Developing a Quick Isolation Bed Inquiry System During the COVID-19 Outbreak: User-Centered Design Approach Based on the Toyota Production System.

backgroundDuring the COVID-19 outbreak in May 2021, our hospital-designated as a specialized facility for severely infected patients-faced critical staff and resource shortages. The urgent need for efficient bed management to ensure timely admissions underscored the inefficiencies of the manual, phone-based allocation process, which averaged 454 seconds per query. Traditional IT solutions were not feasible due to time and cost constraints.

objectiveThis study aims to design and implement a rapid, zero-cost Quick Isolation Bed Inquiry System that provides real-time bed information and enables timely admissions without requiring additional workforce or expense.

methodsWe conducted a 3-cycle pre-post quality improvement study guided by the Toyota business practice (TBP), an 8-step problem-solving framework. After clarifying the problem and constructing a value stream map, we identified bottlenecks. A user-centered solution was developed by leveraging an underutilized data export function in the hospital's bed inquiry platform. Using Microsoft Excel Visual Basic for Applications, we automated the filtering and display of relevant bed information. The primary outcomes were process time and number of steps; secondary outcomes included staff time savings and system accuracy.

resultsThe baseline manual process required 25 steps and 454 seconds to complete a query. The new system reduced this to 3 steps and 12 seconds, representing a 97.4% gain in efficiency. Single-click execution generated 3 outputs (administrative PDF, large-screen display, and mobile version) in 4 seconds, with distribution to the hospital LINE group completed in 7 seconds. Reliability reached 100%, with continuous availability through virtual private network access. Development and debugging were completed within 3 days using only existing resources. Postpandemic, the system was adapted for general ward management with minimal modifications.

conclusionsApplying TBP enabled the rapid development of a user-centered, zero-cost bed management tool by repurposing existing digital assets. The intervention markedly improved efficiency, reliability, and usability without additional staffing or expenditure, providing a scalable model for agile health care systems operating under resource constraints. Future work will focus on deeper automation, such as application programming interface-based real-time updates, and on evaluating downstream impacts on patient flow and bed turnover.