JIT manufacturing
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JIT manufacturing

This presentation reviews just-in-time manufacturing with analysis based on complex adaptive system (CAS) theory. 
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:
  • 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
health care
?  This presentation:
  • 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

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