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

KAIZEN IN KAIZEN IN HOSPITAL HOSPITAL

MANAGEMENTMANAGEMENT

Dr S SridharanDr S SridharanMBBS, M.Sc (Med.Admn.), MD (Col.), Dip. ITMBBS, M.Sc (Med.Admn.), MD (Col.), Dip. IT

KAIZENKAIZENINCREMENTAL BUT CONTINUOUS PROGRESS

KAIZENKAIZEN

It has two elements:It has two elements: Improvement / for betterImprovement / for better Ongoing / ContinuityOngoing / Continuity

KAIZENKAIZEN

KAIZEN means improvement. Moreover KAIZEN means improvement. Moreover it means continuing improvement in it means continuing improvement in personnel life, home life, social life and personnel life, home life, social life and working place.working place.

When applied to the workplace KAIZEN When applied to the workplace KAIZEN means continuing improvement means continuing improvement involving everyone – managers and involving everyone – managers and workers alike.workers alike.

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; andClean, orderly and safe working environment.

•Anything that doesn’t add value;changing form fit or function

• Anything that doesn’t help meetcustomer requirements

• Anything our customers would not be willing to pay us to do

GEMBA KAIZENGEMBA KAIZEN

GembaGembaA 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.

GembutsuThe tangible objects found at gemba such as

work pieces, rejects, jigs and tools and machines

MUDAMUDA

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

Seven deadly wastesSeven deadly wastes

1. Overproduction: Blood draws done early to accommodate lab

2. Transportation: Moving patients to tests3. Excessive Processing: Asking patient the

same information multiple times4. Waiting: Inpatients waiting in ED, MDs waiting

for test results.5. Inventories: Dictation waiting for transcription6. Movement: Looking for missing charts or

equipment7. Defects: medication errors

MURA ( Irregularity)MURA ( Irregularity)

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

MURI (Strenuous work)MURI (Strenuous work)

Muri means strenuous condition for Muri means strenuous condition for worker and machines as well as for worker and machines as well as for the work processesthe work processes

New wastes in KAIZENNew wastes in KAIZEN

►Waste of Human Potential;Waste of Human Potential;► Inappropriate System;Inappropriate System;►Electricity and Water;Electricity and Water;►Wasted Material;Wasted Material;►Service and Office equipments;Service and Office equipments;►Cost of Time; andCost of Time; and►Defecting CustomersDefecting Customers

Reasons Why KAIZENReasons Why KAIZEN

Lower Cost;Immediate Results;Less Waiting;Energize Employees; Improve Productivity; andCreativity and Innvation

Process Improvement; Short Time; Zero / Less Defect; Human Resource Development; and

Profits and Sharing.

ProcesProcess Names Name

1. OP1. OP 2.In2.In 3.Tran3.Transs

4. 4. ProcesProcessingsing

5.Waitin5.Waitingg

6. 6. InventoryInventory

7.Motio7.Motionn

DefectDefectss

0= No waste found to 4 =A lot of waste

Golden Rules of Golden Rules of Gemba Gemba managementmanagement

When a problem (abnormality) arises When a problem (abnormality) arises go to gemba first;go to gemba first;

Check the gembutsu (relevant Check the gembutsu (relevant objects);objects);

Take temporary countermeasures on Take temporary countermeasures on the spot;the spot;

Find the root cause; andFind the root cause; andStandardize to prevent recurrence.Standardize to prevent recurrence.

Ten basic rules for Ten basic rules for practicingpracticing kaizenkaizen in in gembagembaDiscard 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;

Ten basic rules for Ten basic rules for practicingpracticing kaizenkaizen in in gemba gemba

……Do not spend money for kaizen;Do not spend money for kaizen;Wisdom is brought out when faced Wisdom is brought out when faced

with hardship;with hardship;Ask ‘Why?’ five times and seek the Ask ‘Why?’ five times and seek the

root cause;root cause;Seek the wisdom of ten people rather Seek the wisdom of ten people rather

the knowledge of one; andthe knowledge of one; andRemember that opportunities for Remember that opportunities for

KaizenKaizen are infinite. are infinite.

Encourage suggestions from employeesEncourage suggestions from employeesEmployee participation in managementEmployee participation in managementEncourage managers to visit the Encourage managers to visit the

workplace (GEMBA)workplace (GEMBA)Mistake proofingMistake proofingMinimize patients and Employee Minimize patients and Employee

accidentsaccidentsReduce inventories in Wards / UnitsReduce inventories in Wards / Units

Productive maintenance of Productive maintenance of Hospital equipment and furnitureHospital equipment and furniture

Reduce WasteReduce WasteReduce waiting timeReduce waiting time

MINIMIZE DEATHS & MINIMIZE DEATHS & COMPLICATIONSCOMPLICATIONS

Benefits of KaizenBenefits 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