Quality and Safety in Health Care, Part LXXXII

Abstract

Reports from the Institute of Medicine regarding the number of errors in medicine leading to fatalities prompted a major review of medical practices and a move to make medical systems high reliability organizations. Many of the concepts used today to improve performance in health care are borrowed from what has been learned from successes and accidents in other industries, especially in the aviation, space, and nuclear power programs. An emphasis on excellent leadership and communication, the knowledge that there needs to be an emphasis on system failures rather than human failures, and having a safety culture that encourages everyone to be mindful of potential errors and report errors are critical to achieve high reliability.

Quality and Safety in Healthcare, Part XCIII

“…Also, the A3 form of Lean provides a relatively easy guide to follow. 9,[21][22][23] Although Six Sigma is a specific quality improvement methodology, it does use multiple tools used in other improvement methodologies, including those used in the TPS, in many of the steps in this process. 24 A more formal synthesis of some of the best aspects of Lean and Six Sigma, apply named Lean Six Sigma, has been promoted by many.…”

“…Lean also emphasizes reducing or getting rid of waste and using the value stream map as a guide to doing that, and offering maximum value to the customer. Also, the A3 form of Lean provides a relatively easy guide to follow 9,21–23 …”

Quality and Safety in Healthcare, Part XC

“…Indeed, in his article on the Triumph of the Lean Production System Krafcik did not discuss most of the details and many of the important principles of the TPS. 11,24,27 Whereas ultimately what is TPS is defined by Toyota, "unfortunately, (a) we do not have a good definition of Lean, and (b) not everybody means the same thing when they talk about Lean." 25…”

“…3 Having continuous flow regarding the processes is critically important to decrease waste. 11,12 Standard work refers to having each step in a process clearly described so that it will be done in the best possible known way by all workers performing the task. In a factory, this includes not only how machinery will be operated but also other tasks such as how maintenance will be performed and how requests for repairs will be done.…”