The Real Face of Healthcare Reform

In his latest online column for Time magazine, Drucker Institute Executive Director Rick Wartzman writes about a major community health system in Wisconsin that has “established an extraordinary record of raising quality . . . while controlling the cost of inpatient care.”

“With Washington stalemated and the government’s new online medical insurance exchanges trying to work out the kinks, much of the nation is fixed on the fate of Obamacare,” Wartzman writes. “To really understand where our health system may be headed, however, I suspect that Peter Drucker would have turned his gaze elsewhere: to ThedaCare.”

The secret of ThedaCare’s success: It uses Lean, a set of management principles originated by Toyota in the late 1940s to build cars.

“Drucker’s influence on the Toyota Production System was profound,” Wartzman writes, “and so it’s not surprising that he would have found much to admire in ThedaCare’s techniques.”

Among other things, ThedaCare has “created a culture of continuous improvement, with staff at all levels encouraged to ceaselessly experiment and then readily adopt what works, so that the bar is perpetually being raised.”

It also “puts the patient at the center of everything”; “rallies all of its employees around a small number of well-articulated strategic objectives”; and “flips the org chart on its head, with nurses and others traditionally at the bottom of the hospital hierarchy trusted—indeed expected—to do most of the innovating.”

If any of this sounds simple, Wartzman explains, it isn’t. Lean “is not a quick fix,” ThedaCare’s former CEO, John Toussaint, and Texas A&M professor Leonard Berry wrote in the journal Mayo Clinic Proceedings. “Rather, Lean is a cultural transformation that changes how an organization works . . . It requires new habits, new skills and often a new attitude throughout the organization.”