Lean Methods for Aerospace and Healthcare in Ontario


    Article – How Toyota builds cars

    Here's an article from Canada about how Toyota (an automaker) manages to be influential to Bombardier (maker of planes) and St. Joseph's Hospital in Hamilton, Ontario (a fixer of people).

    The article, I think, somewhat overplays the value of metrics. Don't get me wrong, performance measures are important in manufacturing or healthcare — if they are timely, frequently taken, relevant to the employees, and are used for performance improvement, not punishment.

    This is how it works: Posted outside of each department in each facility is a newspaper-sized piece of paper showing the performance rank of each department on a daily basis using five key metrics: safety, cost, quality, productivity and employee relations. These pieces of paper serve at once as an incentive for improvement and an easy way to identify and address issues on a day-today basis, Mr. Robert said.

    Every morning the plant manager walks through the factory and collects the data off these sheets, and any problems that have arisen in the previous day's work are discussed during a fast-paced 30-minute meeting held at 10 a.m. with the department heads. Any issues are addressed collectively here.

    None of that is bad, but it's not the full essence of Lean.

    St. Joseph's Lean journey, as many in healthcare, began with heavy influence from a manufacturer, in this case Toyota.

    St. Joe's partnership with Toyota came together somewhat serendipitously after a family member of the head of Toyota Motor Manufacturing Canada, Ray Tanguay, became a patient at the hospital. In the hours Mr. Tanguay subsequently spent at the hospital, he started to notice ways the automaker's methodology might be able to help with the hectic flow of traffic through St. Joe's.

    The next day, Mr. Tanguay called Dr. Smith and encouraged him to come visit the automaker's operations and to see if they could work together — a service Toyota has offered free of charge through its charitable arm.

    What are the results in their Emergency Department?

    Since the new system was implemented, St. Joe's wait times have fallen on average by a couple of hours per patient, Dr. Smith said. Roughly 90% of St. Joe's patients now have a wait time of less than four hours, as opposed only 50% before, he added.

    Less waiting – and I'll bet better care at a lower cost. These tend to go hand in hand with Lean.

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    Mark Graban
    Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


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