Creating a Continuous 
Improvement Culture 
Webinar
August 13, 2013
Welcome!
• Argentina
• Australia
• Bermuda
• Brazil
• Canada
• Finland
• France
• Great Britain (UK)
• India
• Latvia
• Ne...
 Coach / Facilitator / Consultant / Trainer: 
Lead Lean transformations & develop people 
across all industries.
 Teache...
© 2013 The Karen Martin Group, Inc. 4
Upcoming Webinars
• How Outstanding is Your Organization?:  An Assessment
– Tuesday,...
© 2013 The Karen Martin Group, Inc. 5
After the webinar…
• All recordings are available on:
– www.vimeo.com/karenmartingro...
© 2013 The Karen Martin Group, Inc. 6
Key Topics
• The 4 conditions you need to create to 
build a continuous improvement ...
© 2013 The Karen Martin Group, Inc. 7
Kaizen
Kai = Change Zen = Good
Continuous Improvement: 
A Way of Life
© 2013 The Karen Martin Group, Inc. 8
Improvement needs 
to be part of        
doing the work.
© 2013 The Karen Martin Group, Inc. 9
Continuous Improvement Classics
1982 1982 1986
Recent “Daily Kaizen” Books
© 2013 The Karen Martin Group, Inc. 11
The Toyota Way 2001
• Respect for People
– Respect – We respect others, make every ...
© 2013 The Karen Martin Group, Inc. 12
Continuous 
Improvement: 
The Relentless 
Pursuit of Perfection
© 2013 The Karen Martin Group, Inc. 1313
New Ideas Generated, Tested, Refined, and 
Implemented by Everyone, Everyday, Eve...
© 2013 The Karen Martin Group, Inc. 14
True Continuous Improvement
CHECK
CHECK
CHECK
ACT
ACT
ACT
© 2013 The Karen Martin Group, Inc. 15
What does 
Continuous Improvement 
look and feel like?
© 2013 The Karen Martin Group, Inc. 16
Meet Menlo Innovations
© 2013 The Karen Martin Group, Inc. 17
One million ideas a year.
© 2013 The Karen Martin Group, Inc. 18
What’s it take to 
create a true 
C.I. culture?
© 2013 The Karen Martin Group, Inc. 19
Creating a C.I. Culture: 
Requirements
• Will
• Skill
• Authority
• Guidance
© 2013 The Karen Martin Group, Inc. 20
© 2013 The Karen Martin Group, Inc. 21
You have to 
want it.
© 2013 The Karen Martin Group, Inc. 22
You have to develop 
an intrinsic belief that 
good enough never is.
We need to pass the improvement baton 
from the elite few 
to the common many
23
Respect for People: Develop & Engage
The people who do the work are the experts.
24
© 2013 The Karen Martin Group, Inc. 25
Foster an environment of curiosity
“Why?”
“Why not?”
“What if?”
© 2013 The Karen Martin Group, Inc. 26
= Development
© 2013 The Karen Martin Group, Inc. 27
Requisite Knowledge & Skills
• Value‐adding vs. non‐value‐adding
• Three conditions...
© 2013 The Karen Martin Group, Inc. 28
Detailed Steps
  1.  Define and break down the problem.
  2.  Grasp the current con...
© 2013 The Karen Martin Group, Inc. 29
Root Cause Analysis: 4 Key Tools
CauseCause--andand--Effect DiagramEffect Diagram
M...
© 2013 The Karen Martin Group, Inc. 30
Empowerment
Work: Degrees of Granularity
Value 
Stream
Process Process Process
Step StepStep
31
Micro 
Perspective
• Identify the  
ta...
You may need 
to draw them 
out.
© 2013 The Karen Martin Group, Inc. 33
Boundaries
Learning & development
© 2013 The Karen Martin Group, Inc. 34
Give every team member
“Freedom with Boundaries”
© 2013 The Karen Martin Group, Inc. 35
Loosening the Reins
36
C.I. Essentials:
Supervisors & Managers must become proficient 
Process Managers & Improvement Coaches
© 2013 The Karen Martin Group, Inc. 3737
How are you performing?
Gray – Highest industry quality scores
Purple – Median in...
© 2013 The Karen Martin Group, Inc. 38
Daily Kaizen vs. 
Breakthrough Kaizen 
(Kaikaku)
© 2013 The Karen Martin Group, Inc. 39
1. Increase sales 5%.
3. Achieve 10% profit.
Jan Feb Mar Apr May Jun Jul Aug Sep Oc...
Tie Improvement to Future State          
Value Stream Maps
Referring
Physician
% C&A = 85 %
Send
Reports
(Imaging)
Cycle ...
Tie Improvement to A3s
41
© 2013 The Karen Martin Group, Inc. 42
Attaining Mastery
From The Outstanding Organization, p. 115
© 2013 The Karen Martin Group, Inc. 43
Skill Development Progression*
Unconscious 
Incompetence
Conscious 
Incompetence
Co...
© 2013 The Karen Martin Group, Inc. 44
What you can do immediately no 
matter where you sit…
1. Make sure you know and are...
© 2013 The Karen Martin Group, Inc. 45
Upcoming Webinars
• How Outstanding is Your Organization?:  An Assessment
– Tuesday...
© 2013 The Karen Martin Group, Inc. 46
Karen Martin, President
7770 Regents Road #635
San Diego, CA 92122
858.677.6799
ksm...
© 2013 The Karen Martin Group, Inc. 47
Your Questions
1. Are there unique challenges that exist with establishing 
CI cult...
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Creating a Continuous Improvement Culture

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Lean has been in popular use since the late 1990's in some circles and since the mid-2000's in others. Yet very few organizations have establishing true continuous improvement cultures. Why?

In this webinar you will learn the essential elements for infusing C.I. into your organization's DNA--including the must-have leadership and management behaviors--and tips for selling these needs to your leadership team.

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Creating a Continuous Improvement Culture

  1. 1. Creating a Continuous  Improvement Culture  Webinar August 13, 2013
  2. 2. Welcome! • Argentina • Australia • Bermuda • Brazil • Canada • Finland • France • Great Britain (UK) • India • Latvia • Netherlands • New Zealand • Spain • United States • Uruguay www.ksmartin.com/subscribe
  3. 3.  Coach / Facilitator / Consultant / Trainer:  Lead Lean transformations & develop people  across all industries.  Teacher: University of California, San Diego  Author & Speaker: Karen Martin, President The Karen Martin Group, Inc. www.ksmartin.com 3 October 2013 Shingo Prize  winner!
  4. 4. © 2013 The Karen Martin Group, Inc. 4 Upcoming Webinars • How Outstanding is Your Organization?:  An Assessment – Tuesday, September 17, 2013 – 11:00 am‐12:15 pm – https://www2.gotomeeting.com/register/923117162 • Value Stream Mapping: Visualizing Work Flow and  Aligning People for Organizational Transformation – Tuesday, October 8, 2013 – 11:00 am‐12:15 pm PT – https://www2.gotomeeting.com/register/151856458 • Improvement Facilitation & Coaching: An Open Forum – Tuesday, October 29, 2013 – 11:00 am‐12:15 pm PT – https://www2.gotomeeting.com/register/999232762
  5. 5. © 2013 The Karen Martin Group, Inc. 5 After the webinar… • All recordings are available on: – www.vimeo.com/karenmartingroup – www.youtube.com/karenmartingroup – www.slideshare.net/karenmartingroup – www.ksmartin.com/webinars • The materials are available on – www.slideshare.net/karenmartingroup
  6. 6. © 2013 The Karen Martin Group, Inc. 6 Key Topics • The 4 conditions you need to create to  build a continuous improvement culture. • What continuous improvement looks and  feels like. • How to sell leadership on the management  and leadership behaviors and skill  development needs that lead to continuous  improvement.
  7. 7. © 2013 The Karen Martin Group, Inc. 7 Kaizen Kai = Change Zen = Good Continuous Improvement:  A Way of Life
  8. 8. © 2013 The Karen Martin Group, Inc. 8 Improvement needs  to be part of         doing the work.
  9. 9. © 2013 The Karen Martin Group, Inc. 9 Continuous Improvement Classics 1982 1982 1986
  10. 10. Recent “Daily Kaizen” Books
  11. 11. © 2013 The Karen Martin Group, Inc. 11 The Toyota Way 2001 • Respect for People – Respect – We respect others, make every effort to understand each other, take  responsibility, and build mutual trust. – Teamwork – We stimulate professional growth, share the opportunities of  development, and maximize individual and team performance. • Continuous Improvement – Challenge – We form a long‐term vision meeting challenges with courage and  creativity to realize our dream.  – Kaizen – We improve our business operations continuously, always driving for  innovation and evolution. – Genchi Genbutsu – We believe in going to the source to find the facts to make correct  decisions, build consensus, and achieve goals at our best speed.
  12. 12. © 2013 The Karen Martin Group, Inc. 12 Continuous  Improvement:  The Relentless  Pursuit of Perfection
  13. 13. © 2013 The Karen Martin Group, Inc. 1313 New Ideas Generated, Tested, Refined, and  Implemented by Everyone, Everyday, Everywhere
  14. 14. © 2013 The Karen Martin Group, Inc. 14 True Continuous Improvement CHECK CHECK CHECK ACT ACT ACT
  15. 15. © 2013 The Karen Martin Group, Inc. 15 What does  Continuous Improvement  look and feel like?
  16. 16. © 2013 The Karen Martin Group, Inc. 16 Meet Menlo Innovations
  17. 17. © 2013 The Karen Martin Group, Inc. 17 One million ideas a year.
  18. 18. © 2013 The Karen Martin Group, Inc. 18 What’s it take to  create a true  C.I. culture?
  19. 19. © 2013 The Karen Martin Group, Inc. 19 Creating a C.I. Culture:  Requirements • Will • Skill • Authority • Guidance
  20. 20. © 2013 The Karen Martin Group, Inc. 20
  21. 21. © 2013 The Karen Martin Group, Inc. 21 You have to  want it.
  22. 22. © 2013 The Karen Martin Group, Inc. 22 You have to develop  an intrinsic belief that  good enough never is.
  23. 23. We need to pass the improvement baton  from the elite few  to the common many 23
  24. 24. Respect for People: Develop & Engage The people who do the work are the experts. 24
  25. 25. © 2013 The Karen Martin Group, Inc. 25 Foster an environment of curiosity “Why?” “Why not?” “What if?”
  26. 26. © 2013 The Karen Martin Group, Inc. 26 = Development
  27. 27. © 2013 The Karen Martin Group, Inc. 27 Requisite Knowledge & Skills • Value‐adding vs. non‐value‐adding • Three conditions to eliminate: – Mura ‐ unevenness – Muri ‐ overburden – Muda ‐ waste • Eight types of waste • PDSA/PDCA (Plan‐Do‐Study‐Adjust or Check‐Act) – Including root cause analysis • Process metrics – Process time – Lead time – % Complete & accurate • Process mapping & process documentation 
  28. 28. © 2013 The Karen Martin Group, Inc. 28 Detailed Steps   1.  Define and break down the problem.   2.  Grasp the current condition.   3.  Set a target condition.   4.  Conduct root cause & gap analysis.   5.  Identify potential countermeasures.   6.  Develop & test countermeasure(s)   7.  Refine and finalize countermeasure(s).   8.  Implement countermeasure(s). Study Evaluate  Results   9.  Measure process performance. 10. Refine, standardize, & stabilize the process. 11. Monitor process performance. 12.  Reflect & share learning. Adjust Do Clarifying the PDSA Cycle Plan Develop  Hypothesis Conduct  Experiment Refine  Standardize  Stabilize Phase Continuous  Improvement New  Problem 50‐80%  of the  total  time
  29. 29. © 2013 The Karen Martin Group, Inc. 29 Root Cause Analysis: 4 Key Tools CauseCause--andand--Effect DiagramEffect Diagram Machine Measurement Environment People Material / Info Method Budgets Submitted Late Lack of experience Time availability No sense of import No stnd spread sheet Email vs. FedEx No standard work Input rec’d late Forecast in other system Manual vs. PC System avail. No milestones $ vs. units Weather delays Dispersed sales force Changing schedule Machine Measurement Environment People Material / Info Method Budgets Submitted Late Lack of experience Time availability No sense of import No stnd spread sheet Email vs. FedEx No standard work Input rec’d late Forecast in other system Manual vs. PC System avail. No milestones $ vs. units Weather delays Dispersed sales force Changing schedule 5 Why’s Why?    Why?     Why?  Why?     Why? Paret o Chart Credit Applicat ion Delays 2 9 0 9 6 2 7 5 6 1 2 4 2 1 8 0 2 4 9 3 4 1 % 7 7 % 8 6 % 1 0 0 % 9 7 % 9 4 % 0 500 1000 1500 2000 2500 3000 3500 N o Si gna t ur e I ns uf f i c i e nt B a nk I nf o N o pr i or a ddr e s s C ur r e nt C us t ome r N o C r e di t H i s t or y O t he r Reason f or Delay 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Check Sheets Quantify Occurrences |Equipment failure |||||||||||||Changing customer requirements w/ no adjustment to expected delivery ||||||||||Order entry error |||Staffing/absenteeism |||||Quality issue requiring rework |||||||Material shortage TallyReason |Equipment failure |||||||||||||Changing customer requirements w/ no adjustment to expected delivery ||||||||||Order entry error |||Staffing/absenteeism |||||Quality issue requiring rework |||||||Material shortage TallyReason
  30. 30. © 2013 The Karen Martin Group, Inc. 30 Empowerment
  31. 31. Work: Degrees of Granularity Value  Stream Process Process Process Step StepStep 31 Micro  Perspective • Identify the   tactical “how” • Heavy frontline  involvement • Metrics‐Based   Process Mapping Macro        Perspective • Define strategic  direction (“what”)  • Heavy leadership  involvement • Value Stream  Mapping
  32. 32. You may need  to draw them  out.
  33. 33. © 2013 The Karen Martin Group, Inc. 33 Boundaries Learning & development
  34. 34. © 2013 The Karen Martin Group, Inc. 34 Give every team member “Freedom with Boundaries”
  35. 35. © 2013 The Karen Martin Group, Inc. 35 Loosening the Reins
  36. 36. 36 C.I. Essentials: Supervisors & Managers must become proficient  Process Managers & Improvement Coaches
  37. 37. © 2013 The Karen Martin Group, Inc. 3737 How are you performing? Gray – Highest industry quality scores Purple – Median industry quality scores Blue – Our quality scores
  38. 38. © 2013 The Karen Martin Group, Inc. 38 Daily Kaizen vs.  Breakthrough Kaizen  (Kaikaku)
  39. 39. © 2013 The Karen Martin Group, Inc. 39 1. Increase sales 5%. 3. Achieve 10% profit. Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec IT Mktg Ops HR Bob Fin PE Pario COM  Direct  CDs /  AMs PD  Rec PD  Mgmt BMD SWS 2 3,500 units sold by 12/31/2013 through all channels  (approx. $700K) X X X X X X X X X X X X Bob Dana 2 3 3 3 2 3 3 1 1 3 3 1 3 11 Develop & deliver training to top 50 Dealers X X X X X X Bob Rex/Tim  3 3 3 21 Revised course materials by 6/30/2013 X X X Bob Josh R? 2 3 3 2 2 5 Education: 1 school district spec'd/underperforming  COM distributor (25) by 12/31 valued at min $35K each X X X X X X X X X X X X Howard Michael  S 1 3 2 3 3 8 10 new dealers on board (net) ($500K per dealer this  year) X X X X X X X X X X X X Howard Mike B 2 3 9 5 new distributors bringing $200K annual rev (& 5  terminated) X X X X X X X X X X X X Howard Howard 1 1 1 2 3 17 10 projects spec'd  by 12/31; $300K rev by 12/31 X X X X X X X X X X Howard Dana 1 3 3 3 29 20 by year‐end X X X X X X X X X X X X Howard Mark H 2 3 3 3 32 TBD X X X Howard Howard 33 TBD X X X X X X X X X Howard Howard 10 Useful reporting and metrics are established and in  place  X X Jim Randall 3 1 1 1 1 1 1 30 TBD X X X X X Jim Josh 3 31 TBD X X X X X X Jim Josh 1 1 1 3 1 1 1 1 1 1 1 1 1 1 25 TBD Jim  Shannon  3 3 1 1 1 1 1 26 System 7.0's in place X X X Jim  Randall 3 2 1 2 1 15 100% accurate payroll; 100% management satisfaction  at April mgmt. meeting X X X Josh Phyllis 1 3 20 Internet task list is simplified and streamlined for  PDs then plan is rolled out to PDs  X X X X Michael M Michael M 2 3 2 3 22 Design Calculator is updated successfully and rolled  out X X X Neall Matt D 3 1 1 3 2 2 3 24 Competitive Analysis complete and distributed for use X X X Neall Dana 2 3 3 3 3 3 3 1 Design changed to solve delam issue  long‐term X X X X X Susan David R 3 2 3 12 30 parts sourced in U.S.; completed plan for managing  China‐sourced parts X X X X X X Susan Shannon 3 3 2 2 13 Warehouse laid out; kanban revised; Syspro  implemented X X X Susan Shannon 3 14 Lay out complete; equipment installed X X X Susan David R 3 3 X = Planned 2013 Priorities 2013 Goals & Objectives 4. Improve morale (metric TBD). 2. Achieve 50% gross margin. Created: 01‐14‐13 Revised:  Level of Effort/Involvement Required Priority Goal or Measurable Objective Exec Owner Plan review dates: Tactical  Owner ● =  Actual < Company Name > Contentremoved for confidentiality  Tie Improvement to  Annual Strategy Deployment Plans
  40. 40. Tie Improvement to Future State           Value Stream Maps Referring Physician % C&A = 85 % Send Reports (Imaging) Cycle Time = 3 mins. % C&A = 90 % 6 Hospital Schedule appt Pre-register Cycle Time = 11 mins. Lead Time = 45 mins. % C&A = 98 % 6 CT=Cycle Time LT=Lead Time %C&A=% Complete & Accurate 0.0833 hrs. 1 mins. 0.583 hrs. 10 mins. 0.333 hrs. 10 mins. 0.0833 hrs. 2 mins. 2 hrs. 15 mins. 7 hrs. 1 mins. 0.0333 hrs. 1 mins. 0.5 hrs. 3 mins. LT = 11.3 hrs. CT = 43 mins. CT/LT Ratio = 6.32% Lead Time = 45 mins.Lead Time = 15 days Prep Patient (Tech) Cycle Time = 10 mins. % C&A = 100 % 2 Check-in Patient (Imaging) Cycle Time = 1 mins. % C&A = 98 % 3 Complete Exam (Tech) Cycle Time = 10 mins. % C&A = 90 % 2 Transmit Images (Tech) Cycle Time = 2 mins. % C&A = 100 % 2 Read/Dictate Exam (Radiologist) Cycle Time = 15 mins. % C&A = 95 % 2 Review Draft/Sign (Radiologist) Cycle Time = 1 mins. % C&A = 95 % 2 Print Reports (Imaging) Cycle Time = 1 mins. % C&A = 99 % 2 20 mins. 5 mins. 120 mins. 420 mins. 2 mins. 30 mins.35 mins. E Pay ExcelSymposium Internet Waiting Room Management System Fax Order Solutions PACS 5 mins. Set-up Reduction Remove Check in and Reduce System Access Work BalancingStandard Work Pull System (Supplies Kanban) Visual Workplace Voice Recognition Batch Reductions 5S Co-locate Standard WorkWork Balance Continuous Flow Value Stream Alignment Auto Fax 80% Us Mail 15% MD Mailbox 5% Rolled First Pass yield = 40% Rework Loop via Fax 10% of the time Customer Demand: 15 patients perDay (Takt Time1920 seconds) 8 hours per day 1 2 3 4 5 6 7 8 9 10 11 Risk Reduction (Joint Commision) Meditech
  41. 41. Tie Improvement to A3s 41
  42. 42. © 2013 The Karen Martin Group, Inc. 42 Attaining Mastery From The Outstanding Organization, p. 115
  43. 43. © 2013 The Karen Martin Group, Inc. 43 Skill Development Progression* Unconscious  Incompetence Conscious  Incompetence Conscious  Competence * Commonly attributed to Noel Burch,  Gordon Training International Start Goal Unconscious  Competence Consciousness Competence 1 4 32
  44. 44. © 2013 The Karen Martin Group, Inc. 44 What you can do immediately no  matter where you sit… 1. Make sure you know and are highly skilled in  improvement basics. 2. Begin asking “why,” “why not?” and what if?” in  every encounter/meeting. 3. Establish an improvement‐safe zone in your sphere  of influence; quantify the number of ideas  implemented. 4. Coach, coach, coach…and then coach some more. 5. Quantify results when possible and broadcast,  broadcast, broadcast.
  45. 45. © 2013 The Karen Martin Group, Inc. 45 Upcoming Webinars • How Outstanding is Your Organization?:  An Assessment – Tuesday, September 17, 2013 – 11:00 am‐12:15 pm – https://www2.gotomeeting.com/register/923117162 • Value Stream Mapping: Visualizing Work Flow and  Aligning People for Organizational Transformation – Tuesday, October 8, 2013 – 11:00 am‐12:15 pm PT – https://www2.gotomeeting.com/register/151856458 • Improvement Facilitation & Coaching: An Open Forum – Tuesday, October 29, 2013 – 11:00 am‐12:15 pm PT – https://www2.gotomeeting.com/register/229489922
  46. 46. © 2013 The Karen Martin Group, Inc. 46 Karen Martin, President 7770 Regents Road #635 San Diego, CA 92122 858.677.6799 ksm@ksmartin.com For Further Questions Blog & newsletter:  www.ksmartin.com/subscribe
  47. 47. © 2013 The Karen Martin Group, Inc. 47 Your Questions 1. Are there unique challenges that exist with establishing  CI cultures in union workforces? 2. Companies I worked for push Return on Investment as  the metric for gauging CI activities and culture  effectiveness. Is this the best metric, and are there  others that we should be looking at? 3. How long does it take to change a 125‐year old culture?  4. How do you recommend broadcasting successes and  making them relevant? 5. Our division president wants to implement a long‐term  vision, whereas corporate seeks quarterly results. How  do I interact w/ president & direct reports to ensure  buy‐in? 6. What are things that a middle manager can to do drive  Lean culture?
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