JIT manufacturing
Summary
This presentation reviews just-in-time manufacturing with analysis based on complex adaptive system (CAS) theory.Introduction
Have you ever wondered why Just in time (JIT) applied to manufacturing has improved quality and reduced costs while the approach failed in The structure and problems of the US
health care network is described in terms of complex adaptive
system (CAS) theory.
The network:
health care?
This presentation: The network:
- Is deeply embedded in the US nation state. It reflects the conflict between two opposing visions for the US: high tax with safety net or low tax without. The emergence of a parasitic elite supported by tax policy, further constrains the choices available to improve the efficiency and effectiveness of the network.
- The US is optimized to sell its citizens dangerous
levels of: salt,
sugar, cigarettes,
guns, light, cell phones, opioids,
costly education, global travel,
antibacterials, formula, foods including
endocrine disrupters;
- Accepting the US controlled global supply chain's offered goods & services results in: debt, chronic stress, amplified consumption and toxic excess, leading to obesity, addiction, driving instead of walking, microbiome collapse;
- Globalization connects disparate environments in a network. At the edges,
humans are drastically altering the biosphere. That
is reducing the proximate natural environment's
connectedness, and leaving its end-nodes disconnected and
far less diverse. This disconnects predators from
their prey, often resulting in local booms and busts that
transform the local parasite
network and their reservoir and amplifier
hosts. The situation is setup so that man is
introduced to spillover
from the local parasites' hosts. Occasionally, but
increasingly, the spillover results in humanity becoming
broadly infected. The evolved
specialization of the immune system
to the proximate environment during development
becomes undermined as the environment transforms.
- Is incented to focus on localized competition generating
massive & costly duplication of services within
physician based health care operations instead of proven
public health strategies. This process drives
increasing research & treatment complexity and promotes hope
for each new technological breakthrough.
- Is amplified by the legislatively structured separation
and indirection of service development,
provision, reimbursement and payment.
- Is impacted by the different political strategies for managing the increasing cost of health care for the demographic bulge of retirees.
- Is presented with acute
and chronic
problems to respond to. As currently setup the network
is tuned to handle acute problems. The interactions
with patients tend to be transactional.
- Includes a legislated health insurance infrastructure which is:
- Costly and inefficient
- Structured around yearly contracts which undermine long-term health goals and strategies.
- Is supported by increasingly regulated HCIT which offers to improve data sharing and quality but has entrenched commercial EHR products deep within the hospital systems.
- Is maintained, and kept in alignment, by massive network effects across the:
- Hospital platform
based
sub-networks connecting to
- Physician networks
- Health insurance networks - amplified by ACA
narrow network legislation
- Hospital clinical supply and food
production networks
- Medical school and academic research network and NIH
- Global transportation network
- Public health networks
- Health care IT supply
network
- Describes how problems in manufacturing were overcome by
the application of Just in time(p.3)
methods
- Outlines the core techniques(p.4) of Just in time including its leverage of total engagement of personnel
- Highlights the aspects of
manufacturing(p.6) that enables these improvements, aspects
which are missing in health care