Toyota's "Just-In-Time Comes To The Hospital

"In the factories of Toyota Motor Corp., any worker who spots a serious problem can pull a cord and stop the assembly line. Richard Shannon, chairman of medicine at Allegheny General Hospital, is applying the Toyota technique to an intensive-care-unit here."

Above is the first paragraph of a front-page story in Friday's Wall St. Journal about yet another attempt to remake American medical practice.

In Shannon's hospital, when a nurse wants something done right now, she can call him direct, and he cuts through the delays.

In an example cited in the paper, a nurse couldn't get someone to come and replace an IV line, so Shannon called the chairman of radiology at home - on a Sunday afternoon.

The guy came in and "within two hours put in the new IV line himself." Said Shannon: "That's the Toyota production system. No problem should be left unsolved."

Memo to Shannon (after I stopped laughing so hard I cried): The next problem you're gonna be facing is finding a new radiology chairman.

That guy didn't go into radiology and climb to the top of his department's hill to play intern at age 55 on a Sunday afternoon. Ha.

Besides which, he probably hasn't put in a central line himself in 20 years. Residents do that stuff. No wonder it took him two hours to do a 15-minute procedure.

Said Dr. Paul Kiproff, the radiology chairman, "It's not in my interest to be putting in lines all day long." He's being very polite.

More from the article, by Bernard Wysocki, Jr.:

    Hospitals aren't factories, though. Doctors, nurses, and other hospital staffers don't think of themselves as assembly-line workers or their patients as anything resembling a Camry under construction.

    To ease the potential culture clash, many hospitals play down the Toyota name. But the conflict between the culture of efficiency and the culture of caring is never far from the surface.

    Continued on the next page Page 1 — Page 2

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  • 1 - RJ Elliott

    Apr 12, 2004 at 12:55 am

    The US Health Care System needs to begin implementing cost-effective practices. We cannot afford the current trend.

    Empathy is (literally) cheap. We should better train our health care personnel in that department.

    But other things are expensive. They will therefore be rationed. See: Canada. Or, the UK.

  • 2 - JR

    Apr 12, 2004 at 9:39 am

    The US Health Care System needs to begin implementing cost-effective practices. We cannot afford the current trend.

    It would probably be "cost-effective" to just let people die. Except for the rich ones, of course, who can be kept alive for years in a semi-vegetative state until their money runs out.

  • 3 - RJ Elliott

    Apr 13, 2004 at 12:44 am

    Life's not fair. There are simply not enough resources available to keep every citizen perfectly healthy. That's a fact.

    Every country engages in rationing health care. The US does, through HMOs. Canada and the UK do, through their federal health services.

    Despite these cost-control mechanisms, spending on health care is simply out of control. Everyone agrees about this.

    What is YOUR proposal?

  • 4 - RJ Elliott

    Apr 13, 2004 at 12:44 am

    Life's not fair. There are simply not enough resources available to keep every citizen perfectly healthy. That's a fact.

    Every country engages in rationing health care. The US does, through HMOs. Canada and the UK do, through their federal/national health services.

    Despite these cost-control mechanisms, spending on health care is simply out of control. Everyone agrees about this.

    What is YOUR proposal?

  • 5 - JR

    Apr 13, 2004 at 9:25 am

    Ban drug advertising.

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