Mark Graban Webinar - ASQ LED, Suggestion Boxes & Kaizen


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Suggestion boxes, while well intended, usually fail to engage workforces in meaningful improvement. The "kaizen" model (from Lean and Toyota Production System), however, is alive and thriving in many organizations.

This webinar will focus on key differences between suggestion box programs and the kaizen model, giving specific tips and ideas that your organization can adopt.

bout the Presenter

Mark Graban is a popular speaker at conferences and private healthcare meetings. He has guest lectured at schools including MIT and Wharton and has served as a faculty member for the Institute for Healthcare Improvement.

He has been quoted and interviewed in many publications, including Health Affairs and the New York Times.

Published in: Business, Technology
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Mark Graban Webinar - ASQ LED, Suggestion Boxes & Kaizen

  1. The  Sugges)on  Box  is  Dead…   But  Staff  Improvement  Ideas   Live  On     Mark  Graban   President,  Constancy,  Inc.   Chief  Improvement  Officer,  KaiNexus   Faculty,  Lean  Enterprise  Ins)tute     August  23,  2012  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  2. ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  3. ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  4. Dysfunc)ons  of  Sugges)on  Systems   •  Slow  /  No  Response   •  Yes  /  No  Answers   •  Not  CollaboraDve   •  Not  Transparent   •  Buy  Instead  of  Do?   •  Complaints  Against  Others   •  IncenDves  à  FighDng   •  Quotas  à  Gaming   Builds  on  the  book  Ideas  are  Free!  by  Robinson  &  Schroeder  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  5. Kaizen  =  Change  for  the  BeTer     •  ‘Kai’  means  “change.”   •  ‘zen’  means  “good.”    ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  6. Kaizen is Not Just Events   Very few Large issues System Kaizen Six Sigma Few Project Medium issues Lean Event Many Small issues Daily Kaizen Adapted from: “The Toyota” Way Fieldbook, Liker and Meier©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  7.        “What  Sets  Us  Apart?”   “Every  Toyota  team  member  is   empowered  with  the  ability  to   improve  their  work  environment.   This  includes  everything  from  quality   and  safety  to  the  environment  and   produc)vity.    Improvements  and   sugges)ons  by  team  members  are   the  cornerstone  of  Toyotas  success.”  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  8. Kaizen  is  for  Everyone!   “…  emphasizes  morale-­‐ boos)ng  benefits  and   posi)ve  employee   par)cipa)on  over  the   economic  and  financial   incen)ves…”     -­‐  Masaaki  Imai  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  9. Dr.  Berwick’s     Call  for  Kaizen  (1989)     •  Kaizen  =  “the  conDnuous  search  for   opportuniDes  for  all  processes  to  get  beYer”       •  Dr.  Donald  Berwick   –  Founder,  InsDtute  for  Healthcare  Improvement   –  Former  Administrator,  Medicare  and  Medicaid  (CMS)   CitaDon:  Berwick,  DM,  “ConDnuous  improvement  as  an  ideal  in  health  care,”  New  England   Journal  of  Medicine,  1989  May  25;320(21):1424-­‐5.    ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  10. Barriers  to  Kaizen?  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen    
  11. Fear  of  Layoffs   Found  posted  in  a  hospital  lab  (during  ini9al  Lean  assessment)  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source  unknown  
  12. “No  Layoffs  Due  to  Lean”  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  13. We  Don’t  Have  Time?   “Mikki  Gremp,  RN,  lef  one   hospital  because  a  number   of  policies,  including  its   pracDce  of  flexing  down,   lef  her  feeling  that  nurses   werent  valued.”   AJN Report: The Other Side of Mandatory Overtime Roxanne Nelson BSN, RN Maureen Shawn Kennedy MA, RN, editorial director AJN, American Journal of Nursing April 2008, Volume 108 Number 4, Pages 23 - 24©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  14. People  Hate  Change?   “People  don’t   resist  change,   they  resist  being   changed.”     –  Peter  Scholtes   (1938-­‐2009)  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  15. Why  Not  Best  Prac)ces?   “People   support  what   they  create.”    -­‐  Margaret  J.  Wheatley   See  YouTube:  hYp://­‐Create  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  16. Joint  Commission  Now  Says…   “it  may  be  Dme  for  hospitals   to  move  away  from  best   prac)ces  and  develop   comprehensive  process   improvement  tools  —  which   can  include  Lean,  Six  Sigma   or  other  emerging   methodologies  —  that  allow   for  deeper,  more  specific   analyses  of  their  pa)ent   safety  needs.”    -­‐  Mark  Chassin,  MD,  President    ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  17. A  Proposed  Formula  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  18. Completed  Kaizen  Example  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  19. “Quick  and  Easy”  Kaizen   Find   1.  Find   2.  Discuss   Discuss   3.  Implement   Implement   4.  Document   5.  Share   Document   Share  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  20. Why  Kaizen?   Norman Bodek 1.  Make your work easier 2.  Make your work more interesting 3.  Develop your skills & capabilities©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  21. Start  Small   •  “There  are  no  big  problems,  there   are  just  a  lot  of  liYle  problems.”     –  Henry  Ford     •  Make  your  job  easier   •  Save  a  few  seconds   •  Improve  paDent  care  or  service   •  Improve  safety   •  Reduce  waiDng  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  22. Itera)ve  PDSA  Improvements   ImprovementsIdeas One  improvement  ofen  leads  to  another  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen    
  23. Improvements  for  NICU  Moms  (1)  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen    
  24. Improvements  for  NICU  Moms  (2)  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen    
  25. Improvements  for  NICU  Moms  (3)  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen    
  26. Kaizen:  Real,  Daily,  Visual   (Visual  Idea  Board)  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Children’s  Medical  Center  Dallas  (Lab)  
  27. Kaizen:  Real,  Daily,  Visual   (Electronic  -­‐  KaiNexus)  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  28. Completed  “Idea  Card”  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  29. Kaizen  on  Her  FIRST  Day  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen    
  30. Kaizen  “Wall  of  Fame”  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Children’s  Medical  Center  Dallas  (Lab)  
  31. Innova)on  &  Kaizen                        EHART  Blood  Pressure  Cuffs   Before After Taking time digging through the bucket on top Place a small strip of Velcro® brand hook and loop fasteners on the of the crash cart to try to find the correct size wall with different sizes of BP cuffs. Staff is able to quickly visualize blood pressure cuffs. This can be problematic the different sized cuff and get the proper size for the patient, and the during an EHART® when you want to get a blood pressure can be obtained quicker. blood pressure (BP) in a hurry so that you can get medications in the patients. The Effect Improved quality of care and faster response to the needs of the patient in an acute setting. Name Supervisor Date Savings Elizabeth Black Diana Brown, Manager 12-10-2008 Quality©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen    
  32. “Just  Do  Its”  &  Problem  Solving  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  33. Problems  &  Opportuni)es  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  34. What  Can  We  Do  as  Leaders?  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  35. ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  36. ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  37. What  Can  We  Do  as  Leaders?   •  Ask  for  Kaizen   –  Help  create  Dme   –  Don’t  stop  asking   •  Lead  by  example  –  parDcipate   –  Get  involved  –  coach,  mentor,  lead   –  Go  to  the  gemba   –  Teach  root  cause  problem  solving   –  Follow  the  PDSA  process   •  Recognize  and  celebrate  Kaizen  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  38. Asking  Every  Day   •  Are  there  any  problems   interfering  with  your   work?   •  With  paDent  care?   •  Have  you  had  any  ideas   for  improvement  lately?   •  Do  you  have  what  you   need  to  do  your  job?  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  39. Coaching  on  Idea  Cards  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen    
  40. Before  /  Amer  Data  from  CMC  Lab   Before Lean 12 Months After Starting Lean 3. I have the opportunity to do what I do best every day. 3.11 3.92 8. I feel free to make suggestions for improvement. 2.84 3.48 10. I feel secure in my job. 2.32 3.42 13. Stress at work is manageable. 2.43 3.23 17. I am satisfied with the lab as a place to work. 2.51 3.43 18. I would recommend my work area as a good place to work to others. 2.38 3.46 Grand Average 2.96 3.69©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  41. KaiNexus  Data  /  Charts  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Whitepaper:  hYp://    
  42. Franciscan  Par)cipa)on   %  People  Par)cipa)ng   60%   50%   40%   30%   56%   46%   20%   10%   0%   2011   Since  2007  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen    
  43. #  of  Recorded  Kaizens  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen    
  44. Franciscan  Savings  Impact  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen    
  45. Ideas  vs.  Sugges)ons   “  SuggesDons  are  things     I  think  you  should  do…            Ideas  are  things          that  I  can  do.”     -­‐  Norman  Bodek  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.    
  46. Q&A  /  Contact  Info   •  Email:   •  Blog:     •  Startup:   •  TwiTer:   •  Books:   –   –   •  ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.