Industrial engineering success stories
A series of blogs presented by IISE President Michael Foss
ATTN: Business and company leaders whom aspire to excel
Meet Isaac Mitchell, Director, Lean Continuous Improvement, East Tennessee Children’s Hospital. Bachelor of Science, Industrial Engineering, University of Tennessee
“Looking for applications of industrial and systems engineering in healthcare? The opportunities are abundant. Many of us were taught in school about Taiichi Ohno, who is commonly referred to as the father of the Toyota Production System. The Toyota Production System has helped create a world class manufacturing environment centered around the relentless pursuit of continuous improvement focused on the customer, respect for humanity, and elimination of waste. One of Taiichi Ohno’s foundational tools, the chalk circle or Ohno circle, can help point us in the right direction. Ohno would draw a circle on the manufacturing floor, ask a manager to stand in the circle, and then simply tell them to “watch.” Hours later, Ohno would return to the circle and ask, “What did you see?” If a manager answered, “No issues”, Ohno would tell them to look closer until they find a gap between the actual and target condition. This chalk circle practice gives insight on where improvements are needed.
So how does this apply to healthcare and what can industrial and systems engineers do to help? To step back a bit, after graduating from the University of Tennessee with a Bachelor’s of Science in industrial engineering, I started my career at Toyota. My goal was to learn from the source about the Toyota Production System and lean methodologies. During this time, I read articles in IIE’s Industrial Engineer journal about industrial engineers in healthcare. Intrigued by the possibilities in healthcare, I decided to make the industry transition.
When I started at East Tennessee Children’s Hospital as an internal lean consultant, I knew I had an abundance to learn about healthcare operations. I used the Ohno circle to help with my transition. During my Ohno circle observations, I quickly learned that there was a great need for industrial engineers in healthcare. I saw opportunity to directly apply my industrial engineering training to help solve complex healthcare issues.
Over the past seven years at East Tennessee Children’s Hospital, I have worked on a wide variety of projects. These projects including deployment of lean tools such as 5S and Kanban, facility design, systems analysis, huddle boards for daily continuous improvement, management systems including training on employee coaching, and creating standard work focused on evidence based medicine called CareMaps. Below are a few highlights of projects that show a blend of traditional IE tools and methodologies in a healthcare setting.
Inventory Control Systems: When most people think about healthcare they think about the relationship between a patient and a doctor or nurse. Behind the scenes, however, is a complex supply chain that delivers the goods and services needed to provide patient care. One of the first projects I carried out focused on reviewing patient non-chargeable supplies and implementing a Kanban system to signal orders. I reviewed the process utilizing a value stream map and calculated inventory levels, safety stock, and reorder points in order to meet patient demand. As a result, we decreased staff non-value added inventory time by 76% and reduced inventory levels by an average of 41% resulting in $89,900 in savings.
New Tower Facility Design: I also had the opportunity to be involved in planning and designing of a new hospital expansion that includes space for surgery, clinics, and NICU (neonatal intensive care unit). I worked extensively with front-line staff to help design the floor plan and room design to meet both patient and provider needs. We constructed full-scale cardboard models in a local warehouse for sections of the various patient care areas and individual rooms. Staff worked in the mock rooms to test different scenarios with equipment and infrastructure (sinks, cabinets, monitors, etc.) to lay out the rooms exactly as they needed to best serve our patients. Our goal was to prevent redesign after construction. In addition to the cardboard mock rooms, I also utilized simulation modeling to determine room capacity and staffing requirements. This model resulted in $812,000 cost avoidance of two planned operating rooms and validation of the number of pre-operative rooms required. This was monumental in bringing staff and physicians on board to help validate the facility design.
Huddle Board for Continuous Improvement: One of the biggest drivers of building a culture of continuous improvement is engaging all staff, especially front-line staff, in identifying and making improvements daily. To accomplish this, we implemented the use of department based huddle boards. Staff meet around these boards to discuss ideas and provide updates on problem solving projects focused on eliminating waste, reducing cost, improving quality, and improving patient and staff satisfaction. One outcome of a staff driven projects resulted in a redesigned patient admission process to reduce patient length of stay from an average of 17 hours to 10 hours. Since establishing the unit-based boards, over 1000 staff improvement ideas have been implemented.
These are just a few examples of application of industrial and systems engineering in healthcare. As industrial engineers, we are trained problem solvers with excellent business acumen. There is a great need in healthcare for our expertise. All you need to do is look. Draw a circle, open your eyes, observe, and improve.
Bio: Isaac Mitchell has more than 13 years of experience driving change utilizing lean methodology in organizations ranging from automotive manufacturing, fiberglass boat production, machining job shops, and healthcare systems. He is a full time lean practitioner at East Tennessee Children’s Hospital, a lecturer at the University of Tennessee’s Department of Industrial and Systems Engineering, and an instructor for the Institute of Industrial and Systems Engineers. He holds a Master of Business Administration from Xavier University and Bachelor of Science in Industrial Engineering from The University of Tennessee. Additionally, he holds a Lean Six Sigma Black Belt certification through the Institute of Industrial Engineers and a Project Management Professional (PMP)® certification through the Project Management Institute. He serves on the Board of Directors for both the Tennessee Hospital Association’s Society for Organizational Improvement and the Institute of Industrial and System Engineer’s Society for Health Systems. His passion and focus is on training and implementing lean techniques that transform work cultures to improve healthcare processes and outcomes for patients and providers. For more information on his background please visit www.IsaacBMitchell.com.
Industrial and system engineers provide incredible value to any organization in any industry and I am really excited to share these stories and inspire you and your company to hire ISEs.
Blessings to you all!
President, Institute of Industrial and Systems Engineering