Monday, February 1, 2016

Just In Time (JIT)

JIT, one of the two pillars of the Toyota Production System, is the procurement and delivery of resources, whether that be drugs, supplies, access to diagnostic equipment, doctors or staff, just exactly where it is needed, when it is needed, and in the amount needed. Nothing more and nothing less. JIT is an ideal direction and goal, but in a real world, we may have “buffer inventories” that protect us from running out of supplies due to variation that we did not anticipate. It is based on the way United States supermarkets restock inventory on the shelves during the night, to replace what was purchased the previous day. For instance, the ultimate JIT would be for a drug company to send you the 14 antibiotic tablets as soon as you dispense them to a patient. Again, in reality, we may choose to order no more than weekly or order in certain box quantities, so we end up with some inventory (this could be viewed as Type 2 or “necessary” waste).

But, as mentioned above, this idea doesn’t have to refer to just inventory. For example, a doctor’s time is limited and his or her skills are unique and valuable. These resources should be committed only in the necessary places, at the correct time and in the right amount. A doctor’s time is best utilized doing work such as diagnosing illness, creating treatment plans, or performing surgery, rather than running fecal exams, drawing blood samples for lab profiles, or invoicing clients. Making sure that doctors are spending most of their time being doctors is another example of the “respect for people” principle or making sure we don’t waste their talents or capabilities. The scenario of the radiographs mentioned above is an example of JIT. They are taken only when necessary and in the amount necessary.

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