Jan 20, 2009

Getting Lean at MIT

I spend most every weekday morning in a panic. I shower, throw on clothes, shovel in some breakfast, and frantically gather my wallet, keys and phone before running out onto an icy sidewalk -- and even then I'm generally at least five minutes late.

Today, a few members of the IHI Open School team went to MIT to learn about "Lean" - a production practice that seeks relentlessly to eliminate waste. Lean came out of Japan's post-WWII auto industry, but it has broad applications for practically any sort of production (including the elaborate production that is my morning routine).

Lets take a look at a Lean practice called 5S: Sort, Straighten, Scrub, Standardize, Sustain.

SORT: My alarm goes off and I knock over two glasses of water and a couple of books trying to hit the snooze button. I end up throwing out a sodden issue of Wired Magazine. I ought to SORT through the items on that tabletop and get rid of what's not needed.

STRAIGHTEN: My clothes aren't organized in any systematic way, and I spend a lot of time visually searching for what I need. When I STRAIGHTEN out my closet by putting things in bins, I save time.

SCRUB: I didn't do the dishes last night, and now I have to spend precious time rinsing out a cereal bowl. Last night I could have SCRUBBED the dishes and made them ready.

STANDARDIZE: I lose five minutes running from room to room, looking for my keys. I could create a STANDARD place for them - say, on the hook by the door -- so I'll never search again.

SUSTAIN: Here's the challenge. Once I decide on these changes, I need to SUSTAIN them over time.

Okay, so that solves my morning mess. But Lean is a lot more than a way to get yourself to work on time. It's a way to cut waste from any process - defined as a set of actions that transforms an input into an output. Whether the output is a chem problem set, a healthy patient, or a Toyota Prius, lean production requires you to sit down and understand key processes, noting which steps add value and DON'T add value for the customer.

So how to apply these principles to a system as big and complex as health care? Start by checking out "Going Lean in Health Care," a free white paper from IHI.

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