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Quality Improvement

Virginia Mason is recognized internationally for the Virginia Mason Production System (VMPS), a management method that seeks to continually improve how work is done. VMPS is based on the Toyota Production System, a manufacturing approach that Toyota has developed and used for more than 50 years to produce some of the world̠s best automobiles. VMPS empowers frontline staff to prevent errors as well as identify and eliminate waste in patient care.

Because of the work done to increase efficiency in Virginia Mason's health care delivery system, residents spend more time engaging with patients and their families. Emphasis is placed on patient care, rather than completion of more menial tasks. Behind the inscrutable Japanese terminology and relentless focus on reducing waste adopted by Virginia Mason, there is a highly effective mechanism of change that strives to make our medical center an incredible place to work. View our VMPS fast facts »

Having participated in many QI projects within medicine prior to residency, I spent time studying Virginia Mason’s unique commitment and approach to quality improvement. This was one of the primary reasons for my being drawn to Virginia Mason; the LQIP allows residents to take ownership over key facets of how we optimize care for our patients.

Alex Kettering, MD

Virginia Mason has been nationally recognized as a quality leader in patient experience, health outcomes, LGBTQ health care equity, patient safety and more. Virginia Mason was one of 105 hospitals designated The Leapfrog Group̠s highest rating for patient safety in 2020, and we are one of only 29 hospitals in the United States to have received this designation all 18 years of the program̠s existence. U.S. News and World Report also recognized Virginia Mason as the No. 2 hospital in Washington state in 2021. View our other quality awards.

Virginia Mason has earned these recognitions by instilling quality improvement into our everyday work. Our daily workflows reflect our deep dedication to patient care, safety, and high-quality outcomes. Residents in our program benefit from continuous system improvements, such as evidence-based note templates, order sets, and glycemic control graphs. In addition, residents direct and manage quality improvement initiatives, becoming well versed in tools such as root cause analysis and PDSA (plan-do-study-act) cycles. Instead of accepting the status quo, our graduates ask questions such as "why is this happening? and how can this be done differently? The culture at Virginia Mason is one that seeks to transcend the status quo. In our program, residents embody critical thinking, creativity, and evidence-based approaches to patient-centered care.

I participated in a Kaizen event to improve our clinic flow at the Eastgate Public Health clinic, and with great success. I was impressed with this process of quality improvement and decided to join the pathway to learn more about it and apply it to not only my professional career but also my personal life.

Quan Truong, MD

Opportunities to get involved in quality improvement

Through the Systems-Based Practice elective, residents learn about quality improvement through the lens of VMPS. Residents learn basic tools and concepts of VMPS, experience VMPS in action by shadowing in several quality-focused departments at Virginia Mason, and participate in major system-wide improvement efforts through week-long rapid process improvement workshops (RPIW) or more focused, two-day “Kaizen” events. These experiences provide more in-depth exposure to VMPS methodology. One resident was even able to align her involvement in a lower GI bleed workshop with future career plans in gastroenterology.

Residents report issues with patient safety (called “patient safety alerts”) and assist in their resolution. Several resident ideas have been implemented, including creating a “no AM labs” order to reduce unnecessary lab draws and using messaging within the EMR to reduce the volume of pages. There are also plenty opportunities in clinical informatics — the use of technology to improve patient care.

Leadership in Quality Improvement Pathway

The Leadership in Quality Improvement Pathway (LQIP) is open to both categorical and primary care residents and is an unparalleled opportunity for residents to become innovative leaders in health care. The LQIP is a longitudinal curriculum composed of protected time focused on specific classes and didactics in quality improvement, leadership, and change management. It is a curriculum that includes meetings with Virginia Mason's senior leadership teams and participation in quality improvement events. Residents gain experience in VMPS methodology under the guidance of mentors who are experts in VMPS - identifying and eliminating waste in order to develop a value stream map, lead innovation exercises, and promote change. The pathway ultimately culminates with a personalized quality improvement project that affords residents the opportunity to design and implement a capstone quality improvement project within the medical center, using the tools and principles obtained throughout their tenure. Learn more about the Leadership in Quality Improvement Pathway.

In reality, how you train in residency has the biggest impact on how you practice long-term. Training in a culture where process improvement is assessed in every aspect of care delivery, from timing of antibiotics to patient food delivery to eliminating waste in the billing department (my first Kaizen experience), sets the tone for your career. Better never stops!

Jackie Lemon, Chief Resident 2020-2021