Value Stream Mapping Webinar March 27, 2014
Value Stream Mapping Case Studies

© 2014 The Karen Martin Group, Inc. Welcome! • Austria •
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 Coach / Facilitator / Consultant / Trainer: Lean transformation & business performance improvement in all industries. 
Teacher: University of California, San Diego  Author & Speaker: Karen Martin, President The Karen Martin Group, Inc. www.ksmartin.com 3 2013 Shingo Prize winner! www.ksmartin.com/subscribe

© 2014 The Karen Martin Group, Inc. 4 After the webinar… • Recordings:
– www.ksmartin.com/webinars – www.vimeo.com/karenmartingroup – www.youtube.com/karenmartingroup – www.slideshare.net/karenmartingroup (+ slides) Before the webinar… • Materials available one hour prior: – www.ksmartin.com/files/webinarmaterials/MM‐DD‐YYYY_slides.pdf (or _handout.pdf)

5 Wednesday, April 23, 2014 11:00 am – Noon PT Hosted by Gemba Academy
http://www.gembaacademy.com/webinars Value Stream Mapping: From Tool to Management Practice More Webinars! 11:00 am‐12:15 pm PT www.ksmartin.com/webinars Coaching: The Art of Asking the Right Questions

© 2014 The Karen Martin Group, Inc. 6 May, June, July Webinars: The Agenda is Yours! •
Refresher & current thinking on previous topics? – E.g., Kaizen Events, A3, Work Standardization, Metrics‐Based Process Mapping, Visual Management, Kanban, Process Management, Lean 101, etc. • New topic I haven’t covered before? – E.g., Leadership standard work, going to the Gemba, countering resistance to change, Lean transformation model, facilitation tips, etc.

© 2014 The Karen Martin Group, Inc. 7 Share your learning needs & wants at the end of today’s webinar When you leave today’s webinar,
click “File – Exit” vs. closing your browser window

© 2014 The Karen Martin Group, Inc. 8 You will learn… • What the driver was for value stream
improvement. • What the planning process consisted of. • The discoveries and challenges that surfaced—and the shifts that occurred— during the 3‐day activity. • Projected & actual transformation results.

© 2014 The Karen Martin Group, Inc. 9
To order from Amazon: www.bitly.com/VSMbk
For more information: www.ksmartin.com/VSM
Now available!

Prepare Understand Current State Design Future State
Develop Transformation Plan Execute Transformation Plan Three Consecutive Days 4 Weeks Prior to Mapping Following Mapping Repeat Value Stream Mapping Activity Phases and Timing 10 January 7, 2014 February 18, 2014January 21, 2014 www.ksmartin.com/webinars

© 2014 The Karen Martin Group, Inc. 11
www.ksmartin.com/VSM

Value Stream Defined Value Stream: All of the activities required to transform a customer request into a good or service. 12 Value Stream
First defined in The Machine That Changed the World, James Womack, Daniel Jones, & Daniel Roos, 1990. Process ProcessProcess Customer Request Customer Receipt © 2014 The Karen Martin Group, Inc.

Degrees of Granularity: Hiring Value Stream Hire Recruit Select
Onboard Write job description Post externallyPost internally 13© 2014 The Karen Martin Group, Inc. Tactical Process‐level Perspective Strategic Value‐stream Perspective

© 2014 The Karen Martin Group, Inc. 14 Value Stream Mapping Benefit: Seeing the Whole 14
Value Stream Mapping enables a mapping team to get ABOVE the work

15
Value Stream Mapping: A Storyboard
Visualize the flow of work on a single sheet of paper
© 2014 The Karen Martin Group, Inc. 15

© 2014 The Karen Martin Group, Inc. 16
Value Stream Map ≠ Process Flow Chart

Value Stream Map ≠ Swim Lane Process Map Benefits Administrator Receive negative
drug screen results Complete “New Hire Approval” form; send to recruiter Recruiter Sign “New Hire Approval” form Recruiter Sign “New Hire Approval” form Set up employee in SAP; notify hiring manager Hiring Manager Request laptop on “New Hire Equip. Request” form IT Manager Approve “New Hire Equip. Request”

© 2014 The Karen Martin Group, Inc. 18
Value Stream Mapping Benefit:
Reaching Leadership Consensus

© 2014 The Karen Martin Group, Inc. 19 Why do organizations map their value streams? •
To provide greater customer value • To solve vexing problems – Quality Cost Delivery Safety Morale • To stay ahead of the competition • To generate cross‐functional teamwork • To develop its leadership team • To experiment with the approach

Value Stream Mapping
Value Stream Mapping
Case Study #1

© 2014 The Karen Martin Group, Inc. 21 Manufacturing: Quote to Cash Why VSM? •
New General Manager who has extensive Lean experience • His goal: improve overall performance & create capable, repeatable processes

Projected Results* • Reduced lead time (PO to Ready‐to‐Ship) from 17 months to 7.5 months. •
Freed capacity: the equivalent of 23 FTEs (due to process time reduction). • Freed $25M in working capital (annualized). * 11 months to fully realize the future state. As of today, they about a month behind due to CEO change.

1 2 1 3 2
4 3 5 4 5 1 6 2 7 3 8 4 9 5 10 1 2 1 3 2 4 3 5 4 1 2 3 4 Date: Date: Contact Information Budget-to-actual expenses per PO/project. Signature: Signature: Signature: Date: 2013 average ontime delivery. Executive Sponsor Value Stream Champion Facilitator Annualized quantity of change orders. Profitably grow our business and open new markets. Prod Development Charlie F Relevant Data Agreement Reduce customer's warranty & LD exposure. Finance Lori P Capable processes that are repeatable (process focused). Design Manager Andrew M Projects completed on time (customer) & under budget (business). Function Name Reduced lead times & increased sales opportunities. IT Mars L Sales Kellie McMahon Benefits to Customers & Business On-Call Support Create variance tracking methodology. Program Mgmt Leia Chang Standardize the change process to reduce the # of Change Orders. Manufacturing Robert Cashman Reduce lead time (PO to ready to ship) from 12 mos to 8 mos. CFO Sharon Prince No KPIs. Sales Ed Borge Goals & Measurable Targets Engineering Joakim Gutan On-going changes to project parameters (design, test dates, & supply chain). Supply Chain, purch, log, ware Tom Johnson Consistently late delivery. CEO Mark Simpson Increase average ontime delivery (to "ready to ship") from 17% to 60%. Quality Sally Jones Projects are not scoped accurately (voice of the customer). Function Name Lack of consistant processes and execution. Operations John Morgan Briefing Dates &Times Feb 3, 4 & 5, 2014 4:00 - 5:00 pmImprovement Timeframe Future state realized by December 31, 2014 Current State Problems & Business Needs Mapping Team Contact Information Last Step Product shipped Boundaries & Limitations Must use existing resources (people, IT, etc.) Briefing Attendees ** required *optional ** Frank L, Rick M, Cory C, Glen S, Sinan, Ben, Jane, Sal, Malaika, Andrew, AE's, Sales Mgr's, Rachel, Adam, Dustan Base-camp Location Bldg B, Conf Room A Trigger Customer submits RFQ First Step Sales receives RFQ Logistics Coordinator Georgette Winters Meals Provided Continental breakfast, lunch, snacks Specific Conditions Land-based Value Stream Champion Janice Mitchell Demand Rate 300 units (40 projects; 20 POs) per year Facilitator Karen Martin Value Stream Mapping Charter Scope Accountable Parties Logistics Value Stream Equipment type A Executive Sponsor Joe Abrams Event Dates & Times Mon, Tue, Wed Feb 3, 4 & 5, 2014 8:00 am - 5:00 pm

© 2014 The Karen Martin Group, Inc. 24 Mid‐Mapping Charter Revisions Improvement Timeframe
Future state realized by December 31, 2014 Last Step Product shipped Boundaries & Limitations Must use existing resources (people, IT, etc.) Trigger Customer submits RFQ First Step Sales receives RFQ Specific Conditions Land-based Demand Rate 300 units (40 projects; 20 POs) per year Value Stre Scope Value Stream Equipment type A • Land‐based • Retractable • Multi‐stage • Medium complexity (3 drawings, 6 new parts) • 3 units per project 1. Added additional specific conditions. 2. Discovered current state was worse than assumed. 1 2 3 4 5 Create variance tracking methodology. Standardize the change process to reduce the # of Change Orders. Reduce lead time (PO to ready to ship) from 12 mos to 8 mos. Goals & Measurable Targets Increase average ontime delivery (to "ready to ship") from 17% to 60%. Median current state lead time was actually 17 months.

© 2014 The Karen Martin Group, Inc. 25 3. Expanded scope to include receive cash. Modified definition of “shipped” to “ready to ship.”
4. Refined target : “internally‐produced” change orders. … to reduce the # of internally‐ produced change orders. Improvement Timeframe Future state realized by December 31, 2014 Last Step Product shipped Boundaries & Limitations Must use existing resources (people, IT, etc.) Trigger Customer submits RFQ First Step Sales receives RFQ Specific Conditions Land-based Demand Rate 300 units (40 projects; 20 POs) per year Scope Value Stream Equipment type A Modified Last Step: Receive cash. 1 2 3 4 5 Create variance tracking methodology. Standardize the change process to reduce the # of Change Orders. Reduce lead time (PO to ready to ship) from 12 mos to 8 mos. Goals & Measurable Targets Increase average ontime delivery (to "ready to ship") from 17% to 60%. Mid‐Mapping Charter Revisions

© 2014 The Karen Martin Group, Inc. 26
Current and Future State Maps

End‐of‐Day Briefing #2

J F M A M
J J A S O N D 1 PROJ Joakim 2 PROJ Leia 3 KE Kellie 4 KE Joakim 5 PROJ Joakim 6 PROJ Ed 7 KE Sharon 8 PROJ Mark 9 JDI Kellie 10 PROJ Robert 11 PROJ Joakim 12 PROJ Robert 13 JDI Ed 14 PROJ Tom 15 PROJ Tom 16 KE Tom Value Stream Champion Janice Mitchell Start: 2/10/2014 Value Stream Mapping Facilitator Karen Martin Value Stream Transformation Plan Value Stream Land-based, retractable, medium complexity equipment Scheduled Review Dates Executive Sponsor Joe Abrams Every other Monday 10 am Socialize new criteria for engineering, quality, & purchasing involvement. Date Created 1/5/2014 Kaizen Burst # Measurable Target Objectives Proposed Countermeasure Exec. Method * Owner Planned Timeline for Execution Status Create procedure/train GS service engineers to properly feedback suggestions to engineering. Create bulletin re: standardized headplate design to eliminate flange orientation. Create visual "milestone" timeline to educate customers. Define technical info Ebara needs from customer and when. Revise standard Ts & Cs to incorporate time limit for customer approval for final payment. Error proof P.O. info (correct specs, ship to, etc.); notify customer re missing info and drop dead date. Create criteria for LOI acceptance. Add initial project release in SF. Enforce customer-requested CO procedure. One piece engineering flow Move to one release (equip & systems) Create commodity management team & supplier SLAs. Standardize WPS/PQR from suppliers. Revise proposal template to limit time to 4 revisions. Create trigger to release (BOMs) for purchase. Removed for confidentiality purposes

© 2014 The Karen Martin Group, Inc. 29 Significant improvements not reflected in kaizen bursts •
Better customer information upfront • Proper kick‐off meeting • P‐PAP before production • Added pre‐production trials • Clarified Roles and Responsibilities • Reduced tension between engineering and production

© 2014 The Karen Martin Group, Inc. 30 Defined Key Performance Indicators • Total Lead Time (PO to Ready to Ship)
• % On‐time delivery • Total Process Time • # Internally‐produced Change Orders

Value Stream Mapping
Value Stream Mapping
Case Study #2

Healthcare: Outpatient Imaging Value Stream • History –
Hospital lost 25% outpatient imaging business in 1 year. – Radiology group believed market share loss was due to the patient experience at the aging hospital. • Wanted to enter into JV with hospital to build a free‐standing imaging center to compete with the new one across town. – Hospital leadership believed poor quality radiologist work created market share loss. • Value Stream Mapping was selected as the means to analyze & improve performance.

© 2014 The Karen Martin Group, Inc. 33 1 2 1
3 2 4 3 5 4 5 1 6 2 7 3 8 4 9 5 10 1 2 1 3 2 4 3 5 4 1 2 3 4 Date: Date: Name Name Susan Okowski Sally Letsgetlean Eva Garcia Todd Warberg FacilitatorValue Stream Champion Joe Flowberg Contact Information Contact Information Demand Rate Trigger 15 CT scans per day Recognition of need for CT scan Value Stream Mapping Charter Scope Accountable Parties Logistics Sally Letsgetlean, VP Ops Joe Flowberg, Imaging DirectorSpecific Conditions CT Scans Value Stream Champion Outpatient imaging Executive Sponsor Value Stream Event Dates & Times February 4-6, 2014 8:00 AM - 5:00 PM Joyce Mapper Base-camp Location Facilitator Current State Problems & Business Needs Mapping Team Boundaries & Limitations Improvement Timeframe Existing IT; existing CT equipment; current operating budget; no additional staff 6 months Future state fully realized by August 15, 2014 Last Step Physician receives report Logistics Coordinator Toni Details Februrary 4-6, 2014 4:00 - 5:00 PM First Step Physician office calls to schedule appointment Briefing Dates & Times Meals Provided Briefing Attendees ** required *optional *Rick Green (CEO), **Paul Johnston (COO), *Connie Miller (VP Fin), **Jerry Vickers (VP IT), *Jeanette Wiser (CMO) Director, Admitting Measurable Target Condition Radiologist Average patient wait time is 45 mins. VP, Operations Director, Scheduling & Reg Referrals down 20% since competing imaging center opened. Function High staff turnover (50% last year); using too many agency techs. Director, Imaging Increase referrals by 20% in 2014 & an add'l 15% in 2015 & 2016. Referring MD Office Manager Rebecca Cole Dee Jones Dina Lee Reduce lead time (patient arrival to report received) by 50%. Lead CT Tech Ability to attract and retain highly skilled techs. Faster response time & report quality - happier doctors and patients. Function Ability to recapture lost market share. Radiologist Conitinental breakfast & lunch Conference Rm A Benefits to Customers & Business On-Call Support Richard Ridenour Nicole Coder Improve staff morale (techs and admin). Manager, Imaging Reduce rework when sending reports by 50%. Director, IT Improved ROI for imaging equipment. Review patient sat surveys, especially anecdotal feedback. Survey radiologists & imaging staff. Signature: Date: Relevant Data Agreement Survey referring phyisicians. Executive Sponsor Sally Letsgetlean Market share intelligence. Joe Flowberg Signature: Signature: Joyce Mapper

Imaging Inpatient Outpatient X‐Rays (15%)
MRI (20%) CT Scans (30%) Mammography (25%) Value Stream Scoping Diagram Defining Specific Conditions Potential selection criteria: • Highest volume? • Highest margin? • Most painful? • Most supportive leadership? 34

© 2014 The Karen Martin Group, Inc. 35
Outpatient Imaging Current State VSM

© 2014 The Karen Martin Group, Inc. 36
Current State Value Stream Map
Outpatient Imaging

© 2014 The Karen Martin Group, Inc. 37
Future State Value Stream Map
Outpatient Imaging

Imaging Value Stream Transformation – Round #1 Results Metric Before After
% Improvement Timeline Lead Time 4.0 days 1.3 days 67.5% Timeline Process Time* 59 minutes 48 minutes 18.6% Activity Ratio 3.1% 7.6% 145.2% Rolled % Complete & Accurate 30.5% 65.0% 113.1% Tech Turnover (annual) 100% 0% Surprise discovery! * Reduction in Tech’s PT frees enough capacity to earn add’l $500K in annual revenue.

© 2014 The Karen Martin Group, Inc. 39 1 2 3
4 5 6 7 8 9 10 11 12 2 Improve quality of referral to 85% KE Sean Michaels 100% 3,4 Reduce lead time between scheduling and preregistration step to 45 minutes Proj Dianne Marie 75% 4 Only one check in per patient KE Ryan Austin 50% 4 Reduce wait time in waiting area by 50% KE Dianne Marie 50% 6 Eliminate 6 hour lead time associated with transcription step Proj Dave Gerald 50% 7 Eliminate redundant data entry Proj Dave Gerald 25% 5 Visually managed inventory; no outages or expired items KE Michael O'Shea 100% 6 Reduce imaging LT to one hour Proj Martha Allen 25% 8 Reduce report delivery LT to 30 minutes Proj Martha Allen 0% 7 Reduce LT at image review to 1 day JDI Dave Gerald 100% Value Stream Transformation Plan Value Stream Value Stream Champion Value Stream Mapping Facilitator Allen Ward 1-Nov-12Executive Sponsor Scheduled Review Dates 21-Nov-12 Outpatient Imaging Paul Scanner Dave Parks 13-Dec-12 10/18/2012 10-Jan-13Date Created Value Stream Mapping Facilitator Increase % of physicians receiving electronic delivery Planned Timeline for Execution Status Signature: Agreement Signature: Signature: FS VSM Block # Measurable Target Proposed Countermeasure Implement standard work for referral process Exec. Method* Owner * Execution Method = JDI (Just-do-it), KE (Kaizen Event), or Proj (Project) Cross-train and co-locate work teams Value-stream specific radiologists Implement voice recognition technology Auto populate between PACS and Meditech 5S CT supplies area; implement kanban Collect copays in Imaging Balance work / level demand Visual metrics and indicators Date: Date: Executive Sponsor Value Stream Champion Date:

Interesting Developments • Worst LT problem was super easy to fix. • During kanban
and 5S work, team discovered $25,000K of expired material and $17,000 of obsolete material. • Forged a far stronger relationship between hospital and radiologists. • Collecting copays in Imaging was reversed. • Implementing voice recognition took 2 years due to technology issues. • Creating a break room for techs boosted morale beyond anyone’s expectation.

© 2014 The Karen Martin Group, Inc. 41
Storage room was converted into a break room, boosting morale.

Miscellaneous Tips • Team composition – Leaders; You may have to pay subcontractors
• Choosing when to go to the Gemba and when not to. • Involving staff before and during mapping. • Pre‐mapping Data Collection – how much is too much; how much is too little. • FS VSM is a living document; visually post!

Prioritization Grid
Creating the Transformation Plan
43

© 2014 The Karen Martin Group, Inc. 44 Questions? • What tips and tricks do you have for
ensuring that transformation efforts continue once a consultant is no longer on site? • Others?

© 2014 The Karen Martin Group, Inc. 45 Karen Martin, President 7770 Regents Road #635 San Diego, CA 92122
858.677.6799 ksm@ksmartin.com Blog & newsletter: www.ksmartin.com/subscribe

© 2014 The Karen Martin Group, Inc. 46 1 2 1
3 2 4 3 5 4 5 1 6 2 7 3 8 4 9 5 10 1 2 1 3 2 4 3 5 4 1 2 3 4 Date: Date: Contact Information Budget-to-actual expenses per PO/project. Signature: Signature: Signature: Date: 2013 average ontime delivery. Executive Sponsor Value Stream Champion Facilitator Annualized quantity of change orders. Profitably grow our business and open new markets. Prod Development Charlie F Relevant Data Agreement Reduce customer's warranty & LD exposure. Finance Lori P Capable processes that are repeatable (process focused). Design Manager Andrew M Projects completed on time (customer) & under budget (business). Function Name Reduced lead times & increased sales opportunities. IT Mars L Sales Kellie McMahon Benefits to Customers & Business On-Call Support Create variance tracking methodology. Program Mgmt Leia Chang Standardize the change process to reduce the # of Change Orders. Manufacturing Robert Cashman Reduce lead time (PO to ready to ship) from 12 mos to 8 mos. CFO Sharon Prince No KPIs. Sales Ed Borge Goals & Measurable Targets Engineering Joakim Gutan On-going changes to project parameters (design, test dates, & supply chain). Supply Chain, purch, log, ware Tom Johnson Consistently late delivery. CEO Mark Simpson Increase average ontime delivery (to "ready to ship") from 17% to 60%. Quality Sally Jones Projects are not scoped accurately (voice of the customer). Function Name Lack of consistant processes and execution. Operations John Morgan Briefing Dates &Times Feb 3, 4 & 5, 2014 4:00 - 5:00 pmImprovement Timeframe Future state realized by December 31, 2014 Current State Problems & Business Needs Mapping Team Contact Information Last Step Product shipped Boundaries & Limitations Must use existing resources (people, IT, etc.) Briefing Attendees ** required *optional ** Frank L, Rick M, Cory C, Glen S, Sinan, Ben, Jane, Sal, Malaika, Andrew, AE's, Sales Mgr's, Rachel, Adam, Dustan Base-camp Location Bldg B, Conf Room A Trigger Customer submits RFQ First Step Sales receives RFQ Logistics Coordinator Georgette Winters Meals Provided Continental breakfast, lunch, snacks Specific Conditions Land-based Value Stream Champion Janice Mitchell Demand Rate 300 units (40 projects; 20 POs) per year Facilitator Karen Martin Value Stream Mapping Charter Scope Accountable Parties Logistics Value Stream Equipment type A Executive Sponsor Joe Abrams Event Dates & Times Mon, Tue, Wed Feb 3, 4 & 5, 2014 8:00 am - 5:00 pm