Corner office: Virginia Mason Health System Chairman and CEO Dr. Gary S. Kaplan on relentlessly fighting waste and what he learned working in a hardware store

Providing high-quality healthcare requires a balance between clinical expertise, technical management systems and effective communication. Gary S. Kaplan, MD, a self-proclaimed "optimistic extrovert," wants his health system to ace each of these elements.

Dr. Kaplan took the helm of Seattle-based Virginia Mason Health System as chairman and CEO in 2000. A board-certified internist, he also practices medicine at Virginia Mason, where he completed his residency and served as chief resident in 1980 - 1981.

Over the last 16 years, Dr. Kaplan has shepherded his organization through significant change — culturally and clinically. Virginia Mason's gary kaplanculture values teamwork and actively seeks to eliminate waste. Under Dr. Kaplan's leadership, the health system adopted the Virginia Mason Production System, inspired by the lean methodology in the Toyota Production System, in 2002. Since then, the hospital has recorded improvements in patient outcomes and waste reduction. For instance, using VMPS principles, the health system was able to increase the amount of time nurses spent with patients to 90 percent, compared to 35 percent prior to instituting VMPS and the nurse-designed new processes. Care is also safer as a result of the establishment of the Patient Safety Alert system, which requires all staff to immediately report and cease any activity that is likely to harm a patient.

In addition to his tenure at Virginia Mason, Dr. Kaplan is chair of the Institute for Healthcare Improvement Board of Directors and chairman of the National Patient Safety Foundation Lucian Leape Institute. He is also a founding member of Health CEOs for Health Reform and has held leadership roles with various other organizations, including the Medical Group Management Association and the Washington Healthcare Forum. 

Here, Dr. Kaplan took the time to answer our seven questions.

Note: Responses have been lightly edited for length and clarity.

What's one thing that really piqued your interest in healthcare?

I grew up working in my father's hardware store. I really enjoyed talking to customers and relating to people. When I was a teenager, one of our customers — a primary care physician — offered to take me on rounds at the hospital where he worked. From there, I really fell in love with the profession of medicine and the opportunity to interact with people and help them during their most vulnerable moments. It's a real privilege for patients to let us into their lives during those personal times. Every day I am inspired by our patients as well as our team members who work continuously to improve the patient experience, quality and safety of our hospital.

What do you enjoy most about Seattle?

My wife and I moved here from Ann Arbor about 38 years ago. After just a month or two here, we loved the Northwest. We knew it was the right place for us. It's a great place to raise a family. There is so much natural beauty, and the recreational pursuits the Pacific Northwest has to offer are really aligned with the things we love to do. But most importantly, it is the intellectual vibrancy of the community. There is a strong spirit of innovation, with many pioneering companies nearby: Amazon, Microsoft, Starbucks, Boeing — companies changing the world. It's a very exciting place to be.

If you could eliminate one of the healthcare industries problems overnight, which would it be?

This should come as no surprise to people who know me and our work at Virginia Mason, but it's waste. Healthcare is full of waste. The lowest estimate I've seen recently is waste accounts for 30 percent of what we do and how we spend our precious resources in healthcare. That waste comes in many forms, such as wasted time and diagnostic procedures and tests. We believe that by using the Virginia Mason Production System, we can identify and eliminate waste in a very systematic way.

What's so exciting is doing this results in higher quality, safer care and a better patient experience. At the same time, there is a lower burden of work for our team members and lower costs. The mythology that you have to pay more to get better quality has gone by the wayside. By relentlessly and systematically focusing on eliminating waste, we can make healthcare better, more affordable and safer.

What do you consider your greatest talent or skill outside of the C-suite?

I believe this is applicable in the C-suite, but I would say I am an optimistic extrovert who derives tremendous energy from interacting with people. Maybe that skill began to develop working in the hardware store beginning at age five, but I love people, engaging in dialogue — including challenging conversations, debate and discussions that bring in diverse opinions. I'm good at synthesizing, guiding others to find common ground and translate that into action, whether in my personal life dealing with friends and family or at work. It's something I've worked hard to be good at.

How do you revitalize yourself?

I have a lot of things I enjoy doing. First and foremost, I love spending time with my wife and family, particularly my grandchildren now, who are seven and five. It is during that time that you have to be present. One of the key things is finding activities that allow you to check out for periods of time. I'm never without my work — it's a 24/7 job — but I've gotten good at compartmentalizing in a way that allows me to be present with family. My wife and I enjoy going for hikes, cycling, skiing and traveling.

What's one piece of advice you remember most clearly?

Tell the truth. If you tell the truth you don't have to remember who told you what. I think that's critically important in our industry. You have to shine a bright light on both the challenges and the opportunities we have. A lot of leaders aren't necessarily willing to shine a bright light on their weaknesses, but I find that by telling the truth about the current state, people find that very refreshing and it allows us to get on with meeting the challenges and opportunities presented to us.

What do you consider your greatest achievement at Virginia Mason Medical Center so far?

I think it's been about transforming our culture. Over the past 20 years, we've been creating a culture truly designed around our patients with a relentless pursuit of quality and safety. This culture is founded on the belief that teamwork and integration is the better way to deliver care. Courageously, our team has brought a new management system from outside healthcare into the organization. We are in our 15th year of applying the Toyota Production System to healthcare. It is quite profound and exciting to see what's possible when we're willing to break out of our comfort zone.

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