The Visible Man ER Training

Project Summary

The Pittsburgh Regional Healthcare Initiative (PRHI) is an innovative model for health system change based on region wide shared learning. PRHI focuses on applying industrial “systems thinking” to healthcare quality and safety. Under the leadership of Paul O’Neill, PRHI works with regional healthcare organizations to implement methods derived from the Toyota Production System (TPS) and the Alcoa Real-time Safety System to systematically improve healthcare delivery.

The current training that exists includes the use of circuit boards to teach healthcare professionals how to use the TPS. The problem is that this method is not applicable to the reality of what these professionals encounter in their daily work.

In order to redesign the training to properly utilize the TPS in the healthcare environment, the current training materials and procedures were analyzed. The group came up with the idea of simulating the Emergency Room using visible men. The visible man training is graded on a point scale, in which the higher amount of points the better. The simulation has certain restrictions the trainees have to follow along with tasks that have to be completed. If the trainees do not complete these tasks or follow these restrictions, they lose points. The training simulation for the ER is done three times. In between each run the facilitator of the training holds discussion, which will help to lead the trainees in the proper direction without exactly telling them what to do. The facilitator should tie in the Toyota Production System Principles as much as possible. Arena simulations were created to verify that the constraints for the bed resources and time limits per injury were realistic. The training was modeled in three separate Arena simulations, one for each training run. After adjusting some constraints, the final training packet is realistic for real world implementation.