Part case study, part manifesto, this groundbreaking new book by a doctor and a healthcare executive uses real-life anecdotes and the logic of lean thinking to make a convincing argument that a revolutionary new kind of healthcare -- lean healthcare -- is urgently needed and eminently doable. In On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry John Toussaint, MD, former CEO of ThedaCare, and Roger A. Gerard, PhD, its chief learning officer, candidly describe the triumphs and stumbles of a seven-year journey to lean healthcare, an effort that continues today and that has slashed medical errors, improved patient outcomes, raised staff morale, and saved $27 million dollars in costs without layoffs. Find out: * How lean techniques of value-stream-mapping and rapid improvement events cut the average "door-to-balloon" time for heart attack patients at two hospitals from 90 minutes to 37. * What ThedaCare leaders did to replace medicine's "shame and blame" culture with a lean culture based on continuous improvement and respect for people. * How the lean principle of "building in quality at the source" broke down divisions among medical specialties allowing teams to develop patient care plans faster. * Why traditional modern management is the single biggest impediment to lean healthcare. * How the plan-do-study-act cycle coupled with rapid improvement events cut the wait time at a robotic radiosurgery unit from 26 days to six. * How the lean concept of "one piece flow" saved time in treating ischemic stroke patients, increasing the number of patients receiving a CT scan within 25 minutes from 51% to 89%. * How senior leaders at other healthcare organizations can begin their own lean transformations using a nine-step action plan based on what ThedaCare did -- and what it would do differently. Toussaint and Gerard prove that lean healthcare does not mean less care. On the Mend shows that when care is truly re-de

Hospitals have long relied on the heroics of one brilliant nurse or doctor to save the day. Such heroics often result in temporary workarounds and quick fixes that leave not only patients and quality care at risk, but also increase costs. This is the story of an organization breaking that habit. Like a growing number of healthcare organizations around the world, ThedaCare, Inc. has been using lean thinking and the principles of the Toyota Production System to improve quality of care, reduce waste, and become more reliable. But lean thinking was incompatible with ThedaCare’s old top-down, hero-based system of management. Kim Barnas, former SVP of ThedaCare, shows us how she and her team created a management system that is stable and lean, to spur continuous improvement. Beyond Heroes shows the reader, step by step, how ThedaCare teams developed the system, using the stories of its doctors, nurses and administrators to illustrate. The book explores each of the eight essential components of the lean system, from front-line problem solving with the scientific method to daily team huddles and creating standard work for leaders all the way to the top of an organization. Finally, the author introduces four executives from healthcare systems across North America who have implemented ThedaCare’s system and share the lessons they learned along the way. Beyond Heroes is not just a call to action or an argument for a better healthcare system. It is a necessary roadmap through the rocky terrain ahead, one that healthcare leaders can customize to their special needs.

Two renowned experts in healthcare transformation show how leaders are implementing behavior-driven strategies to ensure quality care and create lasting change. Healthcare is in the midst of a massive disruption. With financial structures in tatters and the future uncertain, this is the moment to begin the revolution. But first, leaders need to learn how to support staff at all levels as they make transformational improvements in care. This book demonstrates that real change is very personal and has to start at the top―whether you’re an executive, governing board member, manager, or physician. A powerful new approach to healthcare leadership, this book showcases executives in health systems around the world as they: Practice behavior-based solutions to organizational problems Learn how to support continuous improvement Be more present in their leadership role Learn how to reflect and assess themselves as leaders Achieve better results for patients Drawing on a wealth of behavioral research, industry case studies, and personal insights from healthcare professionals, the authors explore how change actually happens—from the inside out, top to bottom, throughout the whole organization. You’ll learn how healthcare systems led by people who are compassionate, principled, and engaged can undergo profound and lasting transformation. Find proven strategies for cultivating principle-driven behaviors that can turn the remotest possibilities on the healthcare horizon into a new working reality. This is more than a leadership guide to revolutionizing healthcare. This is about being a force for change that makes life better for patients, caregivers, and all stakeholders. If you want to take the lead in making change happen, start with Becoming the Change.

Potent Medicine could be the most important book on transforming healthcare ever published. Why? Because John Toussaint, MD, has dedicated his career to taking action that will leave our children with a better healthcare system than we inherited. This book is written for patients, insurance companies, policy-makers and those who work in a hospital or health system. Dr Toussaint has identified actions each group needs to take to make improvements to the system. For example true transparency means using words like death and risk and error. A patient evaluating a hospital for heart surgery needs to research a few simple measures of quality. * Number of medical errors committed in a hospital yesterday, shown both as a number and a historical trend * Number of surgical infections last month * Number of people who come in with chest pains and die * Percentage of people requiring this surgery who died in the hospital, and how many died within the last six months * Average number of days to a full recovery Potent Medicine is the compelling follow-up to Dr Toussaints first book, On the Mend. The stories highlight the tragic consequences that occur when medical teams do not follow a patients progress and just pass them through the system. It offers practical advice from Wisconsins collaborative efforts to transform healthcare and deliver better patient value and is focused on these 3 elements: * Delivery of care designed around the patient - using lean principles and methods to deliver care focused on patient needs * Transparency of treatment quality and cost - making healthcare outcomes public for everyone * Payment for outcome - move away from fee-for-service to a system that pays based on quality and efficient care Potent Medicine highlights the steps to achieving a quality healthcare system.

She thinks she knows this player...but he's full of surprises.SabrinaWhy does my promotion depend on Dan McMullen, of all people? I've been working my butt off for years and now all I have to do is get the star center fielder game ready and it's mine. Yes, our relationship happened ten years ago, but I'll never forget how he broke my heart. He was my first love after all. But I'm older now, wiser. I won't let anything stand in the way of earning that promotion. Not even a sexy player who thinks we're going to kiss and make up.DanBack in college, I loved two things?Sabrina Kelly and baseball. Baseball worked out great. Sabrina, not so much. I know I broke her heart, but I'm not that guy anymore. My busted knee may keep me off the field this season, but it's also given me the chance to get her back into my life. She's a damn good physical therapist and if anyone can get me on my feet, it's her. And while she's here, I just have to convince her to give me another chance.

Discusses successful ways to raise children to be responsible, honest and loving adults.

This very concise and straightforward book is aimed at top executives in virtually any industry who are either new to the concept of Lean and its benefits to them or who have stalled in their transformations and are trying to resurrect their momentum. The book is written in a style that mirrors a typical interaction with an executive across a table with a knowledgeable, experienced Lean coach/consultant. Its style and substance reflect what a candid and casual conversation would sound and feel like. The book includes simple hand-drawn images (thus the title Lean Leadership on a Napkin) to facilitate and simplify basic concepts as if a real dialogue was occurring in an informal setting. It assumes that the executives have a little or no previous knowledge of Lean methodologies or Lean Leadership but have awakened to the possibility of their promise to grow themselves and their enterprises dramatically. Most executives have little time for extensive reading or patience with "sales" presentations. Those same leaders will therefore appreciate the simple, uncluttered, and, above all, objective summary this book provides. The book breaks down the process of transforming the organization around Lean principles into three component transformational phases or steps, namely, Introduction, Integration, and Internalization (i.e., the I-3 strategy). Each phase includes critical factors to understand, do, and share as well as deep reflection questions to help leaders decide on an appropriate path forward for themselves as leaders and for their organizations. While the Integration and Internalization steps are introduced here, the primary focus of this work is on those critical issues arising in the early, Introduction, step. A unique advantage of this book is that it braids together four critical elements of success—Lean concepts/methodology, culture change, leadership, and business performance. Essentially, the reader will obtain a broad, basic, and solid understanding and leadership foundation about Lean, the leader’s unique role in transformation, and confidence to make appropriate decisions about the how and if to proceed. In addition, it will offer a path forward by providing the reader with abundant resources and consulting support for those seeking to launch a Lean transformation.