「華人戴明學院」是戴明哲學的學習共同體 ,致力於淵博型智識系統的研究、推廣和運用。 The purpose of this blog is to advance the ideas and ideals of W. Edwards Deming.

2011年3月23日 星期三

Four Days with Dr. Deming 一段

感謝 David 讓我學英文
Dear HC,,

最近重新翻翻這本書 Four Days with Dr. Deming, p.164 有一段話描述下屬怎樣應付精明的主管

The staff reacted to avoid her punishment. We sanitized the information. Each staff calculated the spin to put on the numbers, to position his or her reports in the best light.

不很確定 calculate the spin to...., position his reports in the best light 的意思與翻譯

Best rgds
David Hsu

這spin 意思是見解
((米略式))(特定の)見解, 解釈
put a political spin on ...

所以"每人提的數據/見解都經過美化 (馬殺雞)
再讀 SPIN 解釋錯誤
原譯用輪盤賭局來解釋SPIN 有點道理

**** 感謝林公孚給我們的
我的COMMENTS: 七八年前某留美化工人將ACCOUNTABILITY 翻譯成當責並出書--書中錯誤頗多
(我在中油訓練所讀到他們當時的 BIBLE 哈哈大笑....)
這些東西都是有點玩字 老生長談
參考 台貪污盛行/蘋論:立院應辦核災聽證會

2011年3月17日 星期四

戴明愛智合作社連絡簿( 59):友情

戴明愛智合作社連絡簿( 59):友情

2006/3/13DAVE HSU來訪。談些家常:他住在陽光山林 20 年前去過一次,現在據云綠數成蔭。

David 跟我談些他們的改善經驗。


我說,產業之有心人應有三書:專業的(譬如說他對 design性能)、一般管理心得、自傳(回憶錄)


《艾略特文學論文文集》「譯者前言」中,「十七世紀玄學派詩人稱為機智( wit)的統一體:巧妙的將思想、情感和感覺三個因素結合成一體」之說法,正是『戴明修煉 II』的主旨。


Dear Tony, 你選的『西遊記 三圖:大鬧龍宮、大鬧天宮、取回真經』請參考,如果有問題請通知 .



英國 The Observer 周日 Sunday March 12, 2006 Simon Caulkin 專欄談企業界經常被管理潮流 `之空話 迷思所惑 Bosses in love with claptrap and blinded by ideologies

他引 Deming 說如果太刻板重視目標之追求,常常會不惜一切但求達標、犧牲一切

Incentives do incentivise - but be careful what you wish for. As W Edwards Deming said, people with sharp enough targets will probably meet them even if they have to destroy the company to do so. And what about change or die?The trouble, they say, is that companies are so bad at it that 'empirically it is change and die'.

foolish, meaningless talk which should not be believed:
Don't believe a word of what he says. It's just a load of claptrap.


陳寬仁老師今天來我處閒聊數小時。我們覺得王大哥的退休紀念會( CSQ)勢在必行。所以請你選一時間(因為七月你可能赴美)。其他由我與林公負責。

現在最優先的是王老師要說 YES,然後發動,請考慮一下。



下周三晚 CSQ討論中原授 Kano 先生榮譽博士之先前作業。


寄英文「製造的近視」(仿 T. Levit 之「行銷的近視」)給 Kevin Justing Kevin HBR 之訪問稿。


狄更斯『德魯德疑案』( The Mystery of Edwin Drood (unfinished) (1870) ,項星耀譯)首章注解:狄更斯在這章的寫作要點曾寫道:「接觸到主旨:『惡人若回頭 …..』」

聖公會早晚禱都用此開頭:「 ……惡人若回頭離開所行的惡、行正直與合理的事、他的靈魂即可得救。」

(這可能就是 W. E. Deming 每天之禱詞)

西 Ezekiel

18:27 [hb5] 再者、惡人若回頭離開所行的惡、行正直與合理的事、他必將性命救活了.

[lb5] 再者,惡人若回轉離開他所行的惡,而行公平正義的事,他就會將性命救活。

[nb5] 還有,惡人若回轉離開他所行的惡,行正直公義的事,他就可以使自己的性命存活。

[asv] Again, when the wicked man turneth away from his wickedness that he hath committed, and doeth that which is lawful and right, he shall save his soul alive.

[kjv] Again, when the wicked man turneth away from his wickedness that he hath committed, and doeth that which is lawful and right, he shall save his soul alive.

[bbe] Again, when the evil-doer, turning away from the evil he has done, does what is ordered and right, he will have life for his soul.

2011年3月16日 星期三

How Milliken Improves Performance and Innovation

Steadily Breaking Through Barriers: How Milliken Improves Performance and Innovation

Milliken employs a continuous-improvement philosophy designed to overcome four brutal operating truths.

By Laurie Haughey, director education service, Milliken & Co.

March 16, 2011

Editor's Note: Milliken will host a plant tour during IW Best Plants Conference. They also be conducting a
Workshop: How to Build a Stable Foundation to Fully Optimize Lean Principles.

Operational excellence is vital to a manufacturer' s financial health -- and not only because of cost and quality improvements. Operational excellence creates the space for innovation and creativity to blossom. By tackling operations improvements with a systematic regimen of identifying and solving organizational problems, day-to-day incremental innovation emerges and resources are freed up to pursue breakthrough innovations. In the 1990s, Milliken & Co., a multinational group of textile and chemical companies, envisioned operational excellence, institutionalized within the organization, as the delivery system for improved performance and innovative products and services.

Since the 1980s, Milliken leaders have questioned the conventional wisdom that climbing is the hardest part of any journey, deciding instead that climbing is the most valuable experience of the journey. As a result, Milliken prepared to climb, step by step, and launched 125 separate corporate initiatives focused on people, process and business excellence. The company measured anything that could make it stronger -- safety, customer satisfaction, on-time delivery, quality and product development.

"Reviewing leading or lagging indicators was always done with one part patience and two parts determination," says Vice President Craig Long. "We had the tolerance to explore how to improve and the excitement to do it."

Milliken customized the Toyota Production System to its own culture and operations (the Milliken Performance System) and applied the scientific method to new initiatives, examining and experimenting with ways to improve even the smallest aspects of its business. Where new techniques worked, they were shared; where results lagged, experiments began again -- plan, do, check, adjust (PDCA). Soon, the company saw aggregate positive trends, the first steps on a journey that would result in a host of innovations and improvements.

Milliken, a thriving organization with more than 100 years of manufacturing expertise, now operates with the energy, urgency and clarity of purpose found in start-up companies. Company leaders believe Milliken' s blend of disciplined design, purposeful creativity, innovative spirit and experience allows it to win in the face of four brutal truths that often derail organization improvements, preventing innovation and sustainable excellence.

Brutal Truth No. 1:
The majority of performance-improvement programs fail.

Successful improvement requires a strong organizational commitment and culture around learning. There is tremendous value in organizations adopting the healthy self-image of a perennial student -- inoculating them against what David Garvin of the Harvard Business School calls the "not-invented-here syndrome."

Although Milliken was a market leader, metrics gathered during the 1980s and early 1990s indicated the need for a daily management system. The company looked for outside expertise -- specifically, to Japan -- to map the way forward, seeking to adopt process controls outlined by W. Edwards Deming. At the time, Japan was a world leader in sustainable business modeling. Milliken was privileged to learn from companies that had been in business 100 years or more, and that had begun to set the pace for industrial excellence. More than 100 management employees made four exploratory trips to visit leaders of Japan' s best companies -- Ricoh, NEC, Nissan, Toshiba, Dynic and others -- to learn and adopt performance systems. Those trips started an organizational journey that would last a decade and cost millions of dollars.

Milliken had built a system, a foundation, for improvement that could be sustained.

Brutal Truth No. 2:
Organizations will founder unless they cultivate the trusting environment needed to perform honest self-analysis.

A learning organization both applauds success and learns from failures. For Milliken, learning from mistakes is an integral part of the discovery process. Milliken rejects traditional, pessimistic manufacturing beliefs: e.g., There will always be yield loss; accidents are to be expected; and not every customer can be fully satisfied. Instead, quality leaders adopted zero-based thinking as a countermeasure against these paradigms. In each case, the Milliken objective is zero -- period. To get there, Milliken relies upon a holistic systematic approach -- the Milliken Performance System (MPS). As part of MPS, a 10-step focused improvement (FI) process locks into place actions that prevent recurrences. FI processes help to replicate improvements wherever they are transferable.

Laurie Haughey: " Milliken embraced the saying that ' no problem is a problem' and encouraged its workers to expose problems and search for root causes."
"In 2001 we were working on one type of machine to reduce its minor stops to zero," says Steve Meyer, Milliken' s director of client engagement. " This machine was suffering 13 breakdowns a month, so we organized a breakdown elimination team. A log was kept on the model machine to record the reasons for each stop, right down to the zone where the stop occurred." The team realized a 90% reduction on breakdowns when it identified and implemented five countermeasures, added the countermeasures to the process-management process, and developed one-point lessons (highly focused training documents that address a specific learning) to prevent recurrence. " Conducting five-why analysis keeps our eyes open to creatively handling problems like this one," Meyer adds. Five-why analysis broke through the superficial explanations for breakdowns and drove down to root causes.

Long cites the importance of value-stream mapping, which helps companies identify eight forms of manufacturing waste. " Much of our manufacturing involves material going through multiple plants and processes," Long says. " Our first value-stream map involved three plants where we applied seven scheduling points." Milliken applied lean principles and value-stream mapping to improve management of changeovers, level schedules and implement standard work. " We realized a 42% reduction in cycle time and went from seven scheduling points down to two. Applying this company-wide over the past 12 months, our lean pillar work has improved cycle times 48% and working capital has improved more than 20%."

Keeping everyone' s eyes open for opportunities to improve is a constant at Milliken. As a reminder, Milliken MPS leaders received Daruma dolls as gifts from their Japanese manufacturing hosts; by custom, the recipient of a Daruma doll draws or paints one eye of the doll when setting a goal, and the other eye only after the goal has been reached. " We learned to sharpen our eyes during our trips to Japan," Long adds. " We' ve applied this throughout our global operations for several years now, and the results are gratifying."

Milliken embraced the saying that " no problem is a problem" and encouraged its workers to expose problems and search for root causes.

Brutal Truth No. 3:

Organizations often count the wrong things.

In his Harvard Business Review article, " You Are What You Measure," Duke University professor Dan Ariely advocates changing how companies measure CEOs, which has traditionally been done using shareholder value as the primary barometer of performance. Rather than focusing solely on bottom-line numbers, organizations should consider a more holistic approach in measuring corporate success. Milliken positions safety as the foundation of its performance system -- and starts every meeting with a safety review. Employees who know that the company has their interests at the top of their agenda can trust their managers and be open to coaching and support opportunities. Then, too, employees who aren' t worried about injury can invest more effort into developing new skills, mastering new tools and applying new methods (i.e., process innovation can occur).

Milliken holds a total injury and illness rate (TIIR) of just 0.50. EHS Today rated Milliken one of the safest companies in America in 2010 -- the only organization to have repeated the honor. Yet the impact of this focus on safety goes well beyond employee health: When visitors tour a Milliken plant, they notice a unique level of associate (Milliken' s term for " employee" ) engagement. In most Milliken plants, at least one shift runs entirely without a management presence. Hourly associates own and are responsible for 90% of the plant' s safety processes and safety education: Everyone' s head counts who adds to the headcount.

Associates not only take on leadership roles at work but also assume myriad leadership roles in their communities. For example, Treva Rice has been a Milliken associate for nine years. She chairs the Relay for Life, volunteers for the Red Cross and acts as youth director at her local church. In addition to chairing Milliken' s Magnolia site Process Hazard subcommittee, Rice conducts lean audits as part of a Milliken scorecard developed through years of benchmarking. " The work I do counts," she says. " We are our brothers' and sisters' keepers."

Milliken focused first and foremost on safety, which enabled it to engage and empower its workers. In the process, it transformed each associate into a renewable source of improvement and innovation.

Brutal Truth No. 4:
Facts don' t lie -- but they don' t drive change either.

While measurement is the first step in any improvement process, strong companies have a clear bias for action based on data. For example, if a company discovers 33% waste in its production processes but fails to conduct root-cause analysis and implement corrective action, the firm will continue to lose the entire value of an entire production shift for each 24 hours it operates. Data without analysis and deployment is worse than meaningless; it adds another layer of wasted effort.

Scorecards are a vital component of the drive for organizational excellence, but successful firms implement them with a bias for action. Underperformance promotes investigation and experimentation, not blame. Effective scorecards identify problems, leading to explorations of "what" and "why," but never "who."

Tom Peters, author of "In Search of Excellence," notes that Milliken benefits from a long-standing penchant to cut the malarkey and get on with it." In 1986, Wayne Punch, corporate emeritus director of safety and health, was summoned by then-CEO Roger Milliken and other executives to explain why Punch had stopped production to hold an impromptu meeting. " We had been asking for ideas from associates," Punch says. " They were giving ideas at first, but recently we had zero ideas coming in." Punch says the shutdown changed the way forward.

"Ideas had stopped because management wasn' t implementing good ideas from the shop floor. "After the meeting (Punch' s experiment/corrective action), associates began to see evidence that their ideas were being implemented. Creative problem-solving increased. The difference was action."

Milliken views problems as opportunities to explore new ideas and innovation -- not disasters that end in finger-pointing and blame.

The Most Important Toolbox Is the One You Carry in Your Head

For Milliken, breaking through the brutal truths and barriers that prevent improvement meant implementing a performance system owned by passionate associates who carry their most important toolboxes in their heads. Avoiding "flavor of the month" projects, Milliken' s performance initiatives dovetail seamlessly into MPS " pillar work." These pillars rise from a foundation of safety and employee engagement and include daily team maintenance, focused improvement and lean management. Each pillar strengthens what MPS calls " The House."

Allowing associates to own quality and safety and tackle day-to-day issues reduces " firefighting" activities and frees Milliken productionmanagers to explore breakthrough improvements and innovations.

Laurie Haughey is Milliken & Co.' s director, education services and marketing. Formerly she was continuing education director at Clemson University, where she created and marketed training offerings on Six Sigma, lean manufacturing, supply chain management, design and analysis of experiments, project management and executive leadership.

Strategy, meeting technology, 董事會

(我2010年 花錢請工工系的學生將演講打出 可以進一步加工整理)
又 外文系的魏老師的提案 看來也只是"說說而已" 根本沒書面資料 無法下手
你們給董事會的信 我還沒看 主要是要先想自己的.....

我在系統與變異: 淵博知識與理想設計法 (2010)
中有一大段 meeting technology 的說法
想想開會的目的是什麼 我們的path forwards 是什麼

將影像上傳只是很基本的 最方便的...

The Economist Pocket Strategy: Essentials of Business Strategy from A to Z

可惜我去年系統與變異: 淵博知識與理想設計法 (2010)
中談董事會部分未參考它 不過我書中該節已相當不錯啦

2011年3月15日 星期二

一些 "變化/改革"的引語

此文為你搜集一些 "變化/改革"的引語:

With the help of quotegarden.com, I found some quotes about change:

"He who rejects change is the architect of decay. The only human institution which rejects progress is the cemetery." -- Harold Wilson

"If you don't like something, change it; if you can't change it, change the way you think about it."-- Mary Engelbreit

"It is not necessary to change. Survival is not mandatory.'' -- W. Edwards Deming

"Change is inevitable, except from a vending machine." -- Robert C. Gallagher

"When you are through changing, you are through." -- Bruce Barton

Jeff Bonty: Change would suit chambers well
Kankakee Daily Journal

2011年3月14日 星期一




"傾訴我們最憂傷思想的才是我們最甜美的歌" ( To a Skylark)


記得以前讀何炳棣著《讀史閱世六十年》http://hcbooks.blogspot.com/2011/01/blog-post_1096.html 時
以前的科舉晉升之路用了類似 "CAREER LADDER" 字眼

在我1975年東海畢業之後 我一定知道維根斯坦的
"爬完樓梯之後 就該把梯子拿掉"

然而 人可能無法這樣忘情

"東海XX系 實在沒什麼了不起 也沒什麼人肯犧牲的

上周政大的那位願意來談談 我非常佩服 感動
之後 我可以寫一說帖 給董事會並公布在網站上"
他說: "同意"

---我昨天接到 東海大學就業輔導暨校友聯絡室代發的一則EMBA 的"廣告":東海EMBA海外參訪研習團

建議: 貴單位應參加校友會議

上周台北的校友會議 有些感人的事值得報導(
在約10位發言的校友中 約有3位慷慨激昂談到與"校友就業輔導"相關的議題和故事

我希望你們是"校友"的資源 可以多報導/參與這些事
譬如說 我很想發起"訪談"曾在東海任教過而今在台北他校服務的老師


今年台大外文系的某篇博士論文是"德勒之論吳爾夫VW的諸房間" (憑我的記憶 待確定)
VW的 "一間自己的房間"裏 有許多關於"真實"的論述
譬如說某段的末頭: " (真實)就是 往昔的歲月與我們的愛憎所留下的東西"

2011年3月13日 星期日

Google "Deming" Alert: 兩則

Google "Deming" Alert: 兩則 沒什麼深入的內容....

One of the most valuable books is "Out of the Crisis" by W. Edwards Deming. He is the father of total quality management, and his 14 points is as pertinent to business today as they were when the book was published in 1986. People You Should Get to Know: Pieter Droog

An age-old answer

Lao-tzu, whose ancient works are the world’s most translated classic next to the Bible, stated: “It is better not to make merit a matter of reward lest people conspire and contend.”

Nearer our time, W. Edwards Deming has called the system by which merit is appraised and rewarded “the most powerful inhibitor to quality and productivity in the Western world”. He adds that it “nourishes short-term performance, annihilates long-term planning, builds fear, demolishes teamwork, nourishes rivalry and leaves people bitter”. He ought to know because he guided Japan to its international reputation.My bonus by right

2011年3月12日 星期六


這篇將福特汽車公司的品質運動 是說成70年代 錯

Don't Settle for Good Enough.
Dr. W. Edwards Deming, a statistician who worked at the US census bureau, was selected as a member of that distinguished team. It was Dr. Deming who ...

2011年3月10日 星期四

小記 Buckminster Fuller

作者 一石二鳥 除了Deming 之後 再引入美國很有名的一位怪傑 Fuller....

The Revolution...Sorry, Transformation Starts Now!
Huffington Post
... inventor/philosopher Buckminster Fuller and legendary management theorist and systems thinking pioneer W. Edwards Deming have publicly stated that a ...

我們這blog 是為Deming 而設的 大家可以找到許多他的資料
所以介紹一下 有名的怪傑Buckminster Fuller....許多人叫他 Bucky


美國人認為福原義春《文化打造極致創意》的思想與Max 相近:Max Depree, 86, 87, 88, 460;《領導藝術》(Leadersp is an Art, 1987), 86, 87, 460Leadership Jazz., 89n 系統與變異: 淵博知識與理想設計法 (2010) 的索引 (1) a-e

Max 在《領導藝術》(Leadersp is an Art, 1987 pp.114-15)中舉Bucky 參觀當代著名的建築師 Norman Foster 的一作品 Norman 很緊張準備了所有可能的提問
沒想到最後Bucky 的提問
讓Norman 傻住了 : 'How much does it weigh?" 這棟建築多重 ?

Max 跟所有的經營者說:不能太執著於對某單一功能或需求的過份承諾 (It is important that we avoid an overcommitment or rigidity to a single function or need.")

  1. Buckminster Fuller - Wikipedia, the free encyclopedia

    - [ 翻譯此頁 ]
    Richard Buckminster “Bucky” Fuller (July 12, 1895 – July 1, 1983) was an American engineer, author, designer, inventor, and futurist. ...
    en.wikipedia.org/wiki/Buckminster_Fuller - 頁庫存檔 - 類似內容
  2. 巴克敏斯特·富勒- 維基百科,自由的百科全書

    巴克敏斯特·富勒(Richard Buckminster Fuller,1895年7月12日—1983年7月1日),美國 ...
    zh.wikipedia.org/zh-tw/巴克敏斯特·富勒 - 頁庫存檔
  3. Buckminster Fuller」的圖片搜尋結果

    - 檢舉圖片
  4. Buckminster Fuller」的影片

2011年3月3日 星期四

試用戴明修煉 II 中的"顧客之聲"和 "損失函數"設計法.....

"新加坡:空調溫度過低 半數人感覺差 國際日報 - ‎20小時之前‎ 新華社新加坡3月3日電(記者陳濟朋報道員吳瀟瀟)世界自然基金會2日公佈的一項調查結果顯示,新加坡空調溫度調得太低,致使約半數人感覺不舒服。同時,空調使用過度容易導致感冒、咳嗽和皮膚乾燥等健康問題。 這項調查的對象約有450人,是為2011年“地球一小時” ..."


試用戴明修煉 II 中的"顧客之聲"和 "損失函數"設計法.....

2011年3月2日 星期三



在正規的統計品管下 通常"衡量系列"之目的是要"降低變異"
再分別採取對應的策略 方法以"問題系統層別解析"和"實驗法" 為主

我想學校/班級等等無所謂"最佳規模"---台灣新一代人口遞減是共同的因素 可有的學校會讓衝擊減低許多 如我們的"佳美幼稚園"

這些 謹供參考




根據行業統計數據顯示,日本汽車全行業(包括660cc微型汽車)在2月份的銷量達到401292輛,跌幅約為12.4%。日本多家車企報告稱各家銷量在 當月都出現了7.8%到21.3%的跌幅,而日本最大的汽車製造企業豐田汽車公司表示公司當月的銷售業績出現空前的下滑。此外,本田汽車公司當月銷量下降 16.1%,日產汽車公司同期銷量跌幅也達到了7.8%。

日本汽車交易商協會(Japan Automobile Dealers Association.)總經理Michiro Saito在接受記者采訪時表示:「現在斷言日本車市已經走上復蘇的正軌或是跌至谷底還為時尚早。目前我們還需觀望3月份市場的銷售情況,而在那之後我們 將對相關數據進行調整。」

2011年3月1日 星期二

一篇醫療業的"應用": Henry Ford applies lean principles to lab work


Last Updated: March 01. 2011 9:27AM

Henry Ford looks to auto industry for lab efficiency:Henry Ford applies lean principles to lab work

Christine Tierney and Melissa Burden / The Detroit News

With hundreds of technicians handling daily more than 31,000 tests of blood and tissue samples in glass tubes, slides and plastic cups, the laboratories of the Henry Ford Health System aren't that different from the car factories conceived by automotive pioneer Henry Ford.

Like auto assembly plants, labs process vast amounts of inputs and materials under intense pressure to keep down costs, minimize delays and limit errors.


In hospital labs, the stakes are even higher. "A single failure can have catastrophic results for a patient," said Richard Zarbo, chairman of pathology and laboratory medicine at the Henry Ford Health System, which includes five hospitals in Metro Detroit.

Over the past six years, Zarbo has adopted some of the best practices from manufacturing industries — particularly from the auto industry — to achieve remarkable gains in efficiency and turnaround times that have drawn national attention. For patients, the improvements mean faster diagnoses and treatment.

While the U.S. health care debate focused a spotlight on the country's soaring medical costs, America's hospitals also are struggling to reduce tens of thousands of patient deaths annually caused by hospital errors.

Zarbo, who joined Henry Ford Health System in 1987 as a surgical pathologist, was exposed early in his career to the ideas of W. Edwards Deming, a quality consultant whose principles had been adopted by Toyota Motor Corp. as it developed the Toyota Production System, also called Toyota Way.

Having risen to head of pathology, Zarbo sensed the inefficiency as he walked through labs and saw "carts and containers piled everywhere with blood and tissue samples to be tested," he wrote in a first-person account in a book coming out in April.

"Every one of the samples in these large coolers came from a patient who was waiting to know his fate and a doctor who was waiting to decide how to treat the patient."

Ralph G. Benitez, a lab supervisor, recalled workers sitting around waiting for large batches of specimens to arrive and be processed. "We no longer see that and that's a great thing," he said. They now come more frequently in small batches.

Deming's philosophy and the Toyota Way both emphasize and rely on employee input to streamline processes so that inefficiencies or problems can be fixed immediately. Henry Ford himself also had astute observations on quality and efficiency.

"You put all those together and we are able to put together something that works in health care, and we call it the Henry Ford Production System," Zarbo said in an interview.

The changes and improvements are often simple — color-coding tissue samples to indicate the priority level, or hanging a white board on a wall where technicians or workers can jot down types of errors and likely causes — without assigning blame.

Dramatic improvements

The improvements have been dramatic at Zarbo's labs — a $565 million operation within the Henry Ford Health System that employs 785 people handling 11.5 million tests a year for 30 clinics.

Between July 2006 and August 2007, the number of misidentified samples — tissues labeled with the wrong patient's name, for instance — declined 62 percent. The hospital said lab errors that harm patients are extremely rare.

"It's a lot more organized," said Jennifer Negron, 27, of Southgate, a lab assistant who registers specimens.

Test results are processed faster, and wasteful procedures have been eliminated. From the first step, taking a sample from a patient, until the doctor receives a diagnosis, the process has been cut to 24 steps from 35.

"The numbers they've been able to achieve are world-class," said Jeffrey Liker, a professor at the University of Michigan and an expert on Toyota.

"They've gotten to such a low level of errors, and the turnaround time — from the time the test is taken to when the results are sent back to the doctor — is almost always within the same day."

The improvements don't reflect one particular change, Liker said. "It's hundreds, maybe thousands of things they've done over five years, and everyone's involved."

In his book coming out in April, "The Toyota Way to Continuous Improvement," Liker has a chapter on Zarbo's work at the Henry Ford Health System.

Now, John Popovich, CEO of Henry Ford Hospital, is seeking ways to drive out waste throughout the hospital system.

Last fall, he and Zarbo attended a two-day workshop in Grand Rapids sponsored by the Toyota Production System Support Center Inc., an Erlanger, Ky.-based company within Toyota.

Initially established to assist suppliers, it now helps other businesses and institutions to apply Toyota Way methods. In addition to hospitals, customers include other manufacturers, food services companies and schools.

'Look for the flow'

St. Joseph's Healthcare Hamilton hospital in Ontario became a client after Ray Tanguay, one of Toyota's highest-ranking North American executives, took his wife to its emergency room on Christmas Eve 2008.

During a two-hour wait, Tanguay watched as doctors selected batches of folders, and the patients corresponding to those folders were put in rooms where they waited to be treated.

"Whenever I go to a place, I always look for the flow. That's what the Toyota production system teaches," Tanguay said. "The flow wasn't that great."

He called the hospital's chief executive, Kevin Smith, and offered to put him in touch with the Toyota Production System Support Center. Smith took his offer.

Three employees from Toyota's auto plant in nearby Cambridge and a Toyota production center specialist spent months working with doctors, nurses and other staff at the hospital.

They knew there was a problem. The province of Ontario was pressing hospitals to speed up treatment and get patients in and out of emergency rooms within four hours. The average wait at St. Joe's was considerably longer. Administrators were mulling installing a new computer system or adding waiting rooms.

In the end, the emergency room set up a control board that would hold the patients' folders, slotted at the time they arrived. Made in a garage using two pieces of plywood, the board helped change how the flow was managed and the work was allocated.

The turnaround time for emergency room patients — from arrival to discharge for those not being admitted to the hospital — was cut in a year to 3.8 hours. It had ranged from six to seven hours for the majority of cases.

Not all aspects lend themselves to the Toyota Production System, Smith said. "What can't be lost as we improve efficiency is that the patients feel they're getting the time they need."

Still, he said, in laboratory, diagnostic and other "high-volume, high-throughput operations," the Toyota Production System can be very beneficial

Detroit News Staff Writer Christina Rogers contributed.