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The Application of Industrial Production Techniques to Health
Care Delivery
Summary of notesPittsburgh Regional Healthcare Initiative: Perfecting
Patient CareNovember 11-18, 2005
Unless otherwise stated, all slides adapted from course by Pittsburgh Regional Healthcare Initiative: Perfecting Patient Care November 11-18, 2005
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Overview
• Application of industrial thinking to the delivery of health care services
• Not doctoring/nursing
• Why study Toyota?
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What TPS is not
• Simple procedures
• Quick Fix
• Pick and choose (dabble)
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WHAT THE TPS IS
• A Philosophy of Doing Business
• Achieving the idealOn demandDefect freeImmediatelySafeNo waste
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The Toyota Way
People
Process: Lean Production
PhilosophyAdapted from: Liker, JK. The Toyota Way. New York: McGraw Hill, 2004. Page 13
Problem Solving
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PHILOSOPHY Long term thinking
Top down commitment
Base management decisions on long-term goals even at the expense of short term goals
• Customers
• Profitability
• Employees
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PROCESS: OUTCOMES
• Eliminate waste
• Build in quality
• Build in continuous improvement
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PROCESSTypes of Waste
• Overproduction• Excess inventory• Unnecessary transport• Unnecessary movement • Waiting • Over processing and Incorrect processing• Defects• Unused employee creativityAdapted from Liker, JK. The Toyota Way. New York: McGraw Hill, 2004. Pages 28-29.
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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
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Traditional ProcessBatch and Queue: Individual Silos
Push Orders
Finished Products Out to Truck
Assembly Line
Warehouse raw materials and supplies P I
CDEFECTS
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TPS Process One piece flow: Teams
Pull Raw materials and supplies
Finished Product Out to Truck
PULL
Assembly Line
HELP!
Quick responseStabilize processCountermeasure
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Andon Board
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Process: Value FlowEliminating Waste: How much time do you spend looking for
information?
Waiting
Time
Casting Transport Staging Set-
up
Machining Inspection Assembly Staging
Raw Materials Finished Product
From: Liker, JK. The Toyota Way. New York: McGraw Hill, 2004. Page 30.
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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
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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
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PROBLEM SOLVINGScientific Method at the Bench Level
• On site inspection
• Consider all options
• Blame free
• Countermeasures, not solutions
• Sustain the organization
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Applications to Health Care
• Work: cycle, periodic, and fluctuation
• Takt time
• Standardization with contingencies
• Communication
• Problem solving
• Continuous improvement as policy
• NEXT STEP?