Leandro Rocha Case

Virginia Mason Medical Center (VMMC), a private non-profit organization, was founded in 1920. Initially the medical center operates as a partnership that distributed the operating surplus among the physicians in annual bonus. In 1986 was restructured and the physicians sold their group practice to become employees. The physicians no longer carried the debt nor received the profits. VMMC started to face challenges, ardent competition and soon began to experience financial troubles. In addition, its employees were unhappy and the staff morale was declining. To aggravate the situation, the Institute of Medicine has published an estimate of patients who passed away due to medical errors in hospitals.

Dr Gary Kaplan, the CEO elected in 2000, had serious concerns about the survival of the medical center. He thought that they need to change or they won't survive in the future. He was trying to achieve change at VMMC, and his ambition was the transformation of VMMC into the quality leader in health care while keeping both the costumer in first plan and the center culture.

Dr Kaplan had the strategy, but he hadn't the tool to execute it. He proposed that VMMC follow Toyota Production System management method to restructure the way it manage its physicians, nurses and support staff. He felt the VMMC goals were similar to Toyota, especially putting the customer/patient first, focus on quality and safety, and a commitment to employees.