
xi
Foreword
Donald M. Berwick, MD
President Emeritus and Senior Fellow
Institute for Healthcare Improvement
In the spirit of innovation, I was tempted to write the shortest Foreword ever. If I
had done so, it would be this:
If you are in health care and this book doesn’t scare you, you are not paying attention.
But I could not find the courage, so, read on.
Let’s start with the overall theme: “Lean inking and Innovation.” At first
impression, that is oxymoronic. Lean thinking invests deeply in standardization;
wake up a Virginia Mason Production System expert suddenly at night, and he is
likely to mutter something about “standard work.” Innovation is ...