Rebuilding the hospital provided the opportunity
to rebuild the organisation and mind-sets
so everything supports the patient journeys
while also deepening skills and capabilities
What triggers your organisation to
think back from its customers/users
and learn to do new things?
Lean uses the same scientific
approach to diagnose and
treat organisational problems
as doctors use to solve
Science is about asking the right questions
not just about testing hypotheses
We learn through doing experiments every day
and reflecting on them
Also through taking responsibility for solving
real problems with others
We develop capabilities by asking questions
not by giving answers
Everyone has to be involved in
Ask Why &
using the Scientific Approach
How are you taking responsibility
for developing capabilities?
Deputy Minister for Education
Deputy Minister for Lean Across
Previously Deputy Minister of Health
Government of Saskatchewan
A Pioneering Experiment
Began in healthcare – now spreading
right across government
Province-wide Hoshin focusing on the
needs of groups of citizens in order to
mobilize service delivery
Led by doers – supported by politicians
and civil servants
How do you build common actions
across big organisations?
The NHS is struggling with initiative fatigue
We are carrying out experiments
to build management systems
to support lean operations
and deliver results
Distinguish “real” from “created” demand
Recognise common journeys – and complex tail
How predictable is demand?
What causes system driven variation?
What is management doing to
eliminate this noise?
Experience the power of the Exec team
walking and mapping patient journeys
Learn to see the obstacles and delays
Lean where to act to unblock the flow
How to build stable and flexible flows across
departments aligned with demand?
Common practice is created by making the work visible
– not by hiding it in computers!
Hands-on management of the end-to-end flow
is critical for triggering actions
unblocking obstacles and escalating issues
and mentoring and coaching team capabilities
Who is responsible for your end-to-end
PFEP Visual Hospital
How many projects and targets?
How much staff time spent
Will they make a real difference
and are they resourced?
Hoshin is a framework for using CAPD to
focus on the needs of broken value streams
agree the vital few projects to close
key performance gaps
learn how time drives quality
How good are you at focusing
on the vital few?
Which experiments to deploy
to close the gaps?
Manage discharge with tertiary care
Cellularize ED with near patient testing
Synchronise support services to takt
Frequent replenishment of supplies
Which experiments will show
where we need to go next?
We can all learn a lot
The dialogue with informed users and
customers has only just begun
Improving efficiency and quality buys time
But we also need bold experiments with
new ways of delivering services
The scientific approach is key to
acting our way to new ways of thinking
What are you doing to prepare
for this challenge?
Further reading and video links