Addressing the challenges involved in achieving standard work in health care, Getting to Standard Work in Health Care: Using TWI to Create a Foundation for Quality Care describes how to incorporate the most widely used Training Within Industry (TWI) method, the Job Instruction (JI) training module, to facilitate performance excellence and boost employee morale in a health care organization. It not only examines the JI methodology but also explains how this program is as vital and applicable in today's health care environment as it was when it was developed to train replacements of an industrial workforce off to fight in WWII. Placing this methodology squarely within the health care paradigm, the book uses easy-to-understand terminology to describe how this method can make all the difference in the delivery of quality health care. Supplying the foundation for successful Lean practice in health care, it clearly defines the role of standard work and training in relation to Lean health care. The text includes case studies of current TWI usage in health care that demonstrate how to successfully roll out a sustainable Job Instruction initiative.
Containing numerous examples of Job Instruction breakdowns in health care, the book provides you with the understanding of how to use this time-tested methodology to improve training, increase efficiency, and decrease strain in your organization.
CASE FOR STANDARD WORK IN HEALTH CARE When Clinical Best Practice Is Not Actual Practice Introduction Engineering Safety into Our Care More Effective Training for New Caregivers Training Veteran Employees in Clinical Best Practices Conclusion Art of Medicine: It's the People Introduction "Pit Crews, Not Cowboys" Where Things Go Wrong Where We Go from Here Hand Hygiene Training Case Study Introduction Initial Training and Insights Hand Hygiene: The Right Place to Start Training Rollout Results of the Initial Rollout Handwashing Pilot Created "Pull" Conclusion Need for Good Instruction Skill Introduction TWI Application in Health Care From Manufacturing to Health Care Good Job Instruction Technique JOB INSTRUCTION TRAINING Four Steps of Job Instruction Introduction Showing Alone Telling Alone A Sure and Effective Method of Instruction Teaching Hand Hygiene Step 1: Prepare the Worker Detail 1: Put the Person at Ease Detail 2: State the Job Detail 3: Find Out What the Person Already Knows Detail 4: Get the Person Interested in Learning the Job Detail 5: Place the Person in the Correct Position Step 2: Present the Operation Detail 1: Tell, Show, and Illustrate One Important Step at a Time Detail 2: Do It Again Stressing Key Points Detail 3: Do It Again Stating Reasons for Key Points Caution Point: Instruct Clearly, Completely, and Patiently, but Don't Give Them More Information Than They Can Master at One Time Step 3: Tryout Performance Detail 1: Have the Person Do the Job, Correct Errors Detail 2: Have the Person Explain Each Important Step to You as They Do the Job Again Detail 3: Have the Person Explain Each Key Point to You as They Do the Job Again Detail 4: Have the Person Explain Reasons for Key Points to You as They Do the Job Again Caution Point: Make Sure the Person Understands Caution Point: Continue Until You Know They Know Step 4: Follow-Up Detail 1: Put the Person on Their Own Detail 2: Designate Who the Person Goes to for Help Detail 3: Check on the Learner Frequently Detail 4: Encourage Questions Detail 5: Taper Off Extra Coaching and Close Follow-Up If the Worker Hasn't Learned, the Instructor Hasn't Taught Breaking Down a Job for Training Introduction Get Ready Point 2: Break Down the Job What Is an Important Step? What Is a Key Point? Important Step 1: Wet Hands Important Step 2: Apply Soap Important Step 3: Rub Hands Important Step 4: Rub Fingers Important Step 5: Rinse Important Step 6: Dry Summary and Sample Breakdowns Breakdown Sheets and Standardized Work Finding the Key Points: The "Key" to Good Instruction Introduction What to Include and What Not to Include Simple Words and Few Teaching "Feel" How Many Key Points in a Single Step? Common Key Points Observing and Involving Experienced Workers in the Breakdown Process Training Soft Skills: Hourly Rounding to Prevent Patient Falls Getting Patients to Ask for Help "We're Too Busy to Do This" Patient Falls Were Reduced How to Organize and Plan Training Introduction Get Ready Point 1: Make a Timetable for Training Get Ready Points 3 and 4: Get Everything Ready and Arrange the Worksite Training Large Jobs: Divide Them into Teaching Units When, and When Not, to Use Job Instruction Implementation of New Equipment: Everyone Does It the Right Way IMPLEMENTING THE JI PROGRAM Starting Out Strong with a Pilot Project Introduction A Plan for Continuing Results Getting Started on the Right Foot Form a TWI Working Group Responsible to Lead the Way Select a Pilot Project to Show the Need for Standard Work Initial Delivery of TWI Training Create In-House Trainers Create a Rollout Plan and Spread the Training Integrating JI into the Culture to Sustain Results Introduction TWI as a Common Language Using the Tools of Lean with TWI Standard Work Sheet PDSA (Plan-Do-Study-Act) Cycles Standard Work Target Progress Reports Cycle Time Takt Time Root Cause Analysis (RCA) Sustaining Improvement Conclusion: A Call to Action Index