Standard Work for Lean Healthcare: 1st Edition (Paperback) book cover

Standard Work for Lean Healthcare

1st Edition

By Thomas L. Jackson

Productivity Press

124 pages | 95 B/W Illus.

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pub: 2011-07-08
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Proven to increase efficiencies in the manufacturing sector, Standard Work has become a key element in reducing process waste, ensuring patient safety, and improving healthcare services. Part of the Lean Tools for Healthcare Series, this reader-friendly book builds on the success of the bestselling, Standard Work for the Shopfloor.

Standard Work for Lean Healthcare explains how to apply this powerful Lean tool to increase patient safety and reduce the cost of providing healthcare services. It illustrates how standardization can help you establish best practices for performing daily work and why it should be the cornerstone for all of your continuous improvement efforts. Presented in an easy-to-assimilate format, the book describes work in terms of cycle time, work in process, takt time, and layout. It also:

  • Defines the key concepts of standard work and explores the essential elements of a continuous improvement culture
  • Provides detailed guidance through the process of creating, maintaining, and improving standards
  • Illustrates the application of standardization and standard work in healthcare with a range of examples
  • Includes access to helpful websites and further reading on standardization, standard work, the 5S System, and Lean healthcare

A joint effort between the Rona Consulting Group and Productivity Press, this book presents invaluable insights from pioneers in Lean thinking to help you avoid common mistakes that can lead to unnecessary wastes of time and resources. Each richly illustrated chapter includes a chapter summary, reflection questions, and margin assists that highlight key terms, how-to steps, and healthcare examples—making this an essential resource for healthcare professionals starting out on their Lean journey.

Table of Contents

Getting Started

The Purpose of This Book

What This Book Is Based On

Two Ways to Use This Book

How to Get the Most Out of Your Reading

Becoming Familiar with This Book

Becoming Familiar with Each Chapter

How a Reading Strategy Works

Using the Margin Assists

An Overview of the Contents

The Production Processes and Operations of Healthcare

The Industrial Origins of Lean Healthcare

Production, Process, and Operation

Standards and Beyond

What Is a Standard?

Characteristics of Standards

Sources and Types of Standards

Standards and Standard Work versus Best Practice

What Is Standardization?

What Is Standard Work?

Lean Healthcare Methods = Standard Processes and Reliable Methods

Standard Work is a Prerequisite of Lean Healthcare

Standard Work Drives Further ImprovementStandard Work and Evidence-Based Practice

Evidence-Based Practice

A Culture of Continuous Improvement

The Benefits of Standardization and Standard Work

For the Organization

For Patients

For Clinicians and Support Staff


The Path to Reliable Methods

Types of In-House Standards

100 Percent Adherence to Reliable Methods

Communicating In-House Policies and Standards

Often Manuals Are Not Designed for the User

Revisions Are Unsystematic

Information Is Inconsistent with Lean Healthcare Methods

What to Include in Standards Documentation

Technical and Process Standards Sheets

Equipment Manuals

The Value of User-Friendly Standards

Creating and Maintaining Improvements to Standards

How Do You Create Standards and Standard Operations?

Stages of Standards Improvement

A Review of the Process Analysis Tools

Standard Work

Standard Task

Standard Work Sequence

Standard Time

Takt Time

Cycle Time

Wait Time

Lead Time

Standard Work-in-Process (SWIP) Inventory

Standard Work Documentation

Five Steps to Standard Work

Step One: Conduct a Running Time Observation

Step Two: Create a Standard Work Sheet

Step Three: Percent Load Chart

Step Four: Create a Standard Work Combination Sheet

Step Five: Standard Work Instruction Sheet

Ten Guidelines for Maintaining and

Improving Standard Work



Applications of Standardization and Standard Work

Applications of Standardization

New Employee Training

Evaluating Improvement Ideas

Applications of Standard Work

Managing Healthcare Service Production Processes

Patient Safety

Hourly Rounding

Satisfied Employees

Reflection and Conclusions

Reflecting on What You Have Learned

Applying What You Have Learned

Possibilities for Applying What You Have Learned

Implementing Standardization and Standard Work in Your Organization

Your Personal Action Plan

Opportunities for Further Learning



Further Reading about the 5S System

Further Reading about Lean Healthcare

Useful Websites

Each chapter concludes with a Summary & Reflections

About the Author

Rona Consulting Group & Productivity Press

Thomas L. Jackson, Editor

Thomas L. Jackson, JD, MBA, PhD, is the former CEO of Productivity, Inc., and Productivity Press, and a member of the influential Ford Lean Advisory Group. Tom has been a student of lean enterprise since 1988, when he copyedited Hiroyuki Hirano’s JIT Factory Revolution for Productivity Press and reworked two chapters of Yasuhiro Monden’s groundbreaking Japanese Management Accounting. Looking at pictures of Japanese factories and reading about how differently the Japanese count their money, Tom became so fanatical about lean that he left his comfortable position as a professor of business at the University of Vermont to start his own lean consulting company—in Malaysia! There, he learned that the powerful techniques of lean enterprise— JIT, SMED, TPM, and kanban—were only half of the story of Toyota’s great success. The other half of the story was hoshin kanri (a.k.a. the "balanced scorecard") and a revolution in the structure of modern business organization.

In 2005, Tom started applying Toyota’s operational and management methods in healthcare in a small rural clinic in Seward, Alaska. In 2008, Tom decided to trade his Levi’s Dockers for a pair of black scrubs and joined Mike Rona, former president of Seattle’s Virginia Mason Medical Center, as a partner in the Rona Consulting Group, where he and Mike are "transforming healthcare and pursuing perfection." In 2007, Tom was awarded a Shingo Prize for his book, Hoshin Kanri for the Lean Enterprise. In 2009, Tom was appointed Clinical Associate Professor in the Department of Health Services of the University of Washington’s School of Public Health.

About the Series

Lean Tools for Healthcare Series

Learn more…

Subject Categories

BISAC Subject Codes/Headings:
BUSINESS & ECONOMICS / Quality Control
BUSINESS & ECONOMICS / Industries / Service Industries
MEDICAL / Administration