豐田文化- 複製豐田DNA的核心關鍵 The Toyota Culture: The Heart and Soul of the Toyota Way
"豐 田汽車目前正在與舊通用汽車就如何撤出這家汽車裝配廠New United Motor Manufacturing Inc.（簡稱Nummi）的相關事宜進行商談。一名高管說﹐我們的直覺是需要結束生產。通用汽車走出破產保護之後﹐重組後的通用7月份重新啟動﹐而舊通 用則成為遺留問題。"
The Health Factory
Cambridge, Mass. — Today, going to an American hospital seems about as safe as parachuting off a bridge. An estimated 98,000 Americans die each year as a result of medical error, and a nearly equal number succumb to infections they acquire in hospitals. Those rates are unacceptable in the world's most medically advanced country.
This month, President Bush signed a bill intended to reduce the rate of medical errors. The legislation authorizes the creation of "patient safety organizations" to which health care providers can report errors and near misses. On the basis of these reports, the organizations will recommend ways to avoid such mistakes. And to reduce disincentives to reporting, the bill prevents information disclosed to these organizations from being used in malpractice lawsuits.
The new legislation is a step in the right direction. It will allow hospitals to study their errors without fear that acknowledging mistakes will lead to reprisals. But within the hospitals themselves lies a far bigger opportunity to reduce the rate of catastrophic medical error, if the hospitals would just follow the example of the world's most successful industrial organizations.
Companies like Toyota, Alcoa and Vanguard differ from one another in the products they produce and the technologies they employ, but they share a management approach that has resulted in a combination of safety, quality, efficiency and responsiveness unmatched by their competitors.
It may seem a stretch to compare a carmaker's, aluminum refiner's, or mutual fund company's operations with a hospital's. But all these companies manage complex processes that require a great deal of problem solving - and they have something important to teach health care.
Typically, health care workers, like employees in many other industries, tend to work around problems when they encounter them, meeting patients' immediate needs but not resolving the problems' root causes. Therefore, people confront "the same problem, every day, for years," as one nurse phrased it to me. These persistent difficulties manifest themselves as regular inefficiencies within the system, and they occasionally lead to catastrophic mistakes.
What sets the non-health care leaders apart is that as they do their work, they are constantly learning how to do it better. Work is designed to reveal even little problems as they occur- well before they cause errors or near misses worthy of being reported. Managers respond to these problems immediately, with rapid experiments aimed at generating sustainable fixes, rather than with workarounds that are constantly repeated. The knowledge that results from this process is then shared through collaborative experimentation in which all employees take part.
A number of American hospitals have tried this approach, with promising results. For example, hospitals in the Pittsburgh Regional Healthcare Initiative addressed a recurring predicament in intensive care. Catheters placed directly into veins or arteries, called central lines, are used to deliver medication swiftly to critically ill patients. But a quarter-million patients nationwide who receive this treatment each year suffer bloodstream infections as a result, and of those, 15 percent die. At one Pittsburgh area hospital, mortality was a staggering 40 percent of those infected, and the cost for each infected patient was $25,000 to $80,000. To eliminate these infections, the hospitals taught themselves to find problems and institute small process enhancements at a rate far faster than a national reporting program will most likely allow. Together, these small fixes added up to a significant improvement.
For periods of days or weeks, the Pittsburgh hospitals observed the placement and maintenance of every central line, looking for minor breaks in routine that could create opportunities for infection. Along the way, they found dozens of factors that were potentially suspect. One hospital realized that in its line-maintenance kits, gloves were stored on the bottom, causing nurses to fish through sterile material with bare hands. Other kits had drapes - sheets that isolate the area on which a nurse or doctor is working - that were either too small to be effective or so large that patients knocked them out of the way.
Other hospitals discovered that only on certain shifts were there doctors expert in placing the more difficult but least infection-prone type of line. And the shifts that lacked such expertise also lacked simple, reliable ways to signal the experts on other shifts to move lines from high-risk to low-risk locations or to remove them entirely when they returned to work.
By quickly identifying and resolving these small procedural problems, the Pittsburgh hospitals as a group cut their central line infection rates in half, and some hospitals were able to cut their individual infection rates nearly to zero. These hospitals and others used a similar approach to solve other problems, like patient falls and faulty medication administration.
To go from working around problems to identifying and solving them required hospital workers to change the way they worked, from the front lines to the senior levels. But the effects were profound. If the rest of the country's hospitals follow that example, the national savings would be measured in tens of thousands of lives and billions of dollars every year.
Dear David,Yesterday I read the following book (Chinese Translation) and Thought about you and Sara's essay on the management to complex system.
I think some of you might like to read it and discuss about it.
McGraw-Hill: Chasing the Rabbit : Book
Winner of the Shingo Prize for Research and Professional Publication, 2009
How can companies perform so well that their industry ...
- Expert on Leadership and Innovation at Management Consultant
- Assistant Professor at Harvard Business School
- Research Associate at US Congress Office of Technology Assessment
- Harvard Business School
- Massachusetts Institute of Technology
- Massachusetts Institute of Technology - Sloan School of Management
- Princeton University
- 140 connections
- Management Consulting
Steven J Spear’s Summary
Author of "Decoding the DNA of the Toyota Production System," "Fixing Healthcare from the Inside, Today," and the new book _Chasing the Rabbit: How Market Leaders Outdistance the Competition_
I work with senior leaders, coaching them on how to generate and sustain rates of broad based, high speed improvement and innovation that let's their organization outrace rivals, even in the most hyper competitive markets.
Steven J Spear’s Specialties:
High velocity organizations
Health care reform
Quality of care
Steven J Spear’s Experience
(Educational Institution; Higher Education industry)
2006 — Present (3 years)
(Privately Held; 201-500 employees; Hospital & Health Care industry)
2005 — Present (4 years)
Expert on Leadership and Innovation
(Management Consulting industry)
2005 — 2009 (4 years)
(Educational Institution; 1001-5000 employees; Higher Education industry)
1999 — 2005 (6 years)
Developed and taught 2nd year elective: The Operating Manager
US Congress Office of Technology Assessment
(Government Agency; 51-200 employees; Government Administration industry)
1988 — 1989 (1 year)
Electronic Bulls and Bears research team
Steven J Spear’s Education
Harvard Business School
DBA , Business Management , 1995 — 1999
Massachusetts Institute of Technology
MS , Mech. Eng. and Management , 1989 — 1993
Massachusetts Institute of Technology - Sloan School of Management
MS , Management , 1989 — 1993
AB , Economics , 1982 — 1986
德语媒体 | 2009.08.19
《德国金融时报》观察了这一新市场的激烈竞争：“尤其中国雄心勃勃，中国政府要使本国的太阳能行业进入世界领先地位，以亿万元的补贴支持这 一工业。中国厂家在现代化的大型工厂中生产晶体硅和硅薄膜太阳电池，按瑞联银行所说，生产成本明显低于德国竞争对手，平均低30%，所以能够以竞争价格扩 大市场份额。
Bildunterschrift: Großansicht des Bildes mit der Bildunterschrift: 无锡生产的太阳能设备
"当这位持澳大利亚护照的中国人八年前在这个数百万人口的城市建立自己的高科技企业尚德公司时，他的朋友和投资者对建设中国第一家太阳电池工厂的计 划都感到无从做起。但市领导被他说服了并投资六百万美元建设工厂。施正荣学成回国不到十年就成了中国最富有、最有名的企业家之一，有八千名职工的尚德公司 去年的销售额为二十亿美元，是五年前的23倍。
[PDF] The Applicability of Deming's System of Profound Knowledge to Universities...
... of Knowledge that discuss Deming's System of Profound Knowledge. Here are a few of
them. "Communities as Systems" Peter R. Scholtes, Quality Progress, July 1997 ...
www.asq.org/quality-participation/2009/04/process-management/the-applicability-of-demings-system-of-profound-knowledge-to-universities.pdf - Text Version
豐田汽車公司(Toyota Motor Co.)高管稱﹐公司正試圖關閉與舊通用汽車公司(General Motors Corp.)在加利福尼亞州共同組建的一家汽車裝配廠﹐此舉有望提高豐田美國業務的效率。
本 月早些時候﹐豐田章男說﹐通用撤出合資企業的決定給我們造成了一些非常棘手的問題。他當時說﹐豐田正在研究形勢﹐並將很快做出決定。通過把該裝配廠的產能 轉移到北美的其他工廠﹐豐田將能大幅提振製造廠的盈利能力。據總部位於美國的咨詢公司CSM Worldwide的數據﹐目前豐田北美裝配廠的開工率約為50%到60%。
加州國會議員和州長施瓦辛格(Arnold Schwarzenegge)請豐田拯救Nummi及其4,600個工作崗位﹐其中大部分工人都加入了全美汽車工人聯合會(United Auto Workers)。