The Lean Office Blog

Book Review – Andy & Me and the Hospital

I recently finished reading Andy & Me and the Hospital: Further Adventures on the Lean Journey, the latest book from Pascal Dennis. The book is laid out in a fiction format, providing lots of interwoven storylines that make this book both enjoyable and easy to digest. At the same time, it covers concepts like Hoshin Planning and Management Systems in great detail. The book is a continuation of characters and storyline from Pascal’s previous book, Andy & Me.

About the Author

Pascal Dennis is the author of one of my “Mt. Rushmore of Lean Books”: Lean Production Simplified. I always recommend it to people who are moving beyond a basic understanding of Lean concepts – those who are ready to engage more fully on their own Lean journey. Since that time, I’ve been a subscriber to Pascal’s blog, Lean Thinking. Much like his latest book, his blog writing style is very relatable, and full of real-world concepts from all areas of life. Pascal has authored several other books, and is also the President of Lean Pathways Inc.

Book Summary

Andy & Me and the Hospital tells the story of Tom Pappas and his mentor/sensei, Andy Saito. In a previous life, both worked together to successfully turn around a struggling auto manufacturing company, and became an effective and powerful turnaround team in the process. Tom, the main character, wrestles with personal and professional obligations when asked by his leadership to transition from manufacturing into the healthcare sector by helping a struggling hospital, Grandview. The book is a highly entertaining story of how he transforms the hospital, its leadership team, and his own life in the process. While most Lean books focus in on either culture, tools, or strategy, Andy & Me and the Hospital tells the story from all three perspectives. The book covers topics ranging from leadership challenges and change management to visual management and creating flow, all told through the hospital’s departments and cast of (very unique) characters.

Key Takeaways

  • Senior leadership is responsible for creating and maintaining the management system.
  • Employees at all levels of the organization must be engaged. In other words, top-down vs. bottom-up is the wrong debate – instead, the right question is:  How does each level of the organization contribute uniquely to the overall journey?
  • The magic number for resource utilization (80%) applies across industries, and over-utilization can lead to disastrous results.
  • From a strategic level, fight the temptation to work on everything at once. You can improve anything, but you can’t improve everything at the same time.

Book Length

People always seem to want a good “airplane book”, so I’ll express it in those terms. At 224 pages, but with a good, flowing prose, study questions, and lots of illustrations, I would give yourself three flights to knock out this book.

Lean Topics Covered

Visual management, Kaizen, Hoshin Planning, Lean Culture, Lean Management, 5S, Standard Work, Gemba WalksLean Management System, Flow, Daily Management, Problem Solving

What I Liked

  • For someone with limited experience working in the healthcare environment, Pascal’s writing style made the content very relatable.
  • The book is full of illustrations, some of which help visualize important takeaways from the subject matter, others of which help tell the story of Tom’s personal life and past.
  • The personal story interwoven into the larger narrative was helpful in breaking up the deeper content, and was also very relatable. As someone who’s been a student of Lean for ten years, I can relate to the concept of focusing on problems instead of enjoying the present and celebrating success.

What I Didn’t Like

  • The characters in the book, especially Grandview Hospital’s C-Level executives, all helped highlight different people’s response to change management. However, keeping the large cast of characters straight was difficult at times, and I found myself flipping back to remember names.
  • The hardest critique of this book? I need to know what happens next! Most chapters include stories from one department of the hospital, and highlight improvement projects related to that group. Many include “things we’re working on next,” but the book ends before all of those can come to fruition. Alas, all good things must come to an end, so the book leaves the future up to your imagination.


I’m a sucker for stories of transformation, and this book tells an excellent story. I highly recommend it, whether you are a seasoned Lean consultant, a healthcare professional, or someone just starting on their Lean journey and looking for inspiration from someone further up ahead on the road.

Now it’s your turn . . .if you’ve read the book, what did you think? Have a good suggestion on what to review next? Leave a comment below!

Leave a Comment

Your email address will not be published. Required fields are marked *

Time limit is exhausted. Please reload CAPTCHA.