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On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry Hardcover – September 15, 2010

4.5 4.5 out of 5 stars 136 ratings
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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. Toussaint and Gerard prove that lean healthcare does not mean less care. On the Mend shows that when care is truly re-designed around patients, waste and errors are eliminated, quality improves, costs come down, and healthcare professionals have more time to spend with patients, who get even better care.
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  1. Print length
    181 pages
  2. Language
    English
  3. Publisher
    Lean Enterprises Inst Inc
  4. Publication date
    September 15, 2010
  5. Dimensions
    6 x 0.75 x 9.25 inches
  6. ISBN-10
    1934109274
  7. ISBN-13
    978-1934109274
  8. See all details
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Product details

  • Publisher ‏ : ‎ Lean Enterprises Inst Inc; 1st edition (September 15, 2010)
  • Language ‏ : ‎ English
  • Hardcover ‏ : ‎ 181 pages
  • ISBN-10 ‏ : ‎ 1934109274
  • ISBN-13 ‏ : ‎ 978-1934109274
  • Item Weight ‏ : ‎ 1.2 pounds
  • Dimensions ‏ : ‎ 6 x 0.75 x 9.25 inches
  • Customer Reviews:
    4.5 4.5 out of 5 stars 136 ratings

About the authors

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  1. John Toussaint

    John Toussaint

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    John Toussaint, MD, is the CEO emeritus of ThedaCare, a five-hospital system in Wisconsin, and the CEO of the ThedaCare Center for Healthcare Value. He was founding Chair of the Wisconsin Collaborative for Healthcare Quality and of the Wisconsin Health Information Organization, as well as the non-executive leader of the Partnership for Healthcare Payment Reform in Wisconsin. He has participated in many Institute of Medicine subcommittees, including most recently the Value Incentives Learning Collaborative and the CEO Checklist for High Value Healthcare.

    Dr. Toussaint's healthcare improvement work using Toyota Production System principles has been well documented in articles published in Health Affairs, the Harvard Business Review Blog, and Frontiers in Health Management. His work on payment reform and the transparency of provider performance data has been featured in The American Journal of Managed Care and the Commonwealth Fund publications, as well as news publications like The Wall Street Journal, the Milwaukee Journal Sentinel, and Healthcare Finance News.

    He has been a featured speaker at the Association for Manufacturing Excellence, The Agency for Healthcare Research and Quality, the Center for Medicare and Medicaid Services, The Shingo Prize, The Lean Enterprise Institute, the Institute for Healthcare Improvement and many international conferences. His groundbreaking first book, On the Mend, Revolutionizing Healthcare to Save Lives and Transform the Industry, was recently awarded the 2012 Shingo Research and Publication award. It shows how healthcare can be fundamentally improved at the point of delivery to patients using the proven principles of lean management. His just released second book, Potent Medicine, The Collaborative Cure for Healthcare, describes the three core elements necessary to transform healthcare and deliver better value: delivery of care designed around the patient; transparency of treatment quality and cost; and payment for outcomes. Learn more at ManagementontheMend.org.

    See more on the author's page
  2. Roger Gerard

    Roger Gerard

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    Roger A. Gerard, PhD, is the Chief Learning Officer for ThedaCare. He has been with ThedaCare since 1991. He specializes in executive and management development, process improvement, and the use of lean methodologies in bringing about significant and measurable organizational improvement. Dr. Gerard has over 35 years of experience leading executive and management development initiatives, focusing specifically on organizational performance improvement processes. In addition, he has his own management consulting business and creative photography/illustration business that he shares with his wife, Debra.

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Customer reviews

4.5 out of 5 stars
4.5 out of 5
136 global ratings

Top reviews from the United States

Jim Levett
5.0 out of 5 stars Review of On the Mend by John Toussaint and Roger Gerard
Reviewed in the United States on July 8, 2010
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I read this book over the weekend on my Kindle. It is a clear and understandable presentation of using lean in healthcare. The book describes the story of how ThedaCare, a health system in northeasten Wisconsin, transformed itself by studying, planning, and implementing lean principles over the course of several years. The successes as well as the challenges are described, and the authors stress the importance of leadership commitment, practical training, continuous learning, and trusting in the process. ThedaCare is well recognized for its contributions in establishing a lean culture in a major healthcare system, and this book is an interesting and incisive summary of the work that they have done.
2 people found this helpful
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4.0 out of 5 stars More of a management advice book about lean management, than about healthcare per se
Reviewed in the United States on April 7, 2013
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This book is fine, as long as you know what you're getting. It is less about healthcare as such, and more about the application of lean manufacturing and management principles in the healthcare context (although the way the book is written, it could just as easily be applied to any other industry). If you are looking for a book on how to apply lean principles, this book is for you. Actually, I take that back - this book is really more of a cheerleading, or encouragement, to adopt lean principles, than it is a how-to. It is inspirational, more than instructional. And it really is not about the healthcare industry generally, although obviously the benefits to healthcare would be tremendous if the principles described here were applied more broadly throughout the healthcare system. Again, a fine book if you know what you are buying, but it wasn't exactly what I expected...
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-CABT
5.0 out of 5 stars Well written, fascinating story
Reviewed in the United States on March 31, 2011
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On the Mend was a great introduction to the world of efficiency and quality in healthcare, with all its ups and downs. It was well written, the story was engaging - easily accessible to someone not a medical insider and would also be very accessible to someone unfamiliar with business process analysis (in this case, lean). Jargon was avoided and concepts were explained briefly but well. Loved the process maps at the end. An inspiring journey! Who knew health care reform could be uplifting?
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Timothy Pettry
5.0 out of 5 stars Real Healthcare Reform
Reviewed in the United States on June 15, 2010
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I couldn't wait for this book to come out as I was somewhat familiar with the ThedaCare story through articles and other media outlets. Rather than wait for the book to be shipped, I downloaded it using the Kindle for PC option. I devoured this book in a few hours, however I will be studying it for many more.

I was most impressed with the ThedaCare team's demonstration of two key principles of lean - Respect for People and Humility! This book should open the eyes of healthcare leaders and politicians alike in seeing the possibilities of lean (Continuous Improvement) in lowering costs in healthcare, while improving quality of care, patient satisfaction and employee engagement.

I appreciated the honesty in admitting past mistakes and the candor used in how those mistakes were corrected. For example, one of the many key points made in Chapter 5 - Continuous Improvement, while speaking of past attempts at improvement, "In the end, we saw the enemy of our improvement efforts and it was us...Improvements ended when the project was over because nobody was in charge of sustaining change and measuring results." "Looking back at the best of the failed improvement programs, there are two repeating themes: empowering staff-the doctors, nurses, and managers actually doing the work - and measuring results. Without a method, these necessary attributes are nearly impossible to hard-wire into the daily habits of staff. Continuous improvement is that method." This observation demonstrated to me that the leadership at ThedaCare had been through the hard work and had learned that there are no shortcuts to improving.

It is time for the rest of us in Healthcare to step up and be the change we all want to see and not wait for change to happen to us. Congratulations and thanks to John, Roger and the rest of the the Thedacare team for being the pioneers and sharing their experience with the rest of us.
16 people found this helpful
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NICOLE O.
5.0 out of 5 stars Case studies make this an easy, quick read
Reviewed in the United States on May 29, 2013
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The book provides great examples for how to apply the LEAN concept to a hospital setting. Even if you are a different type of health care provider, I think it helps one see how a different way of looking at Value can help us re-imagine care delivery in any setting. Lots of useful nuggets of information.
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Richard A. Jordan
4.0 out of 5 stars Nothing is as easy as proponents would have one believe
Reviewed in the United States on August 11, 2017
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Well balanced and readable for the average individual interested in the transformational journey of a healthcare organization from a hodge-podged run of the mill provider to one of the leading healthcare organizations in the United States. An honest assessment of transformational theory and practice. Nothing is as easy as proponents would have one believe, yet nothing is inherently impossible to achieve with the right leadership in place.
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@BobbyGvegas
5.0 out of 5 stars A welcome cut-to-the-chase book
Reviewed in the United States on July 23, 2010
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I have to agree with another reviewer that the real-life examples of patients' experiences with the system make the book particularly compelling. I do workflow assessment and redesign for EHR adoption support for one of the new federal RECs (see [...]), and I'm a long time ASQ member and QI operative. This is the best yet of the many I have read on the topic of Lean applicability to health care. I think this book should be widely read by the lay public, rather just another swell preach-to-the-QI-choir tome.

As a tech matter, they had me at page vi in the Foreword: "Lean transformation is all about Dr. Deming's Plan Do Study Act (PDSA), otherwise known as the scientific method."

Ding, ding, ding, we have a winner. IMO, God created Dr. Deming, whereupon She rightfully rested. Much that has followed (e.g., "Six Sigma") is mostly about affixing fancy new labels to bottles of venerable fine wine. Had I the money, I'd buy a copy of this book for everyone in my company, and for all of my family and friends.
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Larue, francois
3.0 out of 5 stars Good reading for any healthcare organisation desiring to go on a continuous improvement program.
Reviewed in the United States on May 15, 2013
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Reflects the reality of most healthcare organisations and identifies the must have elements that will insure a certain success. Even while proving that it can work, they still have some ways to go to reach all sectors of operations, proving that resistance to change is most certainly a worthy factor to consider
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Amazon Customer
5.0 out of 5 stars Worth the read.
Reviewed in Canada on August 14, 2016
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Well written and addresses current managerial concerns.
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Reivaj
5.0 out of 5 stars Lean ist universell umsetzbar
Reviewed in Germany on August 26, 2014
Verified Purchase
Inspirierend, auch im Gesundheitswesen kann Lean umgesetzt werden zum Gewinn für Spitäler, Patienten und Mitarbeiter. Wer hätte dies jemals bei Toyota gedacht. Empfehlenswert für alle jene, die aus den üblichen Krankenhäuser, funktionierende Spitäler gestalten will. Insbesondere CEOs und leitende Angestellte.
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Oli Doyle
5.0 out of 5 stars Great read
Reviewed in Australia on December 25, 2015
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This is a great overview for anyone wanting to translate TPS into the health/human services field. It combines real stories with theory and is light on Japanese.
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