1.
How to Manage Your Improvement
Metrics More Efficiently and
Effectively
@MarkGraban (Presenter)
VP of Improvement & Innovation Services
Mark@KaiNexus.com
@Jeff_Roussel (Host)
VP of Sales
Jeff.Roussel@KaiNexus.com

2.
Agenda & Logistics
• Presentation (45 minutes)
• Q&A (10 minutes)
– Use the GoToWebinar
Meeting Panel to
submit a question at
any time
• Recording link & slides will be sent via email
– Also – see the “Handouts” feature and Chat box

3.
About Mark Graban
• 20+ years practicing Lean
– 10 years in manufacturing
– 11+ years in healthcare
• Books:
– Lean Hospitals
– Healthcare Kaizen
(co-author Joe Swartz)
• www.MarkGraban.com
New 3rd Edition!

4.
Why
Measure?

5.
Are We
Improving?

6.
My Most Favorite Book Ever
http://www.spcpress.com/
http://amzn.to/2jJ4fiN
Donald J. Wheeler, PhD

7.
Are We
Improving?

8.
Daily Lean Management

9.
Source: Thinking Lean at ThedaCare (DVD)

10.
How Are We
Doing Compared
to Our Goal?

11.
"Bowling Chart"

12.
Are We
Improving?

13.
Can We Tell From This?

14.
A Better Dashboard
Limited information you need to make decisions

15.
Easier to Tell From This?
400
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650
Aug-05
Sep-05
Oct-05
Nov-05
Dec-05
Jan-06
Feb-06
Mar-06
Apr-06
May-06
Jun-06
Jul-06
Aug-06
Total Cases

16.
In KaiNexus…

17.
Are We
Improving?

18.
Need to Avoid Bad Conclusions
“The average patient satisfaction
increased from 87.2 to 89%”
86%
87%
88%
89%
90%
Before After

19.
Need to Avoid Bad Conclusions
“The average patient satisfaction
increased from 87.2 to 89%”
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Before After

20.
Need to Avoid Bad Conclusions
“The average patient satisfaction
increased from 87.2 to 89%”

21.
Need to Avoid Bad Conclusions
“The average patient satisfaction
DECREASED from 87.2 to 85%”??

22.
Are We Improving?
76
78
80
82
84
86
88
90
92
Patient Satisfaction (Different Data Set)

23.
Linear Trendlines are Easy

24.
Can Linear Trends Be Misleading?
76
78
80
82
84
86
88
90
92
Patient Satisfaction

25.
Same Chart Different Timeframe
78
80
82
84
86
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90
92
Patient Satisfaction

26.
Are We
Improving?

27.
How Can
We Tell?

28.
How Should
We React?

29.
0
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60
3/1/07
3/2/07
3/3/07
3/4/07
3/5/07
3/6/07
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3/9/07
3/10/07
3/11/07
3/12/07
Responding to Daily Changes
KB
GOAL
Daily Production Average
Praise
Team
PT PT
Are we helping? Is this process stable?
KB
Kick
Butt

30.
Isn’t it always the system?
It’s (almost) always the system.

31.
Signal vs. Noise?
"While every data set contains noise,
some data sets may contain signals.
Therefore, before you can detect a signal
within any given data set,
you must first filter out the noise.

32.
“X” Control Chart
(Chart for Individual Values)
Goal = 25 minutes
Upper Control Limit
Lower Control Limit

33.
In KaiNexus…

34.
Surgical Cases Table

35.
Surgical Control Chart
0
100
200
300
400
500
600
700
800
Aug-05 Sep-05 Oct-05 Nov-05 Dec-05 Jan-06 Feb-06 Mar-06 Apr-06 May-06 Jun-06 Jul-06 Aug-06
Total Cases
NOISE

36.
Patient Satisfaction Run Chart
“The average patient satisfaction
increased from 87.2 to 89%”

37.
Patient Sat. Control Chart
78
80
82
84
86
88
90
92
Nov-08 Dec-08 Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09
Patient Satisfaction
NOISE

38.
Lab Turnaround Time
What
Happened?
SIGNAL

39.
Another "Special Cause"
What
Happened?
SIGNAL

40.
X and MR Chart Combo

41.
Does This Small Business Have
Predictable Revenue?
X chart
MR chart
SIGNAL

42.
Is My Blog
Traffic
Increasing?

43.
Evaluate Over Time
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LeanBlog.org Daily Page Loads

44.
“Western Electric” Rules
• Any single point above or below 3-sigma LCL or UCL
• 8 consecutive points on same side of mean
• 6 consecutive points moving same direction
• 14 alternating up/down points in a row
Full rules à http://bit.ly/WErules

45.
Evaluate Over Time
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46.
Shift the Limits as Indicated
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LeanBlog.org Daily Page Loads

47.
Example of Process Shift
• If you made a change that you expected to improve the system,
use a control chart to test the hypothesis
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Process Shift
Daily TAT

48.
Example of Process Shift
• If you did NOT make a change, you need to investigate to
determine the cause of this signal
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Process Shift
Daily TAT

49.
Are We Hitting
Our Goals?

50.
Performance vs. Goals

51.
System View vs. Reactive

52.
Control Chart View

53.
Another Example
Goal

54.
Control Chart View
Goal

55.
So We Should
Do Nothing?

56.
Improve the
System!

57.
NOT Understanding Variation Leads To…
• Pressuring people to get better results
by working harder within the same
system
• Wasting time looking for explanations
of a perceived trend when nothing has
changed
• Not focusing on systemic improvements
that would shift the mean

58.
Our Next Webinar
"The Intersection of Culture and
Technology: Capturing Improvement
Where it Happens"
– Matthew Cannistraro
– Thursday February 23, 1 PM ET
• KaiNexus.com/webinars

59.
Ask Us Anything!
• Mark Graban & Dr. Greg Jacobson
• Next Episode Feb 14, 1 pm ET
• Register & submit questions via
http://kainexus.com/webinars
• Past episodes available
on YouTube

60.
Other Resources
www.KaiNexus.com

61.
Podcasts
• www.KaiNexus.com/podcasts
• Subscribe via:
– iTunes
– Google Play
– Stitcher

62.
Thanks!
• Web:
– www.kainexus.com
– blog.kainexus.com
– www.MarkGraban.com
• Webinars on Demand:
– www.kainexus.com/webinars
• Social Media:
– www.twitter.com/kainexus
– www.linkedin.com/company/kainexus
– www.facebook.com/kainexus
@MarkGraban
VP of Services
Mark@KaiNexus.com
@Jeff_Roussel
VP of Sales
Jeff.Roussel@KaiNexus.com
BONUS RECORDING WILL BE SENT:
HOW TO CREATE CONTROL CHARTS