lean thinking in healthcare มช 14 june 2010

Lean Toyota

HA 12thNorth Regional Forum

.

14 2554

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)

3Genesis of Lean: The Toyota Production System

Interchangeable Parts

Eli Whitney


Eli Whitney

Time & Motion Division of

Labor

F. Taylor


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


Systems

Jidoka

S. Toyoda

Jidoka

S. Toyoda

Just - In - Time

K. Toyoda

Just - In - Time

K. Toyoda

Employee Partnership

P. Drucker


P. Drucker

Quality

E. DemingJ.M. Juran

Quality

E. DemingJ.M. Juran

4TPS HouseTPS House

5Most common mistake

Jumping from problem to solution without clear understanding and analysis

PROBLEM

SOLUTION

6Taiichi Ohnos Seven Wastes

MUDA

Time on Hand(Waiting)

Transportation

DefectiveProducts

Processing

Movement

Stock on Hand(Inventory)

Overproduction

7TPS : Toyota Production System

TPS : Toyota Production System TPS Thinking Production System Thinking Production System TPS (Toyotas

production system)

ThinkingThinking

8The ThinkingThe Thinkingpoints out what is a.

and what is an

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)

10

Toyota Production System (TPS)

(Implementation)

TPS

TPS

11

Toyota Toyota Production System Toyota

Source: Gary Convis,President of TMMK

JITJidokaKaizenHeijunka

Kaizen

True North .

() ()

12

(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

13

(Principles of Lean Thinking) (Value) (Value Stream)

(Flow) (Pull)

(Perfection)Do this every day in all our activities

14

()

15

7 Deadly Wastes - Muda

Transportation

Waiting

Inventory

DefectsMotion

Processing

Overproduction

Page 16 of 29

16

Lean Thinking Principles in System Perspective

Value Stream

Value Chain

Values

C

u

s

t

o

m

e

r

s

Value Stream

SuppliersFlow of Value (Value Added & Non Value-added)

Perfection

Pull

Dynamic AlignmentAdaptive

Extended Value Chain

12

3

4

5

17

7 Wastes in Dr. Vithayas System Perspective

C

u

s

t

o

m

e

r

s

S

u

p

p

l

i

e

r

s

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

18

Lean Lean

: (Waste) (Creating value).

19

(()) ( (commitment), commitment), (patience) , (patience) , (long(long--term thinking) , term thinking) , (positive mindset) (positive mindset) (attitude), (attitude), (continuous improvement) (continuous improvement)

(Lean)(Lean) Lean ?

20

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

21

(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

22

The Lean Enterprise

23

Mass Production

Lean Thinking

From Mass to Lean

Cycle TimeTakt Time

24

Visual FactoryVisual Factory

((Housekeeping)Housekeeping)

CellularCellular

25

The Toyota Way (2001)

(Core Value) The Toyota WayThe Toyota Way Mr. Teruyuki Minoura DNA

Gary Covis TMMK Toyota : Changes and Challenges - 8 2001

26

Toyota Way

27

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 --

28

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

E

m

u

l

a

t

e

T

o

y

o

t

a

s

L

e

a

n

T

h

i

n

k

i

n

gAbstract : Abstract :

Context : Context :

Concrete : Abstract x Context : X

Concrete : Abstract x Context : X

29

14 Dr. Jeffrey Liker

1

2

3

4

30

The Toyota Ways Liker Approach : 4P Model

8. 7. 6. 5. 4. Heijunka3. 2.

Flow of Value

31

Toyota in The World 2020

32

2020Monozukuri

(Monozukuri )

2020

33

Learning from the Toyota Way

Learn how to think, not how to do.

34

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

()

()

35

Man

Material

Machine

Money

Method

Information

Man

Material

Machine

Money

Method

Information

(Finished Good FG)

(Customers)

(Products) (Services)

(Customers)

36

Lean Services VS Lean Manufacturing

Lean Manufacturing 5M+I (Product) ()

Lean Services 5M+I

Lean Service

37

.

Source 2:

38

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)

39

Lean Healthcare

Source 2:

40

(Henry Ford, My Life and Work).

(also from My Life and Work).

Ford (Norwood, Ford: Men and Methods).

41

Mass Production

Lean Thinking

Mass & Lean Thinking

42

Lean System

Hospital Business Process

Patients Flow

BetterFasterCheaper

43

Takt Time Kanban TPMKaizen

7

, ,

CEO

44

Kanban

Kaizen

Tools and Technology

45

(Lean Enterprise)

(Principle of Lean Thinking

(Business Model)

ToyotaGM 14 The Toyota Way

5 GMS GM

(Principle and Practices)

(Lean Enterprise Model)

46

(Technology)

(Process)

(People)

Customer Success

(Value Chain)

(Supply Chain)

(Business Process)

47

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

49

TPS (System)

-Fujio Cho, Chair of the Board, Toyota

Toyota Leaders

50

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

51

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

10

Demand

Supply

Production

New ProductFinance

52

Toyota Leaders

Fujio Cho, Taiichi Ohno Kentucky :

53

(Purpose) (Process) (People)

54

(Purpose) (Processes) (People)

55

4

1.

2.

3.

4.

Source : 2

56

, ,

57

..

..

.

(Servant Leadership) .

58

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,

59

Hino

The Toyota Way

Inside the Mind of TOYOTAInside the Mind of TOYOTA

60

Taiichi Ohno Ohno Ohno

61

TPS is Practice, not theoryToyota : Learning Organizations (Routine to Research)

TheoryRules

Doing!Doing!! againDoing!! again and again

Results : Improvement

Best Practices

E

x

p

e

r

i

m

e

n

t

s

Learning Laboratory : Lifes are experiments


Eli Whitney


Eli Whitney


Labor

F. Taylor


Labor

F. Taylor

Mass Production

Henry Ford

Mass Production

Henry Ford

Mass / Batch

Alfred P. Sloan

Mass / Batch

Alfred P. Sloan


Systems


Systems


P. Drucker


P. Drucker

Quality

E. DemingJ.M. Juran

Quality

E. DemingJ.M. Juran

62

(Knowledges)

(Thinking)

(Problems)

(New Best Practices)

What? What?How?

What &How?

(Best Practices)

OptimizationApproach

(Business Process Improvement)

(Constraints)

()

()

()

Problem Modeling

63

Toyota : Heading for True North

64

(1)

(Value) (Value Creation) (Value Chain) (Value Stream) (5M+I) (5M+I) (Supply Chain) (Business Process)

(Good) (fast) (Cheap)

65

(5M+I)

(Balanced) (Synchronize) (Inventory) (Shortage) (Low Service Level)

(2)

66

(Holistic)

(Flow) (5M+I)

(3)

67

(Just in Time) (5M+I) () ()

(4)

68

(Flexible) (Agile)

(5)

69

(6)

70

:

:

: + =

72

Lean Procurement

Lean Manufacturing

Lean Distribution

Lean Sale & Marketing

Lean Services

Lean Enterprise

73

Hospital Government Construction

TPS

Lean Hospital

Lean Government

Lean Construction

Lean Services

Lean Enterprise

74

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.

[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

lean thinking in healthcare มช 14 june 2010

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