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, 2nd Edition describes how to incorporate the Training Within Industry (TWI) methods of Job Instruction (JI), Job Relations (JR) and Job Methods (JM) to facilitate performance excellence and boost employee morale in a health care organization. It not only examines the TWI methodologies but also explains how this program is as vital and applicable in today’s health care environment as it was when it was developed to train replacements of an industrial workforce off to fight in WWII.

Placing this methodology squarely within the health care paradigm, the book uses easy-to-understanding terminology to describe how these methods can make all the difference in the delivery of quality health care. Supplying the foundation for successful Lean practice in health care, it clearly defines the role of standard work and leadership skills in relation to Lean health care.

The updated text includes new case studies of current TWI usage in health care that demonstrates how to successfully roll out a sustainable TWI initiative. All new chapters on Job Relations and Job Methods give insight into the full scope of TWI skills development. Including examples of TWI application during the Covid pandemic, the book provides readers with the understanding of how to use these time-tested methodologies to improve training, increase engagement, and deliver continuous improvement in your organization.

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 was taught in Japan. He described 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 that led to his follow-up book, Implementing TWI: Creating and Managing a Skills Based Culture, that 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 health care instruction. She is a certified instructor of the TWI Job Instruction program.