Transcript Toyota Motor Manufacturing Kentucky Georgetown, KY

Toyota Integrated Medical
Management
Presentation Overview
• Toyota Safety Overview
• Toyota Kentucky (TMMK) clinic Kaizen
• Toyota Texas (TMMTX) integrated medical
Toyota Motor Engineering &
Manufacturing North America, Inc.
Vancouver, Canada
Cambridge, Canada
Freemont, CA
Princeton, IN
Buffalo, WV
Erlanger, KY
Long Beach, CA
St. Louis, Troy, MO
and Jackson, TN
Georgetown, KY
Baja CA, Mexico
Employment: 38, 340
Capacity : almost 2 million vehicles
Investment: $16.8 billion
Toyota clinics
Huntsville, AL
San Antonio, TX
Toyota
Safety House
Team Member’s Individual Responsibility
Injury &
Illness
Prevention
Business Planning
Early
Intervention
(ESI)
Process Review
Care
Management
Activities
Safety Auditing
Management Commitment
Design
Budget
TPS
Leadership
VALUES
Kaizen
Training
HOSHIN
Toyota
Safety House
Team Member’s Individual Responsibility
Injury & Illness Prevention
•Equipment Design
Early Symptom Intervention
(ESI)
•Early Symptom Investigation
•Process Design
•Investigation
•Vehicle Structure Design
•Countermeasure Plan
•T/M Education & Training
•Re-hab Consultants
•Posture Confirmation
•Low-level Treatment
•Focus on Top 10 Risk Processes
•G/L Modified Duty
•STOP 6 hazard identification
•Concern Registration Systems
•Follow-up
Care Management
•State of the art clinics,
evaluation centers, and
diagnostic tools
•Care Managers
•Modified Duty
•Restricted T/M Utilization
•Repeat Injury Focus
•Workforce Review Meetings
•Complex Case Meetings
•Indefinite Restrictions
•Medical leave of absence
•Job Placement
•Work condition/work
hardening
•Reintroduction
Toyota’s Health/ Wellness Vision:
Integration, Occupational Health & Benefit
Old Vision
Occupational
Health
Personal Health
*Benefits Group
*Safety/Medical
Group
New Vision
Total
Health/Wellness
Care
*Health/Wellness
Group
Toyota Motor Manufacturing
Kentucky
Georgetown, KY
Toyota in Kentucky
Toyota Motor Manufacturing, Kentucky, Inc.
•Established 1986
•Production Start-up 1988
•Employment: Over 7,000 people
•Size: 7.5 Million sq. ft. under roof
•172 acres / equivalent to 156 football fields
TMMK
Toyota Motor Manufacturing KY
• Toyota largest manufacturing facility
outside of Japan
• Annual capacity 500,000 vehicles
Vehicles Built at TMMK
Solara
Convertible Solara
Camry
Avalon
Toyota Kentucky Clinics
• 2000 clinic-Occ health
• 601clinic-Wellness clinic
• 800 clinic-Occ health
601 Clinic/Wellness
Kaizen Activity
• Wellness physicals
• Hearing test
• New hire physicals
Applying TPS to an Occupational Health Center:
Strategy Overview
• CHD Meridian onsite management
participated in a 5 day training activity
focused on Type III Standardized Work
Assessment
• Participants were assigned a specific
staff member to study
• Kaizen and counter-measures were
implemented as a team
• Results were presented to Toyota &
CHD Meridian management
Improving the Process:
Kaizen Activity
• Standardize
– Detailed process and script for each
element of the required physical
– Work Station
• 5S (clean, sort, etc.)
• Use Visual Controls
– Label for supply location
– Key Points for Work Process
• Eliminate non-value added work
• Decrease Walk Time
Standardization of Work & Eliminating
Waste:
Activity Goals
• Learn how to make standardized work in off-line jobs
• Grasp current clinic situation
• Identify areas for standardization improvement
• Eliminate muda (waste) and free up resources to
provide new services
• Target 450-minute reduction across all processes
The TPS Process
• Training on tools and methods
• Evaluate Initial Condition (Time Studies
and Observation)
• Analyze Data
– Identify Muda (Waste)
• Wait time
• Fluctuation
• Kaizen processes
• Develop and implement Standardized
Work
Analyzing the Data
Before Yamazumi
650
600
550
500
570
30
90
20
185
450
450
400
50
20
50
90
10
70
350
90
40
10
10
Fluctuation
Wait
300
566
Work
250
200
6
4
489
440
398
322
150
429
364
364
397
100
50
0
Phy. Assist.
Physical #1
Front Window
2st shift
Front Window
1st shift
Physical #2 (1st Physical #2 (2nd
shift)
shift)
Drug Tech.
Administrative
Assist.
Supervisor
Kaizen Results
• Exceeded Target Reduction (450
minutes)
– Overall reduction of 533 minutes of
process time
• 41% increase in overall clinic capacity
• 45 minute average reduction of
Mandatory Physical Exam process time
• 56 minute average reduction of
Wellness Physical Exam process time
Kaizen Results:
Reduction of Waste & Variance
After Yamazumi
Work
Wait
Fluctuation
35
40
274
266
30
5
46
pe
r
Su
As
tiv
e
tr a
mi
ni s
vis
or
sis
t
ch
Te
Ad
(2
nd
#2
Dr
ug
sh
ift
ift)
ys
ica
l
#2
ica
l
ys
Ph
345
60
(1
st
1s
ow
tW
ind
375
60
sh
ts
hif
ds
hi f
t
2n
Fr
on
10
t
10
#1
Fr
on
tW
ind
Ph
ys
ica
l
ist
ss
375
424
40
100
30
yA
Ph
566
Ph
302
436
ow
600
500
400
300
200
100
0
Outcome
• There was no decrease in staffing. Staff
was shifted so increased services could be
provided.
• Some of the added services was
Convenience Care Clinic
Optometry Services
Convenience Care Clinic
• I.H.S.Clinics are offering treatment for acute personal
health conditions.
• For example:
–
–
–
–
–
Colds, flu, sinus infections, pneumonia
Minor cuts and burns
Eye injuries
Lab work (will send to personal medical doctor)
Acute episodes of chronic diseases (high blood pressure,
diabetics, heart conditions)
• TMMK added this service on 1/23/06.
• TMMK’s Clinic provides quality and convenient health
care for team members.
• Additional service has no impact on other medical
benefits.
Convenience Care Clinic Impact
2006 Cummalitive Totals
2007 Cummulative totals
Convenience Care Clinic - 2007
2408
2400
2228
2200
1946
2000
1907
1723
1800
1400
1205
1321
1318
1200
1005
1000
985
800
808
Since Inception January 2006
624
4315 Episodic Care Visits
634
600
375
400
1527
1613
1600
295
295
351
333
March
April
339
295
294
May
June
8630 Work Hours Saved
200
0
January
February
July
August
Sept
Oct
Nov
Dec
Toyota Manufacturing, Texas,
Inc.
• Established 2004
• Production Start-up 2006
• Employment: Over 2,000 people
• Size: 1.5 million square feet
• Plant size 2,000 acres
• Annual production
capacity 200,000
Toyota Motor Mfg, Texas
Toyota Manufacturing, Texas,
Inc.
The Toyota
Tundra
Toyota Family Medical Center
Toyota Family Medical Center : A
Comprehensive Primary Care Facility
• Built to Deliver
–
–
–
–
Workplace Safety
Cost Savings
Quality Care
Employer of Choice
Status
• Services Offered
– Primary Care
– Occupational health
– Rehabilitation/return to
work/physical therapy
– Optical care
– Diagnostic x-ray/
ultrasound/laboratory
services
– Dental services
– Pharmacy
– High-performance
specialty and hospital
network
Toyota Production System
• Applying TPS / LEAN processing to a Health Center
– Obtaining Efficiencies – Do we take the savings or do more?
– Redeploying Resources – Moving beyond Occupational Health
– Producing Savings – Health Care Costs & Productivity Savings
• The Toyota Family Health Center in San Antonio
–
–
–
–
Occupation Health
Comprehensive Primary Care
Full Service Pharmacy
High Performance Specialty Network & Hospital
Strategy
• Impact costs by improving quality
• Enhance quality through best practice
guidelines and protocols
• Improve access by providing convenient, high
quality facilities
• Gain appropriate access to health care data
• Achieve flexibility in benefit design
• Focus on wellness and prevention
• Data, systems and health care integration
(occupational and non-occupational)
Integrated Medical Strategy
• Implement a comprehensive health care strategy that
contains costs while providing high quality, accessible
care by providing on-site primary care.
Care provided for:
Lower
costs
- Team members
Higher
quality care
- On-site Supplier Employees
Measurable
outcomes of
services
- Eligible Dependents
Healthier Team Members
Primary Care Clinic
Plan
Design
-Family Practice
-Internal Medicine
-Pediatrics
-Physical Therapy
-Rehabilitation
-Dental
-Optometry
-Lab
-Access to a Fitness
Facility
Pharmacy Occupational
Medicine
-TPA Function
-Radiology
Direct Provider Contracting
Integrated Leave Management
Prevention and Disease Management
Data
Health Care Flow
Current Process
Integrated Model Process
-No utilization steerage
-Does not support consumerism
-Toyota is missing from process
-No control of price increases
-Current process leaves room for error
Pediatrics
Pharmacy
Primary Care
On-site Primary Care
Optometrist
Lab tests, MRIs,
X-Rays, etc.
Dentist
Specialists
Hospitalization
3rd party claims
administrator
In-network Specialists
In-network hospitals
3rd party claims
administrator
Direct Provider Contracting
Current System
Direct Contracting
Network
provider
Hospitals and
Doctors
Network
provider
Hospitals and
Doctors
Toyota
Toyota
Price:
• Toyota does not negotiate price
• Toyota does not influence or even see
price
Quality:
• Toyota’s influence on quality is limited
Toyota manages price and quality in a
manner consistent with Toyota Way and
similar to our relationship with other
suppliers
Data Integration
Medical, Dental,
Vision & Rx
Worker’s
Compensation
STD/LTD
Enrollment
Information
Behavioral Health
Results:
Coordination of Benefits
- Claims auditing
- Benefits simulation
- Predictive modeling
- IBNR/Reserve Analysis
- Vendor management tools
- Cost Driver Analysis
- I.D. areas for Disease Mgmt.

Reduction
in errors
On-site Pharmacy
Question: Why have an on-site pharmacy?
How do they save money?
•Only One Restriction: “Closed Door”
•A Closed Door Pharmacy can only
dispense prescriptions to those who are
defined as beneficiaries of the client
organization(s).
Wellness / Disease Management
Programs
• Wellness
• Gordian Get Healthy
• Disease Management
• Focused Health Solutions
(for adults only)
•
•
•
•
•
•
•
•
Weight Management
Fitness
Cholesterol management
Acid Reflux management
Migraine management
Smoking cessation
Stress management
Bone strength
management
•
•
•
Back and neck pain
Heart conditions
High blood pressure
•
•
•
•
(for adults and children)
Diabetes
Asthma
Clinical depression, anxiety
or obsessive-compulsive
disorder (with medication)
TMMTX Worker’s Compensation
• Developing provider network for worker’s
compensation cases.
• Treatment available at on-site clinic and
Family Health Clinic.
• On-site physical therapy services.
• On-site worker’s compensation adjusters.
Conclusion
We take what we learn from
each start up or current
operation and try to make the
next one the best!!