5S-KAIZEN-TQM Approach in Hospitals

1. 5S-KAIZEN-TQM Approachin Hospitals World Business Associates Co. Ltd., Japan Director & Senior Consultant Jun SUGIURA

2. 4. JICA’s Approach “Clean Hospital Program” A part of the contents of this chapter reprints them from the following report of JICA. Thematic Evaluation "Analysis of the Outcome Generating Process of 5S-KAIZEN-TQM Approach in Hospitals" (Final Report): http://www.jica.go.jp/english/our_work/evaluation/tech_and_grant/program/thematic/

3. 4. “Clean Hospital Program” in Africa The Japan International Cooperation Agency (JICA) has conducted the “Program of TQM for Better Hospital Services” since 2007 in 15 African countries and promoted enhanced hospital management and improved hospital service quality by adopting “5S-KAIZEN-TQM Approach” . (Eritrea, Uganda, Kenya, the Democratic Republic of the Congo, Senegal, Tanzania, Nigeria, Niger, Burkina Faso, Burundi, Benin, Madagascar, Malawi, Mali, and Morocco)

4. 4. “Clean Hospital Program” in Africa This program consists of; 1. The African hospital persons and Ministry of Health executives are invited to Japan, or Sri Lanka to have training with an idea of the five S's-KAIZEN-TQM, and to visit the factories and hospitals which five S's-KAIZEN-TQM are applied. 2. The participants devise the Action Plan for making organization and an enforcement schedule to carry it out in the pilot Hospital in their own country through the training. 3. After going back to their country, the trainees enforce the pilot project and deploy five S's-KAIZEN-TQM in the country. 4. Japanese and Sri Lanka’s lecturers will go around each African country to enhance pilot Hospital activity and the quality of health care services through five S's-KAIZEN-TQM, and to deploy the approach more extensive in the future.

5. 5. JICA’s Approach Logic model of “The 5S-KAIZEN-TQM” approach A part of the contents of this chapter reprints them from the following report of JICA. Thematic Evaluation "Analysis of the Outcome Generating Process of 5S-KAIZEN-TQM Approach in Hospitals" (Final Report): http://www.jica.go.jp/english/our_work/evaluation/tech_and_grant/program/thematic/

6. 5. Logic Model of “the 5S-KAIZEN-TQM” approach Logic tree for manufacturing companies

7. 5. Logic Model of “the 5S-KAIZEN-TQM” approach Logic tree for hospitals in Africa

8. 5. Logic Model of “the 5S-KAIZEN-TQM” approach On-site project purposes in African hospitals

9. 5. Logic Model of “the 5S-KAIZEN-TQM” approach Comparison of the project purpose in between African hospitals and manufacturing

10. 5. Logic Model of “the 5S-KAIZEN-TQM” approach Basic structure of the logic model

11. 5. Logic Model of “the 5S-KAIZEN-TQM” approach Example of logic model for eradicate medical accidents

12. 5. Logic Model of “the 5S-KAIZEN-TQM” approach Example of indicators to eradicate medical accidents

13. 6. Quality Improvement of Medical Devices

14. 6. Quality Improvement of Medical Devices KAIZEN/5S • Human Factor • Organization for Management • Education & Training • Management of Operation • Management of Moral Continuous PDCA • 5S: • Create space • Create time • Expose problems • Standardize operation • Follow rules • Educate people • Technology/Skill • Maintenance Technology • Building (Facility) • Medical Device • Operation Technology • Quality Evaluation Technology

15. 6. Quality Improvement of Medical Devices (Logic model) Cause Activities Output Outcome Deficiency in Work environment Sort unnecessary items (S1) Secure more space for easy move Capable to introduce new devices Continuous quality improvement of medical devices Secure safe passageway (S2) Reduce touching, catching and tripping Reduce device troubles Bundle and fix cables (S2) Reduce cutting cables Deficiency in device maintenance Shine devices (S3) Easily find abnormalities Early repairing is possible Set rules for regular inspection (S4) Clarify inspection rules Regular inspection is done Make habit to follow rules (S5) Rules are followed Improving “job” quality Deficiency in technology /skill Education/Training for technology/skill Fields that KAIZEN/5S can not deal with Improving organizational capacity Deficiency in Spare parts Invest in spare parts

16. 6. Quality Improvement of Medical Devices (Indicators)

17. 7. Conclusion

18. 7. Conclusion 1. KAIZEN is; 1) Voluntary bottom up activity by work groups 2) Continuous PDCA spiral 3) One of tools to improve quality 4) Not independent from managers, but depending on manager’s direction 5) Easy to begin but difficult to continue active 2. Hospitals in Japan and in the US; 1) Should reduce medical cost 2) Should decrease medical accidents 3) Should improve patient satisfaction 3. Key factors of success to introduce KAIZEN are; 1) Top manager’s leadership and initiative 2) Developing people 3) Successful experiences 4) Setting measurable indicators

19. 7. Conclusion 4. Japanese hospitals are active on improving; 1) Productivity 2) Quality 5. The US hospitals are active on improving; 1) Quality 2) Safety 6. JICA’s “Clean hospital program” in Africa was introduced; 1) Example of logic model of “5S-KAIZEN-TQM” was explained 2) Table of Indicators for each step of logic model was shown 3) It was explained how to use the logic model 7. Logic model for quality improvement of medical devices is proposed. Thank you for participating in the seminar till the last.