Talk to the hospital board of director members. They redesigned the work by changing geographic location of things and by changing their routes, how teams were assigned, lot of things. Kaplan: …And there is the added impetus to cost escalation of new technology and the ever-increasing expectations of our patients. At the same time, there is a lower burden of work for our team members and lower costs. Being in healthcare is hard work.
But we have also very high false-positive rates. Kaplan: For a period of time we had our own health plan, from 1985 to 1997 — and that was a capitated plan. How are you doing in managing hospital infections? He envisioned the transformation of Virginia Mason Medical Center into the quality leader in health care and sought to lead the organization toward this vision. We have committed leadership at all levels of the organization, and not insignificantly we have a method. This sets up defects both from the upstream supplier of a process and the downstream recipient of the process.
The average age of inpatient nurses is about 48. I have a grandchild with another one coming, and I want them to have a better health-care system. We have a system that needs to be reformed, and is on the way to being reformed, assuming that the good things in reform are allowed to continue to develop over the next several years. He is very concerned about their health care, though he is also concerned about expenditures. Kaplan:: Sure, but I think that's true for internists like myself and other physicians as well.
The gap is so huge in this country and it is getting wider. Your doctor determines where you go, because of admitting privileges and insurance contracts. Kaplan: There are enlightened employers like Howard Schultz, for example, at Starbucks — he feels that every barista is entitled to healthcare and of course he and his management team are still very concerned about the line-item expense for healthcare. The health care delivery system today would never have been designed as it is. The purpose of the Virginia Mason Health System is to advance and support the healthcare and research missions of the Virginia Mason Medical Center and Benaroya Research Institute at Virginia Mason. This is the first piece of major social legislation ever passed in this country with not a single vote of the minority party, not a single vote. In the last year with data available, Virginia Mason Hospital had 22,722 emergency room visits, 15,543 admissions, performed 7,267 inpatient surgeries and 9,973 outpatient surgeries.
We have lots of testimonials from our residents over the last couple of years who have said they are much better prepared than other recent graduates because of what we were doing. Kaplan: Right and we know that commercial insurer payment rates usually shadow Medicare. We do this so we can give our managers, the frontline work unit managers, the tools they need to be effective leaders. He currently serves on the boards of the Institute for Healthcare Improvement, the American Medical Group Association Foundation, Medical Group Management Association Services , the Washington Healthcare Forum, The Seattle Foundation, the Special Olympics, and the Greater Seattle Chamber of Commerce. Every barista is entitled to health care. The Virginia Mason Production System is about designing great systems, but it is about surrounding great people with great systems.
There may be a trade-off between the virtues of focus and specialization, on the one hand, and the virtues of coordination across specialties and service lines, on the other. He completed his internal medicine residency at Virginia Mason and served as chief resident in 1980 and 1981. What value and outcomes are you getting in your community for the salaries you are paying your executives? There were perhaps 10% who were early adopters, 10% who were very resistant to any kind of change and probably 80% of the people—and I'm talking about physicians, nurses and others—in the middle, just sort of saying we'll see what happens and this too will pass. Kaplan: I think that for our clinical teams it was really a combination of factors. But we all need to be smarter about health care.
This is just one question posed by James C. We have one chart, one electronic health record, one integrated team. The second is that we set an organizational vision to become a quality leader not just in Seattle, but everywhere, when we created a new strategic plan in 2000. Kaplan: It's really about applying the systems engineering approach to care delivery. He is recognized as one of the most influential physician executives in health care.
Defensive medicine is not the cost major factor. Kaplan: Change is very, very hard in healthcare. Could you plug in any doctor and get the same result? We will be one of the pilot sites. That system is more highly reliable, has a lot less waste, and it is going to be much more attractive for drawing the best and brightest people into health care. What happens on weekends in hospitals. That is not even close.
So you need both the system and the highly talented people working in that system. Physician ownership of hospitals after December 2010 has been eliminated, and so there are a number of groups trying to get in under the wire. About 15 years ago the advertising agency we were working with at that time was helping us with messaging and developing a tagline. Who is going to ask about outcomes, readmission rates, infection control, necessary or unnecessary surgeries? Robinson: The Virginia Mason experience is the best example of the pathology of fee-for-service payment, which essentially levies a 100 percent tax on improvements and efficiency. How many readmissions do you have that may have been avoided? We did some work with Starbucks that made the front page of the Wall Street Journal in 2007, as an example. He completed his internal medicine residency at Virginia Mason and served as chief resident in 1980 and 1981.