Taking Improvement from the Assembly Line to Healthcare

Quality healthcare is a cornerstone of any healthy society. In the U.S., we have access to sophisticated medical technology, world renowned physicians, highly trained nurses and hospital personnel, advanced pharmaceuticals, and innovations in diagnosis and treatment. But for all of our sophistication, serious problems afflict healthcare systems across the U.S. today - problems that cause severe hardship for families in communities large and small.
Considering its impact on society, healthcare is arguably our most important industry. Good health is a key aspect of a productive and fulfilling life no matter what a person's age, cultural background, social status or career. To live well and provide for ourselves and others, we all depend on a strong healthcare system that can help us prevent illness and access effective treatment when we need it. Needless to say, building and maintaining that robust healthcare system is no easy task.
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 acceptable and are totally preventable. With the healthcare system in such critical condition, Lean is the best possible treatment as it moves to eliminate waste and improve processes.
The revised edition of Taking Improvement from the Assembly Line to Healthcare supplies step-by-step guidance on how to implement Lean methods to achieve world-class improvement with the healthcare industry. The updated edition of this Shingo award winner book provides specific examples of Lean implementation 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. This revised edition presents new and updated client interviews and how the process has changed or been enhanced, what worked and what didn't work. New case studies from U.S. and Canada provide readers with the real-world understanding needed to embark and sustain a successful improvement journey.

Ronald Bercaw is the president of Breakthrough Horizons, LTD, a management consulting company specializing in world-class improvement through the application of the Toyota Production System, more commonly known as "Lean." With over 30 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, Ron 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 (U.S. and Canadian health systems, including health insurance, 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 (U.S. Army, U.S. Navy, U.S. Air Force, including MRO, Pentagon, Veteran's Health Administration, and Surgeon General Assignments), the health insurance sector, and Lean in agriculture. In addition to operating his consulting practice, Ron has published three books: Taking Improvement from the Assembly Line to Healthcare, Lean Leadership for Healthcare, and The Lean Electronic Medical Record. The first two books have been awarded the Shingo Research Award for helping advance the body of Lean knowledge.

Contents Acknowledgments..................................................................................ix About the Author....................................................................................xi Introduction......................................................................................... xiii Chapter 1 Critical Condition: Why Change Is Needed..................... 1 Chapter 2 Fundamentals of Improvement........................................ 15 Chapter 3 Tools for Improvement..................................................... 39 Chapter 4 Case Studies....................................................................... 85 Chapter 5 Getting Started................................................................ 129 Index..................................................................................................... 187