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OM in the News: Kaizen at San Francisco General Hospital

October 16, 2013
Kaizen team leader at SF General Hospital

Kaizen team leader at SF General Hospital

At San Francisco General Hospital, clinicians, executives and staff are peppering their conversations with Japanese words like kaizen and muda.  This “Toyota Way”, writes the San Francisco Chronicle (Oct. 14, 2013),  is an effort to infuse the Japanese automaker’s management philosophy and practices into the way the hospital delivers medicine to its patients.

To make the system work, a team of employees is assigned to analyze a particular area targeted for improvement. The group immerses itself in a weeklong, hands-on session, and emerges with a plan to make specific changes designed to have a big impact on costs or the patient’s experience. One recent kaizen focused on the number of minutes it takes from the moment a patient is wheeled into the operating room to when the first incision is made. A team spent a week trying to come up with ways to whittle 10 minutes off the hospital’s average “wheels in” to incision time of 40 minutes. Another targeted the Urgent Care Center and dropped the average wait from 5 hours down to 2.5 by adding an on-site X-ray machine–instead of forcing patients to endure a 15 min. walk to the main radiology department.

Toyota’s production system has been increasingly adopted by hospitals trying to improve medical quality and increase patient satisfaction. Here are some of its Japanese terms, many of which do not have a direct English translation: Gemba: the place where work is performed. Hansei: a period of critical self reflection. Heijunka: a level production schedule that provides balance and smooths day-to-day variation. Jidoka: using both human intelligence and technology to stop a process at the first sign of a potential problem. Kaizen: continuous improvement. Kanban: a visual card or signal used to trigger the fulfillment of need, such as restocking supplies. Muda: anything that consumes resources but provides no value. Poke-yoke: a mistake-proofing device that prevents errors.

(Ironically, the day before this flattering article about quality appeared, NBC News reported that SF General  lost a 57-year old female patient for 2 weeks–she was just found dead in a hospital stairway.)

Classroom discussion questions:

1. Why are hospitals adopting the “Toyota Way”?

2. Which of the many Japanese terms above could have prevented the lost patient?

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