美国议员尝试用工厂经营方式进行管理

When Virginia Mason Medical Center in Seattle started losing money in 1998, its CEO began a search for a new management system that would get the hospital back on track.

1998年，西雅图的维吉尼亚·梅森医疗中心出现亏损，执行长开始寻求使医院扭亏为盈的新经营方式。

After two years of visiting hospitals around the U.S. and talking with many of the smartest minds in the health care industry, he concluded that there wasn't a single medical institution in the entire country that had a system worth emulating. Instead, he turned to a Japanese carmaker for inspiration.

在两年时间里，他遍访全国各地医院，向专家学者求教，最后得出结论，全美国没有一个医疗机构的制度值得效仿。于是他转向了日本的汽车制造业。

Lean management style

Dr. Gary Kaplan, head of Virginia Mason Hospital in 2001, thought he could adapt Toyota’s lean management style - which focuses on eliminating waste in the production process - to improve healthcare.

2001年，维吉尼亚·梅森医院院长加里·卡普兰医生认为，他可以采用日本丰田汽车的精简经营模式，减少浪费，提高医疗效率。

"He turned to the Toyota production system because it was clear to him that taking these principles and tools and adapting them to healthcare could significantly make Virginia Mason a more efficient operation," says efficiency expert Charles Kenney, author of "Transforming Healthcare, Virginia Mason Medical Center’s Pursuit of the Perfect Patient Experience."

经营效率专家查尔斯·肯尼写了一本书，叫作《医疗机构转型，维吉尼亚·梅森医院追求完美的就医经验》。

One of the first Toyota concepts Kaplan instituted was value stream mapping, which involved taking a complicated process and breaking it down into individual steps to find ways to make each step more efficient. Virginia Mason hired several Japanese consultants, called senseis, to help them with their first value steam map: a cancer patient’s visit. In his book, Kenney recounts how the senseis instructed the staff to trace the patient’s journey on a map of the hospital, using a piece of blue yarn.

肯尼写道，卡普兰院长首先引进丰田公司的价值流程图，将复杂的生产流程分解成为单个步骤，然后寻求提高每一步的效率。医院聘请了几名日本顾问，他们的任务是协助制定第一份癌症病人门诊流程图。日本顾问指导工作人员用蓝色丝线在医院地图上标出病人行走的路线。

"And at the end of the process, the blue yarn was snaking around this piece of paper - the schematic on the floor - and it was this immensely powerful visual experience for the entire team," says Kenney, "and they realized that what was happening was they were taking these patients, for whom time is absolutely the most precious thing in their lives, and they were wasting huge amounts of it."

肯尼说：“最后，蓝色丝线在医院平面图上绕来绕去，蜿蜒蛇行。这种直观图像一目了然，他们立即意识到他们在大量浪费对病人来说无比珍贵的时间。”

So the team used the lean management approach to refine the process of administering chemotherapy treatments. By sorting out the steps, simplifying and standardizing them, they were able to cut the amount of time it takes a patient to receive treatment by 50 percent. Then, they turned to other departments, finding ways to increase efficiency and improve safety.

于是这个工作小组开始修订、简化病人化疗的程序，并使之标准化，从而为病人节省了百分之50的时间。然后，他们又转向其它科室，找出提高效率和改善安全的措施。

"So the Virginia Mason Production System is now viewed throughout the world by many people as a viable alternative to the current system," Kenney says.

现在，维吉尼亚·梅森医院的制度已经被世界各地许多人士看作是可以替代现行制度。

It has been adopted by dozens of hospitals in the United States, including Barnes Jewish in St. Louis, Missouri.

美国已经有十几家医院采用了这项制度，包括密苏里州圣路易斯市的巴恩斯犹太医院。