Henry Ford Production System

Henry Ford Production System
Why Are We here?

Introduction
Goal
• To convey & adopt the Toyota
Production System as it relates to Patient
Safety in Anatomic Pathology & HFHS
• To become the “Best in the Class” for
defect reduction and elimination of waste.

Why are we here?
• Estimated that 98,000 people will die
each year in U.S hospitals from medical
error, according to studies of the Institute
of Medicine.
• Other studies indicate that nearly as
many succumb to hospital acquired
infections.

Healthcare safety expert
Lucian Leape
compares the risk of entering
an American Hospital to that of
parachuting
off a building or bridge.
Harvard Business Review_September, 2005

Magnitude of the Problem
• 99.974% Specimen ID accuracy
1 Mis-ID case/month
• 12/50,000 cases/year or 240 errors per million
• That we know of……
• = 4 sigma (goal 3.4 defects per million @ 6 sigma)
• Real world correlates………………
……………….next page

If 99.9% is Good
Enough…..
• In the next 24 hours –
1,892,160 misplaced phone calls
528,000 checks deducted from wrong bank
accounts
207,333 books shipped with wrong cover
107 incorrect medical procedures performed
56 incorrect drug prescriptions written
12 babies will be given to wrong parents
• Lab with 6.5 million tests (HFH)
6,500 incorrect tests per year or 18 per day
• Lab results drive 90% clinical decisions

Why look to Toyota to learn
from their success of process
design?
• To Delight customers.
• To Identify and fix system problems.
• To Develop people.
• To Create learning.
• To Change culture.
For Success. WHY REINVENT THE WHEEL?

14 principles of the Toyota
Way
• Principle 1
Long Term Philosophy
Base your management decisions on a
long term philosophy, even at the expense
of short term financial goals.

Principle 2:
• Create continuous process flow

Principle 3:
• Use the “Pull
System”

Principle 4
• Level the Work Load

Specimen Delivery Times
Troy
Total
Collected
600
500
400
300
200
100
0
7:00
9:00
11:00
13:00
15:00
17:00
Time
11/8/05-12/10/05
19:00
21:00
23:00
Taylor
Lakeside
NC1
Fairlane
W
Bloomfield

Principle 5:
• Build a culture of
continuous
improvement by
stopping to fix
problems to get
quality right the first
time.
Every hand-off is
correct
EVERYTIME.

Principle 6:
• Standardization of
tasks are the
foundation for
continuous
improvements and
employee
empowerment

Principle 7:
• Use Visual controls
so no problems are
hidden.
When problems remain
hidden they are
neither shared nor
resolved.

Principle 8:
• Use only reliable thoroughly tested
technology that serves your people and
process.

Rules of Work Design
• Rule 1: Activities
Work must be highly specified as to the
content, sequence, timing, location and
expected outcomes.

Rules of Work Design
• Rule 2: Connections
Connections between customers and
suppliers must be highly specified, direct,
with a clear yes-or
or-no way to send
requests and receive responses.

Rules of Work Design
• Rule 3: Pathways
The pathway for every product and
service must be predetermined, simple
but, highly specified, and direct-no loops
or forks.

Rules of Work Design
• Rule 4: Improvements
Improvements are made using the scientific
method, with guidance from a teacher as close
as possible to the front line, aiming towards
THE IDEAL
by teaching people how to solve difficult
problems.
Many small, rapid process improvements made
quickly after careful study. Effects analyzed.

Conclusion: Expectations
of the HFPS
Specimens & Resulting Diagnoses
• Are defect free with quality the customer
expects.
• Can be delivered by one request at a time.
• Can be supplied and delivered immediately.
• Can be produced without waste of materials,
labor or energy.
• Can be produced in a work environment that is
safe, physically, emotionally and professionally
for every employee.

Rita D’Angelo
Anjna Gandhi
Anjna Gandhi
Azadeh Stark
Pathology
Quality
Management
Deb Chapman
Mark Tuthill, Michele Westcott,
Barb Basberg, Jackie Ribbentrop
Judy Shipley
Linda Cardine
Azadeh Stark, Ruan Varney