The Virginia Mason Production System

In 2001, Virginia Mason Medical Center (VMMC) in Seattle, Washington, formed a physician compact listing the physicians’ and organization’s new goals: becoming the quality leader through patient-centred care and evidence-based practice, emphasizing teamwork, and embracing change.

To achieve these goals, they turned to the Toyota Production System (TPS). Toyota and VMMC essentially wanted the same things: a customer focus, the pursuit of perfection, and a dedication to good employee relations. After seeing TPS in action in Japan, they began envisioning the Virginia Mason Production System (VMPS) modelled after Toyota’s. To encourage the staff to participate in process improvements, they guaranteed that no layoffs would occur as a result of newly found efficiencies. They implemented value-stream mapping to chart various processes and identify waste. This was the first step undertaken in the rapid process improvement workshops geared toward eliminating waste, improving processes, increasing efficiency, and improving productivity in a given unit.

They organized the workplace according to the 5S system (sort, simplify, sweep, standardize, and self-discipline) to “unclutter” the system and improve the visibility of potential problems. They implemented the 3P system (production, preparation, process) to redesign the layout according to flow. All employees were encouraged to participate in the “everyday Lean idea system” to reduce waste in their jobs and create value for the patient. The patient safety alert (PSA) system was inspired by Toyota’s Sandon cords to stop the line when a serious mistake occurred. Similarly, PSA empowered front-line employees to signal when a mistake had occurred or a safety problem had emerged, leading to the resolution of the problem onsite. Finally, they instituted the use of bundles or checklists to prevent infections or improve care.

The adaptation of TPS into VMPS was heralded as a success in terms of cost savings and quality improvement. Now legendary, VMMC’s practices have been copied by hospitals across the country.