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Applying TPS (Toyota Production System) in our healthcare system. AHMAD SYUKRI JAMALUDIN d oktordanwang.com. OBJECTIVE. To double or triple speed of any process Ambulance call Resuscitation Patient treatment and care Disaster To build quality into workplace systems - PowerPoint PPT Presentation
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Applying TPS (Toyota Production System) in our healthcare system
AHMAD SYUKRI JAMALUDINdoktordanwang.com
OBJECTIVETo double or triple speed of any process
Ambulance callResuscitation Patient treatment and careDisaster
To build quality into workplace systemsTo eliminate huge cost of hidden wasteTo turn every employee into a quality control
inspector
WHAT AM I PRESENTING?One of the best system in the world.A topic that has never been presented in
medical field before.A system that can be manipulated (to fit any
kind of organization).As big as HKL/HTJAs small as HPD
LESS THAN 30 MINUTES
TOYOTAFrom a company that produced poor quality
vehicles with primitive technology to the world’s greatest manufacturer.
TPSToyota Production System-basis for much of
the ‘lean production’ movement that has dominated manufacturing trends.
Time line from the moment the customer give and order to the point when we collect cash. And we are reducing that time line by removing the non-value-added waste.
Hospital application
Patient seek treatment
Non-value added waste
Treatment complete
Hospital application
Patient seek treatment Treatment complete
THE HEART OF THE TOYOTA PRODUCTION SYSTEM
ELIMINATING WASTE
Applying TPSStart with examining the process from
customer’s perspective to define value. (internal customer and external customer)-what does the customer want from the process?
Example-waste in a truck assembly lineBring all components to the assembly lineWalking 25 feet to pick up the componentRemoving cards and expose the componentsReaching tool for componentPicking up bolts for the componentWalking 25 feet back to the chassis on the assembly line.Positioning the component on the chassisWalking to the power toolReaching for the power toolWalking and pulling the power tool to the component on the chassisPulling the power tool down to the componentPlacing the bolts in the componentTightening the bolts to the chassis with the power toolWalking back 25 feet for the next component
Learning pointOperator takes many individual steps, but only a
small number of the steps add value to the product
In this case, only the three steps identified add value.
Some non value added steps are necessary, eg-operator has to reach to get power tool.
The point is to minimize time spent on non-value-added operations by positioning tools and material as close as possible to the point of assembly.
Example 1-blood investigationPatient seen by doctorDoctor request for blood investigation by filling request form Patient put request form on the registration counterForm taken and put in the treatment roomMedical assistant prepare equipment for blood takingMedical assistant call patient from the treatment roomPatient walk to the treatment roomBlood taken from patientMedical assistant walk to sample table to put blood product and formsample taken by penolong pegawai kesihatan and walk 50 meter to
lab.Penolong pegawai kesihatan walk back 50 meter to emergency
departmentLab process samplePenolong pegawai kesihatan walk 50 meter to lab to take resultPenolong pegawai kesihatan walk another 50 meter to emergency
department and give result to doctor.Doctor analyse the result and give proper treatment.
Waste1. Overproduction. Produce items which there
are no orders, which generates such wastes as overstaffing and storage and transportation cost because of excess inventory.
Waiting. Workers watch an automated machine or having to stand around waiting for the next processing step. Just plain having no work because of processing delays, equipment downtime, capacity bottle neck. Eg. Medical doctor waiting for blood result, PPP waiting for blood or patient to be ready for transportation, lab worker waiting for blood centrifuge.
3. Unnecessary transport. Carrying work in process (eg sample) long distances, creating inefficient transport, or moving patients or equipments between places.
4. Overprocessing or incorrect processing. Taking unneeded steps to process the parts. Inefficiently processing due to poor tool and product design, causing unnecessary motion and producing defects.
5. Excess inventory. Excess material causing expiry, damaged goods, transportation and storage costs and delay. Eg. Too much sample bottle or medication ordering causing expiry.
6. Unnecessary movement. Any wasted motion employees have to perform during the course of their work, such as looking for, reaching for, or stacking parts, tools. Also, walking is a waste.
7. Defects. Production of defective parts or correction. Repair or rework, scrap replacement production, and inspection mean wasteful handling, time, and effort.
8. Unused employee creativity. Losing time, ideas, skills, improvements and learning opportunities by not engaging or listening to your employees.
Example 2- DisasterWhere to set medical base camp?How big is the medical base camp?How many personnel needed? What system of communication are we using?
Example 3 – ambulance servicesHow many ambulance needed?Where to position ambulance?How to service ambulance?
Example 4 - ResuscitationWhere to place patient for resuscitation?What equipment needed and where?How many personnel needed?When and how to transport patient?
