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Confidential Sources Say Salem Health Spending $2.5 Million on Japanese Training

March 2, 2012 -- With all the hubbub about Salem Health announcing cutbacks of $30 million recently, it’s interesting to ask what a health system in the Mid-Willamette Valley can learn from a car company in Asia? According to Salem Health Chief Executive Officer, Norman Gruber, whatever it is, it’s worth the trip.
March 2, 2012

March 2, 2012 -- With all the hubbub about Salem Health announcing cutbacks of $30 million recently, it’s interesting to ask what a health system in the Mid-Willamette Valley can learn from a car company in Asia? According to Salem Health Chief Executive Officer, Norman Gruber, whatever it is, it’s worth the trip.

“For sure, this trip was an experiment,” Gruber said on a video posted to the Salem Health website news page. “Clearly it was absolutely worth going.”

According to the video, in October a “diverse group of hospital staffers” traveled to Japan for an immersion experience in Kaizen, the Japanese term for continuous improvement. Based on recommendations from organizations across the country, Salem Health leaders believed that it was important to see Kaizen first hand.

“We talked to a lot of healthcare providers who had gone, other industries that had gone and said you won’t believe it until you see it,” said Cheryl Nester Wolfe, Salem Health Chief Operating Officer, who also appeared on the video.

In the summer of 2009, the Salem Health Board of Trustees committed to a new management system based on the Toyota Production System. According to Beverly Bow, Salem Health’s Senior Vice President for Kaizen, in an article she wrote for the Oregon Healthcare News, the board’s decision resulted from a commitment to improve the patient experience and improve quality while reducing the cost of care.

“Our board’s decision was to implement the Salem Health Production System, based on Toyota’s model, and to enter into a five-year contract with John Black and Associates from Seattle to guide us on our journey.” Bow wrote. “The next five years will give us enough experience to be able to continue the work on our own, although it will take closer to twenty years to fully embed the system in our culture.”

According to confidential sources who spoke to The Lund Report, the cost of those five years of experience is $2.5 million a year, a number that has never been confirmed by the hospital. Bow and Salem Health spokesperson, Sheryll Hoar, did not respond to questions about exactly how that $2.5 million is being spent, other than the dollars for the contract with John Black and Associates and trips to Japan.

According to Bow’s article, over the course of the contract, each of Salem Health’s leaders will complete “lean leader certification” through John Black and Associates. This certification involves an intensive course of study including travel to Japan for a two-week immersion in organizations that use the Toyota Production System. In October 2010, as reported by The Lund Report, Salem Health sent its first round of leaders to Japan.

“I think taking groups away to have that kind of experience, wherever that might be I think is an absolutely critical element in this,” Gruber explained via the video. “It gives us a framework now that we can say what can we gain from that? What parts of that do we want to continue down the road? I think we’re still evaluating that issue.”

It’s unclear what changes have resulted, or what money has been saved, from the Salem Health Production System thus far although Nester Wolf points to Salem Health’s Emergency Department as an example of a recent transformation.

“Today we’re a top performing organization in our Emergency Room,” Nester Wolfe noted. “That I believe is this engagement, this collaboration, this change in the way that we look at our patients and manage them, our intensity of service.”

Both Gruber and Nester Wolfe believe the real evidence of change will take time, that the Salem Health Production System will evolve over the long haul. They also believe that it will require everyone’s involvement from front line staff to Gruber himself.

“Everybody owns the change,” said Nester Wolfe. “So you get much deeper change that way. It’s not quick. But it’s not intended to be quick, and I think that’s been a mistake in healthcare is to do things too fast.”

In the video, Gruber was clear in his commitment to the Salem Health Production System. “I’m committed and I believe our leadership is committed, our board is committed to this very long journey,” he said.

To read the story about the $30 million in cutbacks and the disciplinary action faced by Salem Health because it did not file documents with the Oregon Department of Justice or request an extension, click here.


Submitted by Anonymous (not verified) on Sun, 03/04/2012 - 21:10 Permalink

Health care reforms of, by and for the corporations. Health care, like education, is a business of course. Kris Alman
Submitted by Anonymous (not verified) on Wed, 03/07/2012 - 13:00 Permalink

It's interesting that they tried to get out of the contract with John Black and Associates yet still forge ahead with the outpouring of money into a process that remains largely on a need to know basis and unengaging with the general staff. I think they forge ahead to save face with the Board of Trustees; if they were to admit it was a mistake, Gruber would be looking for a new job.
Submitted by Anonymous (not verified) on Thu, 03/08/2012 - 10:32 Permalink

Your link in this article is broken. The correct link is:!news.12062011_lean Brian Ahier
Submitted by Anonymous (not verified) on Thu, 03/08/2012 - 10:41 Permalink

With so many organizations using Kaizen right now, did they really need to go all the way to Japan to learn about it? What a poor use of judgement!
Submitted by Anonymous (not verified) on Thu, 03/08/2012 - 17:13 Permalink

It is very clear at this time, that Mr Gruber can and will do any/everything he wants, and he will never be terminated. There is a global no confidence in Mr Gruber currently, but that does not seem to make any difference. Oh well. Sigh.
Submitted by Anonymous (not verified) on Fri, 04/13/2012 - 10:02 Permalink

They been told how they are going to come to each Dept. and ask the employee,s what they think will improve and save money for the hospital. this board of directors is just as much a joke as I the administration as they rubber stamp everything. I have never seen as many Doctors and employee,s scared for their jobs . The arrogance that the administration has for everyone is truly amazing. They do not care about state or federal laws and often flaunt them like they are exempt because they have their powerful lawyers to shield them. Kaizan will turn out like their EPIC chart system. Lots of money for low performance. The class I took in business-101 had us asking our pseudo employees what can be done to improve things. We did not need a trip to Toyota to figure that one out. Salem Hospital is the furthest thing from a nonprofit Corporation and is virtually only a money machine at this time. The laws covering Nonprofit need to be examined and corporations like this should be made to pay taxes just like the rest of Us. Thank God that the employee,s have a quality care focus. Not just more quantity oriented like the Administration is. Yes I am glad that I work at their competitor hospital now. After 20+ years at SH. Its like Salem hospital used to be. Community-Employee oriented with quality care. We do not need to go to Japan to know how to get this done. Not a lot of good to say about Salem Hospital. I feel sorry for my Nursing friends and all of the staff. I must say that the memo,s sent out after articles are published here. that the Lund report is doing a great job.The Truth scares the hell out of SH administrators Big Boss Lady...