Posted by: Knightbird | January 7, 2011

One Reaction to Lean Management

Lean Management is a difficult sell to people. I want to share an email exchange with you, and the response I wrote to help the sender understand my thinking. I have Xed the sender’s name out.

To: Patrick Anderson

Subject: RE: Xxxxxx Xxxxxxx

What are you trying to do with our current health care system? It might also be about our culture?

Do you represent Toyota?

Again thank you,

Xxxxxxx Xxxxxxx


Your question is a valid one and one that I have had to respond to for the past 6 years. I usually let our results speak for them selves. So far, we are unique in Alaska. My board of directors, which consists of 7 members from our Villages, approved our adopting Lean Management as our system, and they are very happy with the results.

Every Native Health Care system in Alaska other than Chugachmiut uses the management system that was used by the Ford Motor Company, and modified by General Motors CEO Alfred Sloan in the 1920’s. By using our management system, which was developed by Toyota (and I do not represent Toyota, but respect their leadership), Chugachmiut has greatly improved our health care system while integrating and respecting our culture. This same management system is used by the greatest hospitals in the United States, including Virginia Mason in Seattle, Beth Israel Deaconess in Massachusetts (connected with Harvard University), Sutter Health Corporation in California, and many others. My philosophy is that my patients deserve the best health care that we can provide, and this management system provides us with the tools we need to do that. My staff is patient focused, and using the 2 key principles of the Lean Healthcare Management System, Respect for People and Continuous Improvement, we have made a tremendous difference for our people. Let me explain this a little bit further.

I was a boy in Cordova who went to college and law school, then came back to work for my people here in the Chugach region. In my current health care system, we now have a Physician that we didn’t have 7 years ago. Our patients can get an appointment on the day they want it, including today. When they go to our clinic, their visit from start to finish averages 33 minutes, and they get all of their questions answered. We have had fewer than one complaint every 2 months, and we get compliments all the time. Our clinic in Seward is the cleanest and most sanitary clinic I have ever visited. Our medical staff spend a week in each village (they go out for one week of each month) so they can get to know our people and our culture. We now have a dental program that also goes to our villages, and we have achieved cavity free status in one of our villages. All 55 residents of the village have had all of their teeth restored, and their dental health is improving. We have built 2 new clinics for our 4 villages in the past 7 years. We have 11 Community Health Aides for our 1,300 patients, and 8 of them are certified at the CHAP level, the highest attainable. We have a pharmacist who also travels to our villages and works with all of our patients to ensure that their medication is appropriate and timely delivered. We have an Electronic Health Record system in place and working. We have developed a behavioral health system that has 10 employees providing substance abuse, social work and behavioral health counseling services for our 1,300 clients. The Alaska Native Tribal Health Consortium has used some of our management techniques to improve some of their services.

My employees are very happy using the Lean Management system because it gives them the tools to improve the processes they use to serve their patients, clients, customers and beneficiaries. We have a very high level of employee satisfaction, and people are actually looking to work for us. I have employees who left for other jobs, and have been trying to return-one for almost 2 1/2 years. My board, staff and tribal leadership are excited about the potential that our Restoration to Health strategy holds for reducing the problems we face as a culture, including suicide, substance abuse, depression, domestic violence and a host of others. We are thinking and working every day to find the cause for the problems Native people face so we can propose a solution.

I know that we need to answer the questions asked by caring people like you about our plan and why we believe it will help. Not everyone believed me when I started with Lean Management at Chugachmiut, but I have no skeptics on my board or my staff. We believe we can make a difference in the lives of our people, passionately.

Again, thank you for your passion to improve conditions for our people.


  1. One Reaction to Lean Management « Lean in Alaska Blog…

    Here at World Spinner we are debating the same thing……

  2. Dear Patrick,

    Great post both as way to explain what you try to do at Chugachmiut and as a way to show respect to those who think differently (because of their own perspective and paradigm).

    I will share you’re story with the people here in The Netherlands, trying to do the same.
    Kind regards,
    Arnout Orelio

  3. […] This post was mentioned on Twitter by Mark Graban. Mark Graban said: Great blog post from Patrick Anderson on #lean healthcare in Alaska […]

  4. Dear Patrick,

    You can not give a more respectful and detailed response to the one you made. You have nailed all the points “right on the nose. ”

    Good luck on your journey to Lean Management and more power to your team.

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