Lean Thinking in Healthcare มช 14 June 2010
description
Transcript of Lean Thinking in Healthcare มช 14 June 2010
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Lean Toyota
HA 12thNorth Regional Forum
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14 2554
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2 (Competitiveness)
Distribute
(Business Process)
(Technology)
(People)
CustomersMake or StoreSource
Dynamics Alignment
Dynamics Business Environment
Business Enterprise
Business Values () = Customer Values ()Business Equations ()
Move MoveMake or Store
(Move)(Logistics Values)
(Make)(Product Values)
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3Genesis of Lean: The Toyota Production System
Interchangeable Parts
Eli Whitney
Interchangeable Parts
Eli Whitney
Time & Motion Division of
Labor
F. Taylor
Time & Motion Division of
Labor
F. Taylor
Assembly LineAssembly Line
Waste Elimination
Waste Elimination
System Synchronization
System Synchronization
Mass Production
Henry Ford
Mass Production
Henry Ford
Standard Costing
Standard Costing Model VarietyModel Variety
Mass / Batch
Alfred P. Sloan
Mass / Batch
Alfred P. Sloan
TOYOTA PRODUCTION
SYSTEMTaiichi Ohno
TOYOTA PRODUCTION
SYSTEMTaiichi Ohno
Supermarket Replenishment
Systems
Supermarket Replenishment
Systems
Jidoka
S. Toyoda
Jidoka
S. Toyoda
Just - In - Time
K. Toyoda
Just - In - Time
K. Toyoda
Employee Partnership
P. Drucker
Employee Partnership
P. Drucker
Quality
E. DemingJ.M. Juran
Quality
E. DemingJ.M. Juran
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4TPS HouseTPS House
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5Most common mistake
Jumping from problem to solution without clear understanding and analysis
PROBLEM
SOLUTION
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6Taiichi Ohnos Seven Wastes
MUDA
Time on Hand(Waiting)
Transportation
DefectiveProducts
Processing
Movement
Stock on Hand(Inventory)
Overproduction
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7TPS : Toyota Production System
TPS : Toyota Production System TPS Thinking Production System Thinking Production System TPS (Toyotas
production system)
ThinkingThinking
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8The ThinkingThe Thinkingpoints out what is a.
and what is an
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9Toyota Production System
The Toyota production method won't work unless it is used as an overall management system. The Toyota production system is
not something that can be used only on the production floors. The belief that it is only a production method is fundamentally wrong.
Taiichi Ohno, New Production System, Productivity Press, 1988
(Toyota Production System) (Pull System) (Just in Time)
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Toyota Production System (TPS)
(Implementation)
TPS
TPS
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Toyota Toyota Production System Toyota
Source: Gary Convis,President of TMMK
JITJidokaKaizenHeijunka
Kaizen
True North .
() ()
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(1990 and 1996) (Lean Production System) 1980 The International Motor Vehicle Program (IMVP) MIT James Womack and Dan Jones Toyota 2/3 Lean Production The Machine that Changed the World Lean Thinking 1996 MIT Lean Enterprise Institute (Lean Thinking)
James Womack and Dan Jones
1990 Auto studies
1996 roots of TPS
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(Principles of Lean Thinking) (Value) (Value Stream)
(Flow) (Pull)
(Perfection)Do this every day in all our activities
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()
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7 Deadly Wastes - Muda
Transportation
Waiting
Inventory
DefectsMotion
Processing
Overproduction
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Lean Thinking Principles in System Perspective
Value Stream
Value Chain
Values
C
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t
o
m
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s
Value Stream
SuppliersFlow of Value (Value Added & Non Value-added)
Perfection
Pull
Dynamic AlignmentAdaptive
Extended Value Chain
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3
4
5
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7 Wastes in Dr. Vithayas System Perspective
C
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S
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Overproduction
Motion
Transportation
Inappropriate Process
Waiting
Waiting
Defect
Inventory
Inventory
Inventory
Unutilized Man
1) Supply Chain Waste2) Make waste3) Move waste
Supply Chain Waste
Make waste
Make waste
Move wasteMove waste
Move waste
Move wasteMove waste
Move waste
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Lean Lean
: (Waste) (Creating value).
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(()) ( (commitment), commitment), (patience) , (patience) , (long(long--term thinking) , term thinking) , (positive mindset) (positive mindset) (attitude), (attitude), (continuous improvement) (continuous improvement)
(Lean)(Lean) Lean ?
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Make Make MakeMove
Not Move(Inventory)
I
Controlling capacity Controlling InventoryControlling Movement
Lean is Flow Management
Lean tools are applied to control Flow of Values
Values
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(Lean Tools)
5 S system Visual Management Standardization
Quality at Source TPM
Batch Reduction
POUS
Quick Changeover
Pull / Kanban Takt TimeCellular / Flow
Heijunka
Organizational Development and Culture Change
Flow of Value
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The Lean Enterprise
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Mass Production
Lean Thinking
From Mass to Lean
Cycle TimeTakt Time
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Visual FactoryVisual Factory
((Housekeeping)Housekeeping)
CellularCellular
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The Toyota Way (2001)
(Core Value) The Toyota WayThe Toyota Way Mr. Teruyuki Minoura DNA
Gary Covis TMMK Toyota : Changes and Challenges - 8 2001
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Toyota Way
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Bottom-line of Toyota Way (2001 And beyond)
Mr. Teruyuki Minoura Monozukuri (Making ThingsMaking Things) Monozukuri Hito-zukuri (Making PeopleMaking People) Genchi Genbutsu DNADNA Toyota WayToyota Way --
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From Toyota way to Lean Enterprise
Toyotas Global Operations(TPS)
Supply Chain Operations
Toyota Way(Extended Enterprise of TPS)
Result : Operations Excellenceand Sustainable
The Toyota Way(Likers view of Lean Enterprise Example)
Enterprises Operations(Lean Thinking)
Supply Chain Operations
Result : Operations Excellenceand Sustainable
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gAbstract : Abstract :
Context : Context :
Concrete : Abstract x Context : X
Concrete : Abstract x Context : X
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14 Dr. Jeffrey Liker
1
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3
4
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The Toyota Ways Liker Approach : 4P Model
8. 7. 6. 5. 4. Heijunka3. 2.
Flow of Value
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Toyota in The World 2020
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2020Monozukuri
(Monozukuri )
2020
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Learning from the Toyota Way
Learn how to think, not how to do.
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Changes .. Changes .. Changes ..
It is not the strongest of the species that survive,It is not the strongest of the species that survive,nor the most intelligent,nor the most intelligent,
but the ones most responsive to change.but the ones most responsive to change.
...... ......
Charles DarwinCharles Darwin
()
()
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Man
Material
Machine
Money
Method
Information
Man
Material
Machine
Money
Method
Information
(Finished Good FG)
(Customers)
(Products) (Services)
(Customers)
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Lean Services VS Lean Manufacturing
Lean Manufacturing 5M+I (Product) ()
Lean Services 5M+I
Lean Service
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.
Source 2:
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Information
Clinical assessment
Investi-gations
Clinical decision
Admi-ssion
Treat-ment
Dis-charge
Patients Information
The Fantasy Patient Journey
Adapted from Source : 2
Hospital Internal Supply Chain()
(Logistics Flow)
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Lean Healthcare
Source 2:
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(Henry Ford, My Life and Work).
(also from My Life and Work).
Ford (Norwood, Ford: Men and Methods).
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Mass Production
Lean Thinking
Mass & Lean Thinking
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Lean System
Hospital Business Process
Patients Flow
BetterFasterCheaper
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Takt Time Kanban TPMKaizen
7
, ,
CEO
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Kanban
Kaizen
Tools and Technology
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(Lean Enterprise)
(Principle of Lean Thinking
(Business Model)
ToyotaGM 14 The Toyota Way
5 GMS GM
(Principle and Practices)
(Lean Enterprise Model)
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(Technology)
(Process)
(People)
Customer Success
(Value Chain)
(Supply Chain)
(Business Process)
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Healthcare Value ChainHealthcare Value Chain
Healthcare Supply Chain
Patients
ServiceDesign Patient
Requirem
ents
Raw Material
Suppliers
Values to Values to Patients
Co.1 Co.2 Co.3 Service ValueService Value
New Service Model
Logistics ValueLogistics Value
Value Added Processes
Logistics Management
: How I see the World (Ver.2.0)
GoodFastCheap
BetterFasterCheaperHealthCare Supply Chain Management
Control
Improve
Change
Admission Treatment Discharge
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:
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TPS (System)
-Fujio Cho, Chair of the Board, Toyota
Toyota Leaders
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Lean and System Thinking
Six Sigma
Team Work
Smoother Operation
BetterQuality
Pull Scheduling
Smaller Batches
FasterSetups
ImprovesSetupSkills
Less Inventory
CellularLayout
Basic Elements of LeanCellular LayoutsFast SetupsPull SchedulingSix Sigma QualityTeamwork
Overall resultSuperior QualityLower CostFast Response
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Lean Integrated Planning Process
Strategic Business
Plan
Sale andOperationsPlanning(S&OP)
1ProductionPlan andMaster
Schedule (MPS)
2Material
RequirementPlan
(MRP)
3Takt Time
(Rough CutCapacity Plan)
4PreliminarySchedule
(HeijunkaOptional)
7Release
Schedule(HeijunkaOptional)
6OperationalTakt Time
(Capacity Requirements Plan)
9KanbanReleaseSignals
CustomerDelivery
SUPPLIERS
Daily
Annual
Monthly
Weekly
Shop PerformanceFeedback
Long Lead Time Requirement
5Communicate
8Communicate
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Demand
Supply
Production
New ProductFinance
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Toyota Leaders
Fujio Cho, Taiichi Ohno Kentucky :
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(Purpose) (Process) (People)
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(Purpose) (Processes) (People)
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4
1.
2.
3.
4.
Source : 2
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, ,
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..
..
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(Servant Leadership) .
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Toyota Leaders
Cho Ohno Ohno Professor Satoshi Hino Toyota 2 Inside the Mind of Toyota: Management Principles for Enduring Growth ( DNA . ) Hino Eiji Toyoda, Shoichiro Toyoda, Hiroshi Okuda and Fujio Cho,
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Hino
The Toyota Way
Inside the Mind of TOYOTAInside the Mind of TOYOTA
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Taiichi Ohno Ohno Ohno
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TPS is Practice, not theoryToyota : Learning Organizations (Routine to Research)
TheoryRules
Doing!Doing!! againDoing!! again and again
Results : Improvement
Best Practices
E
x
p
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i
m
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Learning Laboratory : Lifes are experiments
Interchangeable Parts
Eli Whitney
Interchangeable Parts
Eli Whitney
Time & Motion Division of
Labor
F. Taylor
Time & Motion Division of
Labor
F. Taylor
Mass Production
Henry Ford
Mass Production
Henry Ford
Mass / Batch
Alfred P. Sloan
Mass / Batch
Alfred P. Sloan
Supermarket Replenishment
Systems
Supermarket Replenishment
Systems
Employee Partnership
P. Drucker
Employee Partnership
P. Drucker
Quality
E. DemingJ.M. Juran
Quality
E. DemingJ.M. Juran
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(Knowledges)
(Thinking)
(Problems)
(New Best Practices)
What? What?How?
What &How?
(Best Practices)
OptimizationApproach
(Business Process Improvement)
(Constraints)
()
()
()
Problem Modeling
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Toyota : Heading for True North
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(1)
(Value) (Value Creation) (Value Chain) (Value Stream) (5M+I) (5M+I) (Supply Chain) (Business Process)
(Good) (fast) (Cheap)
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(5M+I)
(Balanced) (Synchronize) (Inventory) (Shortage) (Low Service Level)
(2)
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(Holistic)
(Flow) (5M+I)
(3)
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(Just in Time) (5M+I) () ()
(4)
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(Flexible) (Agile)
(5)
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(6)
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:
:
: + =
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Lean Procurement
Lean Manufacturing
Lean Distribution
Lean Sale & Marketing
Lean Services
Lean Enterprise
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Hospital Government Construction
TPS
Lean Hospital
Lean Government
Lean Construction
Lean Services
Lean Enterprise
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Society
Balanced Balanced Balanced
Political System
Economic System
Technology & Innovation
World ViewsNatural System
EarthEcology System
Environment(Global warming)
Lean Thinking in World Views
BalancedIndividuals create values and exchange values. Values are developed to more and more value added to respond to
individual needs and wants.
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[email protected] 02-539-3373
Book Published by E.I.Square Publishing
Lean Toyota HA 12th North Regional Forum . (Competitiveness) Genesis of Lean: The Toyota Production SystemTPS HouseMost common mistakeTaiichi Ohnos Seven WastesTPS : Toyota Production SystemThe Thinking Toyota Production System Toyota Production System (TPS) Toyota Toyota Production System (1990 and 1996) (Principles of Lean Thinking)7 Deadly Wastes - MudaLean Thinking Principles in System Perspective7 Wastes in Dr. Vithayas System Perspective Lean Lean ?Lean is Flow Management (Lean Tools)The Lean EnterpriseFrom Mass to LeanThe Toyota Way (2001)Toyota WayBottom-line of Toyota Way (2001 And beyond) From Toyota way to Lean Enterprise 14 Dr. Jeffrey Liker The Toyota Ways Liker Approach : 4P ModelToyota in The World 2020 2020Learning from the Toyota WayChanges .. Changes .. Changes ..Lean Services VS Lean Manufacturing.The Fantasy Patient Journey Lean Healthcare Mass & Lean ThinkingLean System : How I see the World (Ver.2.0) : Toyota LeadersLean and System ThinkingLean Integrated Planning ProcessToyota Leaders 4 Toyota Leaders (Best Practices)Toyota : Heading for True North (1) (3) (4) (5) (6)Lean Thinking in World Views