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

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. The 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 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 (RNU) 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 process, which dramatically improved the patient outcome and productivity of the therapists.