There's a great story out of the Seattle Post-Intelligencer this morning by Cherie Black on the innovation at Virginia Mason Medical Center in Seattle. Central to their work is the Toyota Production System, which seeks to eliminate wasted time and mistakes. It works with cars - what about health care?

Virginia Mason said benefits include an 85 percent reduction in how long patients wait to get lab results back, and $1 million savings on inventory costs.They've redesigned facilities to make patient and staff work flow more productive. The hospital reduced overtime and temporary labor expenses by $500,000 in one year and increased productivity by 93 percent. While direct cost savings aren't passed on to patients with the new system, less waiting, increased safety and more efficient care are.

(CEO Gary) Kaplan's vision is to have patients start their appointment in the parking garage with a smart card that triggers their entire appointment process. No more waiting rooms, just move directly from the garage to an examination room.

Total flow -- no waiting, no waste and it's all about the patient.

"We have more than enough resources in health care," Kaplan said. "We just need to stop wasting it and only do what's appropriate and value-added and we'd save billions."

Additionally, the Wall Street Journal's Vanessa Fuhrmans had a great article last year (subscription required) about how as the quality of care at Virginia Mason improved, their reimbursement worsened. As the piece states, they've begun to work with a limited number of employers on a reimbursement system that emphasizes high-quality care.

I first learned about Virginia Mason in fall 2006, when Kaplan testified before the Medicare Payment Advisory Commission (MedPAC), which advises Congress on Medicare policy. I found his testimony so fascinating (his starts on page 120 of the transcript; see page 131 for a great story on flu shots) that it prompted me to read The Toyota Way by Jeffrey Liker to understand "lean manufacturing." Liker's book (along with Michael Lewis' Moneyball) changed the way I think about how the world works. In a nutshell: life is full of assumptions, and many of them are wrong.