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The Application of Industrial Production Techniques to Health Care Delivery. Summary of notes Pittsburgh Regional Healthcare Initiative: Perfecting Patient Care November 11-18, 2005
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The Application of Industrial Production Techniques to Health Care Delivery Summary of notes Pittsburgh Regional Healthcare Initiative: Perfecting Patient Care November 11-18, 2005 Unless otherwise stated, all slides adapted from course by Pittsburgh Regional Healthcare Initiative: Perfecting Patient Care November 11-18, 2005
Overview • Application of industrial thinking to the delivery of health care services • Not doctoring/nursing • Why study Toyota?
What TPS is not • Simple procedures • Quick Fix • Pick and choose (dabble)
WHAT THE TPS IS • A Philosophy of Doing Business • Achieving the ideal • On demand • Defect free • Immediately • Safe • No waste
The Toyota Way People Process: Lean Production Philosophy Adapted from: Liker, JK. The Toyota Way. New York: McGraw Hill, 2004. Page 13 Problem Solving
PHILOSOPHY Long term thinkingTop down commitment Base management decisions on long-term goals even at the expense of short term goals • Customers • Profitability • Employees
PROCESS: OUTCOMES • Eliminate waste • Build in quality • Build in continuous improvement
PROCESSTypes of Waste • Overproduction • Excess inventory • Unnecessary transport • Unnecessary movement • Waiting • Over processing and Incorrect processing • Defects • Unused employee creativity Adapted from Liker, JK. The Toyota Way. New York: McGraw Hill, 2004. Pages 28-29.
PROCESSCommon Reactions to Excesses • Increase capacity • Increase size of plant • Increase warehouse • Increase overhead • Increase labor force • Increase overtime Rather than concentrating on eliminating waste
Traditional ProcessBatch and Queue: Individual Silos Push Orders Assembly Line Warehouse raw materials and supplies P I Finished Products Out to Truck DEFECTS C
TPS Process One piece flow: Teams Pull Raw materials and supplies PULL Assembly Line Quick response Stabilize process Countermeasure Finished Product Out to Truck HELP!
Process: Value FlowEliminating Waste: How much time do you spend looking for information?
CRAFTING THE PROCESSSpecifications • Activity: Specific • Connection : Binary, direct • Pathway: continuous, straight • Improvement: Scientific method Then, test each specification to see whether or not they’re meeting expectations
PEOPLE AND PARTNERSDeveloping Trust • Highly selective • Culture for TPS and quality • Grow leaders from within • Job safety • Technology to support not replace people • Align interests of suppliers
PROBLEM SOLVINGScientific Method at the Bench Level • On site inspection • Consider all options • Blame free • Countermeasures, not solutions • Sustain the organization
Applications to Health Care • Work: cycle, periodic, and fluctuation • Takt time • Standardization with contingencies • Communication • Problem solving • Continuous improvement as policy • NEXT STEP?