Teich Sorin T, Faddoul Fady F
Associate Professor, Assistant Dean of Clinical Operations, Department of Comprehensive Care, Case Western Reserve School of Dental Medicine, Cleveland, Ohio, USA; and.
Rambam Maimonides Med J. 2013 Apr 30;4(2):e0007. doi: 10.5041/RMMJ.10107. Print 2013 Apr.
The evolution of production systems is tightly linked to the story of Toyota Motor Company (TMC) that has its roots around 1918. The term "lean" was coined in 1990 following the exploration of the Toyota model that led to the "transference" thesis sustaining the concept that manufacturing problems and technologies are universal problems faced by management and that these concepts can be emulated in non-Japanese enterprises. Lean is a multi-faceted concept and requires organizations to exert effort along several dimensions simultaneously; some consider a successful implementation either achieving major strategic components of lean, implementing practices to support operational aspects, or providing evidence that the improvements are sustainable in the long term. The article explores challenges and opportunities faced by organizations that intend incorporating lean management principles and presents the specific context of the healthcare industry. Finally, the concepts of "essential few" and customer value are illustrated through a simple example of process change following lean principles, which was implemented in a dental school in the United States.
生产系统的演变与丰田汽车公司（TMC）的发展历程紧密相连，丰田公司起源于1918年左右。“精益”一词于1990年提出，此前对丰田模式进行了探索，得出了“转移”论点，该论点支持这样一种观念，即制造问题和技术是管理层面临的普遍问题，并且这些理念可以在非日本企业中效仿。精益是一个多方面的概念，要求组织同时在几个维度上付出努力；一些人认为成功实施精益要么是实现精益的主要战略组成部分，要么是实施支持运营方面的实践，要么是提供证据证明这些改进在长期内是可持续的。本文探讨了有意纳入精益管理原则的组织所面临的挑战和机遇，并介绍了医疗行业的具体背景。最后，通过美国一所牙科学院实施的一个遵循精益原则的流程变革简单示例，阐述了“关键少数”和客户价值的概念。
