Getting To Standard Work In Health Care: Using Twi To Create A Foundation For Quality Care by Patrick GrauppGetting To Standard Work In Health Care: Using Twi To Create A Foundation For Quality Care by Patrick Graupp

Getting To Standard Work In Health Care: Using Twi To Create A Foundation For Quality Care

byPatrick Graupp, Martha PurrierEditorPatrick Graupp

Paperback | August 27, 2012

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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 Caredescribes 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 inthe delivery of quality health care. Supplying the foundation for successful Lean practice inhealth 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.

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Patrick Grauppbegan his training career at the SANYO Electric Corporate Training Center in Kobe, Japan, after graduating with Highest Honors from Drexel University in 1980. There he learned to deliver TWI and other training to prepare employees for assignment outside of Japan. He was transferred to a compact disc fabrication plant in I...
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Title:Getting To Standard Work In Health Care: Using Twi To Create A Foundation For Quality CareFormat:PaperbackDimensions:223 pages, 9.7 × 7 × 0.5 inPublished:August 27, 2012Publisher:Taylor and FrancisLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:1439878501

ISBN - 13:9781439878507

Reviews

Table of Contents

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

Editorial Reviews

Martha and Patrick combined their years of experience in Patient Care and Training to look at how the Training Within Industry¿s Job Instruction program supports three critical needs at Virginia Mason Medical Center: engineering safety into patient care, more effective training for new caregivers and continually updating best practices for veteran employees to turn best practices into actual practices. In their own words: ¿¿with our emphasis on improvement and the creation perfect care, we will show how the TWI method of Job Instruction is indispensible to the achievement of what needs to be done in healthcare today.¿ This breakthrough book is a must read for all healthcare providers.¿Robert J. Wrona, Executive Director, TWI Institute; and Author of The TWI Workbook: Essential Skills for Supervisors and Implementing TWI: Creating and Managing a Skills-Based Culture The methods of Training Within Industry hold tremendous promise in transforming how we prepare our healthcare workforce to succeed in their work. Healthcare leaders demonstrate respect for people when systems are established that provide adequate and effective training for essential skills. The traditional methods of posting a memo or holding a brief in-service have not successfully demonstrated transference of knowledge and practice, leading to ongoing safety and quality issues for our patients. There is a rich difference between telling while showing vs. posting instructions as it relates to effectively changing the practice.¿ Having served as a trainer utilizing the methods of TWI, there are added benefits of spending time on the gemba and understanding the barriers our staff encounter when attempting to do the right thing. The quality and quantity of information that came to us from simply being out and understanding their experience and conditions were invaluable. Every healthcare system should understand and utilize the methods of TWI. ¿Charleen Tachibana, RN, MN, Senior Vice President, Chief Nursing Officer, & Hospital Administrator, Virginia Mason Medical Center