Open Letter to Hospital Chairperson of the Board

Dear Chairperson:

Hospitals exist in a rapidly changing environment with threats from many directions. To survive Hospitals must become agile and robust. Agile to move quickly to unanticipated and anticipated challenges and Robust to withstand changes.

Some Benefits of the Toyota Production System

Firstly, let me paint a picture of your future Hospital System after implementing the expertise of the Toyota Production System. The advantages of a maniacal  focus on process and system improvement:

  • Most importantly, everyone in the Hospital System is directed toward success,
  • Consequently, the Hospital System attains Profound Knowledge of Hospital Processes, and
  • Attain a new winning culture,
Hospitals Protect Patients
  • Consequently, everyone on a Value Stream becomes a quality inspector through the use of andon:
    1. Certainly, Hospital-Acquired Infection Rate plummets,
    2. Insurance costs decrease,
    3. Lawyer costs decrease
    4. Reputation increases, and
    5. Patients are happy.
Build an Efficient Emergency Room
  • An NIH paper determined that 37% of ER patients do not have an Emergency
  • Move this 37% to a more efficient, lower-cost ER

  • Certainly, the Hospital System Seeks Perfection:
    1. At a rate of 11 ideas per employee per year,
    2. Hospital Management defines the direction of all these ideas,
    1. This is how no competitor will ever catch Toyota, and
    2. Your culture improves to one of winning by involving all employees.
  • Above all, organize your suppliers into at least 7 categories:
    1. Tier 1: Strategic and deliver Just-in-Time,
    2. Tier 2: Strategic and meeting Sigma Performance Requirements,
    3. Tier 3: Strategic and desired Just-in-Time deliveries,
    4. Tier 4: Strategic and not meeting Sigma Performance Requirements,
    5. Tier 5: Not Strategic and Just-in-Time,
    6. Tier 6: Not strategic and not meeting Sigma Requirements, and
    7. Tier 7: Not Strategic and meeting Sigma Requirements.
  • All smaller but often purchased items can be put into a double bin system to decrease inventory costs and increase availability,
  • Implement the Pull Methodology wherever possible. It increases process speed and minimizes inventory waste,
  • Implement Lean Six Sigma to:
    1. Increase process velocity,
    2. Decrease process costs,
    3. Increase process quality,
    4. Increase the number of surgeries performed in a day, and
    5. Flow patients quicker through the Hospital.
  • Above all, Success Metrics are periodically reported to management,
  • You attain Profound Knowledge of your whole Hospital System, and
  • Your organization no longer worries about the competition but welcomes them. Your System will get stronger year after year.
In Summary

The Toyota Production System is a 6+ Sigma System and a Hospital can strive for that level of performance also. Consider making progress toward a Malcolm Baldrige Award (indicating the realization of Operational Excellence, a competitive advantage). Become the fast, efficient, agile, and robust Hospital the adroitly tackles the challenges of tomorrow.


Jim FitzGerald

Lean Six Sigma Master Black Belt


Apply the Tools of The 6+ Sigma Toyota Production System to the Hospital System