Making a “better tomorrow” with a KAIZEN* Mind

One of the world’s fastest growing economies – Cambodia.
Skyscrapers line the streets of the nation’s capital, Phnom Penh.
And yet, remnants of historical chaos burden with social and educational issues.
Together with an NPO providing medical support, TOYOTA’s local staff has been nurturing the
ideals of continuous improvement with a “KAIZEN Mind”.
By confronting the difficulties found at the local hospital, a “better tomorrow” comes into view.

[KAIZEN* is a core TOYOTA principle for continuous improvement. It is a philosophy that
helps to ensure maximum quality, the elimination of waste, and improvements in efficiency.]

An exhaustingly long wait was ordinary when making a hospital visit.

Located 35 kilometers from the capital city of Phnom Penh in the former capital city of Oudong is Ponhea Leu public hospital (PL). Here, the NPO Japan Heart operates the Japan Heart Medical Center (JH). Together, they work as a team to see many patients every day. At PL Hospital, needy patients are treated without cost, and at the JH Center, a specialist in treatment of childhood cancer is on duty at all times. Many of the patients travel great distances to be treated.
The check-in counter at PL Hospital, which handles incoming patients for both facilities, would be crowded with patients from early in the morning. For some, they were only treated as the sun began to set – even after waiting since the morning. It was difficult to treat patients in the order that they arrived, and some – after an overly long wait – would have to give up and go home.
Spending most of the day trying to check-in, the patients and family and friends accompanying them must miss work or school. Even pregnant women and children who want to go to class have no choice but to wait.

The PL public hospital together with a medical center operated by the Japanese NPO, Japan Heart, attend the regional health care needs.

The morning scene (8:30) at the hospital – before introduction of the KAIZEN* program.
Patients cluster in a crowd at the desk awaiting check-in.

With Cambodia’s high birthrate, many of the patients are pregnant women. Some women need to lie down since it’s difficult to sit for long periods with their swollen tummies.

That was the daily scene – and problem – at the hospital. According to the JH staff member, Mr. Von, he felt very sorry for the patients before the program was initiated.
“Previously, there were patients who got angry at being forced to wait so long. We staff members had to take time out to direct patients to where they should go and weren’t able to perform our other duties. And that even added to the waiting time.”

Elrophi lin (25) and her daughter, Mapashita (3) – right. They rode a bus for 7 hours, traveling from near the Thai border to get treatment for her child’s ear. They had to wait 8 hours to receive a 30-minute treatment. “It is a long wait, but to help my daughter, I have no choice”.

Smiles on the patients’ faces make KAIZEN* worthwhile

Those conditions lasted until between 2018 and 2019 when the “Toyota KAIZEN* Movement” was launched in two phases. Though the cooperation of many people, a program based on principles of The Toyota Production System (TPS) was initiated. The administrative and medical staff of both hospitals, together with Toyota employees, worked to alleviate issues facing the hospital.
One example is the creation of clearly defined direction guidelines. There was a problem with patients getting lost, not knowing where to go for treatment. To resolve it, color-coded lines were painted on the floor. Patients – some who could not read – were then told to follow a specific colored line to find the appropriate room without getting lost. This saved the staff the time-consuming task of rescuing lost patients.
Other examples are the issuing of numbered patient cards and the organization of patients’ medical records for quick retrieval at the check-in counter. These measures were able to reduce the waiting times by half.

With the size of the hospital, more than 70% of the patients had gotten lost after checking-in trying to find where they are meant to go. After 5 brightly colored lines were drawn, those numbers were reduced to 20%.

View of the patient medical records cabinet before introduction of the KAIZEN* program. Prior to the reorganization, much time was wasted searching through records in order to re-examine a patient.

View of the patient medical records after introduction of the KAIZEN* program. Arranged in the cabinet by number, the records for a returning patient is easily found.

A key administrative staff member, Mr. Von told us,
“With the waiting time for patients cut in half, we can concentrate on our other duties. When there are other issues, I think the staff can get together to discuss solutions. We are much more motivated now.”

Mr. Von

Generally, young people in Cambodia seek favorable conditions such as higher wages in the capital, Phnom Penh. Miss Sopheap, a key program participant at the JH Center, was one of those young people considering that choice.
“Previously, since I only worked to earn wages, I did think about finding work in Phnom Penh. But, after the first phase of the KAIZEN* program, I began to understand the problems facing the hospital and ways to solve them. Every day became interesting and now I have decided to continue working at the hospital as long as possible,” she told us.

The budding spirit of “making things better”
growing to nurture a promising future.

As the driver and interpreter for the program, Mr. Sykong has closely witnessed the attitude changes in Mr. Von and Miss Sopheap. He shared his thoughts about the future of his country:
“In our country with its tragic history, there aren’t enough educators to instill a moral sense. Not feeling any significance in their work other than money, few people can experience the joy of being of service. If only there were more young people like them, I’m sure the future of Cambodia would be brighter.”
Since being established in 2004, in regions with insufficient medical facilities, the international medical volunteers of Japan Heart have provided needed medical support to ensure the country’s welfare. The head of the management section, Miss Yamashita told us:
“I believe that the greatest reward would be if even without our support, the local population could carry on in the same way. By training young people like Mr. Von and Miss Sopheap, someday we can leave the hospital management to them.”
Each improvement made through the program may be just a small adjustment. But at the same time, KAIZEN* means making the norm at the local hospital a better one. Each member of the local staff has raised their sights – which will lead to further growth and development.

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