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Matt Anderson, PMP, PMI-ACP
Director, Cerner Technology Services
Slow Down to Speed Up:
It’s All About Delivery
We’re hiring!
Big Data
C#
Java
Python
Ruby
Web
& more!
engineering.cerner.com
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
2
Tortoise and the Hare
• Aesop’s Fable
• Agile
• Agile processes promote sustainable development
• The sponsors, developers, and users should be able to maintain a
constant pace indefinitely
• Lean
• Create Continuous Process Flow to Bring Problems to the Surface
• Use Pull Systems to Avoid Overproduction
• Level Out the Workload
• Win the “Development Game” – Alistair Cockburn
• “Speed is not the objective, it is a means to an end; the objective is
making money” – Don Reinertsen
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
3
Utilization Versus Throughput
100% Road utilization
=> Terrible throughput
Car in Car out
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
4
Utilization Versus Throughput
Size
matters…
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
5
Start and Stop vs Flow
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
6
MODOT Flow Problem
• Springfield, MO
• 4-lane highway overpasses not able to handle the
volume of traffic
• Option 1
• Tear down existing and build a new 6 lane overpass
($10 M cost)
• Option 2
• Find a better way to achieve throughput with
existing structure
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
7
Double Cross-over Diamond (DCD) Exchange
• https://www.fhwa.dot.gov/publications/publicroads/10novdec/01.cfm - Cost $3.2M
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
8
DCD Improvements in Flow
• In comparison to conventional model
• Total delay
• 67% reduction per vehicle
• Total number of vehicle stops
• 50% reduction
• Time spent stopped
• 75% reduction
• Capacity
• 30% increase
• 4 lane DCD = 6 lane conventional
• Improved efficiency saves cost of construction of 2 lanes
• Able to refactor existing bridge infrastructure as opposed to rebuilding
• Safety
• 5 year comparative study
• DCD – 11 light injury accidents (no fatalities)
• Conventional – 23 fatal or severe injury accidents
• Vehicle speed
• Slower per vehicle (24 mph vs 34 mph)
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
9
Elimination of Conflicts
• Traditional
• 26 conflict points
• DCD
• 14 conflict points
• Conflicts =
Handovers in
software
development
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
10
Roundabouts
• Throughput
• Delays reduced by 89%
• Number of vehicles stopping by 56%
• Average 20% increase over 4 way stop
• Average 40% increase over stop light
• Safety
• More than 90% reduction in fatalities
• 76% reduction in injuries
• 35% reduction in all crashes
• Reduce conflict points from 32 to 8
• Fuel consumption reduced by 32%
• Speed reduced to 15-25 mph
• 5-10 mph slower than conventional
• Mythbusters study
• http://www.youtube.com/watch?v=OvoFjirrgYA
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
11
Queuing System:
items in queue &
items in service
Arrivals Departures
Simple System Dynamics
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
12
Queuing Theory
• Mathematical study of waiting in lines (or queues)
• Key Measures
• Lead Time
• Time from client request to client deployment – “arrival rate”
• Cycle Time
• Time from work started to when item is ready for delivery – “completion rate”
• Goal
• Fastest possible average time of delivery
• Not as concerned about a single item as with overall throughput
• Method
• Reduce Wait Times
• Largest contributor to slow cycle times
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
13
Little’s Law and Arrivals
L = λ W
Average number of
items in a system
Average wait time in the
system for an item
Average arrival rate• Assumptions:
• Stable system (stationary processes)
• Long Running Averages
• Consistent Units
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
14
Little’s Law Restated for Cycle Time
WIP / Throughput = Cycle Time
100 projects 10 projects/week 10 weeks
150 projects 10 projects/week 15 weeks
50 projects 10 projects/week 5 weeks
• Little’s Law
• Average Cycle Time = Average WIP / Average Throughput
• Ways to improve Cycle Time (aka System Performance)
• Increase Throughput
• Decrease WIP
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
15
Wait Time Based on Utilization – Low Variability
Wait time at 95% is 25x
greater than at 75%
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
16
Wait Time with Variability
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
17
Ways to Reduce Cycle Time
• Change the way work arrives
• Example: Lights at on-ramps to busy freeways
• Reduce Variability
• Change the way work is processed
• Example: High Occupancy/Carpool (HOV) Lanes, DCD
Intersections, Roundabouts
• Modify batch size to create a steady rate of service
• Theory of Constraints – Find and fix bottlenecks
• Do not fix other areas as it will not increase throughput and is
waste
• Eliminate Waste
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
18
Theory of Constraints – Smooth Flow
Team
Goal
Problem
Strategy
Adapted from Henrik Kniberg
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
19
Suboptimization
Specialist 2Specialist 1 Specialist 3
Specialist 2
Specialist 1
Specialist 3
January February March April May June July
6 months
3 months
Done!
Done!
We’re a lot faster!
I’m a bit
slower
We’re slow!
I’m fast!
Adapted from Henrik Kniberg
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
20
Kanban Core Principles
• Visualize the workflow
• Limit WIP (work in progress)
• Manage Flow
(measure and optimize)
• Make Process Policies
Explicit
• Implement Feedback Loops
• Improve Collaboratively
(using models)
To do Dev Release
H C
2
Test
35
Done!
3
D
G
K
A
B
FLOW
“Don’t build features that nobody needs right now. Don’t write more specs than you
can code. Don’t write more code than you can test. Don’t test more code than you
can deploy”
– Corey Ladas
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
21
0
5
10
15
20
25
30
35
Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14
To Do
Build
Test
Release
Done
Cumulative Flow Diagram
Cycle Time
Lead Time
WIP
Arrival Rate
Completion
Rate
RemainingWork
Backlog
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
22
Combining Scrum and Kanban Boards
• Use Kanban for end to end workflow
• Use Scrum for development team
Cards are Stories or Epics
Cards are Tasks
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
23
Economics of Fast Feedback
• Scenario: 2 digit lottery with $1.00 ticket price and $100 payout
• Options:
• Purchase both digits immediately for $1
• Purchase one digit for $.50 and only purchase second for $.50 if first matches
Pay $1
Pay out = $0
Pay out = $100
Expected net gain = $0
99%
1%
Pay $.50
Pay out = $0
Pay $.50
90%
10%
Pay out = $0
Pay out = $100
9%
1%
Expected net gain = $45
Spend $100 to get $100
Spend $55 to get $100
Adapted from Don Reinertsen
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
24
So now what???
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
25
Value Stream Mapping – Video Game
Draft
Concept
Pres.
Assign
Team
Graphics
Design
Sound
Design
Dev
Integr. &
Deploy
2d 1m
4h
6m
8
Game backlog
1w 6m 6m
15
Design-ready
games
12
Production-ready
games
1m 3w 3m
(1m+2m)
3w2h 1d
3 m value added time
25 m cycle time
= 12%
Process
cycle
efficiency
 Games out of date
 Missed market windows
 Demotivated teams
 Overhead costs
Adapted from Henrik Kniberg
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
26
Waste, Flow and Value
• Lean’s primary objective is commonly equated to
eliminating Waste
• The true end goal is to deliver Value
• Flow and Waste Elimination are tools to meet that goal
• Value trumps Flow
• We may interrupt overall flow to deliver faster on a specific high
value work item
• Expedite policies
• Class of Service policies
• Defect Management policies
• Flow trumps Waste Elimination
• There are times when we purposely introduce “waste” to
improve flow
• Buffers and Queues
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
27
How to Focus on Delivery
• Determine how your team delivers Value to the Client
• Tool: Value Stream Mapping
• Synchronize work with the entire delivery stream
• Tool: Value Stream Mapping and Kanban
• Determine your Team speed limit
• Avoid over commitment and high congestion
• Team assigned projects/capabilities, not individually assigned
• Tool: Kanban and WIP Limits
• Find the bottleneck(s)
• Ensure the bottleneck is never “starved”
• Tool: Kanban with a Buffer column before the bottleneck
• Tool: “Done” queues to show where work is stuck
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
28
How to Focus on Delivery
• Decompose all work to small batch sizes
• Tool: Epics, User Stories and Tasks
• Tool: Fast Feedback loops
• Slow Down to Speed Up
• Eliminate/Reduce stops and starts
• Avoid Suboptimization
• Tool: Agile Continuous Planning, Cross-Functional Training
• Make all work visible
• Tool: Kanban/Scrum boards
• Control the Input Queue
• Tool: Kanban, Keep teams together, Prioritization
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
29
How to Focus on Delivery
• Understand and plan for variability with each project
• Tool: Definition of Done in Kanban columns
• Tool: Scatterplots and Monte Carlo Simulations
• Measure and Optimize Flow
• Tool: Cumulative Flow Diagrams
• Tool: Create Service Level Agreements (SLAs)
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
30
Q&A
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
31
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KCDC 2015 Slow Down to Speed Up

  • 1. Matt Anderson, PMP, PMI-ACP Director, Cerner Technology Services Slow Down to Speed Up: It’s All About Delivery
  • 3. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 2 Tortoise and the Hare • Aesop’s Fable • Agile • Agile processes promote sustainable development • The sponsors, developers, and users should be able to maintain a constant pace indefinitely • Lean • Create Continuous Process Flow to Bring Problems to the Surface • Use Pull Systems to Avoid Overproduction • Level Out the Workload • Win the “Development Game” – Alistair Cockburn • “Speed is not the objective, it is a means to an end; the objective is making money” – Don Reinertsen
  • 4. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 3 Utilization Versus Throughput 100% Road utilization => Terrible throughput Car in Car out
  • 5. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 4 Utilization Versus Throughput Size matters…
  • 6. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 5 Start and Stop vs Flow
  • 7. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 6 MODOT Flow Problem • Springfield, MO • 4-lane highway overpasses not able to handle the volume of traffic • Option 1 • Tear down existing and build a new 6 lane overpass ($10 M cost) • Option 2 • Find a better way to achieve throughput with existing structure
  • 8. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 7 Double Cross-over Diamond (DCD) Exchange • https://www.fhwa.dot.gov/publications/publicroads/10novdec/01.cfm - Cost $3.2M
  • 9. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 8 DCD Improvements in Flow • In comparison to conventional model • Total delay • 67% reduction per vehicle • Total number of vehicle stops • 50% reduction • Time spent stopped • 75% reduction • Capacity • 30% increase • 4 lane DCD = 6 lane conventional • Improved efficiency saves cost of construction of 2 lanes • Able to refactor existing bridge infrastructure as opposed to rebuilding • Safety • 5 year comparative study • DCD – 11 light injury accidents (no fatalities) • Conventional – 23 fatal or severe injury accidents • Vehicle speed • Slower per vehicle (24 mph vs 34 mph)
  • 10. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 9 Elimination of Conflicts • Traditional • 26 conflict points • DCD • 14 conflict points • Conflicts = Handovers in software development
  • 11. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 10 Roundabouts • Throughput • Delays reduced by 89% • Number of vehicles stopping by 56% • Average 20% increase over 4 way stop • Average 40% increase over stop light • Safety • More than 90% reduction in fatalities • 76% reduction in injuries • 35% reduction in all crashes • Reduce conflict points from 32 to 8 • Fuel consumption reduced by 32% • Speed reduced to 15-25 mph • 5-10 mph slower than conventional • Mythbusters study • http://www.youtube.com/watch?v=OvoFjirrgYA
  • 12. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 11 Queuing System: items in queue & items in service Arrivals Departures Simple System Dynamics
  • 13. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 12 Queuing Theory • Mathematical study of waiting in lines (or queues) • Key Measures • Lead Time • Time from client request to client deployment – “arrival rate” • Cycle Time • Time from work started to when item is ready for delivery – “completion rate” • Goal • Fastest possible average time of delivery • Not as concerned about a single item as with overall throughput • Method • Reduce Wait Times • Largest contributor to slow cycle times
  • 14. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 13 Little’s Law and Arrivals L = λ W Average number of items in a system Average wait time in the system for an item Average arrival rate• Assumptions: • Stable system (stationary processes) • Long Running Averages • Consistent Units
  • 15. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 14 Little’s Law Restated for Cycle Time WIP / Throughput = Cycle Time 100 projects 10 projects/week 10 weeks 150 projects 10 projects/week 15 weeks 50 projects 10 projects/week 5 weeks • Little’s Law • Average Cycle Time = Average WIP / Average Throughput • Ways to improve Cycle Time (aka System Performance) • Increase Throughput • Decrease WIP
  • 16. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 15 Wait Time Based on Utilization – Low Variability Wait time at 95% is 25x greater than at 75%
  • 17. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 16 Wait Time with Variability
  • 18. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 17 Ways to Reduce Cycle Time • Change the way work arrives • Example: Lights at on-ramps to busy freeways • Reduce Variability • Change the way work is processed • Example: High Occupancy/Carpool (HOV) Lanes, DCD Intersections, Roundabouts • Modify batch size to create a steady rate of service • Theory of Constraints – Find and fix bottlenecks • Do not fix other areas as it will not increase throughput and is waste • Eliminate Waste
  • 19. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 18 Theory of Constraints – Smooth Flow Team Goal Problem Strategy Adapted from Henrik Kniberg
  • 20. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 19 Suboptimization Specialist 2Specialist 1 Specialist 3 Specialist 2 Specialist 1 Specialist 3 January February March April May June July 6 months 3 months Done! Done! We’re a lot faster! I’m a bit slower We’re slow! I’m fast! Adapted from Henrik Kniberg
  • 21. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 20 Kanban Core Principles • Visualize the workflow • Limit WIP (work in progress) • Manage Flow (measure and optimize) • Make Process Policies Explicit • Implement Feedback Loops • Improve Collaboratively (using models) To do Dev Release H C 2 Test 35 Done! 3 D G K A B FLOW “Don’t build features that nobody needs right now. Don’t write more specs than you can code. Don’t write more code than you can test. Don’t test more code than you can deploy” – Corey Ladas
  • 22. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 21 0 5 10 15 20 25 30 35 Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 To Do Build Test Release Done Cumulative Flow Diagram Cycle Time Lead Time WIP Arrival Rate Completion Rate RemainingWork Backlog
  • 23. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 22 Combining Scrum and Kanban Boards • Use Kanban for end to end workflow • Use Scrum for development team Cards are Stories or Epics Cards are Tasks
  • 24. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 23 Economics of Fast Feedback • Scenario: 2 digit lottery with $1.00 ticket price and $100 payout • Options: • Purchase both digits immediately for $1 • Purchase one digit for $.50 and only purchase second for $.50 if first matches Pay $1 Pay out = $0 Pay out = $100 Expected net gain = $0 99% 1% Pay $.50 Pay out = $0 Pay $.50 90% 10% Pay out = $0 Pay out = $100 9% 1% Expected net gain = $45 Spend $100 to get $100 Spend $55 to get $100 Adapted from Don Reinertsen
  • 25. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 24 So now what???
  • 26. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 25 Value Stream Mapping – Video Game Draft Concept Pres. Assign Team Graphics Design Sound Design Dev Integr. & Deploy 2d 1m 4h 6m 8 Game backlog 1w 6m 6m 15 Design-ready games 12 Production-ready games 1m 3w 3m (1m+2m) 3w2h 1d 3 m value added time 25 m cycle time = 12% Process cycle efficiency  Games out of date  Missed market windows  Demotivated teams  Overhead costs Adapted from Henrik Kniberg
  • 27. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 26 Waste, Flow and Value • Lean’s primary objective is commonly equated to eliminating Waste • The true end goal is to deliver Value • Flow and Waste Elimination are tools to meet that goal • Value trumps Flow • We may interrupt overall flow to deliver faster on a specific high value work item • Expedite policies • Class of Service policies • Defect Management policies • Flow trumps Waste Elimination • There are times when we purposely introduce “waste” to improve flow • Buffers and Queues
  • 28. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 27 How to Focus on Delivery • Determine how your team delivers Value to the Client • Tool: Value Stream Mapping • Synchronize work with the entire delivery stream • Tool: Value Stream Mapping and Kanban • Determine your Team speed limit • Avoid over commitment and high congestion • Team assigned projects/capabilities, not individually assigned • Tool: Kanban and WIP Limits • Find the bottleneck(s) • Ensure the bottleneck is never “starved” • Tool: Kanban with a Buffer column before the bottleneck • Tool: “Done” queues to show where work is stuck
  • 29. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 28 How to Focus on Delivery • Decompose all work to small batch sizes • Tool: Epics, User Stories and Tasks • Tool: Fast Feedback loops • Slow Down to Speed Up • Eliminate/Reduce stops and starts • Avoid Suboptimization • Tool: Agile Continuous Planning, Cross-Functional Training • Make all work visible • Tool: Kanban/Scrum boards • Control the Input Queue • Tool: Kanban, Keep teams together, Prioritization
  • 30. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 29 How to Focus on Delivery • Understand and plan for variability with each project • Tool: Definition of Done in Kanban columns • Tool: Scatterplots and Monte Carlo Simulations • Measure and Optimize Flow • Tool: Cumulative Flow Diagrams • Tool: Create Service Level Agreements (SLAs)
  • 31. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 30 Q&A
  • 32. BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner 31 Titanium Sponsors Platinum Sponsors Gold Sponsors

Editor's Notes

  1. Cerner is a gold sponsor at KCDC this year. We won’t know our location of our booth until Wednesday evening, June 25. Attendees can stop by our booth for stickers, t-shirts, and more.
  2. Excellent for quick, back of the envelope calculations. If you know 2 then you can calculate the third.
  3. 1/15/15 – Moved from later in the class as a supplement to the flow point. (cerctr) --- Theory of Constraints – typically we put stuff into the pipe at the rate of my intake area. This will immediately log jam and put pressure on other parts of the system. Everyone’s 100% at capacity except fof the folks that live beyond the bottleneck, who are potentially under utilized. So, go fix the bottleneck via the way work is processed or change the way work arrives (see prior slide). This will open up the bottleneck, so that you can go focus on the next biggest bottleneck. Continue this process until you have a level flow through the process. Adding resources earlier doesn’t help. Options are to Change way work arrives or Fix bottleneck Cerner Bottleneck: IP is big enough. Client can’t take them fast enough.
  4. Similar to AMS – SWx – IP More done in parallel vs. sequential. May slow you down (personally) to speed up the team overall (me vs. we) It’s called “slow you down to speed you up”. Slowing you down personally to speed up the group as whole. Difficult to accept because people think of “me”
  5. Dev takes 3m although only 1m of man hours