Biography – Jennifer Ralston <ul><li>Jennifer Ralston is the Health Care Subject Matter Expert for The Quality Groups Mast...
Biography – Kathy Price <ul><li>Kathy Price is the Director, Clinical Effectiveness, Sisters of Charity of Leavenworth Hea...
<ul><li>We will focus on Delivery of Services and Patient Safety can be enhanced by reducing waste and using a data-driven...
<ul><li>Interactive Discussion is a Must </li></ul><ul><li>Please Participate in Discussion </li></ul><ul><li>Ask Question...
American Red Cross Biomedical Services Mission & Vision American Red Cross Biomedical Services will fulfill the needs of t...
 
Aligning strategy to focus the organization on shared priorities
Related   Initiative Status Summary  Executive Review: M4 Performance Summary (SDP) 3 M4: Analysis, Opportunities and Issu...
<ul><li>Began Six Sigma Deployment August 2005 </li></ul><ul><ul><li>Trained 78 BBs </li></ul></ul><ul><ul><li>Trained 40 ...
Six Sigma Lean Quality Enables Speed Speed Enables Quality Culture + Quality Speed + Low Cost Goal   Improve performance O...
Execution Prioritization Definition Idea  Generation X 2  = Project Selections All Projects Must Pass Through a Strategic ...
Leadership Team Project Champion Project Champion Master Black Belt Black Belt Green Belt Black Belt Green Belt Yellow Bel...
Key Belt Attributes
Career Ladder
Y  = Successful Deployment X 1  = Leadership Commitment X 2  = Project Selection X 3  = Black Belts Selection X 4  = Fully...
Sisters of Charity  Mission & Vision “ We will, in the spirit of the Sisters of Charity, reveal God’s healing love by impr...
SCLHS Core Values <ul><li>SCLHS carries out Jesus' healing ministry today through its commitment to the following core val...
Beyond 2011 Under Health Reform Chase the Incentives –  Get Ready Manage the Change Consolidate Your Position <ul><li>Medi...
 
Cost Reduction Efforts: Health Care vs. Other Industries Source: Reinertsen JL, Bisognano M, Pugh MD.  Seven Leadership Le...
A New focus on Kano? <ul><li>Move away from mindset that “lower cost implies poor quality” </li></ul><ul><li>Get to the “d...
Lean Customer-  defined value Map and  understand  value stream Make value  stream  flow Continuous  process  improvement ...
Lean Deployment Architecture <ul><li>Culture Transformation </li></ul><ul><li>Self-sustained model </li></ul><ul><li>Longe...
Lean Accountabilities & Disciplines  <ul><li>Waste reduction 2% per year using 2008 cost figures </li></ul><ul><li>Focus o...
SIX SIGMA Six Sigma concentrates on variation reduction by using statistical methods to lower process defect rates to less...
Cascading Effect of  Performance Excellence Big Dots (Pillars, BSC…) Drivers (Core Theory of Strategy) Projects (Ops Plan)...
 
Advance Training Program (ATP) <ul><li>Advance Training Program for Performance Excellence </li></ul><ul><li>Focus on Lead...
Lean Thinking  Change/Project Leader <ul><li>9 days training </li></ul><ul><li>Require 2 projects – learning and certifica...
Lean Foundation Training <ul><li>6 hours training </li></ul><ul><li>Basics of Lean  </li></ul><ul><li>“ Airplane exercise”...
Lean Sensei Training <ul><li>1 week/per month for 6 months (25 days), with one month off in December </li></ul><ul><li>ASQ...
Mini Courses - Lunch n Learns <ul><li>Tool Reviews </li></ul><ul><ul><li>VSM </li></ul></ul><ul><ul><li>Spaghetti Diagrams...
Advance Courses <ul><li>Minitab – working with data </li></ul><ul><li>TeamSTEPPS – Master Trainer Training </li></ul><ul><...
Changing the old Making the future attractive Framework:  Leadership for Improvement Establish the Foundation Setting Dire...
PULL PUSH 1. Set Direction: Mission, Vision and Strategy Make the status quo uncomfortable Make the future attractive  <ul...
SCLHS Strategic Framework <ul><li>Culture & Talent </li></ul><ul><li>Performance Excellence </li></ul><ul><li>Physician Pa...
How do we nominate projects?
Project Selection Process Problems Opportunities Mandates Projects Selected to Move to the Initiation Stage Strategic Goal...
KAIZEN EVENTS <ul><li>1 - 3 day Rapid Improvement Events </li></ul><ul><li>ED Throughput </li></ul><ul><li>Patient Flow </...
Challenges <ul><li>“ It’s not Lean to fill out all the paperwork” </li></ul><ul><li>“ Lean is about getting rid of my job”...
Results As of 2009 ……………… <ul><li>Achieved > 1.0% (target ~ $11M)  waste reduction through deployment of LEAN project team...
2010 Successes
Innovation <ul><li>“ Innovate and design” have naturally been separated from “improvement work” </li></ul><ul><li>But, des...
Barriers to Innovative Thinking <ul><li>Physiological </li></ul><ul><ul><li>Perceptual </li></ul></ul><ul><ul><li>Emotiona...
Value Innovation <ul><li>Focus on making the competition irrelevant by creating a leap in value for buyers and your compan...
Value + Innovation <ul><li>Value without innovation </li></ul><ul><ul><li>Focuses on value creation at an incremental scal...
Red vs. Blue Ocean Strategy <ul><li>Red Ocean Strategy </li></ul><ul><li>Compete in existing market space </li></ul><ul><l...
Blue Ocean Analytical Tools:  Four Actions Framework Kim, W. C., and Mauborgne, R. (2005)  Blue ocean strategy.  Boston:  ...
Exercise:  Eliminate-Reduce-Raise-Create Grid Eliminate Raise Reduce Create Value
What we both found was… <ul><li>TQG’s Blended e-Learning model helped us to leverage our MBB resources better and to save ...
<ul><li>The Quality Group  (TQG) has been developing and deploying technology-based solutions to address Lean Six Sigma / ...
Why a complete blended e-Learning solution for healthcare quality?  <ul><li>LSS/PI is needed throughout the healthcare ind...
Healthcare Course Content:  Phase Module Intro <ul><li>Six Sigma Introduction </li></ul><ul><li>Introduction to Lean Six S...
Phlebotomy Kits Before:
Phlebotomy Kits After:
Spaghetti Diagram: Before  &  After
Phlebotomist Point of Use Shadow Boards:
Before Visual Management After Visual Management
Before Lab Storage Room
After Lab Storage Room
Blended e-Learning <ul><li>Experienced in 2010 </li></ul><ul><li>Develop all face to face learning modules into blended e-...
What if you don’t use the  Blended e-Learning?  <ul><li>Schedule 9 days of classroom instruction </li></ul><ul><li>Costs <...
With Blended e-Learning <ul><li>•  24/7 online learning access.  Prior to class, participants learn the core concepts and ...
Road Map to  Performance Excellence <ul><li>Roadmap of implementing Lean thinking as an innovative blend Improvement metho...
Look forward to the good that is yet to be. - Mother Xavier Ross “ ”
Q&A
Our Contact Information <ul><li>Rob Stewart:  [email_address]   </li></ul><ul><li>Jennifer Ralston:  [email_address]   </l...
Achieving and Sustaining Excellence - Transforming the Health Care System
Achieving and Sustaining Excellence - Transforming the Health Care System
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  • Lean is a series of tools and techniques utilized in managing processes in an organization. The tools used differ from application to application but are used for both incremental and breakthrough improvements and focus on the elimination of all nonvalue-adding activities and waste from the organization. Types of waste to be eliminated or reduced include scrap, rework, inspection, inventory, queuing or wait time, transportation of materials or products, redundant motion, and nonvalue-adding process steps—basically anything for which a final customer would not want to pay. Lean-focused organizations extend the concepts of waste elimination and value-added processes to suppliers, partners, and customers. A Lean organization is said not to reach full potential until all aspects of its value chain have eliminated waste and are operating at full value-added potential.
  • Six Sigma concentrates on variation reduction by using statistical methods to lower process defect rates to less than 3.4 defects per million opportunities. Six Sigma focuses on implementing measurement systems for work processes whereby variation reduction and process improvement may be identified through Six Sigma projects. These projects may include anything from improving the processes involved in mass-producing component piece parts to completely redesigning, for example, an aircraft completion process so that the aircraft requires less maintenance. Two Six Sigma methodologies, DMAIC (define, measure, analyze, improve, and control) and DMADV (define, measure, analyze, design, and verify) are utilized to this end. DMAIC is an improvement system for existing processes that fall below specifications and need incremental improvement. DMADV (sometimes referred to as Design for Six Sigma, or DFSS) is a system used to develop new processes or products at Six Sigma quality levels.
  • GETTING STARTED -
  • The spirit of our sponsors calls us To be transformative and innovative; To recognize and embrace change; and To be leaders in the ministry of Catholic health care. We have been entrusted with this legacy and is our responsibility to ensure its continued success.
  • Achieving and Sustaining Excellence - Transforming the Health Care System

    1. 1.
    2. 2. Biography – Jennifer Ralston <ul><li>Jennifer Ralston is the Health Care Subject Matter Expert for The Quality Groups Master Champion Network. Ralston is a Multifaceted Manager with unique blend of experience in quality, process improvement, process engineering, regulatory, pharmaceutical, quality auditing, software quality, project and program management, change management and lean six sigma. </li></ul><ul><li>Ralston has worked with American Red Cross Bio Medical Services Headquarters and Organ Transplant Team, United States Postal Service (USPS), the Naval Yard, Genentech part of the Roche Family, The Project Management Institute (PMI), Merck Pharmaceuticals, The Army, Reston Hospital, The National Security Agency (NSA), American Association of Blood Banks (AABB), Medical College of Virginia, University of Maryland Medical System, Georgetown University Cellular Engineering, Department of State, and iJet Travel Intelligence. She has presented Quality Concepts to places such as the University of Cairo in Egypt, conducting an International Audit of the Vascera, in Cairo, Egypt in 2001. This was a unique opportunity to teach regulatory concepts to a pharmaceutical company overseas. Ralston has also won the American Red Cross Spirit of Excellence Award, which is an award for individuals that achieve major results. </li></ul><ul><li>During her time working for American Red Cross, Jennifer was the Director of Process Improvement for Biomedical Services at American Red Cross National Headquarters. She is a certified Master Black Belt, Lean Sensei, and managed the Red Cross’ Lean Six Sigma Program and Computer Simulations. Ralston began her seven (7) year career at Red Cross in 2002, serving as Senior Change Engineer, Change Management, Senior Quality Design Engineer, and Systems Design Engineering. She was also the organization’s first Black Belt and Master Black Belt in the Six Sigma program. In this role, she introduced and implemented Six Sigma and Project Management tools in support of the continuous improvement program and in compliance with FDA regulations, applicable laws, cGMP, CLIA/CMS, as well as AABB, JCAHO and ISO Standards. Ralston is also an auditor for several organizations such as AABB, CAP and ISO. She has also trained with the American Society of Quality as a Certified Quality Auditor and Certified Quality Engineer. Ralston has also worked as a Clinical Technologist, Medical Technologist and Microbiologist when she first started her career in Health Care. </li></ul>
    3. 3. Biography – Kathy Price <ul><li>Kathy Price is the Director, Clinical Effectiveness, Sisters of Charity of Leavenworth Health System (SCLHS), KS, and a Master Lean Sensei responsible for implementing, training, facilitating and leading Lean Six Sigma quality improvement teams and methods for the 11 hospital system and University. She trains, coaches and mentors Lean Thinking Change Leaders and performance improvement teams in the use of quality improvement tools and methods focused on an innovative blend of Lean Six Sigma. First year deployment trained 439 employees and mentored 110 teams to produce $1,299,803 lean savings to exceed target by 133%. Second year deployment trained 256 employees and mentored 150 teams to produce $8,389,778 savings to exceed target by 113%. She trains and mentors local Lean Sensei to become ASQ Six Sigma Black Belt certified. She is responsible for curriculum development, standardization and deployment. She has created curriculum and blended e-learning modules. She has designed and created 1 day, 9 day, 20 day and blended e-learning modules along with just in time (JIT) materials. She is a presenter at national, state and local conventions and meetings. She is published in a peer reviewed journal. She is a leader in Strategy, Vision, and Mission planning. She is successful in Team Building, Negotiating, Consensus Building and Change Management. She is competent in Data Management and Analysis. </li></ul><ul><li>As a Six Sigma Black Belt and Master Lean Sensei she has led, facilitated, and/or coached projects involving: Organizational Assessments, including Baldridge Self Assessment, Operational Efficiency Improvements, Patient Care Management, i.e. Stroke Care and Transforming Care at the Bedside (TCAB), Nursing Documentation, Patient Satisfaction Improvements (HCAHPS), Integration of Electronic Medical Records into Workflows, Redesign of Work Areas and Build Outs, Design for Six Sigma for new construction, Improvement of Patient Billing and Revenue Cycle, Throughput and Cycle Time Reductions, 6S for operations and supplies, and Root Cause Analysis. </li></ul><ul><li>Prior to SCLHS she was a Sr. Improvement Advisor at the University of Texas MD Anderson Cancer Center in Houston, TX.  She previously worked with Quest Diagnostics, SmithKline Beecham Clinical Labs and Richards Laboratories and teaches Biology at the university level. Kathy has been in the Healthcare profession for 30 years. Kathy has a bachelor’s degree in Science from Stephen F. Austin State University, Nacogdoches, Texas; a medical technology certification from St. Paul Hospital, Dallas, Texas; and her master’s in science education from the University of Texas in Dallas.  She has ASQ Six Sigma Black Belt, Project Management, Lean, and TeamStepps Master Trainer certifications. Her professional affiliations include the American Society for Quality, the Quality Institute for Healthcare and the Institute of Healthcare Improvement. </li></ul>
    4. 4. <ul><li>We will focus on Delivery of Services and Patient Safety can be enhanced by reducing waste and using a data-driven methodology </li></ul><ul><li>Applying next Generation Quality Management Philosophy and Methodology in Health Care </li></ul><ul><li>Successful Improvement Projects undertaken in the field </li></ul><ul><li>Achieving Quality and Organizational Performance Effectiveness </li></ul><ul><li>BONUS: You will learn how to use The Quality Group’s new Lean Six Sigma Blended e-Learning Series for Healthcare professionals to drive process improvement initiatives throughout their organizations and take your deployment to the next generation. </li></ul>Pre-Summit Workshop Objectives:
    5. 5. <ul><li>Interactive Discussion is a Must </li></ul><ul><li>Please Participate in Discussion </li></ul><ul><li>Ask Questions </li></ul><ul><li>Open Dialogue is Welcome </li></ul><ul><li>Others? </li></ul>Ground Rules for Workshop
    6. 6. American Red Cross Biomedical Services Mission & Vision American Red Cross Biomedical Services will fulfill the needs of the American people for the safest, most reliable, most cost-effective blood, plasma, and tissue services through voluntary Donations. To be recognized by the people and organizations we serve, as well as others in our field, as the provider of choice for blood, plasma and tissue services. This will be accomplished by commitment to quality, safety and use of the best medical, scientific, manufacturing and business practices. Our Mission Our Vision
    7. 8. Aligning strategy to focus the organization on shared priorities
    8. 9.
    9. 10. Related Initiative Status Summary Executive Review: M4 Performance Summary (SDP) 3 M4: Analysis, Opportunities and Issues <ul><li>SDP sales continue to exceed target: demand and our ability to collect on DOW has been excellent! </li></ul><ul><li>Still some mismatch of DOW requirement, but overall volumes are sufficient </li></ul>M4: Achieve market share >50% (Collections) Owner: Greg Ballish M4: Forward Looking Actions NOTE: These projects identified “Increase donations” as at least one of their strategic goals <ul><li>Six sigma projects aligned to SDP collections are underway </li></ul><ul><li>Managing SDP collections for splits and machine/staff utilization can increase efficiencies </li></ul>CAGR = 7.5% System - Daily Collections Goal Achievement (% of total) Mon Tue Wed Thu Fri Sat Sun Target 16.1% 14.9% 9.8% 11.5% 16.3% 15.7% 15.7% July 16.3% 15.6% 13.0% 13.7% 16.3% 14.8% 10.3% August 16.3% 15.4% 13.3% 13.5% 15.9% 15.1% 10.5% Description Timing Status CRM/DRM strategy execution Will close to new CR IDEO donor environment design project TBD Donor recruitment development TBD SDP strike force (also 6 σ ) TBD Donor assertions Pending best practice assessment Increasing Apheresis donor frequency Pending best practice assessment Determining best choice donor pre-count Pending best practice assessment
    10. 11. <ul><li>Began Six Sigma Deployment August 2005 </li></ul><ul><ul><li>Trained 78 BBs </li></ul></ul><ul><ul><li>Trained 40 GBs </li></ul></ul><ul><ul><li>Trained 350 Champions </li></ul></ul><ul><ul><li>Hired 3 MBBs </li></ul></ul><ul><ul><li>Self Sustaining </li></ul></ul><ul><li>Began Lean Deployment October 2007 </li></ul><ul><ul><li>Lean 101 Awareness Training </li></ul></ul><ul><ul><li>Hired 2 Lean Engineers at the beginning and supplemented with consultants to gain velocity </li></ul></ul><ul><ul><li>Hiring 6 Lean Engineers, 1 Lean Sensei/Program Manager </li></ul></ul><ul><ul><li>Self Sustaining in March 2009 </li></ul></ul>ARC Deployment History
    11. 12. Six Sigma Lean Quality Enables Speed Speed Enables Quality Culture + Quality Speed + Low Cost Goal Improve performance Outliers on Customer Critical to Quality requirement Focus DMAIC with Total Quality Management tools to eliminate variation Method Management engagement, dedicated Champions and Black Belts Goal Reduce waste, increase process speed, and Standard Work Focus Identify non-value added steps and cause for delay Method Kaizen events, Value Stream Maps How we use Lean & Six Sigma
    12. 13. Execution Prioritization Definition Idea Generation X 2 = Project Selections All Projects Must Pass Through a Strategic Filter. Projects Planned Potential Projects Current Projects Available Resources
    13. 14. Leadership Team Project Champion Project Champion Master Black Belt Black Belt Green Belt Black Belt Green Belt Yellow Belts A Sustaining Infrastructure Must Have Senior Management’s Support and Guidance. X 8 = Sustaining Infrastructure
    14. 15. Key Belt Attributes
    15. 16. Career Ladder
    16. 17. Y = Successful Deployment X 1 = Leadership Commitment X 2 = Project Selection X 3 = Black Belts Selection X 4 = Fully Dedicated Black Belts X 5 = Champion Engagement X 6 = Master Black Belt Support X 7 = Organizational Tools X 8 = Sustaining Infrastructure Scale 100 % 75% 50% or less
    17. 18. Sisters of Charity Mission & Vision “ We will, in the spirit of the Sisters of Charity, reveal God’s healing love by improving the health of individuals and communities we serve, especially those who are poor or vulnerable.” Our Mission Our Vision SCLHS Mission realized through unyielding pursuit of performance excellence, innovative growth and health care for all
    18. 19. SCLHS Core Values <ul><li>SCLHS carries out Jesus' healing ministry today through its commitment to the following core values: </li></ul><ul><li>Excellence We offer excellent and compassionate care. </li></ul><ul><li>Respect We recognize the sacred worth and dignity of each person. </li></ul><ul><li>Response to Need The health care we offer is based on community need, with a special concern for the poor. </li></ul><ul><li>Stewardship We are mindful that we hold our resources in trust. </li></ul><ul><li>Wholeness We value the health of the whole person-spiritual, psycho-social, emotional and physical. </li></ul>
    19. 20. Beyond 2011 Under Health Reform Chase the Incentives – Get Ready Manage the Change Consolidate Your Position <ul><li>Medicare Breakeven Targets </li></ul><ul><li>Clinical Integration </li></ul><ul><li>New Service Line Models </li></ul><ul><li>Operating Company Model </li></ul><ul><li>Systems of Care </li></ul><ul><li>Prepare for Medicare 3.0? </li></ul><ul><li>Agile & Adaptable to Change </li></ul><ul><li>Able to Manage Risk </li></ul><ul><li>Lean Initiatives/MAP </li></ul><ul><li>Physician Alignment </li></ul><ul><li>ACO & Medical Home </li></ul><ul><li>Performance Excellence Plan </li></ul><ul><li>EHR & Meaningful Use </li></ul>The Prelude 2010-2013 Market Expansion 2014-2017 Regulation and Restructuring 2018-2020+
    20. 22. Cost Reduction Efforts: Health Care vs. Other Industries Source: Reinertsen JL, Bisognano M, Pugh MD. Seven Leadership Leverage Points for Organization-Level Improvement in Health Care (Second Edition). IHI Innovation Series white paper. Cambridge, MA: Institute for Healthcare Improvement; 2008. (Available on www.IHI.org) <ul><li>Inputs to Core </li></ul><ul><li>Processes </li></ul><ul><li>Supplies </li></ul><ul><li>Staff </li></ul><ul><li>Equipment </li></ul><ul><li>Core Processes </li></ul><ul><li>Evaluating </li></ul><ul><li>Diagnosing </li></ul><ul><li>Treating </li></ul><ul><li>Communicating </li></ul><ul><li>Outputs </li></ul><ul><li>Quality Results </li></ul><ul><li>Safety Results </li></ul><ul><li>Costs </li></ul>Where Other Industries’ Go to Reduce Cost Where Health Care Go to Reduce Cost
    21. 23. A New focus on Kano? <ul><li>Move away from mindset that “lower cost implies poor quality” </li></ul><ul><li>Get to the “dark green dollars” </li></ul><ul><ul><li>Go beyond notional or potential savings to taking real money out of budgets </li></ul></ul><ul><li>Set a cost reduction target (1-3%)? </li></ul><ul><ul><li>. . . A new approach! </li></ul></ul>Reduce costs significantly while maintaining or improving quality
    22. 24. Lean Customer- defined value Map and understand value stream Make value stream flow Continuous process improvement <ul><li>Goals: </li></ul><ul><li>Increase productivity </li></ul><ul><li>Eliminate waste </li></ul><ul><li>Maximize resource </li></ul><ul><li>utilization </li></ul><ul><li>Waste includes </li></ul><ul><li>Scrap </li></ul><ul><li>Rework </li></ul><ul><li>Inspection </li></ul><ul><li>Inventory </li></ul><ul><li>Queuing time </li></ul><ul><li>Transporting materials </li></ul><ul><li>or products </li></ul><ul><li>Redundant motion </li></ul><ul><li>Anything for which a final customer would not want to pay </li></ul>is focused on the elimination of all non value-adding activities and waste from the organization’s processes.
    23. 25. Lean Deployment Architecture <ul><li>Culture Transformation </li></ul><ul><li>Self-sustained model </li></ul><ul><li>Longer deployment time </li></ul><ul><li>Improvement is a daily event for everyone </li></ul><ul><li>Accountability </li></ul><ul><li>Structured education </li></ul><ul><li>Way of life </li></ul><ul><li>Project Based </li></ul><ul><li>Consultant-led </li></ul><ul><li>Shorter deployment time </li></ul><ul><li>Hobbies </li></ul><ul><li>Little accountability </li></ul><ul><li>Selected education </li></ul><ul><li>Flavor of the month attitude </li></ul>
    24. 26. Lean Accountabilities & Disciplines <ul><li>Waste reduction 2% per year using 2008 cost figures </li></ul><ul><li>Focus on Directors and Managers </li></ul><ul><li>System Office certification is good for one calendar year </li></ul><ul><li>Certification requires yearly renewal </li></ul><ul><li>Must provide evidence of Lean Thinking proficiency every year for continuing certification </li></ul><ul><li>Sensei will be certified by American Society for Quality (ASQ) Black Belt, Lean Six Sigma </li></ul>
    25. 27. SIX SIGMA Six Sigma concentrates on variation reduction by using statistical methods to lower process defect rates to less than 3.4 defects per million opportunities. <ul><li>Six Sigma Methodologies: </li></ul><ul><li>DMAIC - define, measure, analyze, improve, and control </li></ul><ul><li>DMADV - define, measure, analyze, design, and verify </li></ul>
    26. 28. Cascading Effect of Performance Excellence Big Dots (Pillars, BSC…) Drivers (Core Theory of Strategy) Projects (Ops Plan) What are your key strategic aims? How good must we be, by when? What are the system-level measures of those aims? Down deep, what really has to be changed, or put in place, in order to achieve each of these goals? What are you tracking to know whether these drivers are changing? What set of projects will move the Drivers far enough, fast enough, to achieve your aims? How will we know if the projects are being executed?
    27. 30. Advance Training Program (ATP) <ul><li>Advance Training Program for Performance Excellence </li></ul><ul><li>Focus on Leadership - Vice Presidents and Above </li></ul><ul><li>10 days SCLHS Affiliate Program </li></ul><ul><li>20 days Intermountain Healthcare </li></ul><ul><li>Both includes completion of a project </li></ul><ul><li>Basic PI sciences and 1 day Lean Champion Training </li></ul>
    28. 31. Lean Thinking Change/Project Leader <ul><li>9 days training </li></ul><ul><li>Require 2 projects – learning and certification project in the magnitude of $25K waste elimination </li></ul><ul><li>DMAI 2 C Methodology </li></ul><ul><li>Commitment to continue deployment of lean at their facility </li></ul>
    29. 32. Lean Foundation Training <ul><li>6 hours training </li></ul><ul><li>Basics of Lean </li></ul><ul><li>“ Airplane exercise” </li></ul><ul><li>Commitment to recognize waste </li></ul>
    30. 33. Lean Sensei Training <ul><li>1 week/per month for 6 months (25 days), with one month off in December </li></ul><ul><li>ASQ Body of Knowledge (BOK) for Six Sigma Black Belt Certification & SME BOK for </li></ul><ul><li>Lean Sensei </li></ul><ul><li>“ People side” </li></ul><ul><li>Coaching and Teaching </li></ul><ul><li>PT/FT Local Sensei </li></ul>
    31. 34. Mini Courses - Lunch n Learns <ul><li>Tool Reviews </li></ul><ul><ul><li>VSM </li></ul></ul><ul><ul><li>Spaghetti Diagrams </li></ul></ul><ul><ul><li>Visual Controls </li></ul></ul><ul><ul><li>6S </li></ul></ul><ul><li>Facilitation Skills </li></ul><ul><li>Committees vs. Lean Teams </li></ul><ul><li>Observation Skills </li></ul><ul><li>Data Management Skills </li></ul><ul><li>Case Studies </li></ul><ul><li>Mentoring / Coaching Skills </li></ul>
    32. 35. Advance Courses <ul><li>Minitab – working with data </li></ul><ul><li>TeamSTEPPS – Master Trainer Training </li></ul><ul><li>Statistics for Performance Analysts </li></ul><ul><li>Facility Design and Simulations </li></ul>
    33. 36. Changing the old Making the future attractive Framework: Leadership for Improvement Establish the Foundation Setting Direction: Mission, Vision and Strategy PULL PUSH Source: IHI Will Ideas Execution
    34. 37. PULL PUSH 1. Set Direction: Mission, Vision and Strategy Make the status quo uncomfortable Make the future attractive <ul><li>3. Build Will </li></ul><ul><li>Plan for Improvement </li></ul><ul><li>Set Aims/Allocate Resources </li></ul><ul><li>Measure System Performance </li></ul><ul><li>Provide Encouragement </li></ul><ul><li>Make Financial Linkages </li></ul><ul><li>Learn Subject Matter </li></ul><ul><li>Work on the Larger System </li></ul><ul><li>5. Execute Change </li></ul><ul><li>Use Model for Improvement for </li></ul><ul><li>Design and Redesign </li></ul><ul><li>Review and Guide Key Initiatives </li></ul><ul><li>Spread Ideas </li></ul><ul><li>Communicate results </li></ul><ul><li>Sustain improved levels of </li></ul><ul><li>performance </li></ul><ul><li>4. Generate Ideas </li></ul><ul><li>Read and Scan Widely, Learn from other Industries & Disciplines </li></ul><ul><li>Benchmark to Find Ideas </li></ul><ul><li>Listen to Customers </li></ul><ul><li>Invest in Research & Development </li></ul><ul><li>Manage Knowledge </li></ul><ul><li>Understand Organization as a System </li></ul>2. Establish the Foundation <ul><li>Personal Preparation </li></ul><ul><li>Choose and Align the Senior Team </li></ul><ul><li>Build Relationships </li></ul><ul><li>Develop Future Leaders </li></ul><ul><li>Reframe Operating Values </li></ul><ul><li>Build Improvement Capability </li></ul>Source: IHI Framework: Leadership for Improvement
    35. 38. SCLHS Strategic Framework <ul><li>Culture & Talent </li></ul><ul><li>Performance Excellence </li></ul><ul><li>Physician Partnership </li></ul><ul><li>Strategic Growth </li></ul><ul><li>Component One: </li></ul><ul><li>Care Reliability </li></ul><ul><li>Patient & Environmental Safety </li></ul><ul><li>Excellent Care Experience </li></ul><ul><li>Cost-Effective Care </li></ul><ul><li>Clinical Transformation </li></ul><ul><li>Component Two: </li></ul><ul><li>Finance </li></ul>Source: SCLHS SPPECD
    36. 39. How do we nominate projects?
    37. 40. Project Selection Process Problems Opportunities Mandates Projects Selected to Move to the Initiation Stage Strategic Goals Financial Expectations and Goals Potential Nonfinancial Benefits Organizational Politics Current Project Portfolio Mix Resource Constraints Project Risk Organization Risk Preferences
    38. 41. KAIZEN EVENTS <ul><li>1 - 3 day Rapid Improvement Events </li></ul><ul><li>ED Throughput </li></ul><ul><li>Patient Flow </li></ul><ul><li>Pharmacy Group </li></ul><ul><li>Physician Group </li></ul>
    39. 42. Challenges <ul><li>“ It’s not Lean to fill out all the paperwork” </li></ul><ul><li>“ Lean is about getting rid of my job” </li></ul><ul><li>“ What I can improve does not save $25K” </li></ul><ul><li>“ I don’t have time to be on a Lean team” </li></ul><ul><li>“ We’re already ‘lean’, we don’t have enough people” </li></ul><ul><li>“ We can’t do Lean while ____ is going on” </li></ul><ul><li>Knowledge Management software </li></ul>
    40. 43. Results As of 2009 ……………… <ul><li>Achieved > 1.0% (target ~ $11M) waste reduction through deployment of LEAN project teams </li></ul><ul><ul><li>Preliminary Dark Green $ 9.8M </li></ul></ul><ul><ul><li>Preliminary Light Green $ 5.7M </li></ul></ul><ul><ul><li>400 projects in Improve or Control Phases </li></ul></ul><ul><ul><li>140 Directors are certified by the System Office as Lean Thinking Team Leaders </li></ul></ul><ul><ul><li>16 Lean Six Sigma Sensei will graduate in March 2010 </li></ul></ul><ul><li>Redesigned multiple work flows to enhance efficiency at care sites and in system office </li></ul><ul><li>Improved patient flow in many care sites </li></ul>
    41. 44. 2010 Successes
    42. 45. Innovation <ul><li>“ Innovate and design” have naturally been separated from “improvement work” </li></ul><ul><li>But, design is interwoven with existing products and processes </li></ul><ul><li>Improvement often means revisiting fundamental design </li></ul>
    43. 46. Barriers to Innovative Thinking <ul><li>Physiological </li></ul><ul><ul><li>Perceptual </li></ul></ul><ul><ul><li>Emotional </li></ul></ul><ul><ul><li>Cultural </li></ul></ul><ul><ul><li>Environmental </li></ul></ul><ul><li>These barriers restrict our left brain (analytical) and right brain (creative) to </li></ul><ul><ul><li>Properly collect the information necessary </li></ul></ul><ul><ul><li>Choose and calculate which information is important </li></ul></ul><ul><ul><li>Communicate those ideas to our consciousness </li></ul></ul><ul><li>for an innovative solution </li></ul>
    44. 47. Value Innovation <ul><li>Focus on making the competition irrelevant by creating a leap in value for buyers and your company, thereby opening up new and uncontested market space </li></ul>Value Innovation Costs Buyer Value
    45. 48. Value + Innovation <ul><li>Value without innovation </li></ul><ul><ul><li>Focuses on value creation at an incremental scale </li></ul></ul><ul><ul><li>May improve value, but is not sufficient to make you stand out in the marketplace </li></ul></ul><ul><li>Innovation without value </li></ul><ul><ul><li>Tends to be technology-driven </li></ul></ul><ul><ul><li>Frequently shoots beyond what customers are ready to accept and pay for </li></ul></ul>Kim, W. C., and Mauborgne, R. (2005) Blue ocean strategy. Boston: Harvard Business Review Press.
    46. 49. Red vs. Blue Ocean Strategy <ul><li>Red Ocean Strategy </li></ul><ul><li>Compete in existing market space </li></ul><ul><li>Beat the competition </li></ul><ul><li>Exploit existing demand </li></ul><ul><li>Make the value-cost trade-off </li></ul><ul><li>Align the whole system of a firm’s activities with its strategic choice of differentiation or low cost </li></ul><ul><li>Blue Ocean Strategy </li></ul><ul><li>Create uncontested market space </li></ul><ul><li>Make the competition irrelevant </li></ul><ul><li>Create and capture new demand </li></ul><ul><li>Break the value-cost trade-off </li></ul><ul><li>Align the whole system of a firm’s activities in pursuit of differentiation and low cost </li></ul>Kim, W. C., and Mauborgne, R. (2005) Blue ocean strategy. Boston: Harvard Business Review Press.
    47. 50. Blue Ocean Analytical Tools: Four Actions Framework Kim, W. C., and Mauborgne, R. (2005) Blue ocean strategy. Boston: Harvard Business Review Press. New Value Curve Eliminate : Which of the factors that the industry takes for granted should be eliminated ? Create : Which factors should be created that the industry has never offered? Reduce : Which factors should be reduced well below the industry’s standard? Raise : Which factors should be raised well above the industry’s standard
    48. 51. Exercise: Eliminate-Reduce-Raise-Create Grid Eliminate Raise Reduce Create Value
    49. 52. What we both found was… <ul><li>TQG’s Blended e-Learning model helped us to leverage our MBB resources better and to save money in the long run as we were training up our resources and ramping up our Lean Six Sigma Deployments…. </li></ul>
    50. 53. <ul><li>The Quality Group (TQG) has been developing and deploying technology-based solutions to address Lean Six Sigma / Process Improvement (LSS/PI) training challenges, since 1992. </li></ul>1) Our e-Learning makes ‘Quality Principles’ come alive for everyday people. 2) Our portal platform powers effective implementation of blended e-Learning. 3) Our processes enable e-Learning solutions that fit your needs, not vice versa.
    51. 54. Why a complete blended e-Learning solution for healthcare quality? <ul><li>LSS/PI is needed throughout the healthcare industry </li></ul><ul><li>LSS/PI experts are spread thin and need to scale their impact </li></ul><ul><li>Healthcare organizations need a less disruptive way to teach LSS/PI </li></ul><ul><li>LSS/PI training costs must be high quality and low cost </li></ul>
    52. 55. Healthcare Course Content: Phase Module Intro <ul><li>Six Sigma Introduction </li></ul><ul><li>Introduction to Lean Six Sigma for Healthcare </li></ul><ul><li>Lean Six Sigma Fusion </li></ul>Define <ul><li>Project Charter </li></ul><ul><li>Voice of the Customer </li></ul><ul><li>Managing the Project - Teamwork </li></ul><ul><li>Pareto Analysis </li></ul><ul><li>SIPOC </li></ul><ul><li>Introduction to Process Mapping </li></ul><ul><li>Eight Wastes </li></ul>Measure <ul><li>Current State Value Stream Mapping </li></ul><ul><li>What is Statistics? </li></ul><ul><li>Organization of Data </li></ul><ul><li>Measures of Central Tendency </li></ul><ul><li>Measures of Dispersion </li></ul><ul><li>Descriptive Statistics: Self-Assessment </li></ul><ul><li>Calculating Process-Based Costs </li></ul><ul><li>Validating the Measurement System </li></ul>Phase Module Measure <ul><li>Types of Control Charts </li></ul><ul><li>Introduction to Process Capability and Process Capability Assessments </li></ul><ul><li>Confidence Intervals </li></ul><ul><li>Normal Curve </li></ul>Analyze <ul><li>Cause & Effect Diagrams </li></ul><ul><li>Scatter Diagrams </li></ul><ul><li>Failure Mode & Effects Analysis </li></ul><ul><li>Future State Value Stream Mapping </li></ul><ul><li>Hypothesis Testing </li></ul>Improve <ul><li>Maximizing ROI </li></ul><ul><li>Kaizen Event </li></ul><ul><li>5S/6S </li></ul><ul><li>Visual Management </li></ul><ul><li>Standard Work </li></ul><ul><li>Error Proofing </li></ul><ul><li>Changeover Reduction </li></ul><ul><li>Total Productive Maintenance </li></ul><ul><li>Workplace Design & Layout </li></ul><ul><li>Flow & Pull Systems </li></ul>Control <ul><li>Sustaining ROI </li></ul><ul><li>Extending ROI </li></ul>
    53. 56.
    54. 57.
    55. 58.
    56. 59.
    57. 60.
    58. 61. Phlebotomy Kits Before:
    59. 62. Phlebotomy Kits After:
    60. 63. Spaghetti Diagram: Before & After
    61. 64. Phlebotomist Point of Use Shadow Boards:
    62. 65. Before Visual Management After Visual Management
    63. 66.
    64. 67.
    65. 68.
    66. 69. Before Lab Storage Room
    67. 70. After Lab Storage Room
    68. 71.
    69. 72.
    70. 73. Blended e-Learning <ul><li>Experienced in 2010 </li></ul><ul><li>Develop all face to face learning modules into blended e-learning </li></ul>
    71. 74. What if you don’t use the Blended e-Learning? <ul><li>Schedule 9 days of classroom instruction </li></ul><ul><li>Costs </li></ul><ul><ul><li>Employee Time/Instructor Time </li></ul></ul><ul><ul><li>Meeting location </li></ul></ul><ul><ul><li>Lunch/snacks </li></ul></ul><ul><li>Mixed classes/Adult education </li></ul><ul><ul><li>Different learning styles </li></ul></ul><ul><ul><li>Lecture/activities/group work </li></ul></ul>
    72. 75. With Blended e-Learning <ul><li>• 24/7 online learning access. Prior to class, participants learn the core concepts and tools, then ‘search’ and ‘review’ them later, on the job. . </li></ul><ul><li>• Consistent training delivery . If you teach everyone the same, your course roadmaps have more integrity and your organization alignment increases. </li></ul><ul><li>• More effective use of classroom time . With participants on the same level, class sessions focus on discussion, hands on exercises and project work. </li></ul><ul><li>• Higher retention & better mentoring. Retention increases when users control their pace, ability to review etc. Good e-Learning is flexible for users. Learning more outside class, sets up better mentoring in class. </li></ul><ul><li>• Reduces Costs </li></ul><ul><li>Lean Thinking </li></ul>
    73. 76. Road Map to Performance Excellence <ul><li>Roadmap of implementing Lean thinking as an innovative blend Improvement methods included: Lean, Six Sigma, TOC, PDSA & Queuing Theory. </li></ul><ul><li>Successes and challenges in our Lean Thinking journey to change culture </li></ul><ul><li>Tools to improve patient safety and outcomes, reduce waste, enhance efficiency and increase overall effectiveness. </li></ul>
    74. 77. Look forward to the good that is yet to be. - Mother Xavier Ross “ ”
    75. 78. Q&A
    76. 79. Our Contact Information <ul><li>Rob Stewart: [email_address] </li></ul><ul><li>Jennifer Ralston: [email_address] </li></ul><ul><li>Kathy Price: [email_address] </li></ul>
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