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Lean in Action: Streamline your processes and achieve results! Presentation & case study with UCSF Medical Center's Director of IT Quality
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Lean in Action: Streamline your processes and achieve results! Presentation & case study with UCSF Medical Center's Director of IT Quality


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Lean’s origins started in manufacturing and the automotive industry, but Lean has also found success in other lines of business. With a focus on value from the customer’s perspective, operational …

Lean’s origins started in manufacturing and the automotive industry, but Lean has also found success in other lines of business. With a focus on value from the customer’s perspective, operational waste is reduced and processes are streamlined. Employees are empowered to provide improvement solutions and metrics show the fruit of the organizational labor. Take a look at how UCSF Medical Center is using Lean to improve IT services.

Key takeaways:
-You will understand the high level concepts of Lean.
-You will see how customer focus actually reduces cost.
-You will be able to define and identify operational waste.
-And… you will know that you want to learn more!

About the presenter:
Pierre Brickey has over twenty years of experience in the technology industry spanning the defense, telecom, and healthcare sectors. As Director of IT Quality at UCSF Medical Center, he is focused on enterprise IT value, process improvement, and service quality. In his spare time, he is the IT Program Director for the Mission Bay Hospitals construction effort, due to open in February 2015.

Published in: Business, Technology

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  • 1. Lean Overview and Case Study UCSF Medical Center – Information Technology Pierre Brickey October 2013
  • 2. 2 Agenda • What is Lean? • Origins • Aligning Vision and Purpose with Lean • What is Customer Based Value? • Value Stream Analysis • Identifying Operational Waste • Case Study: UCSF Information Technology – Reason for Action – Gap Analysis and Rapid Experiments – Summary of Improvements – Baseline, Achievements and Targets – Sustained Results – Final Staff Insights and Quotes
  • 3. 3 What Is Lean?  Organizational alignment in vision and purpose – How many number one priorities can you have?  Customer based value – Which steps in your business process are of value to the customer?  Identify and eliminate waste – The right process will produce the right results  Develop and empower your people – The people doing the work know more than you think.  Continuous Improvement – Question paradigms, chase root causes, and don’t rest on past improvements Philosophy, process, methods, tools and eventually culture
  • 4. 4 Origins  Manufacturing-  1902: Sakichi Toyoda, the father of the Japanese industrial revolution, invented an automatic power loom that stopped itself when a problem occurred.  Automobile Industry –  1908: Henry Ford invented the moving assembly line and raised the daily wage to $5.00.  1940’s: Taiichi Ohno, a production engineer at the Toyota Motor Company, applied the same concepts to eliminate waste –non-value added activities – within the Toyota organization, and the concept of Just in Time (JIT).  These two pillars would be supported by a foundation of Standard Work, and would become the Toyota Production System. JustIn Time Stopthe Line TPS Standard Work
  • 5. 5 Aligning Vision and Purpose with Lean • To Be the Best Provider of Health Care – Standard Work that enables staff to provide safe, outcomes- oriented care each and every time – A relentless focus on value from the patient’s or internal customer’s perspective • To Be the Best Place to Work – Improvement initiated and driven by staff – Engaged leaders encourage and supported efforts • To Be the Best Environment for Teaching and Research – All are encouraged to participate and contribute
  • 6. What is Customer Based Value? 6 Value Added Activity Non-Value Added Activity Non-Value Added but Essential Activity A step or a process that is perceived to add value, from the customer’s perspective A step that is considered waste but is required either because of regulations or as a pre- requisite to completing a value-added step A step that does not directly contribute to or add value to the product or service.
  • 7. 7 Value Stream Analysis IdealState Current State Process Lean Tools & Kaizen Events Elimination of Waste Future State Process • Sort -Straighten –Scrub- Standardize -Sustain -Safety • Standard Work • Pull Systems and One Piece Flow
  • 8. 8 Value Stream Analysis Current State Future State
  • 9. 9 Identifying Operational Waste Sources of Non-Value Added Activity 1. Defects Production or goods or services that require rework, or correction. 2. Waiting Patients waiting for tests & procedures, care delays stemming from staff not being available, staff waiting for equipment, approvals etc. 3. Motion/Movement Excessive motion by staff 4. Transportation Transporting resources, supplies or equipment 5. Inventories Accumulation of items awaiting processing (email, orders, work queues) 6. Over-Processing Repeat placement of requests due to process errors, vetting a decision that was already made 7. Over-Production Producing products or services “just in case,” duplicative paper work, reports and documentation, 8. Under-Utilization Equipment, staff, physical space that is not fully utilized or working at potential
  • 10. 10 Case Study – UCSF Information Technology • Turnaround time for new iPhone and PC request fulfillment did not meet customer expectations • Field Services team routinely faced variable workflows and demand, preventing timely delivery of new hardware • Lack of standard work drove unnecessary complexity for customers and IT staff Reason for Action
  • 11. 11 Gap Analysis and Rapid Experiments Problem Potential Root Causes Rapid Experiments Information Gathering • Type • Timing • Accuracy • Use of free text in Service Now tickets • High potential for error within intake process • Lack of standard workflow and Service Now use • Source data not trusted and multiple manual checks required • Remove / redirect non standard procurement portals • Test Customer Intake form with several customers No Standard Work within Field Services Team • Priority over task • No ticket “Pull System” • Non-Specific categorization of work • Internal “Trust” issue with accuracy of data and completion of other’s work • Development categorization and priority workflow • Define Pull and Fulfillment standard work • Test dedicated resource model Inventory Management • Zero demand analysis • No integrated inventory management system • Very manual process • No global transparency (across the entire Field Services team) • No process for removal of obsolete equipment (stock-piles of equipment that will never be deployed); clutter distorts visibility • Validate inventory • Define Par Levels • Remove obsolete inventory • Explore Pull inventory systems • Explore Service Now and PMM inventory management options No established iPhone deployment process • Porting Blackberry process to new product • Forms obsolete • Lack of oversight • Define HW Standard review cycle • Explored self deploy strategy Field Services managing scope beyond IT • Network • Facilities • Lack of single Service Management platform • Field Services first and last touch point • Poorly defined roles and responsibilities • Explore wireless standard deployment • Meet with Facilities to understand process, scope, tools
  • 12. 12 Summary of Improvements: Request Intake and Deployment Manual and variable information gathering process Service Now standard request form/script Multiple procurement channels Service Now as only procurement source Competing Field Service demands Better categorization of work and dedicated deployment resource model Extended wait times for new requests Self-deployment option Network cable install significantly increase turnaround time Standard wireless deployment Problem Solution
  • 13. 13 Summary of Improvements: Inventory Management Manual Inventory Management Automated Inventory Management with Reporting Capability Limited Inventory Transparency Across Techs & Locations Increase transparency through PMM and ServiceNow Large Quantities of Surplus Inventory Right Sized Inventory With Monthly Par Levels Identified H-Level “Off the Grid” No Cleaning in H-Level Space for Several Years Now Added to the Hospitality Services Cleaning Priorities Fragmented Storage in 3 locations Consolidated Inventory with Real Time Reporting & JIT Replenishment Problem Solution
  • 14. 14 Baseline, Achievements and Targets Kaizen Metrics Baseline Achieved during Kaizen 30 days 60 days 90 days iPhone Fulfillment 16-24 days 5 days 2-5 days 2-5 days 2-5 days PC Fulfillment 8-19 days 5 days 3-5 days 1-5 days 1-5 days 0 5 10 15 20 25 30 iPhone Fulfillment Initial State Current State PC Fulfillment Initial State Current State 0 5 10 15 20 25 30 79% Reduction! 74% Reduction!
  • 15. Sustained Results 15 July August Sept Oct Nov Dec Jan Feb March April May June Days 11.3 9.2 19.6 17.6 7.9 10.2 7.8 4.2 4.3 6 5.88 5.29 0 5 10 15 20 25 IPhone Provisioning
  • 16. Sustained Results 16 July Aug Sept Oct Nov Dec Jan Feb Mar April May June Days 11.8 13.8 9.2 13.3 15.2 12.6 13.8 11.5 6.3 4 3.2 3.25 0 2 4 6 8 10 12 14 16 Desktop/Laptop Provisioning
  • 17. 17 Final Staff Insights and Quotes “Two dedicated weeks of focused work, netted the equivalent of nine months of regular work.” – Vishnu S “A multi-disciplinary approach enables full utilization of existing tools” – Rob H “Everybody has a great idea.” – Dave G Insights • Customer feedback is key • Customer satisfaction makes work satisfying • Standard Work is only possible if documented and consumed • Mapping the workflow and process reveals waste • To make true progress, we had to demolish existing paradigms • Having the doers be part of the process creates a foundation for continuous improvement • The camaraderie that we’ve developed in this room will carry forward to our other work together “For the first time, I feel like we’re really thinking outside the box” – John C “The collaboration in this room is awesome!” – Mark U