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The Lean Prescription


  • Author
    Dr. Patricia Gabow & Philip Goodman

Powerful Medicine for Our Ailing Healthcare System Dr. Gabow, former CEO of Denver Health of 20 years, teamed up with Philip Goodman, a 34-year veteran of Denver Health who directed the Lean System group, to share their Lean journey in The Lean Prescription: Powerful Medicine for Our Ailing Healthcare System. Readers can look forward to this honest story of how Gabow led Denver Health to become the first healthcare organization to be awarded the Bronze Medallion Shingo Prize for Operational Excellence. The book details the foundational Lean principles and concepts and provides a "How To" book on applying Lean in from the experience of an integrated healthcare system's successful seven year Lean journey. This book grew out Gabow’s 40 years' experience as a practicing physician, teacher, researcher and leader of a large, urban public healthcare system. About ten years into her twenty years as CEO of the healthcare system, she became increasingly convinced that while there were new drugs and technologies, healthcare was provided in the same way it was when she was an intern more than 40 years earlier. When she shared this concern with her physician colleagues, one common response was, "We are doing things the same way because it must be the right way." All you had to do to know that wasn’t true was watch the activity in any clinic or on any hospital unit. No one would have consciously designed the work the way it was being done. Therefore, she began to look at how one could actually make healthcare work right. Was there some "medicine" out there that healthcare could "take" that could "heal" its current dysfunction? After a year of study, she and her team concluded that Lean was exactly what healthcare needed. And the seven year Lean journey at Denver Health proved this to be correct. Lean was the medicine and the financial, quality and employee engagement results were amazing: The quality of care achieved was impressive, particularly given the vulnerability of the population served. Denver Health achieved an observed to expected mortality of almost 0.5, the lowest among the academic health center members of the University Health System Consortium in 2011. The financial results were equally impressive. Denver Health realized almost $200 million of well-documented, hard financial benefit over seven years, $50 million in 2012. Employees enthusiastically embraced Lean. Eighty-three percent of Denver Health's employees affirmed that they understood how Lean helped us maintain our mission. There are few, if any other approaches, that hit the target on quality, cost, and employee empowerment. In Gabow's decades in healthcare, she tried many approaches to reducing cost and increasing quality but Lean was the most powerful approach to improvement and engagement. The authors hope others are inspired by this true story of transformation.
About the Shingo Institute

Housed at the Jon M. Huntsman School of Business at Utah State University, the Shingo Institute is named after Japanese industrial engineer Shigeo Shingo. Shingo distinguished himself as one of the world's thought leaders in concepts, management systems and improvement techniques that have become known as the Toyota Business System. Drawing from Shingo's teachings and years of experience working with organizations throughout the world, the Shingo Institute has developed the Shingo Model™ which is the basis for several educational offerings including workshops, study tours and conferences. It also awards and recognizes organizations that demonstrate an exceptional culture that continually strives for improvement and progress. Those interested in more information or in registering to attend the 30th International Shingo Conference may visit