@article{486,
  keywords = {Lean, Toyota Production System, diagnostic error, diagnostic waste, patient safety, value streams},
  author = {Nila S. Radhakrishnan and Hardeep Singh and Frederick S. Southwick},
  title = {Teaching novice clinicians how to reduce diagnostic waste and errors by applying the Toyota Production System.},
  abstract = {<p>Background Diagnostic waste, defined as the ordering of low value tests, increases cost, causes delays, increases complexity, and reduces reliability. The Toyota Production System (TPS) is a powerful approach for process improvement that has not been applied to the diagnostic process. We describe a curriculum based on tools and principles of TPS that provides medical students with an approach for reducing diagnostic waste and improving patient management. Methods A 2-day elective course "Fixing Healthcare Delivery" was offered to medical students at the University of Florida, Gainesville. A section within the course had three learning objectives related to TPS: (1) define value in health care; (2) describe how diagnostic waste leads to time delays and diagnostic errors; and (3) apply sequential and iterative value streams for patient management. Instruction methods included videos, readings, and online quizzes followed by a 2-h seminar with facilitated discussion and active problem solving. Results During the 3 years the course was offered students (n = 25) achieved average scores of 95% on a pre-seminar test of manufacturing principles applied to the diagnostic and management process. Course evaluations averaged 4.94 out of 5 (n = 31). Conclusions Students appreciated the application of the TPS principles to the diagnostic process and expressed the desire to apply these manufacturing principles in their future diagnostic and management decision-making.</p>},
  year = {2019},
  journal = {Diagnosis (Berl)},
  volume = {6},
  pages = {179-185},
  month = {12/2019},
  issn = {2194-802X},
  doi = {10.1515/dx-2018-0081},
  language = {eng},
}