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Vital Health Care Reformation

Manufacturing principles applied to the medical industry
By Timothy Stansfield and Joshua Manuel

 “The competition keeps getting better, so we need to do the same.” This phrase is uttered time and again in modern-day automotive manufacturing plants. The meaning behind this statement is not hard to understand: In order to stay in business, the company must find ways to improve the bottom line, usually through cost reduction and efficiency improvements. The problem with this philosophy is that the motivation is completely reactive. The companies using this phrase are implying that they are falling behind and they must improve out of necessity.

A better way to ensure success in the marketplace is to be the industry leader. In order to accomplish this goal, a proactive approach is required. In the automotive industry, Toyota has become the benchmark for success. Early on, they recognized the difference in approach. Understanding that continuous improvement is an absolute necessity, Toyota utilized improvement techniques that address all avenues of competition and in doing so, cemented their place in history. American automakers have yet to recover from Toyota’s customer-driven philosophies, cost containment measures, new echelons of quality assurance and unceasing search for innovation. The American automakers have developed programs of improvement within lean and Six Sigma, but have difficulty driving these programs to the bottom line. History predicts that the health care industry can expect a similar journey. Who will be the health care industry leaders in the next five years?

The industrial engineering approach to health care reformation is to address all of the avenues of business competition including cost, quality, speed and customer service. Cost improvement within the health care arena can be an emotional effort, to say the least. Professional groups offering high-cost opportunity can include pharmacists, nurses, respiratory therapists, medical technologists and yes, even doctors. These immediate and necessary cost improvement efforts seem almost irresponsible when applied to an overworked and understaffed professional medical service department. However, our studies have consistently presented data that indicates that redesigns to these medical service processes, roles and scheduling practices can drive the utilization of these personnel to significantly higher levels.

Cost improvement can also be addressed through improving the low levels of asset utilization typically experienced in health care. More surgeries, urgent care patients, pathology tests and ancillary support services will ensure competitive advantage in the 21st century.

IET Inc., a comprehensive industrial engineering firm, commissioned a team of full-time professionals to work with an Ohio-based medical center on the principal focus of improving first-case, on-time start performance in the main operating rooms. To attain significant improvement, three aspects of the surgical preparation process needed to be observed, measured, optimized, redesigned and implemented. The three contributing factors for punctuality in the pre-op area depend on the patient, the provider and the information flow.

The team of IE professionals measured the surgery scheduling and preparation process to create a baseline and ultimately develop an accurate health care process record that visually correlates each individual flow of information and key resource interaction against a chronological time scale. Utilizing this tool along with other industrial engineering principles, IET was able to drive bottom-line results. Implementation plans for the prescribed improvements are still underway. It is expected that the surgery first-case, on-time start percentage will double and reach unprecedented heights in the medical industry.

The medical industry can learn a great deal from automotive manufacturing history. Specifically, there is a requirement for reformation in the health care industry, and significant change is just around the corner. The question is whether an organization desires to lead this reformation or spend the next generation struggling in a competitive chase.

Timothy Stansfield is the president of IET Inc. based in Toledo, Ohio. Joshua Manuel is the company’s industrial engineering supervisor. Look for a related article in the April issue of Industrial Engineer magazine.

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