Pragmatic Problem-solving for Healthcare: Principles, Tools, & Application

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Tools, Techniques & Strategies for Change

Manimay Ghosh
Ph.D Student
Montana State University

Durward K Sobek, II
Associate Professor
Montana State University

The authors will introduce the Toyota Production System (TPS) design rules, and a powerful problem solving technique adapted from Toyota. They will present how the TPS rules and the problem solving technique were used to redesign work in a meal therapy program in a hospital, and the results.

There is a growing national concern that health care organizations do not have a sound operating system in place. Reforming the operating system has assumed significance because of increasing operating costs and diminishing reimbursements from the payers. Critics argue that in the last 100 years or so significant strides have been made in product innovation but very little in process innovation. In an effort to improve the internal systems, health care leaders have adopted various process improvement techniques, yet success has remained elusive in most of the cases. Toyota Production System (TPS), built on basic Industrial Engineering principles offers powerful tools to revamp health care's work processes. Its application in the health care sector has been limited despite showing signs of promise. The authors present a very successful application of TPS design rules, using a problem solving process adapted from Toyota, in improving the group meal therapy process in a Rehabilitation Nursing Unit of a hospital. They present how participants observed the problem first hand, did root cause analysis, and then used the TPS design rules to redesign the improved process, which dramatically improved the patient outcome and productivity of the therapists.