Ppj webinar final_download

Getting to Everyday Improvement:
How to Connect the Science and
Culture of Problem Solving
February 14, 2013
Judy Worth
Beau Keyte
© 2013 LTG, LLC. All rights reserved.

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Today’s Presenter

Judy Worth
• Faculty, Lean Enterprise Institute
• Partner Lean Transformations Group; focus:
• Organizational development & instructional
design
• Co-facilitated value-stream improvement
efforts in healthcare & other organizations
• Began lean journey as instructional designer
on Mapping to See (LEI)
• Coauthor with Tom Shuker, Beau Keyte, et al,
of Perfecting Patient Journeys

Today’s Presenter
Beau Keyte
• Faculty, Lean Enterprise Institute
• Partner, Lean Transformations Group;
focus:
• Work & management processes
• Began lean journey in automotive; now
healthcare & admin
• Coauthor Mapping to See & Shingo-Award
winning book The Complete Lean Enterprise
• Coauthor with Judy Worth, Tom Shuker, et
al, of Perfecting Patient Journeys


On Sale Now … LEI’s Latest Book

Perfecting Patient Journeys
Improving patient safety, quality, and
satisfaction while building problem-
solving skills

By Judy Worth, Tom Shuker, Beau
Keyte, Karl Ohaus, Jim Luckman,
David Verble, Kirk Paluska, and Todd
Nickel

Download forms and excerpts at
lean.org/Store

Training

Take a deeper dive into this methodology for whole value-
stream improvement

• Register for the full-day workshop - From Fire Fighting to
Continuous Improvement: Sharpening PDCA Problem-
Solving Skills

 March 12, Lean Transformation Summit, Orlando
(March 13-14)

 June 4, Lean Healthcare Transformation Summit,
Orlando (June 5-6)


Typical Default Positions In
Problem Solving
• Blanket solutions & best practices
• Boss/subordinate interactions: Directive
solutions
• “A Team”
• Expert problem solvers


Why Don’t Problems Get/Stay
Solved?
• We assume:
– we know what the problem is without seeing what is
actually happening
– we know how to fix a problem without finding out
what is causing it
– we know what is causing the problem without
confirming it
– the problem has only one cause


Solved?
• We don’t engage the people closest to the work
in solving the problem
• We lack a common methodology for solving
problems
• We don’t develop management systems to
sustain the improvements


How Do We Improve
Continuous Improvement?

GTS

ACT PLAN
GRASP
THE
SITUATION

CHECK DO


Connecting the Technical
and Social Sides
• The gap we would like to discuss today:
– Traditional approaches to problem definition
– Solution-based improvements
– Minimal front line ownership
– Minimal management system linkage


The Technical Side:
Small Reversible Experiments
• Systemic scientific thinking and acting
– Within the process
– Within the management of the process
– Quick cycles of learning
• Focus on learning, not implementing solutions


Why Small and Why Reversible?

• Frame proposed solutions as hypotheses about
cause and experiments as tests of proof
• Prevent blanket solutions
• Prevent solutions that don’t link to causes
• Encourage investigation of root cause(s)
• Remind us that big problems have multiple
causes


Plan-Do-Check-Adjust Cycle of
Problem Solving & Implementation

GTS

ACT PLAN
GRASP
THE A P
SITUATION C D
A P
C D
CHECK DO A P
C D
A P
C D
A P
A P C D
A P C D
C D

Running Small
Reversible
Experiments


Running an Experiment Means:

• Developing a THEORY about what you expect to
happen… (GRASP THE SITUATION)
• Developing a way to TEST your theory… (PLAN)
• Running the test and OBSERVE the results…
(DO)
• ANALYZ(ing) the results… (CHECK)
• CONFIRMing (or REJECT) your theory… (ACT)


To Plan Your Own Experiment,
Remember:
Who? What? When? Where? How?
• Who is going to try out the change?
• What specifically are they going to do?
• When are they to do it? What day? What time of day?
How many times?
• Where are they going to do it?
• How will you know that whether the change(s) worked
(solved or improved the problem)?


Running the Experiment: Some Tips

• Before you run the experiment, do a dry run and adjust
• Develop an elevator speech and inform everyone who
needs to know.
• Run the experiment.
• Interview the participants and get their feedback.
• Review participant feedback and observer data and
decide what happens next.
• Write a summary of your results and share with
participants in the experiment and/or key stakeholders.


Questions?

Reflections?


Solved?
• We assume….
• We don’t engage the people closest to the work in
solving the problem
• We lack a common methodology for solving problems
• We don’t develop management systems to sustain the
improvements


The Social Side: Engaging the
Organization in Thinking
• Socialization is a cycle of communication,
modification, and consensus building.
– each stakeholder an opportunity to hear, think, and
respond
– the “real” reality and context become apparent


What Do You Need to Socialize?

• The need for change
• The problems to address and who is principally
involved
• The role of others
• Information on the problem and gap . . .


What Do You Need to Socialize…?

• Ideas generated within the problem-solving
process
• Ideas and plans for experiments
• Results of experiments and thoughts for new
processes
• Just about everything in the change process!!


Why Do You Need to Socialize?

• Engage the organization in problem solving
• Confirm assumptions and data
• Discover other views of reality
• Uncover hidden risks (technical or social) for
different ideas
• Learn more, “adjust” our thinking to the
problem


Before You Socialize,
You Need to Agree on…
• Who needs to:
– Agree (Authorize/Allow)
– Accept/Support/Contribute
– Know about
• What to Share
• How to Connect & Share—formal and informal
• Roles
• Timing


What’s Your Change Story…

2) Why? – Business need or purpose
1) What? – Conditions need to be changed
3) How? – Your idea but leave open for
discussion
4) Why this How?


Socialization Methods:
Formal and Informal
• Agenda items for regularly scheduled meetings
• Huddles (for shifts AND for problem solving)
• Key person assignments
• Food and fun
• Visual tools


Socialization:
Be Sure You Close the Loop


What Difference Does ALL This Make…
for Healthcare?
• Reduced average length of stay (LOS) in a large emergency
department by 30% and LWOBS BY 60%; increased
independently gathered customer (patient) satisfaction scores
by 73%
• Reduced Operating Room changeover time, which increased
the number of surgical procedures performed by 20%,
• Reduced annual staff turnover from 30% to >1%
• Reduced in inpatient admissions for diabetic patients by 92%
and physician interruptions by 90%; eliminated routine
overtime, improved patient satisfaction by 40%
• Reduced LOS by 30% and LWOBS by 50%; increased patient
satisfaction scores by 63% and produced
widespread improvement in teamwork

for Office and Service?
• 400% productivity increase in back office financial
services processing
• Improved Call Center quality by 19%, reduced operator
hold time by 11%
• Reduced defects in external
financial reporting by 95%
• Reduced emergency credit card
replacement cycle time by 50%;
increased customer satisfaction
by 20%


for Manufacturing?
• $1.5 billion in annual savings in value streams outside
plant facilities
• 50% reduction in product development lead time
• 30% increase in engineering
capacity
• 60% improvement in customer
satisfaction


Keep Learning After the Webinar

Book: Perfecting Patient Journeys (hardcover, 161 pages)
 Download forms, templates, excerpts
On sale now lean.org/ppj

Workshop: “From Fire Fighting to Continuous
Improvement: Sharpening PDCA Problem-Solving Skills”
 March 12, Lean Transformation Summit, Orlando
(March 13-14)
 June 4, Lean Healthcare Transformation Summit,
Orlando (June 5-6)


Discover What LEI Has for You
• Visit lean.org
• Follow LEI on LinkedIn, Twitter, Facebook, YouTube,
Google+
• Subscribe to our weekly newsletter

Contact us:
• info@lean.org
• 617-871-2900


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