Gemba Academy: Stories about the Eight Types of Waste in Healthcare

Approximately $750B in wasted healthcare spending each year in the United States…

Breakdown of the $750B in waste

• Institute of Medicine Report (2012): Best Care at Lower Cost: The Path to Continuously Learning Health Care in America
  • Shortcut: http://www.leanblog.org/IOM

$2.5 trillion in U.S. healthcare spending (2009)

• Article about the various studies
  • Shortcut: http://www.leanblog.org/2009costs

Malyia Jeffers story

• Shortcut: http://www.leanblog.org/jeffers
• Video: http://www.leanblog.org/jeffersvideo
• NEJM article (“The Waits that Matter”):
  • http://leanblog.org/waits

The Eight Types of Waste:

• Defects
• Overproduction
• Transportation
• Waiting
• Inventory
• Motion
• (Over)Processing
• Human Potential

Waste Mnemonics:

• DOTWIMP
• TIMWOOD(S)
• WORMPIT
• DOWNTIME
• UWITDMOP

Shigeo Shingo quote:

“We have to grasp not only the Know-How but also ‘Know Why,’ if we want to master the Toyota Production System.”

Dr. Donald M. Berwick on waste and value:

• 20-30% figure: http://leanblog.org/berwick2030
• Don’s RFP for replacing his knee without harming him: http://leanblog.org/berwicksknee
• Thoughts on value: http://www.leanblog.org/2009/12/notes-from-my-first-ihi-national-quality-forum-ihi09/

Henry Ford Quote:

“In the ordinary hospital the nurses must make useless steps. More of their time is spent in walking than in caring for the patient. This hospital is designed to save steps… we have tried to eliminate waste motion.”

• 1922 book: “My Life and Work”
  • http://leanblog.org/ford1922 (link to Google Books version)

Darrie Eason Case:

• NBC story: http://leanblog.org/eason
• My blog posts on pathology errors:
  • http://www.leanblog.org/2007/10/this-will-happen-again-unless/
  • http://www.leanblog.org/2009/06/pathology-mistakes-again-on-oprah-and/

Mary McClinton Case:

• Summary: http://seattletimes.com/html/localnews/2002100635_deathfolo25m.html
• Carl Dorsey: http://www.chron.com/news/article/When-few-hospitals-report-honest-ones-look-bad-1721173.php
• Patient Safety Alert system at Virginia Mason: http://www.innovations.ahrq.gov/content.aspx?id=1698

Contact Info:

• Mark Graban
• mark@constancy.us
• 817-993-0630
  • leanblog.org
  • MarkGraban.com
  • KaiNexus.com
  • Healthcare Kaizen
  • Lean Hospitals
  • Measures of Success