TWI In Healthcare

TWI Teams up with Lean in Healthcare

healthcareThe emergence of Lean and TWI in healthcare has created a powerful organizational approach to solving some of healthcare’s major challenges such as nursing shortages, rising costs, shrinking reimbursements, and fast-changing technology. Quality, patient centered care remains at the forefront.

The TWI Institute is leading the way in the integration of TWI into Lean Healthcare with great success at pioneer institutions such as Virginia Mason Medical Center (VMMC) in Seattle, Baptist Memorial Health Care in Memphis, and St. Joseph Health System in California. Patrick Graupp, Senior Master Trainer at the TWI Institute, and Martha Purrier, RN and former Director of the Kaizen Promotion office at VMMC authored a book in 2012 chronicling this success and demonstrating how to use TWI to create a world-class foundation for quality care.

Although Lean and TWI are most often associated with manufacturing, the principles are universal and apply to many fields. The fundamental goal of Lean is to eliminate waste in all processes through the application of defined tools and techniques. These tools help employees to focus on tasks that bring value and eliminate those that do not. TWI bolsters Lean by providing the tools to train staff quickly, consistently and effectively, increase cooperation, resolve conflicts, and improve safety in the workplace. In the healthcare field every area can benefit including patient care, safety, billing, pharmacy, facilities and food services, to name only a few. The outcomes are impressive: shorter wait-times, faster test results, reduced errors, lower costs and more time for staff to spend on direct patient care.

Lessons from the past – TWI in hospitals during WWII

TWI has a little known, but powerful, history in healthcare in WWII where it made huge impacts during a wartime shortage of healthcare workers. The American Journal of Nursing published several articles attesting to the impact of TWI. These quotes summarize the findings.

“Can nursing instructors learn from the experiences of industrial supervisors? Yes-it’s being done. A plan using the principles of the job instruction program of the ‘Training Within Industry’ Service … is being used for hospitals. Briefly, this plan is intended to present a sure-fire method of teaching a person on the job to do a job, correctly, quickly, and conscientiously.”
Training Within Hospitals, Ellen L. Aird, R.N., The American Journal of Nursing, 1943

“The need for Job Instruction on the ward is even greater than in the classroom. The rapid turnover of nonprofessional workers has created a constant problem of orientating new and often poorly qualified workers. Head nurses, supervisors, and housekeepers, all frequently make the mistake of thinking that telling is teaching. As a result, errors are multiplied, workers grow discouraged, and work lags.”
We Cannot Afford To Hurry, Sister Mary Brich, R.N., The American Journal of Nursing, March 1944

“The program of supervision of auxiliary workers has greatly improved morale in this group, developing in them a keen interest and sense of personal responsibility. It (TWI) has accomplished standardization of work methods and quality performance that is proving its efficacy. Auxiliary workers now feel they are valued as part of the nursing personnel. Better women are applying for work and, because the turnover is less, the hospital is selecting personnel with better care.”
TWI Methods of Teaching Auxiliary Nursing Personnel, Olive White, The American Journal of Nursing, June 1944

TWI Healthcare Program Modules

The TWI Institute has adapted the traditional “J” Programs to healthcare settings and they transfer seamlessly. View descriptions