2Presentation Overview Toyota Safety OverviewToyota Kentucky (TMMK) clinic KaizenToyota Texas (TMMTX) integrated medical
3Toyota Motor Engineering & Manufacturing North America, Inc. Vancouver, CanadaCambridge, CanadaFreemont, CAPrinceton, INBuffalo, WVErlanger, KYLong Beach, CASt. Louis, Troy, MOand Jackson, TNGeorgetown, KYBaja CA, MexicoEmployment: 38, 340Capacity : almost 2 million vehiclesInvestment: $16.8 billionToyota clinicsHuntsville, ALSan Antonio, TX
4Management Commitment TPSVALUESHOSHINDesignTrainingBudgetLeadershipKaizenProcess ReviewBusiness PlanningSafety AuditingManagement CommitmentInjury &IllnessPreventionEarlyIntervention(ESI)CareManagementActivitiesToyotaSafety HouseTeam Member’s Individual ResponsibilityTMMK’s commitment to team members’ safety and well-being is categorized into three categories:Injury and Illness Prevention – focus to prevent injuries;Early Intervention – activities to address discomfort before an injury or illness occurs;Care Management Activities – activities and options to return injured t/ms to productive work.After reviewing the first two components of TMMK’s Safety Program, we will spend the most time focusing on the area generating the most questions, Care Management.
5Team Member’s Individual Responsibility Early Symptom Intervention ToyotaSafety HouseTeam Member’s Individual ResponsibilityInjury & Illness PreventionEarly Symptom Intervention(ESI)Care ManagementEquipment DesignProcess DesignVehicle Structure DesignT/M Education & TrainingPosture ConfirmationFocus on Top 10 Risk ProcessesSTOP 6 hazard identificationConcern Registration SystemsEarly Symptom InvestigationInvestigationCountermeasure PlanRe-hab ConsultantsLow-level TreatmentG/L Modified DutyFollow-upState of the art clinics, evaluation centers, and diagnostic toolsCare ManagersModified DutyRestricted T/M UtilizationRepeat Injury FocusWorkforce Review MeetingsComplex Case MeetingsIndefinite RestrictionsMedical leave of absenceJob PlacementWork condition/work hardeningReintroduction
6Toyota’s Health/ Wellness Vision: Integration, Occupational Health & BenefitOld VisionOccupational Health*Safety/Medical GroupPersonal Health*Benefits GroupNew VisionTotal Health/Wellness Care*Health/Wellness Group
7Toyota Motor Manufacturing Kentucky Georgetown, KY Here is the plant
8Toyota in Kentucky Toyota Motor Manufacturing, Kentucky, Inc. Established 1986Production Start-up 1988Employment: Over 7,000 peopleSize: 7.5 Million sq. ft. under roof172 acres / equivalent to 156 football fieldsTMMK
9Toyota Motor Manufacturing KY Toyota largest manufacturing facility outside of JapanAnnual capacity 500,000 vehicles
10Vehicles Built at TMMKCamrySolaraConvertible SolaraAvalon
11Toyota Kentucky Clinics 2000 clinic-Occ health601clinic-Wellness clinic800 clinic-Occ health
12601 Clinic/Wellness Kaizen Activity Wellness physicals Hearing test New hire physicals
13Participants were assigned a specific staff member to study Applying TPS to an Occupational Health Center:Strategy OverviewCHD Meridian onsite management participated in a 5 day training activity focused on Type III Standardized Work AssessmentParticipants were assigned a specific staff member to studyKaizen and counter-measures were implemented as a teamResults were presented to Toyota & CHD Meridian management
14Improving the Process: Kaizen Activity StandardizeDetailed process and script for each element of the required physicalWork Station5S (clean, sort, etc.)Use Visual ControlsLabel for supply locationKey Points for Work ProcessEliminate non-value added workDecrease Walk Time
15Standardization of Work & Eliminating Waste: Activity GoalsLearn how to make standardized work in off-line jobsGrasp current clinic situationIdentify areas for standardization improvementEliminate muda (waste) and free up resources to provide new servicesTarget 450-minute reduction across all processes
16The TPS Process Training on tools and methods Evaluate Initial Condition (Time Studies and Observation)Analyze DataIdentify Muda (Waste)Wait timeFluctuationKaizen processesDevelop and implement Standardized Work
18Kaizen Results Exceeded Target Reduction (450 minutes) Overall reduction of 533 minutes of process time41% increase in overall clinic capacity45 minute average reduction of Mandatory Physical Exam process time56 minute average reduction of Wellness Physical Exam process timeESI is one of the keys to preventing injuries.We need to continue to focus on improving this program.
20OutcomeThere was no decrease in staffing. Staff was shifted so increased services could be provided.Some of the added services was Convenience Care ClinicOptometry Services
21Convenience Care Clinic I.H.S.Clinics are offering treatment for acute personal health conditions.For example:Colds, flu, sinus infections, pneumoniaMinor cuts and burnsEye injuriesLab work (will send to personal medical doctor)Acute episodes of chronic diseases (high blood pressure, diabetics, heart conditions)TMMK added this service on 1/23/06.TMMK’s Clinic provides quality and convenient health care for team members.Additional service has no impact on other medical benefits.
22Convenience Care Clinic Impact Since Inception January 20064315 Episodic Care Visits8630 Work Hours Saved
23Toyota Manufacturing, Texas, Inc. Established 2004Production Start-up 2006Employment: Over 2,000 peopleSize: 1.5 million square feetPlant size 2,000 acresAnnual productioncapacity 200,000Toyota Motor Mfg, Texas
24Toyota Manufacturing, Texas, Inc. The Toyota Tundra
26Toyota Family Medical Center : A Comprehensive Primary Care Facility Built to DeliverWorkplace SafetyCost SavingsQuality CareEmployer of Choice StatusServices OfferedPrimary CareOccupational healthRehabilitation/return to work/physical therapyOptical careDiagnostic x-ray/ ultrasound/laboratory servicesDental servicesPharmacyHigh-performance specialty and hospital network
27Toyota Production System Applying TPS / LEAN processing to a Health CenterObtaining Efficiencies – Do we take the savings or do more?Redeploying Resources – Moving beyond Occupational HealthProducing Savings – Health Care Costs & Productivity SavingsThe Toyota Family Health Center in San AntonioOccupation HealthComprehensive Primary CareFull Service PharmacyHigh Performance Specialty Network & Hospital
28Strategy Impact costs by improving quality Enhance quality through best practice guidelines and protocolsImprove access by providing convenient, high quality facilitiesGain appropriate access to health care dataAchieve flexibility in benefit designFocus on wellness and preventionData, systems and health care integration (occupational and non-occupational)
29Integrated Medical Strategy Implement a comprehensive health care strategy that contains costs while providing high quality, accessible care by providing on-site primary care.Care provided for:- Team members- On-site Supplier Employees- Eligible Dependents
30Health Care Flow Current Process Integrated Model Process No utilization steerageDoes not support consumerismToyota is missing from processNo control of price increasesCurrent process leaves room for errorOn-site Primary CareOptometristPediatricsPrimary CareDentistPharmacyLab tests, MRIs, X-Rays, etc.SpecialistsIn-network SpecialistsIn-network hospitals3rd party claims administratorHospitalization3rd party claims administrator
31Direct Provider Contracting Current SystemDirect ContractingNetworkproviderNetworkproviderHospitals andDoctorsHospitals andDoctorsToyotaToyotaPrice:Toyota does not negotiate priceToyota does not influence or even see priceQuality:Toyota’s influence on quality is limitedToyota manages price and quality in a manner consistent with Toyota Way and similar to our relationship with other suppliers
33Question: Why have an on-site pharmacy? How do they save money?Only One Restriction: “Closed Door”A Closed Door Pharmacy can only dispense prescriptions to those who are defined as beneficiaries of the client organization(s).
34Wellness / Disease Management Programs Focused Health Solutions(for adults only)Back and neck painHeart conditionsHigh blood pressure(for adults and children)DiabetesAsthmaClinical depression, anxiety or obsessive-compulsive disorder (with medication)WellnessGordian Get HealthyWeight ManagementFitnessCholesterol managementAcid Reflux managementMigraine managementSmoking cessationStress managementBone strength management
35TMMTX Worker’s Compensation Developing provider network for worker’s compensation cases.Treatment available at on-site clinic and Family Health Clinic.On-site physical therapy services.On-site worker’s compensation adjusters.
36ConclusionWe take what we learn from each start up or current operation and try to make the next one the best!!