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Sabi Singh, MS
Director of Operations Improvement
University of Iowa Hospitals and Clinics
Iowa City, IA


The latest patient satisfaction scores for the emergency department at University of Iowa Hospitals and Clinics put the 650-staffed-bed academic medical center in the 95th percentile of its peer group—a sharp increase from the 68th percentile achieved the quarter before a Kaizen (Japanese for “change for better”) event in November 2005. The improvement is one of many examples of Toyota’s Lean Manufacturing principles driving healthcare change. Sabi Singh, director of operations improvement, tells why his move from the automotive industry has been so satisfying.

Singh: A Kaizen event is a very intense two- to four-day time period when a multidisciplinary team is working on an entire revamping of their processes. They go out and try these different experiments to improve their processes. Quality and flow are the mantra.

We provide the tools and training, but it is the team in the department that comes up with suggestions to improve. I received 28 project requests from different departments last quarter, all from word-of-mouth when people hear how it has helped the patients, the staff and the morale.

The culture has changed. People know the things they are doing are helping the patients; they can see that on the patient satisfaction scores, and they are excited about it. On a daily basis, they come up with suggestions to improve quality and flow—every day.

—Lola Butcher