Taking Improvement from the Assembly Line to Healthcare : The Application of Lean within the Healthcare Industry book cover
1st Edition

Taking Improvement from the Assembly Line to Healthcare
The Application of Lean within the Healthcare Industry

ISBN 9781439862391
Published November 3, 2011 by Productivity Press
180 Pages 44 B/W Illustrations


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Book Description

According to a report by the Institute of Medicine, up to 98,000 deaths per year occur in U.S. hospitals as a result of adverse events. In other words, errors in hospitals cause more annual deaths than car accidents, breast cancer, or AIDS. With the healthcare system in such critical condition, Lean is the best possible treatment.

Winner of a 2013 Shingo Research and Professional Publication Award!

Taking Improvement from the Assembly Line to Healthcare: The Application of Lean within the Healthcare Industry supplies step-by-step guidance on how to implement Lean methods to achieve world-class improvement within the healthcare industry. Specific examples of this approach are provided in emergency medicine, diagnostic imaging, orthopedic clinics, general internal medicine, administration, and community care. Highlighting quality, safety, and financial evidence as to why immediate change is both possible and essential, the book provides a firm foundation in Lean improvement and the tools used to deliver sustainable solutions. It presents client interviews and case studies from the U.S. and Canada to provide readers with the real-world understanding needed to embark and sustain a successful improvement journey.

With two decades of experience in industrial operations management, Ronald Bercaw details a proven approach for discovering waste and delivering improvement in healthcare organizations. He presents powerful insights gained through successful Lean implementations in private industry, U.S. and Canadian healthcare systems, U.S. Pentagon business systems, U.S. Surgeon General assignments, and U.S. Navy, Army, and Air Force maintenance applications.

Providing a comprehensive view of improvement within and outside the walls of the hospital and clinic, the book reveals valuable lessons learned and mitigation strategies to increase your chances of success. It identifies and addresses the leadership challenges that are likely to emerge and includes a detailed roadmap to provide you with the tools needed to achieve sustainable improvements in quality, patient safety, productivity, and staff development and engagement.

Watch Ronald Bercaw discuss how to apply the Toyota Production System to the healthcare industry.

Part I: http://www.youtube.com/watch?v=XTnKWHZ82vM&feature=youtu.be

Part II: http://www.youtube.com/watch?v=tBsoRcKDOaM&feature=youtu.be

Table of Contents

Critical Condition: Why Change Is Needed Now
Introduction: The Perfect Storm
Quality of Care
Access to Services
Affordability of Healthcare Services
Shortage of Resources

Fundamentals of Improvement
What Is Lean?
Value-Added Activities
Non-Value-Added Activities
Themes of Lean Improvement: Continuous Improvement
Themes of Lean Improvement: Respect for All People
Seven Wastes
Principles of Improvement: Lean DNA
     Flow Concept
     Pull System
     Defect-Free Work
     Visual Management

Tools for Improvement
     Takt Time
          Clinic Example
     Direct (Time) Observation
     Loading Diagram
     Spaghetti Mapping and Circle Diagrams
          Circle Diagram
     Flow Diagram with Value-Added/Non-Value-Added Analyses
          Value-Added and Non-Value-Added Analyses
     Standard Work
     Process Control
Putting Tools Together
     A-3 Thinking
     Value Stream Mapping and Analysis

Case Studies
Revolutionizing Emergency Services: Enhanced Quality and Access
Accelerating Productivity and Access in Diagnostic Imaging
Creating the Ultimate Patient Experience: A Visit to an Orthopedic Clinic
World Class Care at Inpatient Medical Unit
Beyond the Hospital: Continuing Care in the Community
Creating More Time for Quality Care: Streamlining Administration

Getting Started
Define Measurable Outcomes
     Select and Map Value Streams
Begin Improvement
     Sustain Improvement and Manage Visually
     Process Control
     Results Management
Support Improvement with Lean Training and Coaching
Spread Improvement
     Replication of Artifacts, Products, Solutions, and Process
     Adding Additional Value Streams

Leadership Lessons Learned
Walk the Value Streams
Commit Resources to Ensure Success
     Team Resources
     Improvement Supplies
     External Resources
Hold People Accountable
Engage Physicians
Establish Governance Structure
Address Antibodies
Develop and Deliver Communication Strategy
Redeployment versus Unemployment
Demand and Monitor Results
     Expect improvement!

Glossary of Lean Terms


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Ronald Bercaw is the President of Breakthrough Horizons, LTD, a management consulting company specializing in World Class Improvement through the application of the Toyota Business System, more commonly known as Lean. With more than 20 years of experience in operations, his Lean management experience was gained through multiple enterprise transformations in different industries including custom packaging, power reliability electronics assembly, and test and measurement products.

Educated at Purdue University, he learned the details and disciplined applications of Lean principles, habits, and tools from both the Shingijutsu Sensei and their first generation disciples. Working in both shop floor and above the shop floor areas, Ron has vigorously strived to remove waste from businesses through the involvement and ideas of the people doing the work.

Ron has consulting experience in the healthcare sector (US and Canada Health Systems, including primary care, acute care, and community applications of both clinical and back shop improvement), the commercial sector (administration, manufacturing, distribution, supply chain, and engineering), and the public sector (US Army, US Navy, US Air Force including MRO, Pentagon, and Surgeon General Assignments).


Ron Bercaw has made an important contribution to the Lean healthcare movement by starting with the ABCs of Lean and showing through detailed healthcare case studies how they can be used to greatly improve healthcare. He then goes on to give a rich description of the leadership role, the single most important success factor in creating a culture of improvement. Anyone in healthcare doubting that Lean can apply to them should be convinced of the power of Lean by this book.
—Professor Jeffrey K. Liker, University of Michigan and Shingo Prize-Winning Author of The Toyota Way