Tag Archives: lean healthcare

Don’t Hide Problems in Computers

Making things visible is a key to effective management. And data in computers can be easy to ignore. Don’t forget to make data visible. Paul Levy, CEO of Beth Israel Deaconess Medical Center in Boston recently hosted Hideshi Yokoi, president of the Toyota Production System Support Center and wrote this blog post:

Together, we visited gemba and observed several hospital processes in action, looking for ways to reduce waste and reorganize work. It was fascinating to have such experts here and see things through their eyes. Mr. Yokoi’s thoughts and observations are very, very clear, notwithstanding a command of English that is still a work in progress.

The highlight? At one point, we pointed out a new information system that we were thinking of putting into place to monitor and control the flow of certain inventory. Mr. Yokoi’s wise response, suggesting otherwise, was:

“When you put problem in computer, box hide answer. Problem must be visible!”

The mission of the Toyota Production System Support Center to share Toyota Production System know-how with North American organizations that have a true desire to learn and adopt TPS.

Related: The Importance of Making Problems VisibleGreat Visual Instruction ExampleHealth Care the Toyota Way

Management Improvement Carnival #62

Mark Graban is hosting the Management Improvement Carnival #62 on the Lean blog, highlights include:

  • Why Quality is Dangerous (Dr. John Toussaint – ThedaCare Center Blog): “If we are going to have carrots and sticks it should be centered on what improvements healthcare organizations and providers are making every day, month, and year. Measuring and improving is how we are going to create better performance in healthcare not dictating and punishing.”
  • Beth Israel Deaconess: Systems, safety, and (avoided) severance… (Steven J. Spear – Chasing the Rabbit): “… BIDMC’s efforts to achieve perfect safety by being transparent when systems fail, using that transparency to see problems so they can be solved.
  • Going to Gemba (Paul Levy – Running a Hospital): “By witnessing problems and work-arounds in real time, the team can have a better idea of how to solve problems to root cause and make incremental improvements in work flows.”
  • Managing the Burning Platform (Mark Rosenthal – Lean Thinker Blog): “It is really easy to say that, in these emergencies, long term thinking doesn’t matter. But I contend that it is even more important right now. This is a time for action. It is not a time for panic.”
  • LeanBlog Video Podcast #2 – Kevin Frieswick, Error Proofing Handwashing (Mark Graban – Lean Blog): “I’m still experimenting with video podcasting, after my first attempt with Jamie Finchbaugh. LeanBlog Video Podcast #2 is… the video from Kevin Frieswick and MetroWest Medical Center with the device for error proofing hand washing on the way into patient rooms”

Overview of the management improvement carnival.

ER Checklist

The popular ER TV show highlighted the importance of using checklists in surgery yesterday.

Such powerful quality tools, like the checklist, are just waiting to be used. But far too many fail to use these simple improvement tools. And in health care those failures are potentially critical.

Related: Checklists Save LivesThe Power of a Checklistmanagement improvement dictionaryArticles on Improving the Health Care System

Univ Michigan Hospital Adopts Toyota Methods

U-M hospital takes page from Toyota [the broken link was removed] by Sharon Terlep. This continues the trend (trend rather than fad because I like that it is happening :-)) of hospitals adopting lean management methods.

In health care, the one-at-a-time approach could mean taking a patient’s call, pulling the patient’s records, scheduling a visit and performing the exam that day, rather than creating a backlog of appointments or letting people crowd a waiting room. That way, if something goes wrong, it’s easy to target where the problem happened and fix it right away.

This article gets some of the ideas down but I think presents them in a fairly confusing way. So take this for what it is a report on one more hospital trying these ideas. Then read the many available resources to learn about one-piece flow, poka-yoke, eliminating waste, identifying errors, kaizen… rather than relying on this article. The purpose of this article is just to report on the new methods being used at the hospital not provide a detailed report on exactly how the new methods actually work – that would take a much longer form of presentation than a short newspaper article.


ThedaCare: Lean Healthcare

Area health systems put customer service first [the broken link was removed] by MaryBeth Matzek

In 2005, ThedaCare was able to save $10 million thanks to its lean programs and officials hope to save another $12 million this year, Toussaint said.

ThedaCare’s march toward lean began when Toussaint started looking for a way to improve quality and service while cutting costs. He found what he was looking for in an unlikely place – a factory that produces lawnmowers and snow blowers.

The model Ariens used was adapted from a system put in place by Toyota, the Japanese automotive manufacturer. As part of the system, teams are formed to look at processes and find ways to improve them – whether it’s cutting out an unnecessary step or finding a better way to serve the customer.

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