Sunday, February 20, 2011

Book Review - On the Mend

One of several books that helps me enormously to better understand the lean healthcare world is On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry written by John Toussaint, MD and Roger Gerard, PhD with Emily Adams. This book makes it simple to understand some of the challenges we must prepare ourselves for in leading change in a healthcare and the application of lean management principles in the healthcare environment.

On the Mend is part storytelling, part case study and part inspirational in writing about the lean transformation of ThedaCare, a four-hospital healthcare system in Wisconsin as seen through the eyes of the authors who lead this revolution. ThedaCare’s lean transformation journey began in 2002 and continues to this day, and the book highlights their early years through 2009.

What I enjoyed most about this book is the easy writing style that made great use of patient examples and conflict issues that brought the story to life while tackling important questions like, “How do we define value anyway?”

There were many topics covered that I found intriguing like the use of the “Collaborative Care Unit” concept. I enjoyed reading about the improvement process of a common heart attack (an ST segment elevated myocardial infarction or STEMI) to go door-to-balloon in 90 minutes or less. And why that is critical. Also covered well was the use of familiar lean tools and ideas like value stream maps, asking the “5 Whys”, PDCA, 7 wastes, spaghetti diagrams and standard work, only these were translated for the healthcare point of view. The authors focused more on the application of these tools and left the technical “how to do” for others to explain.

The authors did a nice job of emphasizing that the lean healthcare focus is on the patients and the care around them, identifying value for the patient and minimizing the time to treatment. Ultimately, it comes down is finding better ways to save lives and improve outcomes which are goals we all can rally behind.

I highly recommend On the Mend to both healthcare and non-healthcare lean leaders to read and then read it again. There are many valuable insights to any lean journey found here to helps us find our way. However, don’t read this book and expect to find any silver bullets. As we know, silver bullets do not exist in lean, only hard work and dedication to the continuous improvement process.

Overall, I think the lean healthcare journey is best described in this book in the words of the authors, “There are no right answers or everlasting solutions, only incremental improvements to be tested and implemented as employees get closer to the goal of identifying what is value to the patient, then delivering it reliably.”

Full Disclosure: I did receive a complementary copy of this book from the publishers to review.

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