Driving improvement in patient care: lessons from Toyota.

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Thompson DN, Wolf GA, Spear SJ. J Nurs Admin. 2003;33:585-595.

Representatives from University of Pittsburgh Medical Center (UPMC) describe the implementation of the Toyota Production System (TPS), a standardized approach to improving systems mastered at Toyota. Specifically, TPS is a method of managing people engaged in work that emphasizes frequent, rapid problem solving and work redesign. Individuals are expected to identify barriers and problems in the workplace and then are given the responsibility, resources, teaching, and managerial support to correct them by determining the root cause and redesigning work to eliminate recurrence. The authors describe the rationale for applying TPS to health care and its implementation. They provide specific examples in inpatient medication administration and postulate that TPS could significantly improve patient care and safety.

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