Our chief of medicine, Mark Zeidel, was one of our senior management group who took a course in Lean process improvement philosophy and techniques. He decided he would share what he was learning with his faculty and students, in the form of a section of each week's departmental newsletter named "Kaizen Corner".
Mark is an enthusiastic and excellent teacher, and there are already reports throughout his department of lots of use of Japanese terms! (Courses for the residents and interns will expand and reinforce these messages.) I reprint excerpts here from his June 9 inaugural edition and will give you some later editions for each of several days next week.
The hospital has engaged Greater Boston Manufacturing Partnership, Inc., to partner with Alice Lee and her staff in developing training in Toyota production and process improvement techniques for BIDMC. I am enjoying the privilege of taking one of the first courses, a series of 8 or 9 six hour sessions, (with homework) focused on the fundamentals of continuous improvement. The course is terrific, and is beginning to point to the way in which we can become a self-learning, continuously- improving organization of the kind that Steven Spear, our recent visiting lecturer, outlines in his book, Chasing the Rabbit. Members of our Department who are taking these initial courses include Ken Sands and Julius Yang.
To help spread an understanding of the principles of the Toyota system, I will outline elements in the Newsletter each week. We start with the Japanese term, kaizen: This means, “incremental improvement.” Kaizen is the continuous pursuit by all employees of ways to do their jobs better (more safely and reliably), faster (more efficiently, with less strain) and cheaper (at lower expense because there is less waste).
We will go forward with four critical concepts:
1. Customer first.
Customers may be our patients, or referring physicians or the physicians we sign out to.
We strive to provide to each customer exactly what is needed and desired—immediately. This is summarized by the directive, “Produce the customer’s exact order immediately.”
The only acceptable level of quality from the customer’s standpoint is zero defects.
2. Employees are the most important resource.
This means that we must strive to engage each and every employee in helping improve the work we do. We must help each employee to work creatively in our environment.
3. Direct observation as the path to improvement.
Even after years of observation of a process, new discoveries as to how it can be improved can occur every day. If you want to improve something, go and see for yourself how it is working now, with an eye toward how it can be improved
4. Kaizen is for everybody, every day.
We must make improvement part of everyone’s job, something that they do as part of their job, every day. This is the key to becoming a self-learning organization. We must make it possible and normal for people at the front lines to recognize when a process is not going as well as it could go, call it out and work with coworkers or management to fix it as soon as possible.
There is an enormous amount of content in this one page. Over the next series of newsletters, I will try to outline many of the critical elements of the Toyota system. I hope that these descriptions will help people become acclimated to some of these concepts, so we can move them from the minds of a few to the practice of all.