A hospital seems like one of the first places you’d want to institute the andon cord. From To Fix Health Care, Hospitals Take Tips From Factory Floor:
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.Just the other day, a nurse brought the medical “production line” to a halt. Candice Bena thought a 76-year-old patient needed a new intravenous line but couldn’t get the radiology department to install one immediately. Fearing the patient would develop an infection, the nurse phoned Dr. Shannon.
That was the equivalent of pulling “the ‘andon’ cord,” says Dr. Shannon, using the Japanese word for “lantern.” He immediately called the hospital’s chairman of radiology, who within two hours installed the new IV line himself. “That’s the Toyota production system. No problem should be left unsolved.”
It’s good medicine, he says. Using the Toyota approach, for instance, the hospital traced problematic infections in some patients to their source, prompting two intensive-care units to change the way they insert intravenous lines. The result: a 90% drop in the number of infections after just 90 days of using the new procedures.
It’s also good business: By reducing infections, the new procedures have saved almost $500,000 a year in intensive-care-unit costs. “It’s not in my interest to be putting in lines all day long,” says Paul Kiproff, chairman of radiology. But with infections down, “this is clearly advantageous.”
Similar things are happening in at least a dozen hospitals across the country. The Toyota system emphasizes the smoothest possible flow of work — accomplished by, say, mapping out work processes and eliminating unnecessary steps, and using teamwork to identify and fix problems as soon as they crop up. Hospitals are using the tactics to reduce patient waiting times, slash wheelchair inventories, prepare operating rooms faster and move patients through a hospital stay or doctor visit quickly, seamlessly and error free.