Derek Wilson

Chapters 8-9 Graban (HC= healthcare, HF= human factors)

Chapter 8: Preventing errors

Why isn’t 100% inspection a good solution in HC? Some people will get complacent because
they expect the next person to catch any errors they may make.

What is error-proofing in lean and HF and how can we use it in HC? Error proofing is the
“Creation of devices or methods that prevent defects or inexpensively and automatically
inspect outcomes of a process.”

What is a robust or error-tolerant system? How could we create a robust HC system? It is a

system that is ready if an error occurs and can handle it so it is not a huge deal. We
could put things in place that absorb errors so they do not have large effects on the
patients.

What is andon and why would we use it in HC? It is when a process is stopped at the first
sign of an error. It could be used in Healthcare to fix any errors before they spread to
major problems.

Chapter 9: Improving Flow

How do we reduce variation by mura or evening flow? We have employees that can float to
other positions when different things are busy. This way if one thing needs more workers
they could borrow them from something that is not as busy.

What do we do about natural unevenness in HC (e.g. Monday morning rush)? Right now we
have enough workers staffed for the highest peaks all the time. So we are wasting work
hours a lot of the time by being over-staffed.

What ways does the book discuss for using mura? Do you think they will work? How would you
implement them? Worker spreading. I think they will work. I would implement in the parts
of the hospital that have large peaks in workload at specific times.

How does increased flow relate to quality and teamwork? It will improve teamwork and
quality of work because everything will be smoother and workers will communicate
better. This would be a great improvement.

What improvements would the hospital see if we could discharge patients evenly across all 7
days of the week? Is this possible? They would show an even workload for employees.
This could be possible with better scheduling of patient appointments.

How might improved flow help improve the quality of care for the patient? It will remove
wasted time they may spending waiting. This would improve the level of care they
receive by cutting out time they have waiting for treatment or care.

What is the proper balance between patient waiting time and physician waiting time? The
perfect proper balance would be no waiting time for either one. If people are waiting this
is time wasted that could be used for something else.