Seattle Hospital Implements Toyota Just-In-Time System

[Mulboyne]

[floatr][/floatr]SeattlePI: Hospital adapts techniques from Japanese factories
When you think of a hospital, what comes to mind? Patients, emergency rooms, technology and medical advancements. Making the sick and injured well again. When officials at Virginia Mason think of hospitals, they think of cars. A car manufacturing plant, to be exact. Beginning in 2000 the hospital's leaders looked at their infrastructure and saw it was designed around them, not the patient, said Dr. Gary Kaplan, Virginia Mason's chairman and chief executive officer...They began looking for a better way to improve quality, safety and patient satisfaction. After two years of searching, they discovered the Toyota Production system, also known as lean manufacturing...Virginia Mason has tailored the Japanese model to fit health care..." 'People are not cars' is very common for me to hear," Kaplan said. "We get so wrapped up in the seriousness and specialness of health care, but we also have to open our eyes to other industries...Toyota is obsessed with the customer and customer satisfaction ... all those things Toyota was about was what we wanted"...He said not everyone has agreed with the new system and a few physicians have left Virginia Mason because of it. "To some it seems like obsessive-compulsive disorder run amok, but it's part of a solution that eliminates mistakes," Pittenger said...more...

The Washington Post carried this story three years ago. Also, the Wall Street Journal covered a similar plan at Allegheny General Hospital in 2004 which prompted this response:

"When you're sick, and miserable, and scared, which describes 99% of the patients in American hospitals, the last thing you want is some nurse trying to be efficient instead of sitting with you and calming you down. Take your inhumanity back to the factory, folks".

[ttjereth]

[floatr][/floatr]SeattlePI: Hospital adapts techniques from Japanese factories
When you think of a hospital, what comes to mind? Patients, emergency rooms, technology and medical advancements. Making the sick and injured well again. When officials at Virginia Mason think of hospitals, they think of cars. A car manufacturing plant, to be exact. Beginning in 2000 the hospital's leaders looked at their infrastructure and saw it was designed around them, not the patient, said Dr. Gary Kaplan, Virginia Mason's chairman and chief executive officer...They began looking for a better way to improve quality, safety and patient satisfaction. After two years of searching, they discovered the Toyota Production system, also known as lean manufacturing...Virginia Mason has tailored the Japanese model to fit health care..." 'People are not cars' is very common for me to hear," Kaplan said. "We get so wrapped up in the seriousness and specialness of health care, but we also have to open our eyes to other industries...Toyota is obsessed with the customer and customer satisfaction ... all those things Toyota was about was what we wanted"...He said not everyone has agreed with the new system and a few physicians have left Virginia Mason because of it. "To some it seems like obsessive-compulsive disorder run amok, but it's part of a solution that eliminates mistakes," Pittenger said...more...

The Washington Post carried this story three years ago. Also, the Wall Street Journal covered a similar plan at Allegheny General Hospital in 2004 which prompted this response:

"When you're sick, and miserable, and scared, which describes 99% of the patients in American hospitals, the last thing you want is some nurse trying to be efficient instead of sitting with you and calming you down. Take your inhumanity back to the factory, folks".

I've had the misfortune of having to translate several presentations on Toyota's system and IMNSHO it's crap. It mainly just involves checking and double checking, filling out forms blah blah blah.

It's also horribly self-contradictor in several areas, and seems to me like overall it would result in less actual work being done, because everyone is too busy checking that they have filled out all the forms and that everything the last guy did is perfectly according to the rulebook.

Having to read about it in detail was bad enough, I'd really rather not be subjected to it in a hospital.

[Samurai_Jerk]

I've had the misfortune of having to translate several presentations on Toyota's system and IMNSHO it's crap. It mainly just involves checking and double checking, filling out forms blah blah blah.

It's also horribly self-contradictor in several areas, and seems to me like overall it would result in less actual work being done, because everyone is too busy checking that they have filled out all the forms and that everything the last guy did is perfectly according to the rulebook.

Having to read about it in detail was bad enough, I'd really rather not be subjected to it in a hospital.

Considering how well Toyota's done, it can't be that bad.

[Ol Dirty Gaijin]

I've had the misfortune of having to translate several presentations on Toyota's system and IMNSHO it's crap. It mainly just involves checking and double checking, filling out forms blah blah blah.

Yup, and it should be read as on Just in OUR time.*

*Grumblebum is a bit miffed on projects pushed out in timing and having to change plans again this week.

[Kuang_Grade]

http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande?currentPage=all

The New Yorker had something similar a few months back, although I don't think it involved Toyota but rather a similar determination to follow set patterns/checklists rather than just letting every doctor/nurse do what he or she wanted and each one doing it slightly differently each time. Apparently the one biggest problem was dealing with doctors egos who wanted to think that they were more important and more skilled than needing to follow a checklist, even though overall costs dropped and quality of care significantly improved after the implementation of checklists

[Charles]

http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande?currentPage=all

The New Yorker had something similar a few months back, although I don't think it involved Toyota but rather a similar determination to follow set patterns/checklists rather than just letting every doctor/nurse do what he or she wanted and each one doing it slightly differently each time. Apparently the one biggest problem was dealing with doctors egos who wanted to think that they were more important and more skilled than needing to follow a checklist, even though overall costs dropped and quality of care significantly improved after the implementation of checklists

Yeah, I read that article (in a waiting room at a hospital, no less) and was impressed with the whole argument. It's something I've been saying for years, in every high-tech situation, the limiting factor is never technology, it's always human resources. For many years we've had the technology for everything on the checklist, but nobody ever thought to develop the methods that people use to apply the technology. And there's no medical research trial methods for the checklist so there's no real way to get it peer reviewed and into widespread usage like it was a new drug or medical device.

Anyway, the Just In Time method doesn't strike me as useful in a medical environment where you need to respond to any medical crisis. It has done wonders for the computer trade. If you hear stories like how Apple measuring its efficiency by the amount of product they have in the warehouse and supply chain (typically less than a week's supply) that is all from the JIT programs. I remember the early days when warehoused wholesale supplies of computers were measured in months, new machines would take a year to ramp up in the market.

[Samurai_Jerk]

By the way, let's not give Toyota and the Japanese too much credit for implementing Deming and Ford's ideas.