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.

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