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Lean Healthcare Transformation Summit 2010

Join the Lean Enterprise Institute and the ThedaCare Center for Healthcare Value June 9-10, 2010, in Orlando, FL, at the First Annual Lean Healthcare Transformation Summit, specially designed to deliver comprehensive, high-quality information about fundamentally improving healthcare delivery through lean thinking.

Come spend two comprehensive days in an intimate setting, learning the latest best practices from leaders in the lean healthcare movement. The Summit is also a great way to network and compare notes with others who are using lean to improve patient safety, quality, cost, patient access, and staff morale.


Summit Highlights

  • Special keynote "Real Healthcare Reform: Lean Thinking for Healthcare Delivery" by Dr. John Toussaint, CEO emeritus of ThedaCare, CEO of the ThedaCare Center for Healthcare Value, and author of the forthcoming book On the Mend. He'll challenge the conventional thinking of what ails healthcare by presenting a proposed cure that includes eye-opening data from numerous healthcare organizations, healthcare policy experts, national transparency initiatives, and academic research.
  • During Plenary Sessions, you'll hear executives describe the essential business cases for adopting lean healthcare, and explain why they view lean as a strategic initiative.
  • In subsequent Breakout Sessions, change agents from each organization build on the plenary discussions by providing detailed descriptions of how and why particular methodologies were used, what challenges they overcame, and what results were achieved.
  • Concurrent Learning Sessions offer new applications and practical methodologies in small interactive sessions where you can learn, discuss, and reflect. Sessions are repeated so you can attend multiple sessions.
  • Pre-Summit Workshops build skills or introduce concepts that you'll need to make your transformation successful and sustainable.
  • The CEO Panel is your chance to talk with and interact with leaders from organizations implementing lean healthcare.
  • Limited attendance gives you ample time for discussions and follow-up questions.
  • Summit networking is a high priority with breaks, receptions, and luncheons providing many formal and informal ways for you to connect with counterparts who are tackling the same challenges that you face today. Don't forget your business cards!
  • Continuing Education Information for Participants (click here for complete CME/CNE/ACHE accreditation information)
    • ACHE Category II Credit applied for through the American College of Healthcare Executives
    • Designated for Continuing Medical Education credit
    • Continuing Nursing Education contact hours to be awarded

You'll hear actionable, no-nonsense advice from pioneering healthcare professionals in the Healthcare Value Leaders Network who have had remarkable success using lean thinking to go beyond isolated islands of kaizen and lean tools to lean management systems, connecting the enterprise.


Who Should Attend

The Lean Healthcare Transformation Summit is the one event designed to assist your entire team, including front-line clinical or professional staff, physicians, managers, administrators, senior leaders - virtually any healthcare professional involved in or interested in change within their organizations. Don't go it alone! Learn together with colleagues, it's an excellent way to get your team on the same page.


Your Hosts

Healthcare Value Leaders


Summit Program

Keynote Speaker John Toussaint Special keynote "Real Healthcare Reform: Lean Thinking for Healthcare Delivery" by Dr. John Toussaint, CEO emeritus of ThedaCare, CEO of the ThedaCare Center for Healthcare Value, and author of the forthcoming book On the Mend. He'll challenge the conventional thinking of what ails healthcare by presenting a proposed cure that includes eye-opening data from numerous healthcare organizations, healthcare policy experts, national transparency initiatives, and academic research.



Plenary & Breakout  Sessions

In the Plenary Sessions, pioneering leaders from a cross-section of the Healthcare Value Leaders Network will make the cases for their lean transformations by beginning where transformations should begin - the biggest point of need for improvement. In this year's Summit you will hear and learn from executives from ThedaCare and Group Health Cooperative.

In the Breakout Sessions, you will have the opportunity to dig deeper into the topics discussed by the Plenary speakers. These sessions are designed to deliver more detail and engage in discussions about what has been done, what's left to do, and what lessons were learned along the way.


Group Health
Group Health Cooperative
Michael Erikson, MSW, Vice President Primary Care Services
Seattle, WA

Group Health's lean journey began in 2004 and today touches nearly every one of their 9,000 employees and 600,000 patients. The Group Health Management System is composed of Strategy Deployment (Hoshin Deployment), "Daily Managements," and cross-functional management. Their lean-based management system directly contributes to achieving goals and allows Group Health to win in a complex, rapidly changing, and competitive healthcare market place. Their rapid growth as an enterprise - health plan and delivery system - in a time of market contraction is not accidental. While unemployment and loss of covered lives were increasing in Washington, Group Health was growing. Michael Erikson will discuss how the Group Health Management system was used to achieve these results.

In the Breakout, learn more in-depth about what makes up the Group Health daily management system, and see its application in core ambulatory patient care processes. Learn why a medical director would entrust the care of 400,000 patients and the practices of over 300 physicians to a lean based daily management system. Paul Fletcher, MD; Wellesley Chapman, MD; Alicia Eng; Lee Fried will share and visually display how the Group Health management system has reduced waste and added value for patients and physicians which in turn is removing costs and is leading to market pricing confidence for the health plan as well as Group Health's brand and image strategies.


Dean Gruner, MD, President and CEO
Appleton, WI

A few years ago ThedaCare was ailing. This major Wisconsin healthcare company was suffering the same symptoms afflicting many providers - costs were escalating out of control and quality was not improving. But instead of trying to bandage its existing system, ThedaCare performed major surgery. Modeling its improvement plan on the lean principles that were working so well in industry, it developed the ThedaCare Improvement System (TIS), an organization-wide quality improvement initiative that has cut process defects, improved patient outcomes, eliminated waste, and developed revolutionary new models of clinical care. In this candid plenary discussion, you'll learn:

  • Why ThedaCare proceeded down the lean path
  • What its successes and "noble failures" have been
  • How it has dealt with major issues of leading change, impact on people, and spreading improvements

You will have the choice to attend one of two ThedaCare Breakout Sessions. In the first, Brian Burmeister and Mark Hallett, MD, will describe their journey of fundamentally changing ThedaCare's primary care office visit value stream. During the session Brian and Mark will include an overview of the main components of their "New Delivery Model", along with their current performance results. They will also share their learnings and insights related to key success factors such as leading provider change, creating a culture of continuous improvement, and spreading the model across all 23 of their primary care sites.

In the second Breakout Session, Kathryn Correia and Mark Hermans, MD, will discuss Collaborative Care. Collaborative Care is ThedaCare's complete redesign of inpatient care in order to create measurably better value for patients, their families, and the community.  During this interactive session, Kathryn and Mark will:

  • Briefly review the 6 key components of the collaborative care model
  • Explore the roles of senior leadership in creating and supporting this innovative model
  • Discuss in-depth the lessons learned in obtaining shareholder buy-in, focusing on independent physicians and clinicians


Learning Sessions

Personalize your Summit experience by exploring topics that can help you on your journey. Each learning session gives enough practical information to apply to your work. These sessions will be offered three times during the Summit so you will have the opportunity to participate in multiple sessions.

Managing with A3 Thinking
Presented by: University of Michigan Health System (Jack Billi)

The most basic definition of an A3 would be a P-D-C-A (Plan-Do-Check-Act) storyboard or report, reflecting Toyota's way of capturing the PDCA process on one sheet of paper. But the broader notion of the A3 as a process - embodying the way of thinking represented in the format - captures the heart of lean management. In this context, an A3 document structures effective and efficient dialogue that fosters understanding followed by the opportunity for deep agreement. It's a tool that engenders communication and dialogue in a manner that leads to good decisions, where the proposed countermeasures have a better chance of being effective because they are based on facts and data gathered at the place where the work is performed, from the people who perform it.

Through instruction, small group discussions and exercises, the learning session participants will:

  • Learn the basic formats of A3s and uses of the A3 as a management process
  • Gain experience in the three basic roles of the A3 process
    • Writing an A3 (Author/Owner)
    • Reading A3s (Responder)
    • Coaching others about their own A3s (Coach)


End to End Patient Flow
Presented by: Hôtel-Dieu Grace Hospital (Nicki Schmidt, RN; Colleen Adams, RN; and Jacqueline M. Andrew, RN, MSc.)

Hôtel-Dieu Grace Hospital has analyzed typical patient journeys using value stream mapping techniques. The hospital documented the current state for a few common patient pathways, including a) a patient's arrival to the Emergency Department to their discharge destination, such as home or long-term care and b) a surgical patient's pre-admission activity through discharge. Improvements were designed and implemented based on the problems and opportunities identified in the value stream analysis. The changes led to an improvement of patients knowing their daily plan of care from 17 percent to 90 percent as well as an increase in the number of patients discharged by the target time.

Through presentation, discussion, and exercises, you will learn:

  • How to use visual management concepts to make an invisible or absent process of the patient journey and daily plan visible for the team, patient and family
  • See how see how patient centered care and lean mesh
  • How to develop a plan for effectively spreading learning and new practices


The Democratization of Improvement: Iowa Health System's Blueprint for Delivering Ideal Patient Care
Presented by: Iowa Health System (Sal Bognanni, M.H.S.A. and Ray Seidelman)

Iowa Health System is building a community of learners by embedding the scientific method and structured problem solving into front-line work to identify barriers to ideal patient care. Problems are solved only after directly observing the work, understanding the root cause, and implementing countermeasures which are tested where the work occurs. Rolled out to approximately one-third of Iowa Health Systems Med-Surg units, the work uses "Adaptive Design" concepts, as developed by John Kenagy, M.D., based on Steven Spear's findings of the true DNA in the Toyota Production System.

Through discussion, video observation, and an exercise, participants will be able to:

  • Understand the value of direct observation of the work
  • Understand the importance of the Scientific Method and structured problem solving in improving care
  • See how the A3 Tool is used for driving real-time problem solving

Results: Hundreds of front line staff are signaling problems, developing A3s, and testing countermeasures.

Tools: Observation of the work, A3s, PDSAs


3P: Designing Facilities and Care Models
Presented by: Park Nicollet Health Services (Steve Mattson and Mark Parkinson)

3P (production preparation process) work has been done in both facility design and in care model development at Park Nicollet. This includes:

  • An OP Clinic located in Chanhassen that was designed using the 3P process. They reduced the footprint by 50,000 sq ft., have patient self rooming (no waiting), and a patient tracker for visual control and LT measurement. It was described in the book Toyota Way to Healthcare Excellence.
  • Endoscopy Suite - going from 35 to 75-80 patients per day at a lower cost and consistent high quality outcomes
  • New Cancer Center designed to bring the services to the patient
  • New nationally-recognized Eating Disorder Institute - using 3P to design both the facility and the care model
  • Currently in the process of designing a Joint Replacement care model

Through instruction, discussions and an interactive exercise, learning session participants will:

  • Gain an overall understanding of the 3P process, including benefits and general framework as applied to design of both facilities and care models and the results of these efforts at Park Nicollet
  • Learn about the how the "7 flows" of healthcare (flow of patients, clinicians, medications, supplies, equipment, information, and process engineering) are considered in the 3P design process
  • Understand how the use of "7 ways" fosters creative ideas


Spreading Patient Flow Improvement Across Multiple Emergency Departments
Presented by: Mercy Medical Center (Kathy Krusie, FACHE and Kathryn Berry)

Lean is about continuously improving - and not assuming that what worked in one area will automatically work in another. Learn how Mercy Medical Center applied single-piece flow principles to the Emergency Department in order to decrease patient waiting and guarantee that treatment would begin within 30 minutes. Improvements have evolved into the current model where patients are triaged as soon as they walk in the door. Naturally Mercy wanted to expand their successes in the Emergency Department to other areas. As part of their improvement efforts they were able to increase exam room utilization at one of the Mercy Care clinics by more than 19 patients per day while decreasing registration time by over 90%! Learn how this worked - and what lessons were learned.

Through presentation, discussion, and small group activities, you will learn:

  • How to implement triage that is specific to a facility's unique characteristics
  • How to improve the registration process and patient flow
  • How to improve exam room utilization


Culture Change: A Laughing Matter
Presented by: ThedaCare (Rosellen Crow and Chris Fettig)

Are you serious about changing corporate culture? Then try humor.

For the past six years that's exactly what Rose Crow, ThedaCare senior vice president, and Chris Fettig, a theatrical producer have done by throwing a party with a purpose. Together with ThedaCare associates, they've built stage sets and created comedy skits for a "follies" night. Besides fabricating a fun night for everyone in the company, the effort builds teamwork and breaks down barriers as associates meet and work with colleagues from different departments. Such collaboration and cooperation helps to support ThedaCare's continuing lean transformation.

This energetic and fun-filled session will include a chance to participate in the creation and performance of a skit to show you how to get started and what can be done in a short time. You'll discover an effective method for introducing humor and show business into lean culture development that works on the team, department, or companywide levels.

You'll learn how to:

  • Acknowledge the responsibilities that lean leaders and executives have for corporate celebration
  • Understand the importance of corporate celebration and the use of humor to the development of corporate culture
  • Participate in exercises that demonstrate the impact of celebration on yourself and others


CEO Panel

In this session, you will hear firsthand from healthcare CEOs and executives about each of their organization's lean journeys. The CEOs will share their lessons learned - what has worked well and what they wish they had known when they started. Here is your chance to ask questions and hear the perspectives of these accomplished senior leaders.

Networking Opportunities

Lunch Roundtables

Break bread with other lean thinkers and share substantial insights into the lean-related issues that are most important to you. Each day at lunch we'll have tables set aside for Lean Thinkers who want to exchange information about particular topics, such as employee involvement, A3, and leadership. Or create your own topic of interest by submitting it during registration.

Other Networking Opportunities

The Summit is designed to be the best networking venue in the Lean Healthcare Community by providing many formal and informal ways for you to connect with counterparts facing the same challenges as you.

  • Networking Breaks
  • Welcome Reception June 8


Pre-Summit Workshops

These in-depth one and two-day workshops will help you build practical skills for addressing "people" issues as well as technical ones you will encounter during a lean transformation. For more information on Pre-Summit Workshops click here.

This year's Pre-Summit Workshops are as follows:


Registration Information


$1,300 USD

The registration fee includes participation in the Summit, participant materials, welcome reception on June 8, and food (breakfast, lunch, and snacks) for both days.

Pre-Summit Workshops are available for Summit attendees on June 7th and 8th for an additional fee.


Once registered, you will receive a confirmation email. To receive a full refund, notice of cancellation must be received by May 14, 2010. Substitutions may be made at any time before June 7, 2010.

If you have any further questions please contact the Lean Enterprise Institute at 617-871-2900 or summits@lean.org.



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