Innovating Health Care Delivery Using Toyota Production System Principles

Project and Grant Information

Innovating Health Care Delivery Using Toyota Production System Principles is a project sponsored by the Innovation and Organizational Change Program of the National Science Foundation.  The project is funded by NSF grant # SES-0115352 for three years, beginning May 2001.  Principle Investigator for the project is Dr. Durward Sobek of Montana State University, and Co-Principle Investigator is Cindy Jimmerson, formerlly of Community Medical Center in Missoula, Montana and now CEO of Lean Healthcare West.  Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.

Project Overview

The Toyota Production System

The Toyota Production System, or lean manufacturing, is perhaps the most powerful model devised to-date for efficient design and management of large-scale operations.  TPS integrates simple low-tech tools with advanced production/information technology and unique social/management practices to create highly responsive systems that consistently produce top quality output at minimum cost.  In recent years TPS philosophies and practices have been transferred to many manufacturing facilities in the US and around the world with great success. Unfortunately, this model has been confined to manufacturing plants.

Transferability has historically been difficult because research on lean manufacturing has yielded either high-level goals that are not actionable, or descriptions of practices/tools that are finely tuned to the context of discrete manufacturing and not applicable to other environments. Recent research at the Harvard Business School, however, may have uncovered a set of actionable principles for TPS that makes transferring this management system to new domains a stronger possibility than ever before.

Objectives

This project aims to conduct action research on how this powerful model of operations management can be applied to the health care industry.  The project proposes to answer the following questions:

  1. Can the principles of the Toyota Production System improve health care delivery?
  2. If so, what implementation strategies are more likely to lead to success?

Based on the answers to these questions, this project will develop a set of user-friendly tools and training materials to help health care institutions nationwide improve their delivery systems through the application of TPS principles.

Approach

The proposed work is a collaborative research project between Community Medical Center (CMC) of Missoula, Montana, and Montana State University (MSU) in Bozeman.  CMC plans to use TPS to improve its care delivery systems, beginning in two pilot units.  This project funds a participant-observer investigation of CMC’s change process, assessment of the changes made, and (assuming successful implementation) development of an empirical model of applying TPS to health care settings.  Through direct participant-observation, journaling by team members, artifacts created in the redesign effort, and interviews, we will explore: the psychological and cultural barriers that make it difficult for health care workers to adopt TPS principles, the effectiveness of organizational strategies used, and the effectiveness of tools and exercises used.  In addition, full TPS implementation requires a major shift in how one thinks about work, down to the lowest levels of the organization.  Thus, we will also observe the transition process and the individual learning units transition to taking TPS implementation on their own.

This project has strong potential to make significant and lasting theoretical and practical contribution.  It will deepen our understanding of the efficient design and management of large-scale operations, and possibly challenge current theory.  At the same time, through actual implementation, the project will demonstrate whether TPS principles can improve efficiencies and simultaneously improve patient and employee satisfaction.  The project has a comprehensive plan to disseminate the research results as broadly as possible, to the people who can put them to work.