TWI Healthcare Programs

Lean and Continuous Improvement methods are increasingly being adopted in healthcare - and for good reason. Generating and sustaining improvements is challenging, yet vital to patient well-being. Training Within Industry (TWI),  an integral component of successful Lean initiatives,  aligns with common organizational goals at all levels such as retaining skilled staff, increasing patient safety, improving caregiver training, increasing the quality of care, reducing waste, and establishing best practices.


TWI Healthcare Program Modules

The TWI Institute has adapted the traditional “J” Programs to healthcare settings and they transfer seamlessly. Hospitals, clinics, medical offices and others are experiencing impressive results with these proven programs:

Job Relations (JR) - Building positive employee relations, increasing cooperation and motivation, and effectively resolving conflict

Studies have shown that the primary reason people leave their jobs is the quality of the relationship with their immediate supervisor. The healthcare industry is no exception. Shortages of skilled workers provide many employment opportunities for dissatisfied nurses, physicians, patient care technicians and administrators. Job Relations teaches people how to prevent problems from arising by treating each other with respect as an individual. When problems do arise, Job Relations teaches a proven method of getting the facts, weighing options, making decisions, taking action, and checking results.

In the video:
 Melanie Edens and James Keller of Baptist Memorial Health Care System provide an overview and discuss the importance of Job Relations. 

Job Instruction (JI) - Quickly training employees to do a job correctly, safely, and conscientiously

Developing and training a flexible staff requires standardized best practices as the foundation, also known as Standard Work in Lean terminology. Program participants are taught how to effectively breakdown a job and deliver instruction for individual tasks. The Job Instruction method teaches the trainer how to prepare the employee to learn, give a proper demonstration, observe the employee perform the task, and taper off coaching with follow-up. This results in reduced training time, fewer patient errors, a more flexible, cross-trained staff, and increased job satisfaction. As new technologies, equipment, and procedures are introduced into the organization, JI will be the key to quickly and safely making them available to patients.

In the video:
Baptist Memorial Health Care System employees demonstrate the application of Job instruction in sterilizing a GI scope.

Job Methods (JM) - Improving the way jobs are performed

The aim of the Job Methods program is to improve the quality of patient care in a given time frame by making the best use of the people, equipment, and materials currently available. For jobs without direct patient contact, the goal is similar; to process greater quantities of higher quality work in less time (e.g. admissions, pharmacy, invoicing, lab analysis, procedure scheduling, etc.). Participants are taught how to break down jobs into their constituent operations. Every detail is questioned in a systematic manner to generate ideas for improvement that can then be quickly put into use by selling the idea to others involved.

In the video:
 Skip Steward of Baptist Memorial Health Care System and Pat Graupp of the TWI Institute discuss how Job Methods is used to deliver higher quality patient care.

Job Safety (JS) - Creating a safe environment for patients and staff

Job Safety training (JS) teaches people how to identify potential hazards and prevent incidents from happening by eliminating the chain of events that lead to unsafe situations. Root causes are identified and remediated to “break the chain”. JS stresses that the relationship of the supervisor and employees plays a pivotal role in a safe and environmentally responsible workplace. This preventive approach to safety will benefit patients and employees in all areas of the organization.

Problem Solving (PS) - Leveraging the TWI skills for solving problems

TWI Problem Solving was developed in 1955 and has since been in use throughout Japan as a means of leveraging the TWI skills to solve specific problems as they occur. Problem Solving is the next logical step for organizations looking to take TWI to the next level by teaching people how they can use Job Relations, Job Instruction and/or Job Methods to solve process problems.