Improving Healthcare Using Toyota Lean Production Methods

Robert Chalice

Description

What differentiates this book from other healthcare improvement books is that it is the only currently available book that presents a simple recipe of 46 lean steps for healthcare providers to reduce cost and improve quality. By taking these straightforward steps, healthcare providers can adopt the same lean methods which have enabled companies like Toyota to become so successful.The first part of the book explains cost and quality issues facing U.S. healthcare. From that understanding, the second part then teaches healthcare providers a 46-step recipe to reduce costs and improve quality by using Toyota Lean Production methods. With industry experts citing that as much as 40% of the total cost of healthcare production is attributed to wasteful processes, it is logical that reducing waste will lower costs. This is the basis of this book.Although other books have presented Toyota's lean methods, this book goes further by showing how to directly apply those successful methods to healthcare, where they are sorely needed. This book is intended to be a practical manual for healthcare providers to use to improve quality and reduce costs. It can be a multi-year strategic plan for healthcare providers to adopt.This second edition includes additional improvement steps and five new appendices of practical examples authored by renowned lean experts.

Sujets

• Business
• Qualité, hygiène, sécurité, environnement
• Techniques
• Technologies de Fabrication
• Technologies de fabrication
• Engineering
• Technology
• Manufacturing
• Sciences et techniques

Informations

• Publié par: ASQ Quality Press
• Date de parution: 14 décembre 2006
• Nombre de lectures: 0
• EAN13: 9780873893718
• Langue: English
• Poids de l'ouvrage: 3 Mo

Extrait

Improving Healthcare Using Toyota Lean Production Methods

46 Steps for Improvement

Also available from ASQ Quality Press:

Lean-Six Sigma for Healthcare: A Senior Leader Guide to Improving Cost and Throughput Chip Caldwell, Jim Brexler, and Tom Gillem

The Manager’s Guide to Six Sigma in Healthcare: for Improvement Robert Barry and Amy C. Smith

Nan: A Six Sigma Mystery Robert Barry

Practical Tips and Tools

Measuring Quality Improvement in Healthcare: A Guide to Statistical Process Control Applications Raymond G. Carey, PhD and Robert C. Lloyd, PhD

The Six Sigma Book for Healthcare: Improving Outcomes By Reducing Errors Robert Barry, PhD, Amy Murcko, APRN, and Clifford Brubaker, PhD

Improving Healthcare with Control Charts: Basic and Advanced SPC Methods and Case Studies Raymond G. Carey

The Six Sigma Journey from Art to Science Larry Walters

Six Sigma for the Office: Roderick A. Munro

A Pocket Guide

Defining and Analyzing a Business Process: Jeffrey N. Lowenthal

A Six Sigma Pocket Guide

stomers,

Customer Centered Six Sigma: Linking Cu and Financial Results Earl Naumann and Steven H. Hoisington

Process Improvement,

Office Kaizen: Transforming Office Operations into a Strategic Competitive Advantage William Lareau

To request a complimentary catalog of ASQ Quality Press publications, call 800-248-1946, or visit our Web site at http://qualitypress.asq.org.

Improving Healthcare Using Toyota Lean Production Methods

46 Steps for Improvement

Second Edition

Robert Chalice

ASQ Quality Press Milwaukee, Wisconsin

American Society for Quality, Quality Press, Milwaukee 53203 © 2007 American Society for Quality All rights reserved. Published 2007 Printed in the United States of America 12 11 10 09 08 07 06 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data Chalice, Robert. Improving healthcare using Toyota lean production methods : 46 steps for improvement / Robert Chalice. — 2nd ed. p. ; cm. Rev. ed. of: Stop rising healthcare costs using Toyota lean production methods. 2005. Includes bibliographical references and index. ISBN 978-0-87389-713-6 (pbk. : alk. paper) 1. Medical care—Cost control. 2. Medical care—Quality control. 3. Medical care— Cost effectiveness. 4. Production management. 5. Production control. I. Chalice, Robert. Stop rising healthcare costs using Toyota lean production methods. II. American Society for Quality. III. Title. [DNLM: 1. Toyota Jidosha Kabushiki Kaisha. 2. Health Care Costs—United States. 3. Cost Control—methods—United States. 4. Health Care Reform—economics—United States. 5. Quality of Health Care—economics—United States. W 74 AA1 C436s 2007]

RA410.53.C43 2007 338.4'33621—dc22

2007004991

ISBN-13: 978-0-87389-713-6 No part of this book may be reproduced in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Publisher: William A. Tony Acquisitions Editor: Matt Meinholz Project Editor: Paul O'Mara Production Administrator: Randall Benson ASQ Mission: The American Society for Quality advances individual, organizational, and community excellence worldwide through learning, quality improvement, and knowledge exchange. Attention Bookstores, Wholesalers, Schools, and Corporations: ASQ Quality Press books, videotapes, audiotapes, and software are available at quantity discounts with bulk purchases for business, educational, or instructional use. For information, please contact ASQ Quality Press at 800–248–1946, or write to ASQ Quality Press, P.O. Box 3005, Milwaukee, WI 53201–3005.

To place orders or to request a free copy of the ASQ Quality Press Publications Catalog, including ASQ membership information, call 800–248–1946. Visit our Web site at www.asq.org or http://qualitypress.asq.org.

Printed on acid-free paper

Contents

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Part I U.S. Healthcare System Problems and Solutions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Chapter1 U.S.HealthcareSystemProblems . . . . . . . . . . 3 RisingHealthInsurancePremiums . . . . . . . . . . . . . . 3 WhyDouble-DigitHealthInsuranceIncreases? . . . . . . . . 9 46.6 Million Americans (Almost 1 in 6) Are Without HealthInsurance . . . . . . . . . . . . . . . . . . . . . . 13 Motivating Healthcare Providers to Reduce Cost and ImproveQuality . . . . . . . . . . . . . . . . . . . . . . . 15 ToyotaLeanProduction . . . . . . . . . . . . . . . . . . . . 18 WasteinHealthcare . . . . . . . . . . . . . . . . . . . . . . 21 ExcessHealthcareAdministrativeandOverheadCosts . . . . 22 Excess Insurance Company Administrative and OverheadCosts . . . . . . . . . . . . . . . . . . . . . . . 26 U.S. Health Expenditures Are a Growing Percentage ofGDP . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 U.S. Spends Twice as Much on Healthcare But Ranks 37thinHealthSystemPerformance . . . . . . . . . . . . 32 QualityProblemsinU.S.Healthcare . . . . . . . . . . . . . 34 Past Failure of Continuous Quality Improvement and Total QualityManagement . . . . . . . . . . . . . . . . . . . . 38 RedesigningtheU.S.HealthcareSystem . . . . . . . . . . . 39

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Table of Contents

Chapter2

RespectforEmployees . . . . . . . . . . . . . . . . .

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Part II Reduce Healthcare Cost and Improve Quality by Using Toyota Lean Production Methods . . . . . . . 43 Chapter 3 46 Steps to Improve Cost and Quality in the U.S.HealthcareSystem . . . . . . . . . . . . . . . . . . . . . . 45 Step 1 Define value from the perspective of the patient(customer) . . . . . . . . . . . . . . . . . . 46 Step2 Mapthepatient’svaluestream . . . . . . . . . . . 47 Step 3 Walk through all your core processes, and observe howtheyworkindetail . . . . . . . . . . . . . . . 48 Step 4 Implement Toyota-style lean production methods . . . . . . . . . . . . . . . . . . . . . . . 50 Step 5 Train administrators, managers, and supervisors tobeleanleaders . . . . . . . . . . . . . . . . . . 52 Step 6 Provide empathetic “change management” to ease thetransitiontolean . . . . . . . . . . . . . . . . . 55 Step 7 Change “quality improvement department” to “quality andcostimprovementdepartment” . . . . . . . . . 56 Step 8 Change the name “quality improvement manual” to “qualityandcostimprovementmanual” . . . . . . 57 Step 9 Educate every employee about the basic strategic planoftheorganization . . . . . . . . . . . . . . . 57 Step 10 Establish an improvement plan with goals to be accomplished by specific people and dates . . . . . 59 Step 11 Implement a simple scorecard for the entire healthcare organization . . . . . . . . . . . . . . . . . . . . . 61 Step 12 Use a simple scorecard to monitor each department . . . . . . . . . . . . . . . . . . . . . . 63 Step 13 The board of directors initiates selected strategic qualityandcostimprovementgoals . . . . . . . . . 65 Step 14 Publish an annual quality report for simultaneous reviewwiththeannualfinancialreport . . . . . . . 66 Step 15 Create a rapid improvement team (RIT) to make quickcostandqualityimprovements . . . . . . . . 67 Step 16 Encourage RIT members to implement Toyota-style workteams . . . . . . . . . . . . . . . . . . . . . . 70 Step 17 Implement rapid improvement circles of employees(RICs) . . . . . . . . . . . . . . . . . . 74 Step 18 Implement a permanent organizational structure for qualityandcostimprovement . . . . . . . . . . . . 77

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Step25 Step 26 Step27 Step 28

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Table of Contents

Set a goal for each RIC member to produce one to fournewsuggestionspermonth . . . . . . . . . . 77 Have a clear reward and recognition program, and communicatenegativeconsequences . . . . . . . . 79 Adopt and teach continuous improvement to as many peopleaspossibleintheorganization . . . . . . . . 79 The rapid improvement team quickly implements a 5Sprogram . . . . . . . . . . . . . . . . . . . . . 80 Identifyunnecessaryitemsusingredtags . . . . . . 83 Promote visual control throughout the workplace andorganization . . . . . . . . . . . . . . . . . . . 83 Eliminateallformsofwaste . . . . . . . . . . . . 85 Reduce specific examples of potential waste . . . . Sequenceworkandstandardizeit . . . . . . . . . . 109 Eliminate bottlenecks to improve continuousflow . . . . . . . . . . . . . . . . . . . 110 Document all important processes in the organization ordepartment . . . . . . . . . . . . . . . . . . . . 112 Implement and maintain continuous improvement . . . . . . . . . . . . . . . . . . . . . 113 Consider radical improvement where appropriate . . . . . . . . . . . . . . . . . . . . . . 114 Videotape each step of entire work processes . . . . Use flowcharts to improve core processes . . . . . Use spaghetti diagrams to trace the path of a patient, employee, orproduct . . . . . . . . . . . . . . . . 117 Measureprocesscycletimes . . . . . . . . . . . . 117 Implement quick changeovers within a process . . . Complement nursing care delivery models withLean . . . . . . . . . . . . . . . . . . . . . . 119 Challenge and work with your extended network of suppliersandpartners . . . . . . . . . . . . . . . . 120 Automate processes to further improve quality andcost . . . . . . . . . . . . . . . . . . . . . . . 122 Learn from benchmark nonhealthcare organizations . . . . . . . . . . . . . . . . . . . . . 122 Learn from other benchmark healthcare organizations . . . . . . . . . . . . . . . . . . . . . 127 Learn from the institute for healthcare improvement . . . . . . . . . . . . . . . . . . . . . 129 Holdontothegainsyou’veachieved . . . . . . . . 129 Reduceadministrativeoverheadcosts . . . . . . . 130

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