Health Services Research & Development

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Radhakrishnan NS, Singh H, Southwick FS. Teaching novice clinicians how to reduce diagnostic waste and errors by applying the Toyota Production System. Diagnosis (Berlin, Germany). 2019 Jun 26; 6(2):179-185.
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Abstract: 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.