Getting to Everyday Improvement:                           How to Connect the Science and                             Cult...
Housekeeping      • To enlarge slides, use the “expand        window” icon just beneath the slides and        to the right...
Today’s Presenter                              Judy Worth                              • Faculty, Lean Enterprise Institut...
Today’s Presenter                                        Beau Keyte                                        • Faculty, Lean...
On Sale Now … LEI’s Latest Book                                        Perfecting Patient Journeys                        ...
Training      Take a deeper dive into this methodology for whole value-      stream improvement      • Register for the fu...
Typical Default Positions In                           Problem Solving      • Blanket solutions & best practices      • Bo...
Why Don’t Problems Get/Stay                          Solved?      • We assume:              – we know what the problem is ...
Why Don’t Problems Get/Stay                          Solved?      • We don’t engage the people closest to the work        ...
How Do We Improve                       Continuous Improvement?                                                 GTS       ...
Connecting the Technical                              and Social Sides      • The gap we would like to discuss today:     ...
The Technical Side:                 Small Reversible Experiments      • Systemic scientific thinking and acting           ...
Why Small and Why Reversible?      • Frame proposed solutions as hypotheses about        cause and experiments as tests of...
Plan-Do-Check-Adjust Cycle of              Problem Solving & Implementation                                               ...
Running Small                                        Reversible                                        Experiments© 2013 L...
Running an Experiment Means:      • Developing a THEORY about what you expect to        happen… (GRASP THE SITUATION)     ...
To Plan Your Own Experiment,                 Remember:       Who? What? When? Where? How?      • Who is going to try out t...
Running the Experiment: Some Tips      • Before you run the experiment, do a dry run and adjust      • Develop an elevator...
Questions?                                        Reflections?© 2013 LTG, LLC. All rights reserved.
Why Don’t Problems Get/Stay                          Solved?      • We assume….      • We don’t engage the people closest ...
The Social Side: Engaging the                   Organization in Thinking      • Socialization is a cycle of communication,...
What Do You Need to Socialize?      • The need for change      • The problems to address and who is principally        inv...
What Do You Need to Socialize…?      • Ideas generated within the problem-solving        process      • Ideas and plans fo...
Why Do You Need to Socialize?      • Engage the organization in problem solving      • Confirm assumptions and data      •...
Before You Socialize,                             You Need to Agree on…      • Who needs to:              – Agree (Authori...
What’s Your Change Story…           2) Why? – Business need or purpose      1) What? – Conditions need to be changed      ...
Socialization Methods:                                 Formal and Informal      •     Agenda items for regularly scheduled...
Socialization:                      Be Sure You Close the Loop© 2013 LTG, LLC. All rights reserved.
What Difference Does ALL This Make…                   for Healthcare?      • Reduced average length of stay (LOS) in a lar...
What Difference Does ALL This Make…              for Office and Service?      • 400% productivity increase in back office ...
What Difference Does ALL This Make…                 for Manufacturing?      • $1.5 billion in annual savings in value stre...
Questions?                                        Reflections?© 2013 LTG, LLC. All rights reserved.
Keep Learning After the Webinar      Book: Perfecting Patient Journeys (hardcover, 161 pages)          Download forms, te...
Discover What LEI Has for You      • Visit lean.org      • Follow LEI on LinkedIn, Twitter, Facebook, YouTube,        Goog...
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Ppj webinar final_download

  1. 1. Getting to Everyday Improvement: How to Connect the Science and Culture of Problem Solving February 14, 2013 Judy Worth Beau Keyte© 2013 LTG, LLC. All rights reserved.
  2. 2. Housekeeping • To enlarge slides, use the “expand window” icon just beneath the slides and to the right on your display console • To adjust the sound, use the volume control on the console or on your computer • Type questions into the console box© 2013 LTG, LLC. All rights reserved.
  3. 3. Today’s Presenter Judy Worth • Faculty, Lean Enterprise Institute • Partner Lean Transformations Group; focus: • Organizational development & instructional design • Co-facilitated value-stream improvement efforts in healthcare & other organizations • Began lean journey as instructional designer on Mapping to See (LEI) • Coauthor with Tom Shuker, Beau Keyte, et al, of Perfecting Patient Journeys© 2013 LTG, LLC. All rights reserved.
  4. 4. Today’s Presenter Beau Keyte • Faculty, Lean Enterprise Institute • Partner, Lean Transformations Group; focus: • Work & management processes • Began lean journey in automotive; now healthcare & admin • Coauthor Mapping to See & Shingo-Award winning book The Complete Lean Enterprise • Coauthor with Judy Worth, Tom Shuker, et al, of Perfecting Patient Journeys© 2013 LTG, LLC. All rights reserved.
  5. 5. On Sale Now … LEI’s Latest Book Perfecting Patient Journeys Improving patient safety, quality, and satisfaction while building problem- solving skills By Judy Worth, Tom Shuker, Beau Keyte, Karl Ohaus, Jim Luckman, David Verble, Kirk Paluska, and Todd Nickel Download forms and excerpts at lean.org/Store© 2013 LTG, LLC. All rights reserved.
  6. 6. Training Take a deeper dive into this methodology for whole value- stream improvement • Register for the full-day workshop - From Fire Fighting to Continuous Improvement: Sharpening PDCA Problem- Solving Skills  March 12, Lean Transformation Summit, Orlando (March 13-14)  June 4, Lean Healthcare Transformation Summit, Orlando (June 5-6)© 2013 LTG, LLC. All rights reserved.
  7. 7. Typical Default Positions In Problem Solving • Blanket solutions & best practices • Boss/subordinate interactions: Directive solutions • “A Team” • Expert problem solvers© 2013 LTG, LLC. All rights reserved.
  8. 8. Why Don’t Problems Get/Stay Solved? • We assume: – we know what the problem is without seeing what is actually happening – we know how to fix a problem without finding out what is causing it – we know what is causing the problem without confirming it – the problem has only one cause© 2013 LTG, LLC. All rights reserved.
  9. 9. Why Don’t Problems Get/Stay Solved? • We don’t engage the people closest to the work in solving the problem • We lack a common methodology for solving problems • We don’t develop management systems to sustain the improvements© 2013 LTG, LLC. All rights reserved.
  10. 10. How Do We Improve Continuous Improvement? GTS ACT PLAN GRASP  THE  SITUATION CHECK DO© 2013 LTG, LLC. All rights reserved.
  11. 11. Connecting the Technical and Social Sides • The gap we would like to discuss today: – Traditional approaches to problem definition – Solution-based improvements – Minimal front line ownership – Minimal management system linkage© 2013 LTG, LLC. All rights reserved.
  12. 12. The Technical Side: Small Reversible Experiments • Systemic scientific thinking and acting – Within the process – Within the management of the process – Quick cycles of learning • Focus on learning, not implementing solutions© 2013 LTG, LLC. All rights reserved.
  13. 13. Why Small and Why Reversible? • Frame proposed solutions as hypotheses about cause and experiments as tests of proof • Prevent blanket solutions • Prevent solutions that don’t link to causes • Encourage investigation of root cause(s) • Remind us that big problems have multiple causes© 2013 LTG, LLC. All rights reserved.
  14. 14. Plan-Do-Check-Adjust Cycle of Problem Solving & Implementation GTS ACT PLAN GRASP  THE  A P SITUATION C D A P C D CHECK DO A P C D A P C D A P A P C D A P C D© 2013 LTG, LLC. All rights reserved. C D
  15. 15. Running Small Reversible Experiments© 2013 LTG, LLC. All rights reserved.
  16. 16. Running an Experiment Means: • Developing a THEORY about what you expect to happen… (GRASP THE SITUATION) • Developing a way to TEST your theory… (PLAN) • Running the test and OBSERVE the results… (DO) • ANALYZ(ing) the results… (CHECK) • CONFIRMing (or REJECT) your theory… (ACT)© 2013 LTG, LLC. All rights reserved.
  17. 17. To Plan Your Own Experiment, Remember: Who? What? When? Where? How? • Who is going to try out the change? • What specifically are they going to do? • When are they to do it? What day? What time of day? How many times? • Where are they going to do it? • How will you know that whether the change(s) worked (solved or improved the problem)?© 2013 LTG, LLC. All rights reserved.
  18. 18. Running the Experiment: Some Tips • Before you run the experiment, do a dry run and adjust • Develop an elevator speech and inform everyone who needs to know. • Run the experiment. • Interview the participants and get their feedback. • Review participant feedback and observer data and decide what happens next. • Write a summary of your results and share with participants in the experiment and/or key stakeholders.© 2013 LTG, LLC. All rights reserved.
  19. 19. Questions? Reflections?© 2013 LTG, LLC. All rights reserved.
  20. 20. Why Don’t Problems Get/Stay Solved? • We assume…. • We don’t engage the people closest to the work in solving the problem • We lack a common methodology for solving problems • We don’t develop management systems to sustain the improvements© 2013 LTG, LLC. All rights reserved.
  21. 21. The Social Side: Engaging the Organization in Thinking • Socialization is a cycle of communication, modification, and consensus building. – each stakeholder an opportunity to hear, think, and respond – the “real” reality and context become apparent© 2013 LTG, LLC. All rights reserved.
  22. 22. What Do You Need to Socialize? • The need for change • The problems to address and who is principally involved • The role of others • Information on the problem and gap . . .© 2013 LTG, LLC. All rights reserved.
  23. 23. What Do You Need to Socialize…? • Ideas generated within the problem-solving process • Ideas and plans for experiments • Results of experiments and thoughts for new processes • Just about everything in the change process!!© 2013 LTG, LLC. All rights reserved.
  24. 24. Why Do You Need to Socialize? • Engage the organization in problem solving • Confirm assumptions and data • Discover other views of reality • Uncover hidden risks (technical or social) for different ideas • Learn more, “adjust” our thinking to the problem© 2013 LTG, LLC. All rights reserved.
  25. 25. Before You Socialize, You Need to Agree on… • Who needs to: – Agree (Authorize/Allow) – Accept/Support/Contribute – Know about • What to Share • How to Connect & Share—formal and informal • Roles • Timing© 2013 LTG, LLC. All rights reserved.
  26. 26. What’s Your Change Story… 2) Why? – Business need or purpose 1) What? – Conditions need to be changed 3) How? – Your idea but leave open for discussion 4) Why this How?© 2013 LTG, LLC. All rights reserved.
  27. 27. Socialization Methods: Formal and Informal • Agenda items for regularly scheduled meetings • Huddles (for shifts AND for problem solving) • Key person assignments • Food and fun • Visual tools© 2013 LTG, LLC. All rights reserved.
  28. 28. Socialization: Be Sure You Close the Loop© 2013 LTG, LLC. All rights reserved.
  29. 29. What Difference Does ALL This Make… for Healthcare? • Reduced average length of stay (LOS) in a large emergency department by 30% and LWOBS BY 60%; increased independently gathered customer (patient) satisfaction scores by 73% • Reduced Operating Room changeover time, which increased the number of surgical procedures performed by 20%, • Reduced annual staff turnover from 30% to >1% • Reduced in inpatient admissions for diabetic patients by 92% and physician interruptions by 90%; eliminated routine overtime, improved patient satisfaction by 40% • Reduced LOS by 30% and LWOBS by 50%; increased patient satisfaction scores by 63% and produced widespread improvement in teamwork© 2013 LTG, LLC. All rights reserved.
  30. 30. What Difference Does ALL This Make… for Office and Service? • 400% productivity increase in back office financial services processing • Improved Call Center quality by 19%, reduced operator hold time by 11% • Reduced defects in external financial reporting by 95% • Reduced emergency credit card replacement cycle time by 50%; increased customer satisfaction by 20%© 2013 LTG, LLC. All rights reserved.
  31. 31. What Difference Does ALL This Make… for Manufacturing? • $1.5 billion in annual savings in value streams outside plant facilities • 50% reduction in product development lead time • 30% increase in engineering capacity • 60% improvement in customer satisfaction© 2013 LTG, LLC. All rights reserved.
  32. 32. Questions? Reflections?© 2013 LTG, LLC. All rights reserved.
  33. 33. Keep Learning After the Webinar Book: Perfecting Patient Journeys (hardcover, 161 pages)  Download forms, templates, excerpts On sale now lean.org/ppj Workshop: “From Fire Fighting to Continuous Improvement: Sharpening PDCA Problem-Solving Skills”  March 12, Lean Transformation Summit, Orlando (March 13-14)  June 4, Lean Healthcare Transformation Summit, Orlando (June 5-6)© 2013 LTG, LLC. All rights reserved.
  34. 34. Discover What LEI Has for You • Visit lean.org • Follow LEI on LinkedIn, Twitter, Facebook, YouTube, Google+ • Subscribe to our weekly newsletter Contact us: • info@lean.org • 617-871-2900© 2013 LTG, LLC. All rights reserved.

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