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VOA标准英语2011--US Hospitals Turn to Toyota for Manageme

时间:2011-05-06 01:11:54

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(单词翻译)

US Hospitals Turn to Toyota for Management Inspiration

When Virginia Mason Medical Center in Seattle started losing money in 1998, its CEO began a search for a new management system that would get the hospital back on track.
After two years of visiting hospitals around the U.S. and talking with many of the smartest minds in the health care industry, he concluded that there wasn't a single medical institution in the entire country that had a system worth emulating1. Instead, he turned to a Japanese carmaker for inspiration.
Lean management style
Dr. Gary Kaplan, head of Virginia Mason Hospital in 2001, thought he could adapt Toyota's lean management style - which focuses on eliminating waste in the production process - to improve healthcare.
"He turned to the Toyota production system because it was clear to him that taking these principles and tools and adapting them to healthcare could significantly make Virginia Mason a more efficient operation," says efficiency expert Charles Kenney, author of "Transforming Healthcare, Virginia Mason Medical Center's Pursuit of the Perfect Patient Experience."
One of the first Toyota concepts Kaplan instituted was value stream mapping, which involved taking a complicated process and breaking it down into individual steps to find ways to make each step more efficient. Virginia Mason hired several Japanese consultants2, called senseis, to help them with their first value steam map: a cancer patient's visit. In his book, Kenney recounts how the senseis instructed the staff to trace the patient's journey on a map of the hospital, using a piece of blue yarn3.
"And at the end of the process, the blue yarn was snaking around this piece of paper - the schematic on the floor - and it was this immensely powerful visual experience for the entire team," says Kenney, "and they realized that what was happening was they were taking these patients, for whom time is absolutely the most precious thing in their lives, and they were wasting huge amounts of it."
So the team used the lean management approach to refine the process of administering chemotherapy treatments. By sorting out the steps, simplifying and standardizing4 them, they were able to cut the amount of time it takes a patient to receive treatment by 50 percent. Then, they turned to other departments, finding ways to increase efficiency and improve safety.
"So the Virginia Mason Production System is now viewed throughout the world by many people as a viable5 alternative to the current system," Kenney says.
It has been adopted by dozens of hospitals in the United States, including Barnes Jewish in St. Louis, Missouri.
Kent Rubach is one of the senseis Barnes hired to guide them on what they call their learning journey. The first change he made was to set up a strategy room for hospital staff. Above a long conference table is a complicated diagram which takes up one entire wall of the room. It is made up of hundreds of hand drawn6 lines that connect dozens of small pink and yellow sticky notes. It's just like the charts in Toyota's strategy rooms.
"You would see the exact same thing, for a part going from raw material to the finished good," Rubach says.
But in this case, the value stream map illustrates7 the process of a patient coming into the hospital with a stomach ache. Each one of the pink notes represents a point in the process where a patient has to wait.
"So if we do have wait, we're trying to add value to that wait, and not just have them sitting and doing nothing," says Daryl Williams, head of the Emergency Department at Barnes. "Can we give the patient education? Can we get their labs done ahead of time so when they get to see the doctor all that stuff is back?"
According to Williams, under the old system, an acute abdominal8 pain visit typically took three hours. Today it's two hours.
A key principle of the Virginia Mason Production System is to encourage staff members to speak up whenever they see a part of their job that can be done more efficiently9 or a process that could be improved.
An employee who worked in the Intensive Care Unit had an idea to help patients' families, who often spend day and night in the waiting room while their loved ones are in the ICU.
Linda Henderson, whose fiancé suffered a stroke, has been living in the waiting room for eight days. Before the lean changes, she would have had to sleep in a chair or on an air mattress10 on the floor. But based on the employee's suggestion, the hospital replaced the furniture in the waiting room with special chairs that recline into beds.
"I can lay back and I have my blanket and my pillow or my teddy bear for my pillow and then I snooze and go to sleep," says Henderson.
The improvements at Barnes Jewish, Virginia Mason and other hospitals using lean management techniques have been noticed. A recent study of the nation's hospitals put Virginia Mason in the top one percent in safety and efficiency for two years running.
But lean management is not for everyone. It requires a tremendous investment of time and resources as well as a leadership willing go forward despite resistance from doctors and staff to the idea of operating like a factory. Also, the process never ends. As the Toyota senseis say, they live in the biggest room in the house, the room for improvement.


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1 emulating 0f2a15ac7cdd2c8dace3849370880337     
v.与…竞争( emulate的现在分词 );努力赶上;计算机程序等仿真;模仿
参考例句:
  • The possibilities of producing something entirely new by emulating nature's very wide crosses are enticing. 用自然界的非常广泛的杂交方法创造出全新植物种的可能性是诱人的。 来自辞典例句
  • The human emulating this archetypal patterning will be quite the accomplished businessperson. 这类原型模式者会是一个很成功的商人。 来自互联网
2 consultants c6fbb5ca6219111731f9c4c4d2675810     
顾问( consultant的名词复数 ); 高级顾问医生,会诊医生
参考例句:
  • a firm of management consultants 管理咨询公司
  • There're many consultants in hospital. 医院里有很多会诊医生。
3 yarn LMpzM     
n.纱,纱线,纺线;奇闻漫谈,旅行轶事
参考例句:
  • I stopped to have a yarn with him.我停下来跟他聊天。
  • The basic structural unit of yarn is the fiber.纤维是纱的基本结构单元。
4 standardizing cea4f4df247b821dfddd5450ebb07063     
使合乎规格,使标准化( standardize的现在分词 ); 规格化
参考例句:
  • These composite indices are derived by standardizing each of its component series. 这些综合指数是使通过把它们的组成部分中的各个数列标准化而获得的。
  • Significant progress was made in rectifying and standardizing nonbank financial institutions. 整顿和规范非银行金融机构取得重要进展。
5 viable mi2wZ     
adj.可行的,切实可行的,能活下去的
参考例句:
  • The scheme is economically viable.这个计划从经济效益来看是可行的。
  • The economy of the country is not viable.这个国家经济是难以维持的。
6 drawn MuXzIi     
v.拖,拉,拔出;adj.憔悴的,紧张的
参考例句:
  • All the characters in the story are drawn from life.故事中的所有人物都取材于生活。
  • Her gaze was drawn irresistibly to the scene outside.她的目光禁不住被外面的风景所吸引。
7 illustrates a03402300df9f3e3716d9eb11aae5782     
给…加插图( illustrate的第三人称单数 ); 说明; 表明; (用示例、图画等)说明
参考例句:
  • This historical novel illustrates the breaking up of feudal society in microcosm. 这部历史小说是走向崩溃的封建社会的缩影。
  • Alfred Adler, a famous doctor, had an experience which illustrates this. 阿尔弗莱德 - 阿德勒是一位著名的医生,他有过可以说明这点的经历。 来自中级百科部分
8 abdominal VIUya     
adj.腹(部)的,下腹的;n.腹肌
参考例句:
  • The abdominal aorta is normally smaller than the thoracic aorta.腹主动脉一般比胸主动脉小。
  • Abdominal tissues sometimes adhere after an operation.手术之后腹部有时会出现粘连。
9 efficiently ZuTzXQ     
adv.高效率地,有能力地
参考例句:
  • The worker oils the machine to operate it more efficiently.工人给机器上油以使机器运转更有效。
  • Local authorities have to learn to allocate resources efficiently.地方政府必须学会有效地分配资源。
10 mattress Z7wzi     
n.床垫,床褥
参考例句:
  • The straw mattress needs to be aired.草垫子该晾一晾了。
  • The new mattress I bought sags in the middle.我买的新床垫中间陷了下去。

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