While this book has two co-authors, Mark Graban and Joe Swartz, we have
done our best to write in a single voice. Any work that we directly participated
in is written about in the third person to avoid confusion about who was writing
particular sections.
Franciscan St. Francis Health is a three-hospital system in Indianapolis.
Throughout this book, we will often refer to individual hospitals in this system
in an abbreviated form like “Franciscan.” That three-hospital system is part of
the Franciscan Alliance, a 14-hospital system located throughout Indiana and
Northeastern Illinois. Where we focus on one of their other 11 hospitals, we will
call them out uniquely, such as Franciscan St. Elizabeth Health.
How to Read This Book
Kaizen is a very nonlinear subject, so we expect readers will jump around and
even skip chapters, depending on their interests and their experience level with
Kaizen. The book is structured as follows.
Section 1: What Is Kaizen?
This section covers conceptual frameworks and the history of Kaizen, or con-
tinuous improvement, starting with other industries and moving into healthcare.
Chapter 1 sets the context, definitions, and core concepts of Kaizen, along
with some initial examples. Chapter 2 provides a brief historical overview
of continuous improvement and staff engagement efforts, including the last
25years in healthcare. Chapter 3 includes different types of Kaizen improve-
ments, including some of the frameworks used by hospitals around the world.
Chapter4 describes the cultural aspects of an organization that has fully
embraced continuous improvement.
xx ◾  Preface
Section 2: Kaizen Methodologies
This portion of the book shares specic methodologies for finding, initiating,
completing , documenting, and sharing Kaizen improvements. Chapter 5 covers
the Quick and Easy Kaizen methodology, especially as practiced by Franciscan.
Chapter6 details an alternative, but complementary, method called the Visual Idea
Board, as practiced by Childrens Medical Center (Dallas) and others. Chapter 7
includes many examples of Kaizen improvements from around the world, docu-
mented in different formats, further illustrating how Kaizen can benefit patients,
staff, andhealthcare organizations. Chapter 8 discusses the art of Kaizen, includ-
ing strategies for mobilizing support and working most effectively with others.
Section 3: Kaizen Lessons Learned
The final section covers lessons learned about the incredibly important role
of leadership and about creating broader Kaizen programs. Chapter 9 details
key mindsets and actions required by leaders from the charge nurses to the
CEO. Chapter 10 discusses key elements of an organization-wide Kaizen pro-
gram, taking Kaizen from a department to the entire healthcare enterprise, such
as a hospital or health system. Chapter 11 shares some of the broader Lean
methods that Franciscan has used to support its Kaizen approach and vice versa.
Chapter12 covers Franciscans encouragement of people to practice Kaizen in
their everyday lives.
Tips for Different Types of Readers
We think this book will be useful to readers in different ways, depending on
your role in your organization and your needs.
If you are a front-line staff member or supervisor looking to dive into
improvement right away, we suggest you read Chapter 1 as a brief introduc-
tion and then Chapter 5 on Quick and Easy Kaizen or Chapter 6 on Visual
Idea Boards.
Front-line or middle managers looking to create a departmental program may
want to also start by reading more about the culture and leadership aspects of
Kaizen, including Chapter 4 on culture, Chapter 8 on the art of engaging others
in Kaizen, and Chapter 9 on the role of leaders.
Executives looking for a quick overview could read Chapters 1 and 4, along
with Chapter 9 and Chapter 10 on organization-wide Kaizen programs.
Internal process improvement groups may also be most interested in
Chapters2 and 3, which give more historical context and depth about the
different types of Kaizen, along with Chapter 11, which discusses how core
Leanconcepts can be incorporated along with Kaizen.

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