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CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
CSAC Champion Training 2013
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CSAC Champion Training 2013

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  • Think about your program: what could you do with these benefits?
  • In the Public Works and General Services Agencies, they asked themselves why aren’t we sharing equipment? The answer? Because we’ve always done it this way.There was in fact no reason not to schedule and share some equipment and when they did, they saved over $400,000.
  • When our forensic scientists heard that there may be ways to get test results to the District Attorney faster, they knew this was a fine opportunity for improvement. The conducted a Kaizen and reduced their time to complete drug analysis from 64 to 17 days. This reduced their backlog, allowing the scientists to complete more cases every day. Because the analyses were completed sooner, people stayed in jail for less time and cases were heard in a more timely manner.
  • Social workers were sending cases to the District Attorney. It was full of error and rework.They make the process error free, relegated the work to an assistant and freed up a full social worker.50 more people get services with no added staff costs.
  • Reality – bureaucrats work too hard!SIPOC - Assessment appeals –citizen has a right to appeal the valuation of their property for purposes of taxesEconomy – 5x more appeals – challenge is to process all within mandated time frames without adding staffApplication – manual between two agencies – see the red bullets? This is where the staff saw waste – mostly duplication!
  • Looking at the current state – we found a great deal of non-value added steps
  • There were 92 steps to hand of each and every application at a cost of about $3,600. Just on the front end, the average cycle time was 177 days. (the total number of days averaged 580 days)
  • You can see the improved process is much lighter. – cut 100 days off, 47 steps, and lopped off about $2000 in staff processing cost. (SLIDE)
  • There are so many examples of agenices finding ways to cut costs without cutting services, but simply looking in all the known places – but with a lean lens!
  • Once we have decided where to focus – products, value streams, problemsWhat do we look for? What do we do?
  • Now talk about quality – six sigmaMeasure, Analyze and Improve is what makes six sigma unique (powerful)In Lean looking for waste, in Six Sigma looking for variation
  • (complete the exercise)First person reads the first box. Should be easy as the words and colors match.Next person must say the color (not read the word)*Be sure to tell them to read one column at a time from left to right* *Time both participantsSometimes, even if you know what to look for, it takes practice when we are not used to it. When it is not what we have been trained to look for in the past.
  • Now lets start with the foundations of using it.
  • Here is a video about a customer who needs something.You will see a leader who makes a small change, that causes people to shift what they want to do. (After watch)What other things could she have done?Why is what she did effective (she didn’t talk to a single person)<you just made a list of things you can do to empower people.>(ex. Steve Jobs bathroom)Why did she do it? – because she wanted to help the customerNow lets talk about our customers.
  • Divide into groups.Use easels and post-its to document what customers need.(later will sort ideas by type) – time, quality, cost, other (policy…)It’s important to design a product to meet the needs of the customer – so know who your customer really is. There can be multiple customers with competing interests. Understand the nature of the interests of the customer.All customers need value from the product or service you are providing.Value A product or service provided to a customer at the right time, at the appropriate price, and with sufficient quality.Various Needs:When you deliver the service – what is important to them.What do they all have in common: value (the things you just described is what LSS calls value)
  • It’s important to design a product to meet the needs of the customer – so know who your customer really is. There can be multiple customers with competing interests. Understand the nature of the interests of the customer.Image: swimmers in a swimlane: kick, stroke, breathing, ; multiple vs’s;
  • Tell group to slow down, we will do one step at a time together.Here’s and example of fixing a problem with the customer in mind. – GSA billing invoice- faster: made it electronic. Also asked customer, what would be helpful to you? The customers wanted to know what they paid last year. Now GSA gets paid faster. Where else if gov’t guilty of not thinking about their customers?: silos, single service multiple billing, web pages – complete but not in logical order, instructions in government language. (find an example)(do you have customers with conflicting needs? Ex. Speed vs. quality) Can you meet both?Exercise: Each group will work together. Each person will have their own “modified SIPOC” form to documentExplain form and use payroll example on form:-Each phase has multiple process steps in it.What do you think is most important to employee? (on time correct)Does employee care about system processing steps?Which steps add value to the customer.-Sometimes customer has input into own process.Step 1 – who are your customers?It’s important to design a product to meet the needs of the customer – so know who your customer really is. There can be multiple customers with competing interests. Understand the nature of the interests of the customer.** INTRODUCE Value Stream Exercise: Start by identifying a key product/service here.
  • Let’s just practice:(use an admin example in class, ask a student – name a customer…)*whatever it is that you identify as the product: the litmus test is can you measure it in time, cost, quality? Because that’s what customers most care about? We provide services is vague, it is like saying we make “stuff”. It’s harder to measure a “service than a product”.Services we provide actually result in a product: as a manager you should clear about your products. One way to know is to ask yourself: Can what you listed be counted, is it specific is it a noun, can you deliver it? Value Stream Exercise: who is the customer
  • “Outcomes” are more difficult to measure and improve than “products”.
  • L6S is a set of tools for process improvement. Today is about what the process is and the role you play. Value Stream Exercise: What are the process steps/phases?
  • Discussion:Now we have a way to view our organization through the Value Stream lens.We have also identified what is of value to the customer. ($, Time, Quality)Performance should be based on your customers point of view: when it’s not, that’s where you want to improve performance.How do we decide what to improve first?
  • Object similar to OutcomesStrategy similar to a more specific goalEx. Burning platform of Permits: Must look beyond just the portion that your agency does, every part of the value stream that delivers the product to the customer must be considered. This is what Champions do. If you were to look at your products, what are your target performance in these 3 categories (or what are your state standards), where are the gaps?What if you meet the state standards, but it takes you a large number of resources? Is that OK. Instead of hiring staff do you need to increase capacity with existing staff?
  • Object similar to OutcomesStrategy similar to a more specific goal
  • Non- Value Stream = add staff or resources to increase capacityValue Stream = Focus on improving the current process used in the value streamStrategy to increase capacity.Other side of coinBusiness sees capacity as an issue/objective - in lean, improving speed/quality (what customer cares about) will improve your performance (profit or capacity) If you think about the customer, you will also improve your own performance.
  • Lucy videoFill out V.S. Form after watching video. (will they write what they see or what the “know” must be involved in V.S.?)Process map exercise: what do you seeHow much of the process did you actually see:They only see their part, they are guessing at the other parts of the VS.What leadership style did you see?Which part of the process needs to be improved? - can see some things, but can you see all? Do you know that the customers experiences is? - which lever to push on “system view”***You could improve all of them, but which problem do you want to solve:
  • Before you engage in a Kaizen – check yourself…Do you already know the solution? Maybe you have a JDI.
  • Change mental model of your role as a manager (get others to think)Point direction and remove obstaclesKnow how change impacts people and what to expect
  • Quote from Abraham Lincoln 1862 “Dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty and we must rise with it. As our case is new, so we must think anew and act anew. We must disenthrall ourselves and then we will save our country.”What I love about this quote is the concept of disentralling ourselves. So, this revolution, then, is a personal one that starts in your mind.
  • Summary: (puzzle pieces)CustomersEmployees are expertsValue streams = products (not departments = products)Neopolitan Ice cream: time, quality, cost = valueChange needs to managed, management starts before the change<how is this all going to happen?.....needaLeadership!!!!>CustomersEmployeesValueValue streamsChange***leadership***
  • What should government leaders do to create a lean revolution? – they need to get in their heads…and be dangerous. Our culture is about staying within the lines – Bureaucracy is built on regulations and rules.But if our cultural safety zone continues to stay this tight, – we remove the opportunity to learn by mistakesExperience a loving relationshipMeasure twinkling eyes – who am I being that that is not happeningDiscover their true spiritExploit the Value proposition of JoyPlay, dream, relax – best ideas come from a free mindGo slowMake a lot of mistakesIf you’re not prepared to be wrong you are not prepared to be innovative.
  • The problems we have and drivers for change are not unexpected, they are inevitable. Over the life of the County we will go through many ups and downs.It is how we adapt to those changes that defines our success.There are two things that can change: you and your environment.Your environment will changeYou have a choice
  • Transcript

    • 1. COUNTY OF VENTURA Champion Training LEAN SIX SIGMA
    • 2. Objectives for Today County Executive Office Learn how to achieve the greatest value for your customer through continuous process improvement Learn how Lean Six Sigma can lead to improved organizational performance Gain a basic understanding of Lean Six Sigma tools and principles
    • 3. Employees County Executive Office Solutions 1. More employees 2. Improved employees • Training • Multitasking • Incentives • Accountability 3. Customers have to wait Process • “Manage”Complaints expectations•What took so long?• Can’t you go any faster?• Who dropped the ball? Customers
    • 4. Customer Becomes the Problem County Executive Office
    • 5. EmployeeService Delivery County Executive Office Before After Process Improvement Customer
    • 6. County Executive OfficeMeasurable Systemic Health IndicatorsBlood pressureCholesterolWaist CircumferenceBody fatResting heart rate
    • 7. County Executive OfficeMeasurable Systemic Health IndicatorsCrime rateProperty valuesPoverty rateAge of the populationEducation rankings
    • 8. County Executive OfficeMeasurable Systemic Health Indicators
    • 9. Traditional Response County Executive Office Cut hours Cut people Cut services Cut programs Across the board budget cuts Hiring freezes Travel restrictions The illusion of numbers
    • 10. Problem with Traditional Response County Executive Office Staff overwhelmed trying to get through the same system with less people. Can’t get the outcomes needed by doing what we have always done.
    • 11. Introductions County Executive OfficeIntroduce yourself.If your team knew how to find time or money through process improvement: What would you do with the extra time? What would you do with the extra money?
    • 12. County Executive OfficeService Excellence Program ObjectiveEncourage a county-wide culture of serviceexcellence, continuous improvement andempirically based decision making as ameans of improving quality, consistency,speed and cost of County Services.
    • 13. County Executive Office
    • 14. Lean Government Exchange County Executive OfficeDes Moines, Iowa 2009 and beyond• Iowa • Hawaii • City of Appleton, WI• Minnesota • County of Ventura, CA • Vermont• Kentucky • City of Cape Coral, FL • Georgia • City of Fort Dodge,• Kansas• Delaware • Washington, Iowa• Ohio DC • Shasta County, CA• Toronto • California • Los Angeles County• Arkansas • Arkansas DPSS, DCSS• Alabama • Kitsap County, • Colorado• Nebraska Washington • Connecticut • Cal State Channel• New Hampshire• South Carolina • Maryland Islands• Illinois • Rhode Island • RTC, Washoe County,• Oregon • Washington Nevada• Oklahoma • CalPoly, SLO, CA 14
    • 15. Where is CPI Applied County Executive Office Environmental permits / Air Quality / Wastewater/Floodplains / Landfills / Manure management Corrections - Offender Re-entry /Forensics Procurement Board of Medical Examiners Investigatory process Veterans Home Admissions / Medical Appointments / Medication Administration / Pharmacy Patient flow / Hospital discharge/Health facilities Human Services processes and services Animal Services Child Abuse Appeals / Foster Child placement across state lines 15
    • 16. Ventura County Value County Executive Office
    • 17. Get the Scoop County Executive OfficePWA and GSA optimizing their heavy equipment trackingand eliminating the need to purchase this equipment. 1 Grader = $225,000 1 Roller = $ 54,000 1 Backhoe = $150,000 $429,000 Breaking down silos and having teams constantly thinking of ways to save. Priceless!
    • 18. Sheriff Forensics Dry Drug Analysis County Executive Office THEN NOW • 64 days to complete • 17 days • Backlog over 200 cases • Backlog down 50% • Productivity up – more cases per scientist
    • 19. County Executive OfficeErrorless process to send case files to DA = 1 FTE Social Worker
    • 20. Mean Number of Days to Process Planning County Executive Office Director-Approved Discretionary Permit Applications Baseline Metric: New Metric: Average Processing Average Processing % Change in Permit Type Time (days) Time (days) Processing Time Planned Development Permit 285 101 64.6%Minor Modification Permit 251 119 52.6% Parcel Map Waiver/Lot Line Adjustment 191 83 56.5% Parcel Map Waiver Merger 102 39 61.8% 20
    • 21. Canal Clean Up County Executive OfficeCost Savings – by eliminating over processing $600,000 – re-purposed to canal repairs
    • 22. High Level Y: Critical to Process - Disposition Inputs (Xs) Controlled/Not controlled X Applications (9) Process Step (Activity) Outputs (Ys) Y Information or Product SIPOC Type Noise Receive Requests for Apps (5) County Executive Office X C opy of Apps -3 Type X C ustomer Application Form 9 C ontrollable Receive and Process Y Processed and Accurate Application The SIPOC map provides a means to further clarify which of the Type Noise Applications (5) X Notificationof Hearings 9 Y Final App in Portal and Filed Type C ontrollable Enter Data (5) X Software and internet -3 Type X C ompleted Apps 1 Noise Distribute Apps Y Distributed Apps inputs have the greatest “push” on the outputs. (3) Type C ontrollable X Hard C opy Apps - 1 Y Application Image Type Noise Scan (1)X Hard C opy Apps -9 Y Accurate Electronic Data Type Noise Input andX Info - Electronic and Hard copy 3 Reconcile Data Type C ontrollable into STAR (5)X Application Assignment Sheets 1 Y Work Item, Electronic List of C ases Based on this ranking system, the Type C ontrollable Assign AppriaserX Site Lode List (1) Type C ontrollable following processes had the greatest X C ontact Information 1 Y Hard C opy for Apprisers Type Noise Create Folders Y C entral Repository and Central Maintenance (5) Prepare Appraisal (2) Y Decision impact: X Recommendation Information 9 Type X Forms 9 C ontrollable Communication to Applicant (Stipulation, Y Resolved C ases or Hearing •Receive requests for application Type C ontrollable Withdraw, option for Hearing) (5) X List from Renee 9 Type C ontrollable Provide Memo to Set Hearing to Y Hard copy of memo to set •Receive and process applications COB (5) X Secured Property Database 1 Type X Memo 9 Type C ontrollable C ontrollable Receive Memo of Hearing and return confirmation to Y List of Apps to Schedule for Hearing •Enter data (Clerk of the Board) Assessors office (5) X C ompleted Application 9 Type X Assessors Memo to Set 9 C ontrollable Notification of Hearing to Y Letter Package •Reconcile and enter into Star (Assessor) Applicant/Agent Type C ontrollable (4) X Blue C ard 9 Y Final Decision Type Noise Board Hearing X Agenda 3 Preparation Type Noise Process (5) X Supplies 3 Type X Applications 3 Type C ontrollable Coordinate Board C ontrollable Hearing (4) Y Agenda •Communication to Applicant •Memo to set processes X Agenda 1 Y Record of Meeting Type C ontrollable Attend and Clerk Hearing (2) X Board Decision 0 Y C losed C ase •Assessment Board Hearing Type Noise Close Out Process Y Updated STAR X Summary and Disposition 9 (4) Type Noise X Summary and Disposition 9 Type C ontrollable Close Out Process (4) Y Summary Y Minute Orders Y C losed C ase Y Updated Portal preparation process
    • 23. Admin Side – Current State County Executive Office Swimlane Map 1 of 2
    • 24. County Executive Office COB CURRENT STATE (Swimlane Map 2 of 2)Total Steps 92Min. Touch Time/Hours 55.46 Max Touch Time/Hours 73.31Min. Process Cost/ 1 Appl. $2,723.70 Max. Process Cost/ 1 Appl. $3,592.40Minimum Cycle Time/Days 136 Maximum Cycle Time/Days 218 (Admin only)
    • 25. Admin Side - Future State County Executive OfficeMetric (Admin only) Current State Future State DifferenceTotal Steps 92 45 -47Average Touch Time 64 hours 23 hours -41 hoursAverage Cost/Appeal $3,158 $1,152 -$2,005Average Cycle Time 177 days 77 days* -100 days* 70 days required for notifications and responses
    • 26. Found Money in Infrastructure County Executive Office GSA Project Management Fee reduced from 12.5% to 9.9%Cost Savings - $480,000 Cost Savings - $600,000 Annual Savings - $350,000 …and growing
    • 27. County Executive OfficeBASIC CONCEPTS OF LEANSIX SIGMA“It’s never too late to become what you might havebeen.” – George Eliot 27
    • 28. Origin of Lean County Executive Office Japan – post WWII – struggling economy Edwards Deming – Quality guru Brought radical ideas not yet implemented in America  Acceptable quality level. cost/quality not a trade off  Daily incremental improvement (everyone involved). Don’t seek perfection…yet (80/20).  Focus – Don’t improve work, eliminate waste
    • 29. Focus County Executive OfficeFocus can help you see more clearly.
    • 30. Paradox County Executive OfficeWe can accomplish more, by doing less.
    • 31. Lean Six Sigma is . . . County Executive Office A Combination of two schools of thought:1. “Lean” - eliminating waste, creating process steps that add value to the customer2. “Six Sigma” - reducing variation to ensure a standard, quality output
    • 32. Cycle of Lean Principles County Executive Office Seek Specify Perfection Customer Value Identify and Remove Waste=Establish Identify “Pull” SPEED Value Stream Achieve Flow
    • 33. Knowledge Work 8- Wastes Product WorkWork not meeting requirements. Defects Scrap, rework, lost capacity due to County Executive OfficeMissing information. Rework. mistakes, inaccurate SOP’s.Too many reports, reviews, approvals. Overproduction Running equipment to keep equipmentBatching paperwork. and people busy.Waiting for meetings to start. Waiting Waiting for equipment, people orInformation, paperwork and process to cycle, waiting for materialsapprovals. and tools.Over or under staffing, talents not Non utilization of Over or under staffing, talents notutilized, work load not balanced. utilized, work load not balanced. people/talentPaper- based data vs. electronic Transportation Long travel distances, unplannedtransfers. Routing of unnecessary premium postal.approvals/processing.Excessive backlog of work to be Inventory Making what we can instead of whatprocessed. Too much paper to be customers need. High obsolescencehandled, processed or filed. and write offs.Walking to deliver paperwork, poor Motion Repetitive/unnecessary movementergonomics, chasing information. caused by poor ergonomic design.Unnecessary steps. Too many Extra or Over Incapable equipment and processes.handoffs, lack of SOP’s. Equipment with unbalanced flow. 33 Processing
    • 34. See Waste, Remove Waste County Executive Office
    • 35. Lean Process Improvement County Executive Office Inspect Inspect Re-work Wait Transport Transport Wait Work Reinstall Work WorkDisconnect Start Finish FLOW TIME = Value = Non-Value-Added Added Time Time (WASTE) Value-Added time is only a very small percentage of the total Time
    • 36. DMAIC County Executive Office Cycle of Six Sigma Phases Define the ProblemMeasure Performance CONTROL DEFINE Define Scope / Boundaries Identify and Remove Variation= Current State Map Baseline Measures QUALITYLean Tool Kit IMPROVE MEASURE ANALYZE Root Cause Analysis Find Waste, Variation, and Value/Non- Value
    • 37. Simple, But Not Easy County Executive Office
    • 38. County Executive OfficeFOUNDATIONAL CONCEPTS –USING LEAN SIX SIGMAPERSPECTIVE 38
    • 39. County Executive Office
    • 40. County Executive OfficeOur Customers Need Us More Than Ever Divide into groups Use the easels and post-its What are your customers complaining about right now?
    • 41. Value Customers Want County Executive OfficeThe 3 most popular flavors: Faster Cheaper BetterDo you know which one is your customers favorite?
    • 42. Where Does Value Come From? County Executive Office Value for customers is generated in the “value stream”. Value Stream A value stream usually consists of several processes which each have many individual process steps that result in a service that is delivered to a customer. 42
    • 43. The Lean View of Your Organization County Executive Office Getting to your value streams: 1. Every agency has customers 2. Every customer gets a product/service 3. Products/Services result in outcomes 4. All outcomes and product/services are driven by processes Conclusion If you want to improve value to customers, improve the value streams/processes. 43
    • 44. 1. Every Agency has Customers County Executive Office Who are your customers? (Everybody has customers) •Who buys it •Who uses it •Who requires it •Two types: Brokers and End-users •Example: License Plate, Grandpa and grandchild red rider BB gun 44
    • 45. County Executive Office2. Every Customer gets Products/Services What products do What is a product? you produce? Products: •Permits 1. Can be counted •Determinations 2. Are specific •Miles of road 3. Are nouns •Tax credits 4. You can deliver them •Vaccinations -Ken Miller •Probation visits •Licenses •Welfare checks •Treatment plans •Jobs •Educational sessions 45
    • 46. 3. Products Produce Outcomes County Executive Office What are the outcomes of your work? •Healthy families •Safe communities •A fair criminal justice system •Better communication •Maintained roads •Improved fire protection •Easier access to public services“Outcomes” are more difficult to measure and improve than “products”. 46
    • 47. 4. All Outcomes and Products/Services County Executive Office are Driven by Processes What are your processes? •Every organization provides products to customers. •Processes and systems create these products. •All Work is a process. •Process steps in the value stream should flow and be designed to meet the customer’s desires. •L6S methodology is centered around improving processes not people. 47
    • 48. County Executive OfficeSELECTING WHICH VALUESTREAMS TO IMPROVE 48
    • 49. County Executive Office
    • 50. County Executive Office How We Select What to Improve Burning Platforms Customer Complaints Grass Roots Organizational Product Maps • Performance Assessments (data analysis) Strategic Planning 50
    • 51. Pick Chart County Executive OfficeThere are four categories on a 2*2 matrix; horizontal isscale of payoff (or benefits), vertical is ease ofimplementation.By deciding where an idea falls on the pick chart fourproposed project actions are provided: Possible Implement Challenge Kill *(thus the name “PICK” chart) 51
    • 52. PICK Chart County Executive OfficeLow Payoff, easy to do - PossibleHigh Payoff, easy to do - ImplementHigh Payoff, hard to do - Challenge Low Payoff, hard to do - Kill 52
    • 53. County Executive OfficeStrategic Approach to Value Streams See it! – Strategic PerspectiveFocus Area: COMMUNITY HEALTHFocus Area Goal: To be the premier health care provider in the industry.Objective #1: Schedule surgeries within 24 hrs.Strategy #1: Increase the capacity for surgical procedures by 40%. 53
    • 54. County Executive Office What is a Value Stream Approach?NON-VALUE STREAM VALUE STREAMS (Lean Perspective)• Increase the number of surgery rooms • Patient flow from schedule to discharge• Staff up for new rooms o Scheduling the rooms o Preparing the room,• Upgrade equipment trays, equip, meds o Prep-ing the patient o Information flow 54
    • 55. What Do You See? County Executive Office
    • 56. County Executive OfficeWe have a Customer ComplaintPROBLEM SOLVING
    • 57. Change for the Greater Good County Executive Office Leadership is the art of getting someone else to do something you want done, because he wants to do it. -President Dwight D. Eisenhower Kaizen 57
    • 58. Just Do It County Executive OfficeNot every idea needs a teamChampions – do not ask for a team solution if you already have oneSolution flags • More Training/Incentives • Add Staff • Improve P&P’s • Add Inspections
    • 59. Team Roles County Executive OfficeBoard of Supervisors CEO Agency Heads Deployment Champion Value Stream Champion All Employees Team Leaders Provides inputs to how to improve their own jobs and work areas Team Belts Members 59
    • 60. It’s scientific! County Executive OfficeY = f (x1, x2,…xn)
    • 61. Process Improvement Filter County Executive Office1. Y = f (x1, x2…)2. Define Y (Charter)3. Identify the X’s (tribal knowledge)4. Identify the red X’s (tribal knowledge) (Vital Few)5. Validate the red X’s (Gemba/data)6. Analysis7. SolutionDon’t accelerate theexcavation until you are sureyour digging in the rightplace.
    • 62. Candy Metrics County Executive Office Customer Order (How do you know what they want?) 5000 wrapped candies Total Candies Processed (Effort-Quality) 15,000 Total Failures/Defects (Do customers care?) 10,000 Yield (Customer Order/Total Processed) 33.3% Percent of Customer Complaints 98% Lean Metrics: Financial, behavioral, and core-processmeasurements that help you monitor your organization’s progress toward achieving the goals of the lean initiative. 62
    • 63. Date Initiated: PH Clinic Registration and Billing Process Revision Date: County Executive Office Event Start Date: DEFINE Event End Date: Project Information ROLE Phone No. LAST NAME FIRST NAME AGENCY Contract with the Department Champion Value Stream Analysis Champion Team Lead Subject Matter Expert Subject Matter Expert team Green Belt Green Belt Total Man Hours Provides guidance. Event Type I Kaizen Event Type II Part of GTEP Business Case Be sure you have the right team, Opportunity or Problem Statement/Business Impact that the problem is scoped, and you Goal Statement have measurable Project Deliverables goals. In Scope Out of ScopeValue Stream Champion Date
    • 64. Gemba/Walk the Process County Executive Office Means to “GO SEE” THE FIVE ACTUALS1. Go to the actual workplace.2. Engage the people who do the actual work.3. Observe the actual process.4. Collect the actual data.5. Understand the actual value stream. 64
    • 65. Exercise: What Went Wrong? County Executive Office What went wrong with the process? No solutions allowed yet; only problems 10 min 65
    • 66. County Executive Office Model SIPOC Y?Suppliers Inputs Process Outputs Customers X X Y Y X X Y X X 66
    • 67. County Executive OfficeVLS CM SCD ECP Current State - 1.0 Develop Alteration Proposal part 1 1.2 A28,A47, 1.6 A65,A68 A28,A47, A65,A68 Review Review ECP & Submit Dept 1 SCD & Comments Submit FT: 88 2.0 Comments TT: 0.25 FT: 56 P: 4 TT: 0.25 P: 4 1.6 A36 Review ECP & Submit Dept 2 1.2 Comments A35 FT: 88 Review TT: 0.2 SCD & P: 1 Submit Comments 1.6 1.7 1.11 A35 1.10 1.1 FT: 56 1.3 1.5 A66 1.8 A66 Review ECP & Submit A66 A66 TT: 4 Consolidate A66 Consolidate A66 Action item Comments Participate in P: 1 & Post ECP to resolution Dept 3 Coordinate SCD Coordinate Sponsor FT: 88 approve Live LInk Sponsor SCD comments ECP Telcon 1.2 TT: 8 ECP FT: 8 Telcon Review FT: 16 Review for ECP A66 P: 1 comments TT: 0.5 for ECP FT: 8 TT: 4 FT: 8 FT: 4 Review 1.6 FT: 16 P: 1 FT: 40 TT: 0.5 P: 1 TT: 0.5 TT: 4 SCD & A66 TT: 8 TT: 4 P: 1 P: 1 P: 1 Submit Review ECP & Submit P: 1 P: 1 Comments Comments FT: 56 FT: 88 Dept 4 TT: 8 TT: 16 P: 1 P: 1 Mgmt 1.0 1.9 1.4 Submit Conduct Submit Finance SCD Sponsor ECP for for review Telecon Review FT: 8 for ECP FT: 8 TT: .5 FT: 4 TT: 6 P: 1 TT: 4 P: 1 P: 1 Swim Lane Process Map
    • 68. Knowledge Work 8- Wastes Product Work County Executive OfficeWork not meeting requirements. Defects Scrap, rework, lost capacity due toMissing information. Rework. mistakes, inaccurate SOP’s.Too many reports, reviews, Overproduction Running equipment to keepapprovals. Batching paperwork. equipment and people busy.Waiting for meetings to start. Waiting Waiting for equipment, people orInformation, paperwork and process to cycle, waiting forapprovals. materials and tools.Over or under staffing, talents notutilized, work load not balanced. Non utilization of people/talentPaper- based data vs. electronic Transportation Long travel distances, unplannedtransfers. Routing of unnecessary premium postal.approvals/processing.Excessive backlog of work to be Inventory Making what we can instead of whatprocessed. Too much paper to be customers need. High obsolescencehandled, processed or filed. and write offs.Walking to deliver paperwork, poor Motion Repetitive/unnecessary movementergonomics, chasing information. caused by poor ergonomic design.Unnecessary steps. Too many Extra or Over Incapable equipment and processes.handoffs, lack of SOP’s. Equipment with unbalanced flow. Processing
    • 69. Analyze for VA/NVA steps County Executive Office Value added time (VA) – Time engaged in an activity performed that increases its value to the customer. Must be done right the first time, the customer must be willing to pay for it, and it transforms or shapes the material or information. Non value added time (NVA) – Time engaged in an activity performed that does not increase its value to the customer Non value added time (NVA) but ESSENTIAL - Meets the definition for NVA time, but cannot be removed. 69
    • 70. Exercise County Executive OfficeValue-Added and Non-Value-Added work Value-Added Activities Non Value-Added Activities  An activity that transforms  Activities that consume resources or shapes material or but create information no value in the eyes of the customer  Customer wants it  Pure waste  Done right the first time  If you can’t get rid of the activity, it is (no rework) necessary Non Value-Added – Essential Activities  Activities causing no value to be created but which E cannot be eliminated based on current state of technology or thinking  Required (regulatory, customer mandate, legal)  Necessary (due to non-robustness of process, currently required; current risk tolerance)
    • 71. Lean Tool Kit County Executive OfficeError-proofingPush/PullSet-up Reduction5-SCellular Work ProcessingWork StandardizationReduce Variation
    • 72. Control Plan Template County Executive Office TargetWho Description When How Why Corrective Action Level Perform Root Cause Analysis: 1. Re-Evaluate Process and Rework. 2. Retrain Personnel. 3. No Change Necessary. Addendum #20, 21 72
    • 73. County Executive Office Future StateMinimized Waste and VariationSteps add valueError-proofedMeasurement plan in place
    • 74. County Executive OfficeAfter the Pilot/Implementation of Future State Ask for the results Communicate results with pride Adjust where necessary Look for ways to continuously improve
    • 75. County Executive OfficePREPARING THEORGANIZATION FOR CHANGE 75
    • 76. County Executive OfficeDogmas of the quiet past are inadequate to the stormy present.The occasion is piled high with difficulty and we must rise with it.As our case is new, so we must think anew and act anew. We mustdisenthrall ourselves and then we will save our country.
    • 77. County Executive OfficeIdeas Government is Enthralled With1. Not driven by profit – We’re different2. No competitive pressure – We don’t have Customers3. Decreasing funds means decreased service (Cut!)4. Decreasing cost can mean decreasing budgets or de- obligating funds (Use it or lose it)5. Quality, Cost, and on-time delivery are not normally measured (Perverse incentives: Cost recovery, WIA, grants vs. unit cost, yield, throughput)6. We don’t have control of our environment or our customers7. Often no process owners, may cross MANY divisional areas (Control vs. Cooperation)
    • 78. People - Culture Trumps Tools County Executive Office Process, Results and Focus Improvement Tools Operations MetricsMust address BOTH ProcessesCulture and Toolsto avoid unintendedconsequences & Invisible:less than desirable Hard to Measure & Changelong-term success with Blind Spots ResistanceProcess Management History Mindsets Norms Assumptions Habits Perceptions
    • 79. County Executive Office
    • 80. Prepare the Field County Executive OfficeMore important than changing what employees do, is changing how employees thinkUnwavering commitment from leadershipMastery, Autonomy, and Purpose (Daniel Pink)
    • 81. HIGH PERFORMANCE County Executive Office VALUE EMPLOYEES CHANGE LEADERS VALUE CUSTOMERS STREAMS 81
    • 82. The ParadoxicalCommandments of Government County Executive Office1. The reward for doing good work is more work. Do good work anyway.2. All the money you save being more efficient will get cut from your budget now and forever. Find efficiencies anyway.3. All the bold reforms you make will be undone by the next administration. Make bold reforms anyway.4. There is no time to think about improving what we do. Make time anyway.5. Employees may fight the change every step of the way. Involve them anyway.
    • 83. The ParadoxicalCommandments of Government County Executive Office6. The future is unpredictable and largely out of your hands. Plan anyway.7. The press only cares when something goes wrong. Share your success stories anyway.8. Legal will never let you do it. Simplify it anyway.9. If you develop your people they will move on to better jobs. Train them anyway.10. Your ideas will at best make someone else look good and at worst get you ostracized by your co- workers. Share your ideas anyway. -Ken Miller
    • 84. You Have a Choice County Executive Office“Change is inevitable, growth is optional” - Charles Darwin 84

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