Value Stream Mapping - Strategy Before Tactics

Value Stream Mapping:
Strategy Before Tactics
Karen Martin

Webinar
August 23, 2012

 Founder: Karen Martin & Associates, LLC (1993).
 Consultant / Coach: Lead Lean transformations &
develop people in office, service and knowledge
environments.
 Teacher: University of California, San Diego’s
Lean Enterprise program.
 Author:

Karen Martin,
Principal

Just released! 2nd Edition
October 2012!

Value Stream Mapping’s Roots

Mike Rother & John Shook, 1999 Beau Keyte & Drew Locher, 2004

Whenever there is a product for a customer,
there is a value stream.
The challenge lies in seeing it.

— Mike Rother & John Shook, Learning to See
© Karen Martin & Associates, LLC 3

Value Stream Defined
Value Stream: All of the activities, required to fulfill a
customer request from order to delivery (and beyond to
cash received).

Value Stream

Process Process Process

Custom er

Customer Customer
Request Receipt

4
© Karen Martin & Associates, LLC

Why Value Stream Mapping?


Value Stream Mapping Benefit #1:
Seeing the Whole

60,000 foot view; Rooftop view


VSM Promotes Systems Thinking

System Efficiency =
Optimal Value Stream
Performance

Individual Efficiency =
Sub‐optimization

7

Seeing the Whole

60,000 foot view; Rooftop view


Truth Value Stream Mapping
Truth Benefit #2
Truth
Truth
Truth
Truth
Truth
How are we really performing? Truth
What’s our customer really experiencing?
Truth 9

Value Stream Maps Serve as Visual “Storyboards”

Makes the disconnects Shows the linkage
and obstacles to flow between material and
visible at a macro level information flow

10

Problems Nearly Always Extend Outside the
Functional Silos in Which They’re Discovered


Consensus Building


Metrics-Based

What are you
going to do to
change the
numbers?


Outpatient Imaging Value Stream
Projected Results
Current Projected %
Metric State Future State Improvement
Lead Time 32.5 hrs 11.3 hrs 65%
Process Time 56 mins 43 mins 23%
Percent Activity 2.9% 6.3% 117%
Rolled First
29% 40% 38%
Pass Yield
# Macro Steps 14 11 21%
Tech turnover
100% 25% 75%
(annual)
Note: Freed capacity (PT reductions) allowed the organization to earn
$500,000 additional annual revenue w/o increasing staff.

Strategy Before Tactics
Where am I?
Where do I want
to go?
?
Which route
?
should I take? ?

I‐80 option I‐40 option I‐70 option


The Work We Do:
Degrees of Granularity

Rooftop Value Value Stream
View Map
(Strategic) Stream


In the Metrics-Based
Weeds Step Step Step Process Map
(Tactical)


Value
Stream
Mapping
Projects,
Kaizen Events,
Just‐Do‐Its


Value Stream Mapping:
As Much Art as Science


ABC Widget Value Stream
Key VSM Components: Current State Map
Demand = 1,800/year

Manufacturing 08/08/2012
Facilitator: Sally Parker
Information Flow

Production
SUPPLIER Control CUSTOMER
1
Product Flow

Process 1 I Process 2 I Process 3 I Process 4
2

Hours Hours Hours Hours LT
Timeline

3 Minutes Minutes Minutes Minutes PT


Key VSM Components:
XYZ Value Stream
Current State Map
Demand = 250/year
Information Flow
Office / Service 08/08/2012
Facilitator: Robert Parker

CUSTOMER

1
I.T. I.T. I.T.
Product Flow

Process 1 Process 2 Process 3 Process 4
2
Timeline

PT
3
LT


Current State Value Stream Map Demand = 15 per day
Outpatient Imaging Services
Customer Demand:
15 patients per Day
(Takt Time 1920 seconds)
Pre-register Schedule 8 hours per day
Patient Appointment
Referring
Hospital
Physician
4 1
Lead Time = 24 days 5 3 Lead Time = 990 mins. 6 2 Lead Time = 12 mins.
Cycle Time = 30 mins. Cycle Time = 11 mins. % C&A = 65 %
Lead Time = 990 mins. Lead Time = 12 mins.
% C&A = 100 % % C&A = 98 %

CT=Cycle Time
LT=Lead Time
%C&A=% Complete & Accurate

Symposium E Pay Excel ADS Meditech Internet Fax Order PACS
Waiting Room Auto Fax 50%
Solutions
Management Us Mail 25%
System
MD Mailbox 25%

Rework Loop
via Fax 25% of
the time

Prep Complete Transmit Read/Dictate Transcribe Review Print Send
Check-in Check-in
Patient Exam Images Exam Report Draft/Sign Reports Reports
Patient Patient
(Tech) (Tech) (Tech) (Radiologist) (MDI) (Radiologist) (Imaging) (Imaging)
(Admitting) (Imaging)
5 mins.

5 5 mins. 6 45 mins. 7 30 mins. 8 5 mins. 9 248 mins. 10 365 mins. 11 960 mins. 12 110 mins. 13 120 mins. 14
5 3 2 2 2 2 6 2 2 6

Cycle Time = 2 mins. Cycle Time = 1 mins. Cycle Time = 10 mins. Cycle Time = 15 mins. Cycle Time = 3 mins. Cycle Time = 15 mins. Cycle Time = 5 mins. Cycle Time = 1 mins. Cycle Time = 1 mins. Cycle Time = 3 mins.
% C&A = 90 % % C&A = 98 % % C&A = 100 % % C&A = 90 % % C&A = 100 % % C&A = 95 % % C&A = 75 % % C&A = 95 % % C&A = 99 % % C&A = 90 %

5 minutes 45 minutes 30 minutes 5 minutes 248 minutes 365 minutes 960 minutes 110 minutes 120 minutes L/T = 13464 minutes
2 minutes 11520 1 minutes 10 minutes 15 minutes 3 minutes 15 minutes 5 minutes 1 minutes 1 minutes 3 minutes VA/T = 11576 minutes
minutes

Rolled First Pass
yield = 29%


Value Stream Mapping Process
Define Products (good or services) with
Product Family common process steps

Foundation (the basis) for the
Document Current future state; 70‐80% accurate is
State acceptable (directionally correct)

Create flow by eliminating waste
Design Future (now obvious from your
3 Day
State current state map); typically 3‐6
Repeat

Event months out

Create Include accountability and
Implementation Plan timeframes for completion

Implement! The goal of mapping!

Value Stream Mapping Charter
Event Scope Leadership / Coordination Schedule
Executive 3 days typically; sequential is
Value Stream Contract processing, rebate processing, etc. VP or C-level Event Date(s)
Sponsor best

Specific What circumstances you're including and Value Stream If needed - often Director or Start/End
6 hrs minimum; 7 or 8 is best
Conditions excluding? (type of cust, time of year, etc.) Champion Manager level Times
Customer Demand How many times is this done per wk, qtr, mo, or yr.?
Facilitator Skilled person leading the activity Location Need ample wall space
Trigger What need does the value stream address?
First Step Task on first process block Meals Always a nice touch; keeps
Team Lead Not always needed
Last Step Task on last process block Provided? the team from wandering.
Boundaries & Interim Aid in consensus building and
What is the team NOT authorized to change? The person arranging logistics
Limitations Briefing(s) organizational learning.
Coordinator (reserving the room, ordering food,
FS Implementation sending meeting notices, etc.) Briefing List required attendees; others
Typically 90-120 days
Timeframe Attendees are optional
Event Drivers Mapping Team
1 Why are you doing this? What are the current state issues? Function Name Contact Information
2 1 Leadership-heavy
3 2
4 3
5 4
Goals & Measureable Objectives 5
1 Aim for objectives w/ measurable targets (from X to X). 6
2 7
3 8
4 9
5 10
Planned Deliverables On-Call Support
1 Current state VSM Function Name Contact Information
2 Future state VSM 1 SMEs that may not be needed full time
3 Implementation Plan 2
4 3
5 4
Potential Obstacles Approvals
1 …to the team's success with the mapping activity. Executive Sponsor Value Stream Champion Facilitator
2
3 Signature: Signature: Signature:
4 Date: Date: Date:

24

Team-Based Improvement Activities
Rules of Engagement
1. The team starts and ends the day together; begin and end breaks
together.
2. No interruptions or distractions – 100% focus; phones on silent; no
email; no texting.
3. Rank has no privilege.
4. Seek the wisdom of ten instead of the knowledge of one.
5. Use creativity before capital (in designing improvements).
6. Finger-pointing and blame has no place: “It is what it is.”
7. Respectful disagreement is encouraged. (It’s OK to disagree; it’s not
OK to be disagreeable.)
8. No veto power from outside the team.
9. No silent objectors; don’t leave in silent disagreement.
10. One conversation at a time; no side bars.
11. What’s said in the room stays in the room.
12. Ask Why? Why not? What if?
13. Ban “Can’t” and “No, because…” from your vocabulary. Think/say:
“Yes, if…”
14. Ban internal, silo’d thinking; think externally (customer); value stream.
25

Step 1 – Label Map
• Label your map in upper right corner:
– Value stream name
– Current or future state
– Customer demand (volume of work per time
period)
– Takt time (if relevant)
– Date
– Facilitator’s name (and/or team)


Takt Time:
The Key to Continuous Flow
Available work time
Takt time =
Customer demand
480 minutes/day
Takt time = = 10.7 mins
45 new accounts/day

“Touch Down”
OR…
Time Available divided by what Kustomer Takes

27

Step 2 – Define Process Blocks

• Identify all blocks in the process (target 5-15 blocks)
– Each block (post-it) contains an activity or group of activities that
occurs before a significant break in the timeline occurs (typically
build up of WIP or handoff)
– Customer icon is placed in upper right or middle
• Upper right if supplier exists (supplier is placed in upper left)
• Middle position if a separate supplier doesn’t exist
– Supplier (if relevant) is placed in upper left
– Activity format is verb/noun – what happens to what
– Include the function who performs the task
– If relevant, include number of workers who perform the task
– Include any major barriers to flow – batches, shared/inaccessible
resources, system downtime, etc.
– When possible, walk the process!


Step 3 – Define I.T. Systems

• Identify all I.T. systems used in the process and
information flow
– For most VSMs, these are placed above the process
blocks
– In very complicated VSMs with two rows of process
blocks, I.T. systems can be placed between the rows, if
necessary.
– Note any scheduling that occurs (calendar, system, etc.)
– Who tells whom to do what? How do they tell them?


Current State Value Stream Map Outpatient Demand = 15 per day
Imaging Services
Customer Demand:
15 patients per Day
(Takt Time 1920 seconds)
Pre-register Schedule 8 hours per day
Patient Appointment
Referring
Hospital
Physician
4 1
Lead Time = 24 days 5 3 Lead Time = 990 mins. 6 2 Lead Time = 12 mins.
Cycle Time = 30 mins. Cycle Time = 11 mins. % C&A = 65 %
Lead Time = 990 mins. Lead Time = 12 mins.
% C&A = 100 % % C&A = 98 %

CT=Cycle Time
LT=Lead Time

Symposium E Pay Excel ADS Meditech Internet Fax Order PACS
Waiting Room Auto Fax 50%
Solutions
System
MD Mailbox 25%

Rework Loop
via Fax 25% of
the time

Prep Complete Transmit Read/Dictate Transcribe Review Print Send
Check-in Check-in
Patient Exam Images Exam Report Draft/Sign Reports Reports
Patient Patient
(Tech) (Tech) (Tech) (Radiologist) (MDI) (Radiologist) (Imaging) (Imaging)
(Admitting) (Imaging)
5 mins.

5 5 mins. 6 45 mins. 7 30 mins. 8 5 mins. 9 248 mins. 10 365 mins. 11 960 mins. 12 110 mins. 13 120 mins. 14
5 3 2 2 2 2 6 2 2 6

Cycle Time = 2 mins. Cycle Time = 1 mins. Cycle Time = 10 mins. Cycle Time = 15 mins. Cycle Time = 3 mins. Cycle Time = 15 mins. Cycle Time = 5 mins. Cycle Time = 1 mins. Cycle Time = 1 mins. Cycle Time = 3 mins.
% C&A = 90 % % C&A = 98 % % C&A = 100 % % C&A = 90 % % C&A = 100 % % C&A = 95 % % C&A = 75 % % C&A = 95 % % C&A = 99 % % C&A = 90 %

5 minutes 45 minutes 30 minutes 5 minutes 248 minutes 365 minutes 960 minutes 110 minutes 120 minutes L/T = 13464 minutes
2 minutes 11520 1 minutes 10 minutes 15 minutes 3 minutes 15 minutes 5 minutes 1 minutes 1 minutes 3 minutes VA/T = 11576 minutes
minutes

Rolled First Pass
yield = 29%

VSM Champion: Paul Scanner Created:
July 17, 2007

Step 4 – Number the Process Blocks
• Number the process blocks
• Connect the customer and supplier,
process blocks and I.T. systems
– “Lightning bolt” arrow for electronic/automatic
information flow
– Regular arrow for push systems
– “Hollow” arrow for product flow
• If parallel processes exist, use alpha
modifiers – e.g. 8A, 8B, etc.


Step 5 – Add Data
• Add key metrics for all process blocks
– Process Time (PT)
– Lead Time (LT)
– Percent Complete & Accurate (%C&A)
• Add work-in-process (WIP) at every step.


Key Metrics: Time

• Process time (PT)
– The time it takes to actually perform the work, if one is able to
work on it uninterrupted
– Includes task-specific doing, talking, and thinking
– aka “touch time,” work time, cycle time
• Lead time (LT)
– The elapsed time from the time work is made available until it’s
completed and passed on to the next person or department in
the chain
– aka throughput time, turnaround time, elapsed time
– Includes Process Time, not merely waiting time.


Key Metrics: Time
Scenario 1

Lead Time (LT)

Work Process Time (PT)
Work passed to
Received next step

LT = PT + Waiting / Delays


Key Metrics: Time
Scenario 2

Lead Time (LT)

Process Time
Work Work passed to
Received next step

LT = PT + Waiting / Delays

3 Types of Work-in-Process (WIP)
Waiting Completed,
to be Currently but not yet
processed in process passed on

WIP

WIP WIP
Process 1 Process 2 Process 3

Step 2’s WIP
36

Current State Value Stream Map
Purchasing — Non‐repetitive purchases less than $5,000
WIP only noted at the 3
Inititate Req. 1
steps where it has
Originator
31
PT = 10 mins.
accumulated.
C&A = 10%
Supplies
Hard Copy

Vendor
Form File File Maker Quicken Excel ERP
Website

Data Entry

Review 4 Enter 7 Approve in 8 Submit PO
Review 2 3 Review 5 Review 6 9 10
Review Req. 20 Reqs Requisition 10 Reqs ERP 63 Reqs to Supplier
Budget Requisition Requisition Requisition
External
Corp Purchasing Supplier
Sys Engineer Admin Asst Corp Purchasing
Finance Supervisor IS Manager Financial Mgr Manager
6 2 1 1 1 1 1
6
2 hrs. PT = 5 mins. 4 hrs. PT = 5 mins. 40 hrs. PT = 5 mins. 8 hrs. PT = 5 mins. 8 hrs. PT = 10 mins. 4 hrs. PT = 15 mins. 24 hrs. PT = 5 mins. 56 hrs. 80 hrs. PT = 20 mins.
PT = 15 mins.
C&A = 60% C&A = 95% C&A = 90% C&A = 100% C&A = 95% C&A = 98% C&A = 90%
C&A = 98%

0.25 days 0.5 days 5 days 1 days 1 days 0.5 days 3 days 7 days 10 days LT = 28.4 days
5 mins. 5 mins. 5 mins. 5 mins. 10 mins. 15 mins. 5 mins. 15 mins. PT = 65 mins.
AR = 0.477%

RFPY = 4.2%
PT = Process Time
LT = Lead Time
Customer Demand: C&A = % Complete & Accurate
615 requisitions per y ear AR = Activ ity Ratio (PT/LT x 100)
RFPY = Rolled First Pass Y ield


Key Metrics: Quality

• %Complete and Accurate (%C&A)
– % of incoming work that’s “usable as is”; the
downstream customer can perform task without
having to “CAC”:
• Correct information or material that was supplied
• Add information that should have been supplied
• Clarify information that should have or could have been
clearer
– Determined by the person receiving the input; metric
goes on the output block.
– Measured by the immediate downstream customer
and all subsequent downstream customers.
– Similar to first pass yield in manufacturing.


Post‐it Conventions
Process #
Process
(Verb/Noun)

Function

# Staff (if
relevant)

Significant
Barriers to flow

Process Time
%C&A
Lead Time


Step 6 – Create Timeline

• Create timeline
• Calculate summary metrics
– Timeline PT Sum
– Timeline LT Sum
– % Activity Ratio (AR)
– Rolled First Pass Yield (RFPY)


Concurrent Work / Parallel Flows

Process Process

LT = 8 hrs


LT = 4 hrs

Bring longest lead time to the timeline,
unless it’s a “dead end step.”

41

Summary Metrics: Time

• Percent Activity (%Act)
– Also referred to as Activity Ratio
– The percentage of time anything is being done to the
work passing through the system (whether value-adding
or non-value-adding)
– %Act = (∑PT ÷ ∑LT) × 100
– 100 – %Act = % Time Work is Idle
– Common current state finding = 1-10% (across value
stream)
– Could also calculate %VA to show proportion of value-
adding time (often significantly lower than % Act).


Summary Metrics: Quality

• Rolled First Pass Yield (RFPY)
– The percent of value stream output that passes through
the process “clean,” with no “hiccups,” no rework
required.
– RFPY = (%C&A x %C&A x %C&A…) x 100
– Example: (0.80 x 0.50 x 0.99 x 0.75) x 100 = 29.7%
– Common current state finding = 0-15%

43

Summary Metrics: Labor Requirements

• Total PT
– Sum of all activities, not just critical path
• Labor Requirements
Total PT (in hrs) X # occurrences/year
# FTEs =
Available work hrs/year
Freed
= Current State FTEs – Future State FTEs
Capacity

* FTE = Full‐time Equivalent (2 half time employees = 1 FTE)


What do you do with freed capacity?
• If expanding market, absorb add’l work without increasing staff
• If flat market, reduce payroll through natural attrition
• Reduce paid overtime
• In-source
• Better work/life balance
• Slow down & think
• Innovate – create new revenue streams
• Conduct ongoing continuous improvement activities
• Do a better job with fewer errors and higher safety
• Get to know your customers better; build stronger supplier
relationships
• Mentor staff to create career growth opportunities
• Provide additional workforce development; cross-training
• Do the things you haven’t been able to get to; get caught up
• Collaborate with other areas

Step 7 – Determine VA & N Steps
• Identify all value-adding (VA) and
necessary non-value-adding (N) steps
– Add “VA” or “N” smaller post-it to relevant
process blocks
– All unnecessary non-value-adding blocks
remain unlabelled


Customer-Defined Value

• Value-Adding (VA) - any operation or activity
your external customers value and are (or
would be) willing to pay for.
• Non-Value-Adding (NVA) - any operation or
activity that consumes time and/or resources but
does not add value to the product (good or
service) the customer receives.
– Necessary – support processes, regulatory
requirements, etc.; also referred to as “essential” or
“value-enabling.”
– Unnecessary – everything else - WASTE


Typical Current State Findings

Unnecessary Necessary NVA
NVA

Order Delivery
Value Add

Islands of activity (process times) within long lead times.

48

Current State Typical Findings:
Work Effort as Defined by the
External Customer

Unnecessary non-value
adding
Necessary non-value-
adding
Value-adding


Future State Design

• Goal: Eliminate all obstacles to flow (“the
thing” should never stop)
– Batches
– Rework
– Bottlenecks & WIP
– Handoffs
– Setup / changeover
– Physical layout
– Motion & transportation


Eight Wastes (Muda)

• Overproduction • Motion (people)
• Inventory • Transportation
• Waiting (material/data)

• Over‐Processing • Underutilized
people
• Errors

52

Eight Questions for
Future State VSM
1. What are the customer requirements? What’s the takt
time?
2. Will we produce to order or to finished goods
inventory? (In office/service sector, you’re almost
always producing to order.)
3. Where can continuous flow be put in place?
4. Where should pull systems be implemented?
5. What is the single point of scheduling?
6. How do we level the load and the mix?
7. What should the management time frame be?
8. What process improvements are necessary to achieve
the future state?
‐‐ Rother & Shook, Learning to See

Future State Design Considerations
• Eliminate steps / handoffs • Implement pull
• Combine steps • Create an organized, visual
• Create parallel paths workplace
• Alter task sequencing and/or • Reduce setup &
timing changeover
• Improve quality (error‐proof) • Eliminate motion &
• Eliminate unnecessary transportation
approvals / authorizations • Co‐locate functions based
• Stop performing non‐value on flow; create cells
adding (NVA) tasks (teams of cross‐functional
staff)
• Standardize work
• Balance work to meet takt
• Reduce / eliminate batches time requirements

54

Future State Value Stream Map Outpatient Demand = 15 per day
Imaging Services

Standard
Work Co-locate Customer Demand:
Work 15 patients perDay
Balance (Takt Time1920 seconds)
Schedule appt
Pre-register 8 hours per day
Referring
Hospital
Physician
3 1
Lead Time = 15 days 6 2 Lead Time = 45 mins.
Cycle Time = 11 mins. % C&A = 85 %
Lead Time = 45 mins.
% C&A = 98 %
Risk
Reduction
(Joint CT=Cycle Time
Commision) LT=Lead Time

Symposium E Pay Excel Meditech Internet
Waiting Room
Fax Order PACS Auto Fax 80%
Solutions
System MD Mailbox 5%

Pull System Value Stream 5S Rework Loop
(Supplies Alignment via Fax 10% of
Kanban) the time
Remove
Check in
and Reduce Work Batch
System Access Balancing Visual Reductions
Standard Workplace Voice
Work Set-up Continuous Recognition
Reduction Flow

Prep Complete Transmit Read/Dictate Review Print Send
Check-in
Patient Exam Images Exam Draft/Sign Reports Reports
Patient
(Tech) (Tech) (Tech) (Radiologist) (Radiologist) (Imaging) (Imaging)
(Imaging)

5 mins. 35 mins. 2
5 20 mins.
2
6 5 mins.
2
7 120 mins.
2
8 420 mins.
2
9 2 mins.
2
10 30 mins.
6
11
3 4
Cycle Time = 1 mins. Cycle Time = 10 mins. Cycle Time = 10 mins. Cycle Time = 2 mins. Cycle Time = 15 mins. Cycle Time = 1 mins. Cycle Time = 1 mins. Cycle Time = 3 mins.
% C&A = 98 % % C&A = 100 % % C&A = 90 % % C&A = 100 % % C&A = 95 % % C&A = 95 % % C&A = 99 % % C&A = 90 %

0.0833 hrs. 0.583 hrs. 0.333 hrs. 0.0833 hrs. 2 hrs. 7 hrs. 0.0333 hrs. 0.5 hrs. LT = 11.3 hrs.
1 mins. 10 mins. 10 mins. 2 mins. 15 mins. 1 mins. 1 mins. 3 mins. CT = 43 mins.
CT/LT Ratio = 6.32%

Rolled First Pass
yield = 40%

Note: Process Time (PT) is referred to as Cycle
Time (CT) on this map


Value Stream Mapping Process
Define Products (good or services) with
Product Family common process steps

Foundation (the basis) for the
Document Current future state; 70‐80% accurate is
State acceptable (directionally correct)

Create flow by eliminating waste
Design Future it is now obvious from your
3 Day
State current state map); typically 3‐6
Repeat

Event months out

Create Include accountability and
Implementation Plan timeframes for completion

Implement! The goal of mapping!

PACE Prioritization Matrix
Policy
21 5 10
I.T.
6 15
Easy 13 Process
Ease of Implementation

2 20
14
23 18 17 25
7
9
26
16 1 8
12
22
24 19
27 4
Difficult

11
3

High Low
Anticipated Benefit 57

Downloadable Excel Prioritization Chart
www.ksmartin.com/the‐outstanding‐organization

The Outstanding Organization: Achieving Focus

Chart Title Prioritization Chart To use this Template:
1) Enter the title of the chart in Cell B2
Number of Items 5 2) Enter the number of items (e.g. projects, improvement activities, etc.) in cell B4
4 3) Enter the item name and ranking information into A8-D8 and so on.
Organizational Degree of
Item Name Benefit Execution Ease Urgency*
Item 1 9 1 1 Prioritization Chart
Item 2 7 3 2
10
Item 3 5 5 3
Item 4 3 7 4 9
Item 5 1 9 5 8
7

Execution Ease
6
5
4
3
2
1
0
0 1 2 3 4 5 6 7 8 9 10
Organizational Benefit

* Degree of urgency is indicated by bubble size.

58

Future State Implementation Plan
Value Stream Outpatient Imaging Implementation Plan Review Dates
Executive Sponsor Allen Ward 11/1/2007
Value Stream Champion Sally McKinsey 11/21/2007
Value Stream Mapping Facilitator Dave Parks 12/13/2007
Date Created 10/18/2007 1/10/2008
Block Implementation Schedule (weeks) Date
Goal / Objective Improvement Activity Type Owner
# 1 2 3 4 5 6 7 8 9 10 11 12 Complete
Implement standard work for referral
2 Improve quality of referral KE Sean O'Ryan
process

Reduce lead time beween schedulingand Dianne
3, 4 Cross-train and colocate work teams PROJ
preregistration steps Prichard

Eliminate the need for two patient check- Michael
5, 6 Collect copays in Imaging KE
ins O'Shea

Dianne
6 Eliminate bottleneck in waiting area Balance work / level demand KE
Prichard

Eliminate lead time associated with
9 Implement voice recognition technology PROJ Sam Parks
transcription step

10 Eliminate batched reading Reduce setup required KE Sam Parks

Reduce inventory costs, regulatory risk Michael
7 5S CT supplies area; implement kanban KE
and storage needs O'Shea

12 Reduce delay in report delivery Implement additional fax ports PROJ Martha Allen

Increase percentage of physicians
12 Reduce delay in report delivery receiving electronic delivery (rather than KE Martha Allen
hard copy)

Approvals
Executive Sponsor Value Stream Champion Value Stream Mapping Facilitator
Signature: Signature: Signature:

Date: Date: Date:


Where Should We Start?


What’s the Problem?


Which comes first? A3 or VSM?

“We need to
“We have a
MAJOR
problem.”
e.g., losing market share
A3 VSM improve our
entire value
stream.”
e.g., new construction

“Let’s look at “Let’s explore
the entire
value stream.” VSM A3 this problem
in the value
stream.”
e.g., to look at overall
product quality and the e.g., why plans are so far off in
reason(s) for long lead times terms of construction logistics


For Further Questions

Karen Martin, Principal
7770 Regents Road #635
San Diego, CA 92122
858.677.6799

ksm@ksmartin.com
Twitter: @karenmartinopex
Subscribe: www.ksmartin.com/subscribe

63

Value Stream Mapping - Strategy Before Tactics

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