National

Nagoya hospital taps Toyota's famed workflow to reduce staff errors

by Yui Matsutake

Kyodo

Toyota Motor Corp.’s famed quality control is being adopted by companies outside the auto sector and is now spreading into medical care.

Nagoya University Hospital in Aichi Prefecture, where Toyota is headquartered, has started a program in collaboration with the Toyota group that aims to improve workflow and to reduce the number of mistakes by pharmacists.

Called ASUISHI and subsidized by the government, the program is targeted at doctors across the nation and aimed at boosting safety and quality in medical care and treatment.

Toyota’s quality control methods include thorough reviews of its production systems and work environment in the event of mistakes to identify the root cause.

Corrective measures are then added to standard procedures to avoid recurrences.

Ayuko Yasuda, deputy chief of Nagoya University Hospital’s quality management and safety department, thought Toyota’s renowned production philosophy could be applied to the medical care industry.

Sixteen doctors took part in the first six-month course, which started last October, and 23 doctors are participating in the second course, which began in July.

The ASUISHI Program is expected to continue through March 2019.

Yoshiyuki Kuwabara, deputy director of Nagoya City West Medical Center, was among the doctors who took part in the first course.

In his hospital’s pharmacy department, about 30 pharmacists work in shifts, dealing with a wide range of medicines stored on large racks and in cabinets.

Errors are made. Sometimes patients are handed the wrong medicines, perhaps because of confusion over where a specific medicine was stored among the many others on the shelves.

In the worst example, more than 10 mistakes were made in the course of a month.

After taking the ASUISHI course, Kuwabara shook up the working environment in the hospital pharmacy as instructed by an ex-Toyota group parts manufacturer employee.

The changed he introduced included attaching pictures of prescriptions and medicines to manuals, showing workflows in diagrams and revamping the labels on cabinets.

The error rate has since been reduced to two to four cases a month.

Further efforts are needed to eliminate mistakes, but Kuwabara said the program has already produced improvements.

“We used to blame each individual for errors, and would have just instructed the staff to be careful next time,” said Kuwabara.

“Toyota’s methods are very new to us.”

Nagoya University Hospital’s Yasuda said: “There is a world of difference between the cultures of Toyota and the medical care industry in terms of controlling work quality and maintaining safety.

“What we need is to change the culture in medical organizations.”

Nagoya University Hospital plans to establish a network among medical facilities that sent participants to attend the program, so they can continue to share vaulable know-how on eliminating errors long after completing the training course.

“I hope the movement to boost patient safety will expand,” said Hiroyuki Nagai, who leads a citizen’s group focused on medical accidents. Nagai is is also a member of ASUISHI’s outside evaluation committee.

Nagai said quality control in medical care is essential for patient safety, but despite this it has not been given priority until now.