2. KAIZEN IN HOSPITAL MANAGEMENT Dr S Sridharan MBBS, M.Sc (Med.Admn.), MD (Col.), Dip. IT

3. KAIZEN INCREMENTAL BUT CONTINUOUS PROGRESS

4. KAIZEN It has two elements:  Improvement / for better  Ongoing / Continuity

5. KAIZEN KAIZEN means improvement. Moreover it means continuing improvement in personnel life, home life, social life and working place. KAIZEN means improvement. Moreover it means continuing improvement in personnel life, home life, social life and working place. When applied to the workplace KAIZEN means continuing improvement involving everyone – managers and workers alike. When applied to the workplace KAIZEN means continuing improvement involving everyone – managers and workers alike.

6. Toyota 1933 1940 1960 1970 1980 1990 2000 2008 2009

7. ELEMENTS OF KAIZEN Appreciate the process, not the result (Always appreciate “human effort”); Encourage ‘Team Work’ for problem solving and decision making (WIT); Go search for the problem. Do not let it come to you; Identify and eliminate waste; Deliver best service possible. Make the workers aware of productivity and quality; and Clean, orderly and safe working environment.

8. Anything that doesn’t add value; changing form fit or function Anything that doesn’t help meet customer requirements Anything our customers would not be willing to pay us to do

10. GEMBA KAIZEN

11. Gemba Gemba A Japanese word meaning “real place” – now adapted in management terminology to mean the “workplace” – or that place where value is added. In manufacturing, it usually refers to the shop floor. Gembutsu The tangible objects found at gemba such as work pieces, rejects, jigs and tools and machines

12. MUDA The Japanese word meaning “waste” which, when applied to management of the workplace, refers to a wide range of non-value –adding activities.

14. Seven deadly wastes 1. 1. Overproduction: Blood draws done early to accommodate lab 2. 2. Transportation: Moving patients to tests 3. 3. Excessive Processing: Asking patient the same information multiple times 4. 4. Waiting: Inpatients waiting in ED, MDs waiting for test results. 5. 5. Inventories: Dictation waiting for transcription 6. 6. Movement: Looking for missing charts or equipment 7. 7. Defects: medication errors

15. MURA ( Irregularity) Whenever a smooth flow of work is interrupted in an operator's work, the flow of parts and machines, or the production schedule, there is mura. Whenever a smooth flow of work is interrupted in an operator's work, the flow of parts and machines, or the production schedule, there is mura.

16. MURI (Strenuous work) Muri means strenuous condition for worker and machines as well as for the work processes Muri means strenuous condition for worker and machines as well as for the work processes

17. New wastes in KAIZEN ► Waste of Human Potential; ► Inappropriate System; ► Electricity and Water; ► Wasted Material; ► Service and Office equipments; ► Cost of Time; and ► Defecting Customers

18. Reasons Why KAIZEN Lower Cost; Immediate Results; Less Waiting; Energize Employees; Improve Productivity; and Creativity and Innvation

19.  Process Improvement;  Short Time;  Zero / Less Defect;  Human Resource Development; and  Profits and Sharing.

20. Process Name 1. OP 2.In3.Trans 4. Proces sing 5.Waiting 6. Inventory 7.MotionDefects 0= No waste found to 4 =A lot of waste

21. Golden Rules of Gemba management When a problem (abnormality) arises go to gemba first; When a problem (abnormality) arises go to gemba first; Check the gembutsu (relevant objects); Check the gembutsu (relevant objects); Take temporary countermeasures on the spot; Take temporary countermeasures on the spot; Find the root cause; and Find the root cause; and Standardize to prevent recurrence. Standardize to prevent recurrence.

22. Ten basic rules for practicing kaizen in gemba Discard conventional rigid thinking about production / service; Think how to do it, and not why it cannot be done; Do not make excuses. Start by questioning current practices; Do not seek perfection. Do it right away even if for only 50% of target; Correct mistakes at once;

23. Ten basic rules for practicing kaizen in gemba … Do not spend money for kaizen; Do not spend money for kaizen; Wisdom is brought out when faced with hardship; Wisdom is brought out when faced with hardship; Ask ‘Why?’ five times and seek the root cause; Ask ‘Why?’ five times and seek the root cause; Seek the wisdom of ten people rather the knowledge of one; and Seek the wisdom of ten people rather the knowledge of one; and Remember that opportunities for Kaizen are infinite. Remember that opportunities for Kaizen are infinite.

24. Encourage suggestions from employees Encourage suggestions from employees Employee participation in management Employee participation in management Encourage managers to visit the workplace (GEMBA) Encourage managers to visit the workplace (GEMBA) Mistake proofing Mistake proofing Minimize patients and Employee accidents Minimize patients and Employee accidents Reduce inventories in Wards / Units Reduce inventories in Wards / Units

25. Productive maintenance of Hospital equipment and furniture Productive maintenance of Hospital equipment and furniture Reduce Waste Reduce Waste Reduce waiting time Reduce waiting time MINIMIZE DEATHS & COMPLICATIONS

26. Benefits of Kaizen For Organization Eliminates hidden costs Service to customer will be highest quality, lowest cost and shortest time possible Major changes quickly and minimum loss of production time For You Can work with ease and comfort by reducing delay and wasted motion You think what you do and contribute ideas Work as a team