This document outlines the objectives and content of a Toyota Production System (TPS) training curriculum. The objectives are to: familiarize participants with TPS; review critical elements like the four rules of TPS; examine the curriculum's uniqueness; develop awareness of benefits and improvements; discuss the unique selling proposition; and discuss opportunities and challenges. The content includes comparisons of traditional vs lean culture, explanations of key TPS tools like value stream mapping and A3 problem solving, details of the 7-day training schedule and follow-up coaching, examples of past projects and their impacts, and perspectives from previous participants on the training's benefits.

2. Objectives of this session:
Acquire a general familiarity of the Toyota
Production System
Review the critical elements of the curriculum
Examine the uniqueness of the curriculum
Develop awareness of the benefits and metric
improvements that can be realized as a result of
training and implementation
Discuss the unique selling proposition of the
program
Discuss the opportunities and challenges associated
with the program

4. TRADITIONAL CULTURE LEAN CULTURE
 Functional Silos
 Managers Direct
 Benchmark
 Blame People
 Rewards: Individual
 Supplier is Enemy
 Guard Information
 Volume Lowers Cost
 Internal Focus
 Expert Driven
 Interdisciplinary Teams
 Managers Teach/Enable
 Seek the Ultimate Performance
 Root Cause Analysis
 Rewards: Group Sharing
 Supplier is Ally
 Share Information
 Removing Waste Lowers Cost
 Customer Focus
 Process Driven

5. MIT researchers coined the term
after discovering
that the Toyota Production System
produced goods with…
HIGHER QUALITY
and LOWER COST
in HALF the TIME
( Womack , Jones & Roos, 1991)

7.  Rule 1: All activities of work
are clearly specified by
content, sequence, timing,
and outcome
 Rule 2: Connections are
direct
 Rule 3: Pathways are simple
and each step is essential
 Rule 4: Improvement –
direct response, as close to
the problem as possible, as
an experiment, by those
doing the work, supported
by a coach

10. The Value Stream Map
VSMs identify every way that a request can
be made
Reserving a Conference Room
Confirmation
- confirm
received info w /
customer
- make sure to
have all
necessary info
Schedule Room
- Check available dates
- Check available tables
and chairs
- Reserve room
Schedule A.V.
- Check available A.V.
equipment
- Reserve A.V.
equipment
Catering
- Order food
- Order beverages
Confirm
- Call/ email/ fax
customer confirmation
Bill
- Review charges
- Create bill
- Send bill

12. Provides an order in which to think and
document specific problems and solutions
Left Side
Issue
Background
Current Condition
 Right Side
Target Condition
Countermeasures
Implementation Plan
Cost and Cost Benefit
Test
Follow-up

15.  IDEAL
 Four Rules in Use
 Observation
 Method for deeply understanding work activities
 Skills must be developed and practiced – it’s not easy!
 Value Stream Mapping
 Lean method for identifying the flow of value to the customer
 10,000 foot view of a process
 A3 Problem Solving
 Problem solving in the course of work
 By people doing the work
 Supported by a coach

16. 7 Day Course Spread over 7 weeks or more
Schedule for days 1 - 6:
3 hour class time (includes time for project work)
minimum of 1 hour coaching time for participants
Schedule for day 7:
2-3 hour report out of projects
5-6 hour training for participants to learn coaching skills
1 Full Day of Train the Trainer
Training for 2 internal trainers
7 Day Course – Same as Above
New Trainers will co-teach the second course with help from the
instructor

17. • Opportunity for senior management buy-
in through Executive Overview
• Combination of training and
implementation
• Improvements made by people doing the
work
• Enhances leadership and communication
skills
• Self-sustaining model for lean
implementation

19.  Everyone becomes an expert
problem solver
 Problems solved in the course of
daily work
 Rapidly solve small focused
problems
 Makes complexity manageable
 Makes problem solving objective
 Takes the emotion/blame out
 Eliminates resistance to change

20.  Develops a common problem
solving process and language
throughout the hospital system
 Replaces complaining with A3
thinking
 Helps solve problems across
departments
 Done by all those involved -
more buy-in
 Naturally results in culture
change

21. Elimination of defects
Reduced waste –
improved flow
Improved patient
satisfaction
Reduced costs
Increased employee
engagement
Reduced employee
turnover

22.  Short-Term Rehab Discharge to Home
 Business Impact
Reduced time that social services spends coordinating
short-term rehab discharges by 25%
Reduced the number of missed short-term rehab
patients due to a delay in another patients discharge
by approximately 20%
Improved employee and patient satisfaction
ROI = 154%

23.  Dressing Change Delays (TPS reVIEW
©
Project)
 Business Impact:
Reduced the combined nursing time spent looking
for dressing supplies by 3.75 hours per day
Reduced the amount of wasted medical supplies to
inaccurate inventory
Improved employee and resident satisfaction
ROI = 590%

24.  Chart-to-Go
 Business Impact
Reduced Activities of Daily Living (ADL)
documentation time by 46%
ADL documentation is more accurate, reducing the
chances of a Department of Health violation
The Case Mix Index (CMI) has increased by 2.8%
The ADL documentation process is now paperless
ROI = 31%

25. Flyer used
for marketing
purposes

26. “But what really sets this training apart from other problem –solving
process improvement courses is the potential to empower front line staff
to help develop and implement solutions, which helps them feel more
connected and thus motivated to continue giving their best efforts
because they can make a difference.”
Michelle
DiGilarmo
Director of HR
and OD
WRC Senior
Services
“TPS in Healthcare using reVIEW
©
provides you with the tools to look at a
process in a way that will assist in finding the best and most efficient
practice.You can ultimately “see” the Return-on-Investment.”
Catherine Grove
Chairperson
NCWIB Healthcare
Partnership

27.  Research-Based
 Experiential
 Simple
 Sustainable (the gift that keeps on giving)
 Coaching Component
 Can Easily Illustrate Metric Improvement
(Level IV Evaluation) a Return-on-
Investment (Level V Evaluation)
 JCAHO likes Lean
 Others?