Getting to Standard Work in Health Care: Using TWI to Create a Foundation for Quality Care

Addressing the challenges involved in achieving standard work in health care, Getting to Standard Work in Health Care: Using TWI to Create a Foundation for Quality Care describes how to incorporate the most widely used Training Within Industry (TWI) method, the Job Instruction (JI) training module, to facilitate performance excellence and boost emp

Table of Contents:
Foreword, Preface, Acknowledgments, About the Authors, SECTION I: CASE FOR STANDARD WORK IN HEALTH CARE, 1. When Clinical Best Practice Is Not Actual Practice, 2. Art of Medicine: It’s the People, 3. Hand Hygiene Training Case Study, 4. Need for Good Instruction Skill, SECTION II: JOB TRAINING, 5. Four Steps of Job Instruction, 6. Breaking Down a Job for Training, 7. Finding the Key Points: The “Key” to Good Instruction, 8. How to Organize and Plan Training, SECTION III: IMPLEMENTING THE JI PROGRAM, 9. Starting Out Strong with a Pilot Project, 10. Integrating JI into the Culture to Sustain Results, Conclusion: A Call to Action

About the Author :
Patrick Graupp began his training career at the SANYO Electric Corporate Training Center in Kobe, Japan, after graduating with highest honors from Drexel University in 1980. There he learned to deliver TWI and other training to prepare employees for assignment outside of Japan. He was transferred to a compact disc fabrication plant in Indiana, where he obtained manufacturing experience before returning to Japan to lead SANYO’s global training effort. Graupp earned an MBA from Boston University during this time and was later promoted to the head of Human Resources for SANYO North America Corp. in San Diego, California, where he settled. Graupp delivered a pilot project in 2001 to reintroduce TWI in the United States. The positive results of the pilot project encouraged him to leave SANYO in 2002 to deliver the TWI program on a wider scale throughout the United States in the same manner as he had been taught in Japan. He described this in his book The TWI Workbook: Essential Skills for Supervisors, a Shingo Research and Professional Publication Prize recipient for 2007. Working with the TWI Institute of Syracuse, New York, Graupp developed standardized training manuals and materials to train and certify trainers on how to deliver the TWI modules as was done by the TWI Service during WWII. The TWI Institute has since trained hundreds of trainers across the United States and around the globe, which led to his follow-up book, Implementing TWI: Creating and Managing a Skills-Based Culture, which was published in October 2010. Martha Purrier is a registered nurse with over 25 years of experience in the hospital setting. She earned a master’s degree specializing in the clinical care of patients with cancer and in the training of nurses. During the past 12 years, she has worked at Virginia Mason Medical Center in Seattle, Washington, as the director of Inpatient Oncology and IV Services. Virginia Mason adopted Lean as a management methodology in 2001, and Purrier was certified in Rapid Process Improvement Workshops in 2006. During her work in IV therapy, the team won the Mary McClinton Patient Safety award for the application of Lean methods, which produced increased safety for patients receiving central lines. In 2008, Purrier was appointed to the Kaizen Fellowship Program. She currently works as the director of Virginia Mason’s Kaizen Promotion Office and is applying TWI to healthcare instruction. She is a certified instructor of the TWI Job Instruction program.

Review :
Martha and Patrick combined their years of experience in Patient Care and Training to look at how the Training Within Industry's Job Instruction program supports three critical needs at Virginia Mason Medical Center: engineering safety into patient care, more effective training for new caregivers and continually updating best practices for veteran employees to turn best practices into actual practices. In their own words: '...with our emphasis on improvement and the creation perfect care, we will show how the TWI method of Job Instruction is indispensible to the achievement of what needs to be done in healthcare today.' This breakthrough book is a must read for all healthcare providers. -Robert J. Wrona, Executive Director, TWI Institute; and Author of The TWI Workbook: Essential Skills for Supervisors and Implementing TWI: Creating and Managing a Skills-Based Culture The methods of Training Within Industry hold tremendous promise in transforming how we prepare our healthcare workforce to succeed in their work. Healthcare leaders demonstrate respect for people when systems are established that provide adequate and effective training for essential skills. The traditional methods of posting a memo or holding a brief in-service have not successfully demonstrated transference of knowledge and practice, leading to ongoing safety and quality issues for our patients. There is a rich difference between telling while showing vs. posting instructions as it relates to effectively changing the practice. Having served as a trainer utilizing the methods of TWI, there are added benefits of spending time on the gemba and understanding the barriers our staff encounter when attempting to do the right thing. The quality and quantity of information that came to us from simply being out and understanding their experience and conditions were invaluable. Every healthcare system should understand and utilize the methods of TWI. -Charleen Tachibana, RN, MN, Senior Vice President, Chief Nursing Officer, & Hospital Administrator, Virginia Mason Medical Center