First, on a personal note… some of you have reached out to express concern about me being in Orlando during Hurricane Irma. My wife and I both go back and forth between Orlando and Fort Worth because of her job and, thankfully, we are both in Texas during all of this. Thanks for your concern and, if you can, please donate to the Red Cross or other organizations that will help with hurricane relief. Unlike with Hurricane Harvey, which didn't affect Fort Worth at all, we have fingers crossed that our Orlando home won't be damaged and, more importantly, that there isn't any loss of life there. And now, today's post…
I've long been appreciative of the work that Toyota does, through their non-profit TSSC subsidiary, to help non-profits and community organizations improve.
The latest example of that is some work done at Children's Health in my other backyard, in Dallas:
As it says in the release:
“Through a collaboration with Toyota, Children's HealthSM, the leading pediatric health system in North Texas, announced today it has successfully reduced rates of central line-associated blood stream infections (CLABSIs) by 75 percent with patients in the gastroenterology unit.”
This is really important work and these are fantastic results.
Dr. Rick Shannon used Lean / Toyota methods to similarly reduce CLABSI rates at multiple health systems, as we discussed in this podcast a few years back:
Back to the improvement work at Children's:
“The teams worked together to identify unintended process breakdowns. Through TSSC's process methodology and expertise, Children's Health determined the immediate environment of care is vital in the process of maintaining cleanliness of the central line.”
I'm not surprised that they found “unintended process breakdowns.” Healthcare quality problems often aren't the result of people not knowing what to do… and these problems are certainly not the result of people not caring or so-called “bad apples.”
What gets in the way of people doing the right work the right way at the right time? It could be supply chain issues. It could be general conditions of overwork caused by there being too much waste in their daily work.
As we typically see in reports of Toyota's work with non-profits and suppliers, they don't come in to tell people how to do their work. They have an improvement process that they teach that allows those doing the work (and their leaders) to discover problems and to work together on systemic improvement.
From the article:
“Children's Health invited us into their units to see the clinical processes firsthand, and together we were able to implement a program that we hope can be a model process,” said Jamie Bonini, vice president of TSSC. “By leveraging the methods of the Toyota Production System, like problem solving, standardization and rigorous training, we are pleased to help make life better for children in our new home in Texas.”
Toyota, of course, recently opened up their new North American headquarters in nearby Plano.
We've seen Toyota's collaborative approach in their work with UCLA-Harbor Medical Center:
I also blogged about this here, with a different video being produced:
And TSSC has done similar work with a food bank and efforts to provide relief after Hurricane Sandy:
Back to the Children's story:
“By the end of 2017, Children's Health will roll out improved practices from the collaboration system-wide, ultimately empowering team members to implement improved care processes to prevent infections across multiple hospital units.”
I'm curious to see how the “roll out” will be managed. In some organizations, an internal “roll out” of best practices isn't always well received.
ThedaCare has had an effective process, tough, where an “alpha” unit (the first unit to create a new method) shares it with another unit, the “beta.” The beta unit can choose to adopt (or adapt) the alpha method and has an obligation to try to improve the alpha method so that learning and improvement can be shared back to the alpha unit.
That takes longer than a simple organizational “copy and paste,” but it's more effective.
I hope TSSC and Children's are using a method like ThedaCare's that spreads practices AND empowers team members along the way.
Again, from the article:
“Additionally, Children's Health plans to share its findings with other health care systems across the country in hopes of reducing preventable harm to children everywhere.”
I hope that other hospitals are willing to adopt not just the new practices for managing central lines… but are also willing to adopt the improvement methods advocated by Toyota and TSSC.
As this release says, Toyota has been helping organizations for 25 years now. Again, I thank them for this work and for giving back to our local DFW community and beyond.
As a final note, I've had the opportunity to do some Lean consulting work previously with Children's back when I worked for ValuMetrix Services when it was a part of Johnson & Johnson. I coached improvement teams in the laboratory and radiology.
Some of that lab improvement work was written up in an article:
Since Children's isn't too far away, I've been able to continue making some pro-bono follow up visits in recent years to provide some ongoing coaching. It's great to see that the lab and radiology have sustained the work we did together — sustaining the methods and the results — and, more importantly, continuing to improve.