One Cultural Shift, Two Safety Improvements

Chelsea Rice, for HealthLeaders Media , March 11, 2013

"The Virginia Mason Production System is predicated on process improvement and a deep respect for our people," says Kaplan. "It's all about people closest to the work having the most valid approach, and therefore being in the best position to redesign the work, and so it really empowers front-line staff… it's very much about creating a new kind of environment and leveling the hierarchy."

"Structuring to people's personality or catering to these super humans that are immune from any criticism or feedback. That is the antithesis of what Toyota practices," says Kaplan.

"The costs of burnout, litigation, lost work hours, employee turnover, and the inability to attract newcomers to caring professions are wasteful and add to the burden of illness. Disrespectful treatment of workers increases the risk of patient injury," reads the NPSF report.

If a patient was harmed it would be swept under the rug in a physician-centered culture because it was not an open culture that embraced apology or disclosure. Kaplan says they've moved that significantly, and it's allowed Virginia Mason to make some major breakthroughs in quality, safety, and in cost. In the past five years, quality improvements have led to a 52% reduction in professional liability insurance.

"Organizations have all kinds of initiatives, like flavors-of-the-month sort of approaches to improve quality, safety, or efficiency, but they do these without addressing the fundamental, prevailing culture, and without focusing on what that means to the people on the front lines of delivering care," says Kaplan.

"I would encourage others take a look at one's culture and what is it that we need to do more of to be safer and improve the environment so our staff can do their very best work. You have to get back to why we went into healthcare in the first place, and that's to deliver the very best care for our patients."

Chelsea Rice is an associate editor for HealthLeaders Media.
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