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Implementing aKaizen Suggestion     System     Part 1/3
• Principal, Leonardo Group Americas LLC.          • Co-Author of Fundamentals of Flow Manufacturing,Richard     Aerospace...
Webinar OverviewAn important element in the creation of a   culture of continuous improvement is   the engagement of the e...
Webinar ScheduleWhat is the Plan?             Learning About Lean Webinar 1: Training and  Setting Up a Kaizen  Managemen...
Kaizen Implementation Steps Webinar 1: Training and Setting Up a  Kaizen Management System. Webinar 2: How to conduct a ...
Lean Hospital Implementation Roadmap                                                                                      ...
Kaizen Suggestion System Roadmap SYSTEM                                               LEAN HOSPITAL KAIZEN SUGGESTION  Qui...
QUICK AND EASY KAIZENNORMAN BODEK
Kaizen Implementation StrategyGuidelines                      In A Nutshell1. Get prepared to process   suggestions. Set u...
The Speed of Change“After you have practiced for a while,     Shunryu Suzuki Roshiyou will realize that it is not possible...
The Q&E Kaizen Cycle                       I                    Receive                     Ideas    V                    ...
Case HistoryActual Experience at TMHU         It’s Not Like Twisting Your Arm Initial Assumption:  Announce the suggestio...
Phase 1: Train Management TeamConduct Management   Kaizen Training
Leadership and Staff Point of Contact                                            Vision and                               ...
Kaizen Lean Management System          Gas Pedal and Steering: Daily          Accountability                              ...
The Four QuestionsLeader Habit             When Following Up                         • What did you do last               ...
Kaizen Lean Management System• Daily Review                                  • Daily Gemba Walk• Daily/Weekly Kaizen      ...
Creating A Unit Target ConditionCurrent   Unknown     Target                                  Vision State     Steps     C...
Example of Weekly  Kaizen
The Management HabitGetting Penquins In A Row   Who Does What                             Common View: Managers Are      ...
Phase 2: Train StaffTrain Staff in   Kaizen
Learning By DoingWhat A Surprise!                             Training Does Not                             Change Behavior!
Training Maturity LevelsClassroom Training Only   Classroom Training With Exercises   and Simulations       Classroom Trai...
The Meaning of “Training”It’s A Marathon, Not A Sprint   Sports, Science, Religion, Art                                 Co...
The Wisdom of AristotleAristotle                History of Philosophy                         “Excellence is an art won by...
The PDCA Cycle     CPI
Q&E Kaizen Rules1. Ideas need to easy to write down.   75 words or less.2. Ideas should be easy to approve.   Approval in ...
Phase 3: Set Up DatabaseSet Up KaizenManagement  Database
Expected Volume of SuggestionsHow Many Ideas Can We                             Can You Handle It?Expect?• What if it is o...
Kaizen Database OptionExcel-Based System              Home-Grown System• Easy to set up. Low cost.     • Access / Sharepoi...
Cloud-Based SystemsCloud-Based System            Formalization Step• Easy to set up. Low cost.• Minimal IT maintenance   n...
Real-Time Status                    Case                   in Point
A Call to Action
Conduct Initial Planning                                  ConductConsensus on       Research      Leadership     Execute  ...
Kaizen Suggestion System Roadmap SYSTEM                                               LEAN HOSPITAL KAIZEN SUGGESTION  Qui...
Questions?Leonardo GroupPrincipals: Gerard Leone & Richard D Rahn303-494-4404Boulder, Co 80303                            ...
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Lean Roadmap to an Engaged Hospital Part 1

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The PowerHealth OnDemand Webinar Series brings you Leonardo Group Americas LLC (authors of the books Lean in the OR, Supplies Management in the OR, Value Stream Mapping in the OR, Lean Training Games in the OR and Quick Changeover in the OR), who will share their experiences and learnings from working with hospitals across the country to develop a Lean mindset/environment that achieves continuous improvement and sustained profitability. The topics covered in Part 1 of this 3-part series include: 1. The Kaizen Roadmap, and how it fits in an overall hospital Lean implementation. 2. Why most suggestion systems fail, and how to launch a successful engagement process. 3. The two types of Kaizen projects, and why you need both.

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  • The reference that we use is a book by Norman Bodek titled The Idea Generator, Quick and Easy Kaizen. The focus of this book is on building a Lean culture and maintaining a suggestion system that actually works. The emphasis is on small ideas that are easy to think up, easy to approve, and easy to implement. Many of us have suggestion systems already in place, but the problem is, we don’t get very many ideas. This book describes how to manage the system correctly. Let’s now take a look at what is actually possible, with actual data.
  • This is a crude graphic of what is called a Lean Management System, as taught by David Mann in his book Creating a Lean Culture. The idea is in essence pretty simple. Experience has showed that the best way to sustain the changes implemented in a Lean transformation project (like this one) is through standardization, daily accountability, visual controls and organizational discipline. We’ll be examining all four of these in this lesson.
  • In a traditional hospital, managers and supervisors are expected to manage and supervise.
  • Here’s the approach to take in order to advance step by step in the direction of perfection, and to reach a target condition. We apply what is called the PDCA method or cycle, which is an application of the scientific method. It’s important to advance one step at a time, and not be changing too many things at the same time. Here’s how it works:We start with an idea or a Plan. This is the suggestion that we want to try, that we feel will advance us on our path to improvement.We try out the idea at the Do step. It is advised to try it out as a pilot or in a limited area of the hospital, since we don’t know with total confidence how it will work out.We Check or measure the results. Did the change work as expected or not?Finally, we Act on the results. If the test was successful we can move to roll the change out to other areas, or to the entire hospital. If the idea did not pan out, we don’t regard it as a failure but as a learning experience. We then return to Plan to try the next thing.How often do we repeat the PDCA cycle? Forever! This is the process improvement habit that needs to be taught and practiced, and mentors in the organization need to help “students” in the application of this way of thinking.
  • Here are the basic guidelines for submitting a Q&E Kaizen suggestion. Note that the idea needs to be written down. Verbal suggestions don’t count!The real-time aspect of the Q&E method comes in here: ideas need to be reviewed and approved (or not) in 24 hours or less. This single point is what differentiates it from ordinary suggestion programs. When people submit ideas and they get approved immediately, this helps to build excitement and a willingness to come up with another one. When the suggestion disappears into a black hole, the response is the opposite.Finally, the expectation is that the suggestion is not something that someone else needs to do, for example “My idea is that maintenance needs to [fill in the blank]. The idea should be completed by the person or persons that submitted it. This isn’t always possible, of course, but that’s the desire.
  • This is just one example among many. Another term that is used these days is “dashboard”, that we use to steer the organization. What data do we need to record, and how often should we record it? And one final point: most mature Lean organizations (even those that can afford any fancy system they might want) record and display this data manually. Why manually? Because it’s immediate, you don’t need a computer to enter the data or see it, and staff has direct ownership of the numbers.
  • There are only two kinds of hopsitals: those who are pursuing a Lean strategy, and those who will.
  • Transcript of "Lean Roadmap to an Engaged Hospital Part 1"

    1. 1. Implementing aKaizen Suggestion System Part 1/3
    2. 2. • Principal, Leonardo Group Americas LLC. • Co-Author of Fundamentals of Flow Manufacturing,Richard Aerospace Flow, In the OR series of Lean Hospital books. Rahn • VP of Technology, John Costanza Institute of Technology. • MBA, University of Colorado and APICS CPIM certified. • Trained over 5,000 Lean professionals since 1994. • Lean Hospital work since 2002. • Creator of the Lean Operations track for the Aerospace Supplier Excellence Alliance (SEA). • 16 years of manufacturing management at Storage Technology Corporation and Ball Corporation prior to consulting career. • Bilingual Spanish-English.
    3. 3. Webinar OverviewAn important element in the creation of a culture of continuous improvement is the engagement of the entire hospital staff in sharing and implementing improvement suggestions. These ideas should be easy to think up, easy to approve, and easy to do. The approach is called “Quick and Easy Kaizen”.
    4. 4. Webinar ScheduleWhat is the Plan? Learning About Lean Webinar 1: Training and Setting Up a Kaizen Management System. Webinar 2: How to conduct a Kaizen Department meeting. Webinar 3: How to implement and sustain improvement suggestions.
    5. 5. Kaizen Implementation Steps Webinar 1: Training and Setting Up a Kaizen Management System. Webinar 2: How to conduct a Kaizen Department meeting. Webinar 3: How to implement and sustain improvement suggestions.
    6. 6. Lean Hospital Implementation Roadmap Train Leadership Team in the principles of To support the Hospital’s Lean A Lean Hospital embraces a An initial assessment of current hospital Hoshin Kanri (Goal Deployment) and formalize journey, Leaders must participative model of Continuous operations, including future vision and level internal process. Use A3-X chart and Team understand the tools and Improvement. All Lean Hospital of process improvement maturity. Includes Charter forms for all Master Plans. culture of Continuous Process employees must be trained to be a analysis of potential benefits. Improvement. part of this culture. Conduct Value Stream analysis for each unit and department to identify 1 3 TRAIN 6 opportunities for improvement. Create a START LEAN HOSPITAL ASSESS O.R. TRAIN unit-level Master Plan. LEADERSHIP TRANSFORMATION OPERATIONS HOSPITAL STAFF TEAM The Lean Hospital Master Plan includes a definition of identified 2 VALUE STREAM 4 7 8 Formalize the SET UP IMPLEMENT improvements, resources DEVELOP UNIT process of soliciting, ANALYSIS AND PERFORMANCE GOAL DEPLOYMENT required, implementation MASTER PLANS receiving, MASTER PLAN DASHBOARD TOOLS timeline, estimated benefits, and evaluating, andROI for the selected value streams. implementing process Establish lean performance metrics improvement and method for suggestions for the 5 reporting, analysis, and follow-up. CONDUCT entire hospital. PILOT PROJECTS Select highly visible areas for proof 9 10 SUSTAINED of concept and buy-in. Follow CONDUCT INITIAL IMPLEMENT KAIZEN Roll-out unit and department PERFORMANCE Kaizen methodology to achieve KAIZEN EVENTS SUGGESTION SYSTEM process improvement results in less than 5 days. activities per the Lean Certify all Internal Lean Hospital Master Plan. Mentors through completion of actual projects and 15 14 IMPLEMENT Knowledge Checks. ROADMAP SUSTAINABILITY COMPLIANCE AUDIT ROADMAP 13 12 KAIZEN MENTOR 11 KAIZEN MENTOR INSTITUTE CERTIFICATION CERTIFICATION UNIT CPI TEAM Conduct a comprehensive, lean- TRAINING focused audit, with the objective of advancing the Lean Culture at the Hospital. Each team leader presents the status of Organize a local Continuous completed Kaizen projects to ensure Train a team of Hospital Staff Process Improvement Team to results and sustained performance. to become internal Lean identify, evaluate, and Mentors. implement improvements. Download at www.flowpublishing.com under “Resources”.
    7. 7. Kaizen Suggestion System Roadmap SYSTEM LEAN HOSPITAL KAIZEN SUGGESTION Quick and Easy (Q&E) Kaizen Continuous Process Improvementis the soliciting, documenting, (CPI) meetings are led by a reviewing, approving and department manager, and take Prioritize ideas according to your implementing small place at least weekly. Suggestions 4 CONDUCT STAFF CPI hospital’s unit priorities or KPIs. improvement suggestions by are captured during this meeting. hospital staff. Initial training MEETINGS For non-Q&E suggestions, identify will be needed. the financial benefits and Use KMS to document detailed qualitative benefits. These tasks, key participants, value 1 CONDUCT suggestions will require planning. streams affected and expected Q&E KAIZEN 5 benefits. Use A3 Team Charter TRAINING 6 format for a consistent format. 5 REVIEW AND Establish activity date. ENTER SUGGESTIONS APPROVE KAIZEN FOR IMPROVEMENT PROJECTS 2 CONDUCT START KAIZEN 2 MANAGEMENT SUGGESTION SYSTEM KAIZEN TRAINING Capture suggestions during the Kaizen meetings and 7 8 9 enter into KMS. Suggestions PROCESS Q&E PRIORITIZE COMPLETE KAIZEN will also come from Value SUGGESTIONS SUGGESTIONS PLANNING 3 SET UP KAIZEN Stream Mapping and MANAGEMENT independent input. DATABASE Good preparation is a key to success, Review, approve and An electronic database is including coordinating with all staff implement ideas at the unit needed, with ability to members, gathering required data or department level. In most 10 manage and share data and securing resources. COMPLETE KAIZEN cases the submitter is also across the hospital system the implementer. Provide EVENT PREPARATION and submit ideas easily. feedback within 24 hours. Conduct the event according to the Kaizen Event Roadmap. The A3 Project Status The Kaizen Leader will 11 Keep hospital informed on the latest Report documents the Pre CONDUCT KAIZEN prepare the final Kaizen suggestions approved and projects and Post-Kaizen state with EVENT Event summary in A3 available. Update dashboard and an explanation of the tools Project Status format. status report. Show results to all applied and the benefits employees. achieved. 14 13 12 FUNCTIONAL KAIZEN COMMUNICATE POST RESULTS OF A3 COMPLETE A3 SUGGESTION SYSTEM RESULTS TO HOSPITAL PROJECT STATUS PROJECT STATUS Download at www.flowpublishing.com under “Resources”.
    8. 8. QUICK AND EASY KAIZENNORMAN BODEK
    9. 9. Kaizen Implementation StrategyGuidelines In A Nutshell1. Get prepared to process suggestions. Set up your KMS.2. Train your Leadership Team.3. Participation is voluntary for staff. Encourage Positive Deviants.
    10. 10. The Speed of Change“After you have practiced for a while, Shunryu Suzuki Roshiyou will realize that it is not possibleto make rapid, extraordinary progress.Even though you try very hard, theprogress you make is always little bylittle. It is not like going out in ashower in which you know when youget wet. In a fog, you do not knowyou are getting wet, but as you keepwalking you get wet little by little. Ifyour mind has ideas of progress, youmay say, "Oh, this pace is terrible!"But actually it is not. When you getwet in a fog it is very difficult to dryyourself. So there is no need to worryabout progress. “
    11. 11. The Q&E Kaizen Cycle I Receive Ideas V II Build Review andEnthusiasm Approve IV III Promote Implement and Quickly Publicize
    12. 12. Case HistoryActual Experience at TMHU It’s Not Like Twisting Your Arm Initial Assumption: Announce the suggestion system and everyone will get on board. Actual Experience: Very little participation. Wary of management motivation. Revised Strategy. Build participation slowly, by encouraging early adapters.
    13. 13. Phase 1: Train Management TeamConduct Management Kaizen Training
    14. 14. Leadership and Staff Point of Contact Vision and Management Executive Lean Team Coordinator Department Department Department Manager Manager Manager Emergency Imaging Tele Floor Surgical Floor Department Department Staff Staff Staff Staff
    15. 15. Kaizen Lean Management System Gas Pedal and Steering: Daily Accountability Fuel:Engine: DisciplineLeaderStandard Work Transmission: Visual Controls
    16. 16. The Four QuestionsLeader Habit When Following Up • What did you do last week? • What will you do this week? • What problems or roadblocks are you finding? • What can I do to help?
    17. 17. Kaizen Lean Management System• Daily Review • Daily Gemba Walk• Daily/Weekly Kaizen • KMS Shared Access Meetings • Weekly Management Meeting Standard Account- Work ability Visual Discipline Controls• Kaizen Status Board • Lead from the Top• KMS Dashboard • Organization reflects Leaders behavior.
    18. 18. Creating A Unit Target ConditionCurrent Unknown Target Vision State Steps Condition
    19. 19. Example of Weekly Kaizen
    20. 20. The Management HabitGetting Penquins In A Row Who Does What  Common View: Managers Are Responsible for Management Duties  Progressive View: Managers Are Responsible for Management Duties Plus Continuous Improvement  Lean View: Management = Managing and Improving Processes
    21. 21. Phase 2: Train StaffTrain Staff in Kaizen
    22. 22. Learning By DoingWhat A Surprise! Training Does Not Change Behavior!
    23. 23. Training Maturity LevelsClassroom Training Only Classroom Training With Exercises and Simulations Classroom Training with Exercises and Simulations Followed by Doing Awareness Training Followed by Application under Mentor Guidance
    24. 24. The Meaning of “Training”It’s A Marathon, Not A Sprint Sports, Science, Religion, Art Continually practicing a skill or discipline under the guidance of a personal trainer or mentor.
    25. 25. The Wisdom of AristotleAristotle History of Philosophy “Excellence is an art won by training and habituation. We do not act rightly because we have virtue or excellence, but we rather have those because we have acted rightly. We are what we repeatedly do. Excellence, then, is not an act but a habit.” -Aristotle
    26. 26. The PDCA Cycle CPI
    27. 27. Q&E Kaizen Rules1. Ideas need to easy to write down. 75 words or less.2. Ideas should be easy to approve. Approval in 24 hours or less.3. Ideas should be easy to implement. Done by the person who submitted the idea.
    28. 28. Phase 3: Set Up DatabaseSet Up KaizenManagement Database
    29. 29. Expected Volume of SuggestionsHow Many Ideas Can We Can You Handle It?Expect?• What if it is only 1 per year?• What if you get 5 per year?• Goal: you should expect 1 per month as a target.
    30. 30. Kaizen Database OptionExcel-Based System Home-Grown System• Easy to set up. Low cost. • Access / Sharepoint / Other• Rely on single point manual • IT involvement needed. data entry. • Can be very expensive.• Security is a concern. • Long-term maintenance• Backup is a concern. needed.• Capacity is a concern. • No leverage for system improvement.
    31. 31. Cloud-Based SystemsCloud-Based System Formalization Step• Easy to set up. Low cost.• Minimal IT maintenance needed.• Benefit from system improvements across multiple users.• Access benchmarking data from multiple hospitals.
    32. 32. Real-Time Status Case in Point
    33. 33. A Call to Action
    34. 34. Conduct Initial Planning ConductConsensus on Research Leadership Execute Action Requirements Training and Master Plan Master Plan
    35. 35. Kaizen Suggestion System Roadmap SYSTEM LEAN HOSPITAL KAIZEN SUGGESTION Quick and Easy (Q&E) Kaizen Continuous Process Improvementis the soliciting, documenting, (CPI) meetings are led by a reviewing, approving and department manager, and take Prioritize ideas according to your implementing small place at least weekly. Suggestions 4 CONDUCT STAFF CPI hospital’s unit priorities or KPIs. improvement suggestions by are captured during this meeting. hospital staff. Initial training MEETINGS For non-Q&E suggestions, identify will be needed. the financial benefits and Use KMS to document detailed qualitative benefits. These tasks, key participants, value 1 CONDUCT suggestions will require planning. streams affected and expected Q&E KAIZEN 5 benefits. Use A3 Team Charter TRAINING 6 format for a consistent format. 5 REVIEW AND Establish activity date. ENTER SUGGESTIONS APPROVE KAIZEN FOR IMPROVEMENT PROJECTS 2 CONDUCT START KAIZEN 2 MANAGEMENT SUGGESTION SYSTEM KAIZEN TRAINING Capture suggestions during the Kaizen meetings and 7 8 9 enter into KMS. Suggestions PROCESS Q&E PRIORITIZE COMPLETE KAIZEN will also come from Value SUGGESTIONS SUGGESTIONS PLANNING 3 SET UP KAIZEN Stream Mapping and MANAGEMENT independent input. DATABASE Good preparation is a key to success, Review, approve and An electronic database is including coordinating with all staff implement ideas at the unit needed, with ability to members, gathering required data or department level. In most 10 manage and share data and securing resources. COMPLETE KAIZEN cases the submitter is also across the hospital system the implementer. Provide EVENT PREPARATION and submit ideas easily. feedback within 24 hours. Conduct the event according to the Kaizen Event Roadmap. The A3 Project Status The Kaizen Leader will 11 Keep hospital informed on the latest Report documents the Pre CONDUCT KAIZEN prepare the final Kaizen suggestions approved and projects and Post-Kaizen state with EVENT Event summary in A3 available. Update dashboard and an explanation of the tools Project Status format. status report. Show results to all applied and the benefits employees. achieved. 14 13 12 FUNCTIONAL KAIZEN COMMUNICATE POST RESULTS OF A3 COMPLETE A3 SUGGESTION SYSTEM RESULTS TO HOSPITAL PROJECT STATUS PROJECT STATUS
    36. 36. Questions?Leonardo GroupPrincipals: Gerard Leone & Richard D Rahn303-494-4404Boulder, Co 80303 PowerHealth OnDemand Scott Calvert VP Business Development 303-683-8239 Greenwood Village, Co 80111
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