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Reducing Waste and Errors: Piloting Lean Principles at Intermountain Healthcare

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Background: The Toyota Production System (TPS), based on industrial engineering principles and operational innovations, is used to achieve waste reduction and efficiency while increasing product quality. Several key tools and principles, adapted to health care, have proved effective in improving hospital operations.

Tools: Value Stream Maps (VSMs), which represent the key people, material, and information flows required to deliver a product or service, distinguish between value-adding and non–value-adding steps. The one-page Problem-Solving A3 Report guides staff through a rigorous and systematic problem-solving process.

Pilot Project at Intermountain Healthcare: In a pilot project, participants made many improvements, ranging from simple changes implemented immediately (for example, heart monitor paper not available when a patient presented with a dysrythmia) to larger projects involving patient or information flow issues across multiple departments. Most of the improvements required little or no investment and reduced significant amounts of wasted time for front-line workers. In one unit, turnaround time for pathologist reports from an anatomical pathology lab was reduced from five to two days.

Conclusions: TPS principles and tools are applicable to an endless variety of processes and work settings in health care and can be used to address critical challenges such as medical errors, escalating costs, and staffing shortages.

Document Type: Research Article

Publication date: May 1, 2005

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  • Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health professionals with the information they need to promote the quality and safety of health care. The Joint Commission Journal on Quality and Patient Safety invites original manuscripts on the development, adaptation, and/or implementation of innovative thinking, strategies, and practices in improving quality and safety in health care. Case studies, program or project reports, reports of new methodologies or new applications of methodologies, research studies on the effectiveness of improvement interventions, and commentaries on issues and practices are all considered.

    David W. Baker, MD, MPH, FACP, executive vice president for the Division of Healthcare Quality Evaluation at The Joint Commission, is the inaugural editor-in-chief of The Joint Commission Journal on Quality and Patient Safety.

    Also known as Joint Commission Journal on Quality Improvement and Joint Commission Journal on Quality and Safety
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