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Lean Healthcare: Standard Work

At YKHC, our process for high reliability is LEAN. Standard work is absolutely foundational to our success with Lean.

I once had the opportunity to attend a conference in Germany where the President of Toyota-Europe would be speaking. I knew he would be presenting to our team long before arriving at the conference so naturally I was very excited to hear his thoughts about what makes Toyota Lean. Eagerly, I sat with pen in hand ready to take notes as his talk began. After the brief initial orientation of Toyota Europe, he began to speak on the topic of the Toyota Production System (TPS) where the term Lean was first coined. For the next sixty minutes the President of Toyota-Europe spoke to the group on standard work using a deck of slides that I had duplicated and taught on myself no less than fifty times before. I was so disappointed. I knew this material I thought. I teach this material. I do this in my own work. Afterwards, as I reflected on his presentation I realized what I failed to grasp, is how foundational standard work is to the overall system. Without the standard work there is no Lean system. There is no basis for improvement. There is no real way to define the right problems that must be solved. The foundation for quality is deeply eroded. That is what I learned from him and to this day, I have never forgotten that learning.

Good standard work contains the following:

  1. The content of the work steps.
  2. The sequence of the steps.
  3. The time for each step.
  4. The location where the work occurs.
  5. The outcome expected at the completion of the steps.

–Ronnie Daughtry

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