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Lean hospitals : improving quality, patient safety, and employee engagement

Author: Mark Graban
Publisher: New York : Productivity Press/Taylor & Francis, 2012.
Edition/Format:   Print book : English : 2nd edView all editions and formats
Summary:
"The new edition of this Shingo Prize-winning international bestseller lays out a framework for defining and understanding Lean hospitals. It starts off by examining the challenges faced by hospitals, including rising costs, falling reimbursement rates, employee retention, and patient safety and satisfaction. Full of examples and case studies, the second edition has been updated to reflect current pressures on  Read more...
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Document Type: Book
All Authors / Contributors: Mark Graban
ISBN: 9781439870433 1439870438
OCLC Number: 773320522
Description: pages
Contents: Machine generated contents note: 1. The Case for Lean Hospitals --
Why Do Hospitals Need Lean? --
A Renewed Sense of Purpose --
Lean Methods Are Not New to Healthcare --
Toyota's Role in Popularizing Lean --
Origins of the Term Lean --
Lean Is Proven to Work Outside Automotive Factories --
Lean Is Helping Hospitals Improve --
Problems in Healthcare --
Price Pressures and Cost Challenges --
Coping with Employee Shortages --
Poor Quality of Care --
Good Quality Costs Less --
A Snapshot of Department Success: Laboratory, Children's Medical Center Dallas --
From Departmental to Hospital-Wide Success --
Conclusion --
Lean Lessons --
Points for Group Discussion --
Notes --
2. Overview of Lean for Hospitals --
What Is Lean? --
Ohno's Definition of Lean --
Lean Thinking --
The Toyota Triangle: Tools, Culture, and Management System --
Human Development --
Philosophy --
Technical Tools --
Managerial Methods --
The "Toyota Way" Philosophy --
Continuous Improvement --
Respect for People. Contents note continued: Four Organizational Capabilities for Lean --
Capability 1 Work Is Designed as a Series of Ongoing Experiments that Immediately Reveal Problems --
Capability 2 Problems Are Addressed Immediately through Rapid Experimentation --
Capability 3 Solutions Are Disseminated Adaptively through Collaborative Experimentation --
Capability 4 People at All Levels of the Organization Are Taught to Become Experimentalists --
Conclusion --
Lean Lessons --
Points for Group Discussion --
Notes --
3. Value and Waste --
Waste Is Not the Same as Cost --
What Is Waste? --
What Is Value? Start with the Customer --
How Do We Define Value? --
Rule 1 The Customer Must Be Willing to Pay for the Activity --
Rule 2 The Activity Must Transform the Product or Service in Some Way --
Rule 3 The Activity Must Be Done Correctly the First Time --
Examples of Value-Added and Non-Value-Added Activities --
Learning to Identify and Describe Waste --
Waste of Defects --
Waste of Overproduction. Contents note continued: Waste of Transportation --
Waste of Waiting --
Patients and Products Waiting --
Employees Waiting --
Waste of Inventory --
Waste of Motion --
Waste of Nursing Motion --
Waste of Overprocessing --
Waste of Talent --
What Non-Value-Added Activities Are Required? --
Non-Value-Added, Pure Waste --
Conclusion --
Lean Lessons --
Points for Group Discussion --
Notes --
4. Observing the Process and Value Streams --
How Do We Find Waste? Go and See --
What Is a Value Stream? --
Value Stream Mapping --
Creating a Current-State Value Stream Map --
The Future-State Maps --
Breaking Down Silos and Reducing Suboptimization --
Observing the Process --
Activity of the Product --
Activity of the Product---Laboratory --
Activity of the Employee --
Activity of the Employee---Nursing --
Activity of the Employee---Primary Care --
Activity of the Employee---Perioperative Services --
Conclusion --
Lean Lessons --
Points for Group Discussion --
Notes. Contents note continued: 5. Standardized Work as a Foundation of Lean --
The Need for Standardized Work --
The Toyota House Metaphor --
Overview of the Lean Foundations --
Lean Foundations: Standardized Work --
Definition of Standardized Work --
"Current" --
"Proper Outcome and the Llighest Quality" --
"To Safely Complete" --
"One Best Way" --
"Fewest Possible Resources" --
Standardized, Not Identical --
Written by Those Who Do the Work --
Considering How Long Tasks Take --
Staffing Based on Data --
Types of Standardized Work Documents --
Standardizing Daily Routines --
Defining Roles and Responsibilities --
Quick Changeover as Standardized Work --
Explaining Why through Standardized Work --
Standardized Work Documents and the Standardized Work System --
Measuring and Observing for Standardized Work Adherence --
"Resistance" to Standardized Work? --
Asking Why When Standardized Work Is Not Followed --
Standardized Work Can Apply to Physicians --
Lean and Checklists. Contents note continued: Standardized Work Can Apply to Managers --
Training through Standardized Work --
Conclusion --
Lean Lessons --
Points for Group Discussion --
Notes --
6. Lean Methods: Visual Management, 5S, and Kanban --
Lean Is More than Tools, but Tools Can Help --
Reducing Waste through Visual Management --
Examples of Visual Management for Patient Flow --
Examples of Visual Management to Prevent Process Problems --
5S: Sort, Store, Shine, Standardize, and Sustain --
First S Sort --
Second S Store --
Third S Shine --
Fourth S Standatdize --
Fifth S Sustain --
Safety as a Sixth S? --
Kanban: A Lean Approach to Managing Materials --
Problems with Traditional Materials Systems --
Trade-offs with Inventory --
Using Kanban to Replenish Supplies --
Conclusion --
Lean Lessons --
Points for Group Discussion --
Notes --
7. Proactive Root Cause Problem Solving --
The Mary McClinton Story --
Improving Quality and Patient Safety --
Cultural Obstacles to Quality Improvement. Contents note continued: Why Do Errors Occur? --
Violations and Errors, Lapses, and Slips --
Examples of Quality Improvement --
Finding Root Causes and Preventing Errors --
Workarounds and the Need for Fixing Root Causes --
Asking Why Instead of Who --
Start at the Gemba --
Find Root Causes Using Simple Methods --
A3 Problem Solving --
Be Proactive and Use Failure Modes and Effects Analysis --
Proactive Resolution of Neat-Miss Problems --
The Safety Pyramid --
Conclusion --
Lean Lessons --
Points for Group Discussion --
Notes --
8. Preventing Errors and Harm --
A Problem That Is Not Going Away --
Moving Beyond Blaming Individuals --
The Darrie Eason Case --
Creating Quality at the Source through Error Proofing --
Being Careful Is Not Enough --
Why 100% Inspection Is Not 100% Effective --
Types of Error Proofing --
Make It Impossible to Create the Error --
Make It Hatder to Create the Error --
Make It Obvious the Error Has Occurred. Contents note continued: Make the System Robust So It Tolerates the Error --
Error Proofing, Not Dummy Proofing --
Examples of Error Proofing in Hospitals --
Banned Abbreviations as Error Proofing --
Computer Systems as Error Proofing --
Preventing Surgery Errors through Error Proofing --
Stopping the Line {Andon) --
Error Proofing the Error Proofing --
Conclusion --
Lean Lessons --
Points for Group Discussion --
Notes --
9. Improving Flow --
Waiting: A Worldwide Problem --
Focusing on Flow --
Value Streams Should Flow Like a River --
Uneven Workloads as a Barrier to Flow --
Naturally Occurring Unevenness --
Mura Caused by Morning Rounds --
Mura Caused by Suboptimizing Courier Routes --
Mura Created by Clinic Scheduling --
Mura in the Patient Discharge Process --
Addressing Mura by Matching Staffing to Workloads --
Improving Patient Flow --
Improving Patient Flow in the Emergency Department --
Reducing "Door-to-Balloon" Time. Contents note continued: Improving Patient Flow in Outpatient Cancer Treatment --
Improving Flow for Ancillary Support Departments --
Improving Flow in Clinical Laboratories --
Reducing Delays in Specimen Collection --
Reducing Delays in the Receiving Areas of the Lab --
Improving Flow Also Improves Quality and Teamwork --
Reducing Delays Inside the Testing Areas of the Lab --
Improving Flow in Anatomic Pathology --
Improving Flow in Pharmacies --
Conclusion --
Lean Lessons --
Points for Group Discussion --
Notes --
10. Engaging and Leading Employees --
Changing How We Manage --
What Is a Manager's Role? --
Strategy Deployment --
Common Management Problems --
Lean as a Management System and Philosophy --
A Daily Lean Management System --
Process Audits or Rounding --
Standardized Audits of the Standardized Work --
A Hierarchy of Rounding --
Performance Measures --
Timely Measures Drive Timely Improvement --
A Balanced Scorecard Focuses on All Stakeholders. Contents note continued: Metrics Should Be Visible, Visual, and Statistically Meaningful --
Daily Stand-up Team Meetings --
Kaizen and Suggestion Management --
Problems with Suggestion Boxes --
The Role of Supervisors in Kaizen --
Finding a Better Method for Managing Kaizen --
Visual Tracking of Suggestions --
Communicating Kaizen Changes --
Conclusion --
Lean Lessons --
Points for Group Discussion --
Notes --
11. Getting Started with Lean --
How Do We Start? --
Where Do We Start? --
What Do We Call It? --
Types of Kaizen --
Kaizen Events --
Pitfalls of Kaizen Events --
Lean Transformation --
Executive Sponsorship and Leadership --
Starting from the Middle --
Establishing a Model Line and a Road Map --
Chartering a Project --
Dedicating Internal Resources: The Lean Team --
The Importance of Change Management --
A Snapshot of Hospital Success: Avera McKennan Hospital --
Conclusion --
Lean Lessons --
Points for Group Discussion --
Notes --
12.A Vision for a Lean Hospital. Contents note continued: Introduction --
When Is a Hospital Lean? --
What Would a Lean Hospital Look Like? --
What Would a Patient Experience in a Lean Hospital? --
What Would It Be Like to Work in a Lean Hospital? --
How Would We Describe a Lean Hospital? --
Strategy and Management System --
Patients --
Employees --
Waste and Kaizen --
Technology and Infrastructure --
Points for Group Discussion --
Notes.
Responsibility: Mark Graban.

Abstract:

"The new edition of this Shingo Prize-winning international bestseller lays out a framework for defining and understanding Lean hospitals. It starts off by examining the challenges faced by hospitals, including rising costs, falling reimbursement rates, employee retention, and patient safety and satisfaction. Full of examples and case studies, the second edition has been updated to reflect current pressures on hospitals, including the Affordable Care Act, and includes new and updated case studies. New material includes discussions on process audits, performance measures and suggestion management as well as a new chapter on strategy deployment"--Provided by publisher.

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Publisher Synopsis

Praise for the New Edition of this Shingo Prize Winner:"Whether it is the ThedaCare story ... Seattle Children's ... or Virginia Mason, the answer is in: Lean works. The question now for all of you Read more...

 
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    schema:description "Machine generated contents note: 1. The Case for Lean Hospitals -- Why Do Hospitals Need Lean? -- A Renewed Sense of Purpose -- Lean Methods Are Not New to Healthcare -- Toyota's Role in Popularizing Lean -- Origins of the Term Lean -- Lean Is Proven to Work Outside Automotive Factories -- Lean Is Helping Hospitals Improve -- Problems in Healthcare -- Price Pressures and Cost Challenges -- Coping with Employee Shortages -- Poor Quality of Care -- Good Quality Costs Less -- A Snapshot of Department Success: Laboratory, Children's Medical Center Dallas -- From Departmental to Hospital-Wide Success -- Conclusion -- Lean Lessons -- Points for Group Discussion -- Notes -- 2. Overview of Lean for Hospitals -- What Is Lean? -- Ohno's Definition of Lean -- Lean Thinking -- The Toyota Triangle: Tools, Culture, and Management System -- Human Development -- Philosophy -- Technical Tools -- Managerial Methods -- The "Toyota Way" Philosophy -- Continuous Improvement -- Respect for People."@en ;
    schema:description ""The new edition of this Shingo Prize-winning international bestseller lays out a framework for defining and understanding Lean hospitals. It starts off by examining the challenges faced by hospitals, including rising costs, falling reimbursement rates, employee retention, and patient safety and satisfaction. Full of examples and case studies, the second edition has been updated to reflect current pressures on hospitals, including the Affordable Care Act, and includes new and updated case studies. New material includes discussions on process audits, performance measures and suggestion management as well as a new chapter on strategy deployment"--Provided by publisher."@en ;
    schema:description "Contents note continued: Standardized Work Can Apply to Managers -- Training through Standardized Work -- Conclusion -- Lean Lessons -- Points for Group Discussion -- Notes -- 6. Lean Methods: Visual Management, 5S, and Kanban -- Lean Is More than Tools, but Tools Can Help -- Reducing Waste through Visual Management -- Examples of Visual Management for Patient Flow -- Examples of Visual Management to Prevent Process Problems -- 5S: Sort, Store, Shine, Standardize, and Sustain -- First S Sort -- Second S Store -- Third S Shine -- Fourth S Standatdize -- Fifth S Sustain -- Safety as a Sixth S? -- Kanban: A Lean Approach to Managing Materials -- Problems with Traditional Materials Systems -- Trade-offs with Inventory -- Using Kanban to Replenish Supplies -- Conclusion -- Lean Lessons -- Points for Group Discussion -- Notes -- 7. Proactive Root Cause Problem Solving -- The Mary McClinton Story -- Improving Quality and Patient Safety -- Cultural Obstacles to Quality Improvement."@en ;
    schema:description "Contents note continued: Metrics Should Be Visible, Visual, and Statistically Meaningful -- Daily Stand-up Team Meetings -- Kaizen and Suggestion Management -- Problems with Suggestion Boxes -- The Role of Supervisors in Kaizen -- Finding a Better Method for Managing Kaizen -- Visual Tracking of Suggestions -- Communicating Kaizen Changes -- Conclusion -- Lean Lessons -- Points for Group Discussion -- Notes -- 11. Getting Started with Lean -- How Do We Start? -- Where Do We Start? -- What Do We Call It? -- Types of Kaizen -- Kaizen Events -- Pitfalls of Kaizen Events -- Lean Transformation -- Executive Sponsorship and Leadership -- Starting from the Middle -- Establishing a Model Line and a Road Map -- Chartering a Project -- Dedicating Internal Resources: The Lean Team -- The Importance of Change Management -- A Snapshot of Hospital Success: Avera McKennan Hospital -- Conclusion -- Lean Lessons -- Points for Group Discussion -- Notes -- 12.A Vision for a Lean Hospital."@en ;
    schema:description "Contents note continued: Introduction -- When Is a Hospital Lean? -- What Would a Lean Hospital Look Like? -- What Would a Patient Experience in a Lean Hospital? -- What Would It Be Like to Work in a Lean Hospital? -- How Would We Describe a Lean Hospital? -- Strategy and Management System -- Patients -- Employees -- Waste and Kaizen -- Technology and Infrastructure -- Points for Group Discussion -- Notes."@en ;
    schema:description "Contents note continued: Make the System Robust So It Tolerates the Error -- Error Proofing, Not Dummy Proofing -- Examples of Error Proofing in Hospitals -- Banned Abbreviations as Error Proofing -- Computer Systems as Error Proofing -- Preventing Surgery Errors through Error Proofing -- Stopping the Line {Andon) -- Error Proofing the Error Proofing -- Conclusion -- Lean Lessons -- Points for Group Discussion -- Notes -- 9. Improving Flow -- Waiting: A Worldwide Problem -- Focusing on Flow -- Value Streams Should Flow Like a River -- Uneven Workloads as a Barrier to Flow -- Naturally Occurring Unevenness -- Mura Caused by Morning Rounds -- Mura Caused by Suboptimizing Courier Routes -- Mura Created by Clinic Scheduling -- Mura in the Patient Discharge Process -- Addressing Mura by Matching Staffing to Workloads -- Improving Patient Flow -- Improving Patient Flow in the Emergency Department -- Reducing "Door-to-Balloon" Time."@en ;
    schema:description "Contents note continued: Four Organizational Capabilities for Lean -- Capability 1 Work Is Designed as a Series of Ongoing Experiments that Immediately Reveal Problems -- Capability 2 Problems Are Addressed Immediately through Rapid Experimentation -- Capability 3 Solutions Are Disseminated Adaptively through Collaborative Experimentation -- Capability 4 People at All Levels of the Organization Are Taught to Become Experimentalists -- Conclusion -- Lean Lessons -- Points for Group Discussion -- Notes -- 3. Value and Waste -- Waste Is Not the Same as Cost -- What Is Waste? -- What Is Value? Start with the Customer -- How Do We Define Value? -- Rule 1 The Customer Must Be Willing to Pay for the Activity -- Rule 2 The Activity Must Transform the Product or Service in Some Way -- Rule 3 The Activity Must Be Done Correctly the First Time -- Examples of Value-Added and Non-Value-Added Activities -- Learning to Identify and Describe Waste -- Waste of Defects -- Waste of Overproduction."@en ;
    schema:description "Contents note continued: Why Do Errors Occur? -- Violations and Errors, Lapses, and Slips -- Examples of Quality Improvement -- Finding Root Causes and Preventing Errors -- Workarounds and the Need for Fixing Root Causes -- Asking Why Instead of Who -- Start at the Gemba -- Find Root Causes Using Simple Methods -- A3 Problem Solving -- Be Proactive and Use Failure Modes and Effects Analysis -- Proactive Resolution of Neat-Miss Problems -- The Safety Pyramid -- Conclusion -- Lean Lessons -- Points for Group Discussion -- Notes -- 8. Preventing Errors and Harm -- A Problem That Is Not Going Away -- Moving Beyond Blaming Individuals -- The Darrie Eason Case -- Creating Quality at the Source through Error Proofing -- Being Careful Is Not Enough -- Why 100% Inspection Is Not 100% Effective -- Types of Error Proofing -- Make It Impossible to Create the Error -- Make It Hatder to Create the Error -- Make It Obvious the Error Has Occurred."@en ;
    schema:description "Contents note continued: Waste of Transportation -- Waste of Waiting -- Patients and Products Waiting -- Employees Waiting -- Waste of Inventory -- Waste of Motion -- Waste of Nursing Motion -- Waste of Overprocessing -- Waste of Talent -- What Non-Value-Added Activities Are Required? -- Non-Value-Added, Pure Waste -- Conclusion -- Lean Lessons -- Points for Group Discussion -- Notes -- 4. Observing the Process and Value Streams -- How Do We Find Waste? Go and See -- What Is a Value Stream? -- Value Stream Mapping -- Creating a Current-State Value Stream Map -- The Future-State Maps -- Breaking Down Silos and Reducing Suboptimization -- Observing the Process -- Activity of the Product -- Activity of the Product---Laboratory -- Activity of the Employee -- Activity of the Employee---Nursing -- Activity of the Employee---Primary Care -- Activity of the Employee---Perioperative Services -- Conclusion -- Lean Lessons -- Points for Group Discussion -- Notes."@en ;
    schema:description "Contents note continued: 5. Standardized Work as a Foundation of Lean -- The Need for Standardized Work -- The Toyota House Metaphor -- Overview of the Lean Foundations -- Lean Foundations: Standardized Work -- Definition of Standardized Work -- "Current" -- "Proper Outcome and the Llighest Quality" -- "To Safely Complete" -- "One Best Way" -- "Fewest Possible Resources" -- Standardized, Not Identical -- Written by Those Who Do the Work -- Considering How Long Tasks Take -- Staffing Based on Data -- Types of Standardized Work Documents -- Standardizing Daily Routines -- Defining Roles and Responsibilities -- Quick Changeover as Standardized Work -- Explaining Why through Standardized Work -- Standardized Work Documents and the Standardized Work System -- Measuring and Observing for Standardized Work Adherence -- "Resistance" to Standardized Work? -- Asking Why When Standardized Work Is Not Followed -- Standardized Work Can Apply to Physicians -- Lean and Checklists."@en ;
    schema:description "Contents note continued: Improving Patient Flow in Outpatient Cancer Treatment -- Improving Flow for Ancillary Support Departments -- Improving Flow in Clinical Laboratories -- Reducing Delays in Specimen Collection -- Reducing Delays in the Receiving Areas of the Lab -- Improving Flow Also Improves Quality and Teamwork -- Reducing Delays Inside the Testing Areas of the Lab -- Improving Flow in Anatomic Pathology -- Improving Flow in Pharmacies -- Conclusion -- Lean Lessons -- Points for Group Discussion -- Notes -- 10. Engaging and Leading Employees -- Changing How We Manage -- What Is a Manager's Role? -- Strategy Deployment -- Common Management Problems -- Lean as a Management System and Philosophy -- A Daily Lean Management System -- Process Audits or Rounding -- Standardized Audits of the Standardized Work -- A Hierarchy of Rounding -- Performance Measures -- Timely Measures Drive Timely Improvement -- A Balanced Scorecard Focuses on All Stakeholders."@en ;
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<http://experiment.worldcat.org/entity/work/data/902279552#Topic/hospital_care_united_states_cost_effectiveness> # Hospital care--United States--Cost effectiveness
    a schema:Intangible ;
    schema:hasPart <http://id.loc.gov/authorities/subjects/sh2009126522> ;
    schema:name "Hospital care--United States--Cost effectiveness"@en ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/hospital_care_united_states_quality_control> # Hospital care--United States--Quality control
    a schema:Intangible ;
    schema:hasPart <http://id.loc.gov/authorities/subjects/sh2009126522> ;
    schema:name "Hospital care--United States--Quality control"@en ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/hospitals_administration> # Hospitals--Administration
    a schema:Intangible ;
    schema:name "Hospitals--Administration"@en ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/just_in_time_systems> # Just-in-time systems
    a schema:Intangible ;
    schema:name "Just-in-time systems"@en ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/juste_a_temps_systeme> # Juste-à-temps (Système)
    a schema:Intangible ;
    schema:name "Juste-à-temps (Système)"@fr ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/patients_etats_unis_securite_mesures> # Patients--États-Unis--Sécurité--Mesures
    a schema:Intangible ;
    schema:name "Patients--États-Unis--Sécurité--Mesures"@fr ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/patients_safety_measures> # Patients--Safety measures
    a schema:Intangible ;
    schema:name "Patients--Safety measures"@en ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/patients_united_states_safety_measures> # Patients--United States--Safety measures
    a schema:Intangible ;
    schema:hasPart <http://id.loc.gov/authorities/subjects/sh85098709> ;
    schema:name "Patients--United States--Safety measures"@en ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/qualitatsmanagement> # Qualitätsmanagement
    a schema:Intangible ;
    schema:name "Qualitätsmanagement"@en ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/soins_hospitaliers_etats_unis_cout_efficacite> # Soins hospitaliers--États-Unis--Coût-efficacité
    a schema:Intangible ;
    schema:name "Soins hospitaliers--États-Unis--Coût-efficacité"@fr ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/soins_hospitaliers_etats_unis_qualite_controle> # Soins hospitaliers--États-Unis--Qualité--Contrôle
    a schema:Intangible ;
    schema:name "Soins hospitaliers--États-Unis--Qualité--Contrôle"@fr ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/total_quality_management> # Total quality management
    a schema:Intangible ;
    schema:name "Total quality management"@en ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/total_quality_management_methods> # Total Quality Management--methods
    a schema:Intangible ;
    schema:name "Total Quality Management--methods"@en ;
    .

<http://experiment.worldcat.org/entity/work/data/902279552#Topic/total_quality_management_organization_&_administration> # Total Quality Management--organization & administration
    a schema:Intangible ;
    schema:name "Total Quality Management--organization & administration"@en ;
    .

<http://id.loc.gov/authorities/subjects/sh2008121881> # Hospitals--United States--Administration
    a schema:Intangible ;
    schema:name "Hospitals--United States--Administration"@en ;
    .

<http://id.worldcat.org/fast/1204155> # United States.
    a schema:Place ;
    schema:name "United States." ;
    .

<http://viaf.org/viaf/73337344> # Mark Graban
    a schema:Person ;
    schema:familyName "Graban" ;
    schema:givenName "Mark" ;
    schema:name "Mark Graban" ;
    .

<http://worldcat.org/isbn/9781439870433>
    a schema:ProductModel ;
    schema:isbn "1439870438" ;
    schema:isbn "9781439870433" ;
    .

<http://www.worldcat.org/title/-/oclc/773320522>
    a genont:InformationResource, genont:ContentTypeGenericResource ;
    schema:about <http://www.worldcat.org/oclc/773320522> ; # Lean hospitals : improving quality, patient safety, and employee engagement
    schema:dateModified "2018-12-07" ;
    void:inDataset <http://purl.oclc.org/dataset/WorldCat> ;
    .


Content-negotiable representations

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