisconsin Collaborative for Healthcare
Quality. He also has served on Governor Doyle‟s E- Health board. ThedaCare and
Toussaint‟s work have been featured in Health Affairs, The Wall Street Journal, Modern
Healthcare, and Harvard Busi-ness School case studies.
Dr. Toussaint‟s new book, On the Mend: Revolutionizing Healthcare to Save Lives and
Transform the Industry, co-authored with Roger A. Gerard, PhD. describes the triumphs
and stumbles of a seven-year journey to lean healthcare, an effort that continues today.
About Healthcare Value Leaders: The partnership between the Lean Enterprise
Institute (LEI) and the ThedaCare Center for Healthcare Value (TCHV) brings together two
of the world‟s leaders in “lean thinking,” with a combined 20 years of experience in lean
implementation and education. Working in partnership allows LEI and the TCHV to leverage
their unique perspectives and not-for-profit missions to accomplish a shared goal of
fundamentally improving healthcare delivery through lean thinking.
Transforming Healthcare thru Lean
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Joe Dager: Thanks everyone for joining us. This is Joe Dager, host of the Business 901
podcast. Joining us today is John Toussaint. John is the CEO of the ThedaCare Center for
Healthcare Value. During his tenure at ThedaCare, he introduced the ThedaCare
improvement system, which is based on Lean methodologies.
John, could you just introduce yourself and tell me what the ThedaCare Center for
Healthcare Value does?
John Toussaint: Thanks for having me, my pleasure to be here. I am the former chief
executive officer of an integrated healthcare delivery system that had several hospitals and
a number of physician clinics, behavioral health, homecare, and other activities. Now I am
the CEO of the ThedaCare Center for Healthcare Value, which is a not for profit 501C3
organization that's focused on trying to reform the delivery of healthcare in the US to
reduce the waste, and take the cost out, and improve quality. We're doing that by
espousing and teaching, facilitating the implementation of healthcare Leans, really around
the world; but we're focused mainly in North America - in the US and Canada.
Joe: You've just authored a book along with Roger Gerard. It's called "On the Mend".
What prompted you to write a book about all this?
John: Over the years I've gotten a lot of questions about, "So, what do you mean about
Lean?" In particular, "What do you mean by Lean in healthcare?" Maybe we understand
what it means in manufacturing, sort of kind of, but we don't think it's applicable to
healthcare. Here at ThedaCare in Wisconsin, we've been at it for many years, and it's been
Transforming Healthcare thru Lean
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incredibly powerful to change the culture of the organization and drive dramatic
improvement in cost and quality results.
What we decided to do was to work with Jim Womack at the Lean Enterprise Institute and
write the book for Lean in healthcare. This book is really the framework for healthcare
Lean. If you read it - it's a fairly short read - when you're done you have a pretty good
understanding of how Lean is applied to healthcare and the framework by which you can
do that.
Joe: I enjoyed the book, especially from the standpoint that I read a lot of - what I would
say fiction books - about Lean, because everybody wants to talk about the cultural thing
and it's easier to put it in a fiction book. But you wrote a non-fiction book with that same
background. It was like reading a story. It was a nice, easy read, and you identified it very
well. In the book, you did not make it seem like it was problem free; that someone came in
and did this and it all worked out, because it didn't all work out.
John: Anybody that's actually implemented, or is implementing Lean principles knows
that it doesn't all work out. If we would've told you that it all worked out, we would've
been lying and you would've known. What we've done is actually told the story from
patients' perspectives, sort of the before and after. Here's how we performed at one point
along the way, and we realized that we were making a lot of mistakes, a lot of service
issues, a lot of clinical quality problems. Then we began to implement a methodology called
Lean. We actually changed it to the ThedaCare Improvement System and took a lot of the
Japanese terms and things out of it, so that our clinicians wouldn't be confused by that.
Then we started applying these principles.
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What we were doing was taking processes which were fundamentally broken, and we'd
give very sharp stories about how those fundamentally broken processes were negatively
impacting our patients. We started to change those processes, redesign them, and started
to improve the performance for our customers - our patients.
Is it perfect? Is it all done? Absolutely not. This is a never-ending story. We wrote it in a
way that hopefully... It's almost kind of a mystery.
"Well, gee? Then they did what? Then they did what? What's really going to happen here?
Is the whole thing going to blow apart, or is there actually good things that happen at the
end?"
We try to keep you on the edge of your seat a little bit and tell you a lot of the... Actually
sort of expose a lot of the dirty laundry along the way...
Joe: I did notice that. One of the questions I ask is why Lean? Why didn't you grab hold of
Six Sigma? Why didn't you grab a hold of another methodology? Why was it Lean?
John: Well, we actually looked at a number of different methodologies over the years. We
dabbled in Six Sigma, we dabbled in 90 Day Workouts, we dabbled in TQM; we dabbled in
just about every single possible idea that you can think of. Finally, when we actually
started to see improvement in action it was at manufacturing plants and specifically at
Aaron's; where we spent a lot of time in our early days, where they make snow blowers,
and they've been on the journey for about five years. Once we started to see it in action, it
was understandable - everyone could understand it, our frontline staff all the way to the
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CEO - we realized that the fundamental problem in healthcare is that we do not have
stable processes. In fact, most of our processes are out of control. The fundamental
formula that Lean brings to the table is that it allows you to begin to stabilize your process.
Then you can standardize it, and then you can improve it.
Great to have statistical process control charts, but frankly every time we delved deeply
into our performance there was 300 percent variation. So studying variation wasn't going
to help us, we really needed to study process and standardize it. And that's one of the
main reasons we gravitated towards the Lean methodology.
Joe: So you felt that if you just looked at removing variation that you really had to go in
there and provide standard work first, put a baseline in there for it.
John: Yes, we had very little standard work for anything. You had 19 doctors doing their
things 19 different ways. There wasn't any way to actually figure out - when there was a
defect - which process was causing it, because the processes were in chaos. That's what
we were doing, is trying to get to a standard work process and then standard work for
each of these areas.
Joe: How did the doctors take hold of that? I look at a doctor... He's used to being - and
maybe this is the wrong word - but in command, in charge, and in charge of his patient.
Then to sit there and say "this is the way we're going to do things", that seems like real
contrarian thinking there.
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John: I would agree the word is in charge. I would say that that's probably part of the
trouble. This autocratic nature of medicine does not allow for any sharing of good ideas
and of improvement ideas. So you end up with, like I said: you've got 19 different doctors,
you've got 19 different processes, none of which are able to be studied to determine which
is delivering the best result. There are defects all over the place and there's no hope to
actually study the defects. What we did was we created model cells in the inpatient units
and model cells in the outpatient units, and we began to develop a standard work around
this redesigned care. Then we began to measure it. Once we proved that model cells were
delivering better performance than the original work, the doctors started to respond.
Actually, doctors respond very effectively to data.
We had to create the model cells for improvement - to prove that we could deliver zero
medication reconciliation errors and 30 percent reduced cost on our collaborative care
unit - before the doctors would say, "well we need to change."
Once we showed the data it became a lot easier. The docs would say, "The results of this
process for our patients are better than the process that I'm using right now, so that
means I'm going to have to change." And for the most part they did.
Joe: When we sit there and talk about changes, and still in a Lean culture, the secret
always is to find the change agents - how did you find them? I am always intrigued by
that, because people forget about that step. Because until you find them, and other people
will not come onboard, but there's got to be two or three people that are willing to “beat to
a different drum.”
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John: Well, that's true. For each model cell that we've developed over the years, there
have been volunteers. In the Collaborative Care Unit, one of the nursing managers
volunteered and said, "I'm sick of this. I can't stand all of the mistakes we're making. This
is not working. We're not going to incrementally improve it. We need to blow it up, start
over." Three value stream go-around's, and 29 Kaizen events later, guess what? We have
a new, completely redesigned inpatient care process; which now is being spread to all of
the hospitals.
But it does take those people that are willing to... In some cases, they're frustrated,
they've had enough and they want to really change it. They are the ones that step-up first
and start to really fight the fight. In the early days, it was fighting a fight, because
common human nature is you don't want to change.
What we're doing is pushing the envelope and saying, "We're going to have radical
change." You do need leaders, champions, that are capable of standing up to a lot of
pressure, but also listening, and willing to change their minds about what this new process
should look like.
Joe: I think in the On the Mend book, you go into the change agents a little bit, but then
you talk about sustaining. And it takes a different type of individual, I think, to sustain it,
does it not?
John: Part of the journey where ThedaCare is today, is basically: there just has to be a lot
more standard work created, and then implemented, and then audited, and then PDSA.
There are still a lot of areas where the standard work is not in play. The type of leader that
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we need at this point is somebody that's just completely a dog on the bone when it comes
to, "The redesign process, stabilize the process. Now, we are going to improve the process.
Now, we're going to teach the standard work. We're going to improve the standard work. A
lot of PDSA (continuous daily improvement) around the work that has been created and is
being created."
I think that is kind of the point at which ThedaCare is at now, is really building the culture
of PDSA, and using standard work that comes out of PDSA, and then auditing it, and then
doing a PDSA all over again.
Joe: People are kind of afraid of the term „standard work' sometimes, and I think
especially, maybe in the healthcare area, that they are a little bit afraid of that too. Can
you explain what 'standard work' really means in healthcare?
John: Typically you'll hear of a doctor say, "Well, that's just cookbook medicine, and
that's no good." The reality about cookbook medicine is that there's been a lot of work
done around using protocols for certain things. We know that about 80 percent of the time,
standard protocol works for delivering reliable patient outcomes. The other 20 percent of
the time it doesn't, and that's when judgment and experience, and other things come into
play.
We're not asking our clinicians to just give up their judgment and experience. It's sort of
like the 747 takes off, and all of a sudden three out of the four engines blowout or quit
working; that's where experience and creativity come in. Landing an airplane on the
Hudson River is an interesting example, standard work was probably not created for that.
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That's why we want that pilot to follow the standard work every single time, and when the
birds blow out all the engines, guess what? It's time to innovate, create on the spot.
The other thing about standard work, I think, that's interesting is that because we don't
have standard work in healthcare, what that does is leaves tremendous amount of
firefighting and non-value added activity that goes on all day long, and sort of this heroism
of, "We saved a patient."
But if we actually had a process that was standardized in the first place, we wouldn't have
to be out there firefighting and saving the patients all day, because actually they would fall
into a standard process. They would do fine, which would free up the clinicians to actually
spend time on trying to think about how to improve it.
Joe: I always think standard work allows us to handle the exceptions better, it takes the
uncertainty out of what we should be doing.
John: I agree with that. I completely agree with that.
Joe: When there isn't something that you have to react to, you've got a basis to work
from. Landing on the Hudson is a perfect example. It wouldn't have happened if there
wasn't a standard procedure on how we do things because you would be struggling, "Are
we going to do it this way?"
Joe: A lot of little things go unsaid in a time of crisis. The other thing that I noticed in the
book is that there really was an effort to tell the stories, and like you had mentioned
before, a little bit of the drama that you wrote into it; which I just have to compliment you
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on. People call it PDCA and PDSA is also used. Why did you use PDSA instead of PDCA? It
sounds like a trivial thing, but that struck me in there, that you chose that acronym.
John: If you go back to Deming's writing, you'll find that he uses PDSA, and "S" means
study. We like to think about the work of improvement as studying the do part. Yeah,
we're great at planning and doing, but we're not--and at least in healthcare, we're not
really good at studying and acting. I like to think about it from the standpoint of, "Let's
study what it is, the experiment that we put in place." That means to me kind of a different
sort of mindset. We're actually involved in trying to deeply understand, deeply study, these
experiments that we constantly are applying to our patients.
It's I guess which word you really like, and at ThedaCare we liked the word 'study, '
because frankly, we are not very good at that. We wanted to give people a word that
would make them think differently about what they were doing, because we do a lot of
doing, but we don't do a lot of really understanding what we are doing. Study, to me, is a
deeper meaning word around understanding what you're actually doing.
Joe: You've restructured your organization. You talked about doing that into product
families and separate value streams. Did you end up with just a lot of different value
streams? Isn't each case different that you practically need a different value stream, or did
you find enough commonality that there were only a few value streams?
John: I would say that we're very early on in this experiment. After seven and one half,
eight years, the organization is finally to the point where they can start to understand how
to design around value streams. We tried an experiment about four years ago in our
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Musculoskeletal value stream, which is if you have a knee problem, or something like that,
and we struggled with that. It was very hard to bring all of the components of the
Musculoskeletal value stream together. Plus, we had a lot of reimbursement issues, where
Medicare was penalizing us for bringing physical therapists from the hospital to the
Musculoskeletal value stream outpatient center, all kinds of stuff like that.
But I think that the more you really start to understand the value stream from the
perspective of the customer--what we're looking at is that horizontal value stream around
the customer experience for the specific health condition, it becomes clearer that we are
simply not organized, structured in a way, to be able to deliver waste-free care to
customers with their conditions.
I think what it is it's a deeper understanding of what the product is we're actually
delivering to the customer. If you're a person who has diabetes you don't really care how
the hospital interacts with the clinic, interacts with the dietitian, blah, blah, blah...
What you care about is am I getting all the appropriate things that I need to do to control
this disease so I stay out of the hospital. What that means is we have to rethink the whole
delivery process rather than just think about it in hospitals, in clinics, and homecare, and
dietitians. It's what the patient need as they flow through that horizontal value stream of
their condition. That is really starting to make us think about a lot of restructuring the
resources to better serve that customer value stream.
Joe: So you're going through the typical steps of value stream mapping for these different
product families?
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John: Each one of these has a value stream map and that's based on the end to end
customer experience. Then applying the various processes, the various clinical processes,
whether it's imaging, or surgery, or inpatient care -- more as a vertical value stream to
this horizontal approach and it's complicated. We've got 50 years‟ worth of workarounds in
healthcare to try to break down in order to organize into product families.
Joe: I am a Lean person and I talk the talk and walk the walk, but if I have one complaint
about it is that Lean people have a tendency to move the control point to within the
organization and internalize the process. I think, when I read the book, what I got out of
the book is that patient care remained on the forefront for you. You did not internalize the
process and was that done purposely from seeing others or was that by accident? How did
that happen?
John: I think there's a lot of 'better to be lucky than good in our work.' It's an experiential
learning process. But, I think one of the things we have been able to do is keep the patient
at the forefront and value, as considered by the patient, at the forefront of the work. The
book really describes how we really fell down on a number of areas of really keeping the
patient as the place where value should be determined. I think that, that's what has really
changed our thinking as we've really looked at these processes from a standpoint of
patient flow and end to end care for the patient. It has really made us think through what
it is that we actually do, in a different way, and certainly more focused on the patient
condition and the flow of the patient through the system.
I've been to 64 Gemba sites now, all over the world, in the last two years. I'm telling you
that this is the biggest struggle all organizations have, is to try to figure out how to create
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that value for the patient; rather than just work on that little piece in the OR, or just look
at the intake at the emergency room. We really have to map this out end to end for the
patient and people are struggling with that.
Joe: I think it's a great focusing mechanism.
John: Absolutely, I think that's right. Because it certainly... What we like to do is have the
patients involved in this activity. The patient's involved in these value stream analysis, and
our Kaizens, and everything else. Because it's remarkable how we can just get the blinders
on as the provider side of the business and think that certain things that we believe are
valuable to patients, patients have believed just the opposite. So if we don't get customers
involved in some of these design processes, we don't end up with as good a result.
Joe: It seems like a pretty big task because aren't you dictated by how Medicare or
Medicaid applies certain principles? You have to adhere to their principles so that people
are covered.
John: There are definitely a lot of barriers in the realm of payment. The inpatient redesign
care that I described earlier, the collaborative care unit, which is very well described in the
book -- we deliver higher quality, lower cost, lower expense care in those units but
Medicare pays us two thousand dollars less per case. On an otherwise, maybe five or six
thousand dollar payment, they pay us two thousand dollars less. So here we are, delivering
better quality at lower cost, and we get paid less. We have a lot of examples like that.
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That's one of the reason I'm running this center is that I'm in Washington a lot, trying to
outline these problems that really need to be fixed, so that all healthcare organizations in
America will be willing to go down this path.
If you go to the healthcare CEO and you say "Hey, you're going to redesign your inpatient
care and you're going to get paid about 25 percent less per case to do that." How many
people are going to sign up for that? But yet that's what we need to do in the US.
We've got to figure out how do we actually fix this payment problem, and it's not that
people don't recognize it in our government, they do. They're just not sure what to do
about it.
What we're doing is trying to make it clear what it is that we need to actually do about it,
so that we can stimulate this innovation and move people along in their Lean journey in
healthcare.
Joe: What has been the reception to Lean in healthcare in Washington?
John: Part of the problem, of course, is that nobody understands it. That was another
reason we wrote the book. If you can't read this book - there's no excuse, it's a 150 page
book - you can get on an airplane and read it and you can get the basic principles. We
wrote it with the idea that we can hand it to one of our bureaucrats or one of our
legislators and on the way back to his district, he can read it on the airplane and get it. I
think that, that actually is starting to play out.
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I've had at least three different legislators that have read it, that have said, "I get it. I
understand what you're doing. I support it. How do we take it forward?"
That really was one of the key reasons that we wrote this thing, so that we could start to
get the wheels grinding a little bit on some of these guys that are making the decisions
that have so much impact on US healthcare.
Joe: Do you believe that this is the best approach on a national level?
John: At the end of the book, I describe three things that I think need to happen in
policy. One is we need to change the payment to reward better value, because Lean
provides better value. We've got to change things so that there's incentive to do it. The
second thing is that we really need to be transparent about our performance, because
healthcare is in a black box when it comes to performance. Not all doctors and hospitals
are treated equal, and not all doctors and hospitals deliver the same results.
So we need to make sure that we have a core group of performance measures that we can
compare. My example is, if there are two hospitals in your community and you knew that
one of them delivered 100 medication errors yesterday and the other hospital delivered
zero, which one would you go to?
Point is that everybody would pick the one with zero and you know what, the one with 100
would get to zero pretty fast. Those are the kinds of performance indicators that we need
out there in the public, real time, not this two year old, three year old data.
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The third component is that we've got to redesign care, and I believe using Lean, but if
there's other quality improvement methodologies people want to use that's fine. But we
have got to take the cost out of the healthcare system. It is exponentially rising at six to
eight percent a year. It's already over 17 percent of our GDP, and the present healthcare
reform bill does nothing to attenuate the cost of care. There are some pilots going on,
maybe in ten years there might be some changes. We can't wait that long; it's got to be
now.
Joe: The Healthcare Leaders Network that you have, what is that about?
John: The Healthcare Value Leaders Network, which has been in existence now for about
a year and a half, are groups of organizations committed to transforming their cultures to
Lean and they are working together as a learning collaborative. The best way to think
about it is to think about it as a Toyota supplier network group. Usually about 12 suppliers
that get together, learn from each other in terms of their Lean journey. This is exactly
what we're doing for these healthcare organizations. We have two of these networks now,
of 10 to 12, and we have another planning session in September with others that are
interested.
Our goal is basically to form as many learning networks as demand for. We are
administering this through a partnership between the Lean Enterprise Institute and my
organization, which is the ThedaCare Center for Healthcare Values.
We bring the Lean experts together with the healthcare experts to build out what we
believe is the best set of processes to learn the Lean methodology.
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Joe: You could with this network decrease your learning curve at a pretty rapid rate, but
you can also stick your toe in the water to see if it works for you, right?
John: A lot of this is experimentation, as you know. We're just constantly experimenting
with the tools, with principles. And what the value that the network members have is that
they can learn from each other. There's usually somebody that's actually tried what you
are going to try and you can go see it. We facilitate two day site visits where you actually
go see the work that each of the members is doing. We do pre-visits to make sure that we
show you the best stuff that they're doing. Yeah, go look and see what it is that you're
going to try to do and usually, there's somebody that's already tried it and learned a lot
about it.
Joe: The middle section of the book on Lean leadership - and I think you found that
leadership was so important as we do in selling any change - was there any big surprises
that you found there or something that you really stumbled upon, that you struggled with
for a long time?
John: Many things, many things. I tell people that the type of leader that I was when I
started as CEO at the organization versus the type of leader I am today - I was 180 degree
difference. I came from this sort of autocratic, controlling physician-led, blah, blah, blah
sort of world. And the world of Lean leadership is exactly the opposite of that; mentor,
facilitator, teacher, helper, communicator. The Lean leadership world is all about you
asking the right questions to stimulate the thoughts that actually then will lead to the
solutions in your staff? And none of us are trained in that sort of leadership style. We're all
trained to have to know all the answers and everybody comes to us to get them.
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This a huge change in the way you lead an organization and you can't underestimate how
hard that's going to be as a leader.
Joe: But you are trained in the healthcare, everybody's trained to ask good questions.
That's how you diagnose someone. You're experts at asking questions. So, doing this in the
management, I would think, would be somewhat second nature.
John: We're asked to ask questions without a team. This is about me asking questions to
the patient. It's about my knowledge. It's about my control of that knowledge and my
control of the people who then, once I make a decision... Lean is much more about, "OK,
let's get the team together to actually ask the questions." What's happened at ThedaCare
is instead of the doctor going in and meeting with the patient, the doctor, the nurse, the
pharmacist, the discharge planner, all go in at the same time within the first 90 minutes of
admission and do a history and an examination together.
When they come out of that, there's a single care plan that all the important
components - all the players in the team actually believe in, understand and have had
input on. That is not how we are trained. As physicians, we are trained to control
everything and make all the decisions and be highly autocratic.
In this new world, all of that's got to be broken down and we've got to get the best
thinking from all of these quite talented and well-educated staff members.
Joe: What's on the horizon? What do you have coming up next?
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John: We have a series of things. Like I said, we're going to be expanding our networks,
so people that are interested in learning from each other go to our website at
HealthcareValueLeaders.org and sign-up to come to one of our sessions, kind of our
introduction to Lean sessions. The other thing that we're really focused on is how do we
actually measure value in healthcare, and this is a really big problem. We've been working
on it for two years and we've worked with Dartmouth people, the Brookings Institution, the
Commonwealth Fund, you name it, on and on and on.
We're still struggling with really, how do you compare Group Health of Puget Sound's
performance to UCLA, to ThedaCare, to Gundersen Lutheran and to Harvard Vanguard
Medical Group? That's what we need to be able to do, is to really understand the value
performance metrics.
We have several experiments in place right now to try to crack that nut and we're working
with a lot of folks on that. Between that and my work in Washington trying to get some of
these folks to change their mind about what the problem is, there's plenty to do.
Joe: I've noticed you put on a few webinars and you speak all over, I see you're quite
active in that area. I know you're at AME coming up in Baltimore. I think you're doing one
of the keynotes or the keynote there. If someone wants to - do you hold webinars on a
regular basis?
John: We're starting to - we're going to start this fall to do more webinars specifically
related to the learning that we're getting out of the network groups. I've done one on Lean
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leadership, I've done one on OSHA planning, and I‟m going to do one on Lean leadership
this fall. We're going to do another one on sustainability.
We're going to take topics, focus in on certain important components of Lean, but really
look at it from this perspective of healthcare. What does sustaining mean in healthcare and
what are the resources and the processes that you need to be able to sustain your
improvements?
Joe: Is there something that you'd like to add maybe, to this conversation, that I didn't
ask?
John: What's fun for me is everyday I'm learning something new because Lean is
tremendous methodology that is so robust that I will never learn it all. It should be an
exciting journey forever.
Joe: I would like to thank all the listeners and also thank you, John. I appreciate it very
much. The podcast will be available on the Business901 blog site and also Business901
iTunes store. So, again, thank you, John.
John: Thank you very much.
Transforming Healthcare thru Lean
Copyright Business901
Business901 Podcast Transcription
Implementing Lean Marketing Systems
Joseph T. Dager
Lean Six Sigma Black Belt
Ph: 260-438-0411 Fax: 260-818-2022
Email: jtdager@business901.com
Web/Blog: http://www.business901.com
Twitter: @business901
What others say: In the past 20 years, Joe and I have collaborated on many
difficult issues. Joe's ability to combine his expertise with "out of the box"
thinking is unsurpassed. He has always delivered quickly, cost effectively and
with ingenuity. A brilliant mind that is always a pleasure to work with." James R.
Joe Dager is President of Business901, a progressive company providing direction in areas such as Lean
Marketing, Product Marketing, Product Launches and Re-Launches. As a Lean Six Sigma Black
Belt, Business901 provides and implements marketing, project and performance planning methodologies
in small businesses. The simplicity of a single flexible model will create clarity for your staff and as a result
better execution. My goal is to allow you spend your time on the need versus the plan.
An example of how we may work: Business901 could start with a consulting style utilizing an individual
from your organization or a virtual assistance that is well versed in our principles. We have capabilities
to plug virtually any marketing function into your process immediately. As proficiencies develop,
Business901 moves into a coach‟s role supporting the process as needed. The goal of implementing a
system is that the processes will become a habit and not an event.
Business901 Podcast Opportunity Expert Status
Transforming Healthcare thru Lean
Copyright Business901