Lean Psychology: Leveraging Human Nature to Achieve Optimal Improvement

Lean Psychology: Leveraging Human Nature to Achievee e ag g u a atu e to c e e Optimal Improvement Company LOGO

Learning Objectives Participants will learn:  How psychology affects the entire improvement process, from strategy to execution.  What you can do to ensure both short- and long- term success. H t t th b i d l h How to meet the basic needs people have through the improvement process. Specific tactics that leverage human nature to Specific tactics that leverage human nature to achieve optimal business performance. © 2011 Karen Martin & Associates 2

Your Instructor  Early career as a scientist; migrated to quality & operations design in the mid 80’squality & operations design in the mid-80 s.  Launched Karen Martin & Associates in 1993.  Introduced to Lean in 2000.  Specialize in applying Lean in non- f i imanufacturing environments.  Co-author of The Kaizen Event Planner; co-developer of Metrics-Based Processco developer of Metrics Based Process Mapping: An Excel-Based Solution.  Instructor in University of California, San Karen Martin Principal, Karen Martin & Associates © 2011 Karen Martin & Associates Diego’s Lean Enterprise program. 3

Why Lean Psychology? Long term interest in human behavior. Avid practitioner of hansei (reflection) – began to notice trends and patterns. Success in changing my own paradigms and approach.pp Growing concern that Lean isn’t being properly appliedproperly applied. © 2011 Karen Martin & Associates

The Win-Win A well-executed improvement approach not only serves the customer and generates significant return for the organization, it also meets the psychological needs of individuals, creating a highly motivated workforce. © 2011 Karen Martin & Associates 5

Maslow’s Hierarchy of Needs

Typical Work Needs  To belong  To be needed  To understand  To see progress  To learn  To create  To be adequately compensated To create  To contribute  T b h d co pe sated  To work in a pleasant environment To be heard  To be recognized environment  To be safe Ph i ll  To be competent  Physically  Emotionally (treated well) 10 To Succeed

When needs aren’t met… Apathy Turnover / absenteeism Obstacle creation (overt and/or covert)Obstacle creation (overt and/or covert) Lawsuits S b tSabotage © 2011 Karen Martin & Associates 11

Components for Effective Change EffectiveEffective ChangeChange VisionVision SkillsSkills IncentivesIncentives ResourcesResources Action PlanAction Plan ConfusionConfusionSkillsSkills IncentivesIncentives ResourcesResources Action PlanAction Plan AnxietyAnxiety GradualGradual VisionVision IncentivesIncentives ResourcesResources Action PlanAction Plan GradualGradual ChangeChange FrustrationFrustration VisionVision SkillsSkills ResourcesResources Action PlanAction Plan VisionVision SkillsSkills IncentivesIncentives Action PlanAction Plan FrustrationFrustration False StartsFalse StartsVisionVision SkillsSkills IncentivesIncentives ResourcesResources s os o SkillsSkills IncentivesIncentives ct o act o a © 2003, Enterprise Mgmt Ltd.

Resistance toResistance to Changeg © 2011 Karen Martin & Associates

Why people resist change Poor understanding Cynicism & skepticism (low trust / faith) Low involvement Change fatigue Lack of consensusLack of consensus Fear © 2011 Karen Martin & Associates 14

Reducing Resistance – Improve Understanding Clear strategy – established by leadership  Hoshin kanri  Value stream maps Customer Demand: 15patients perDay (Takt Time1920seconds) 8 hours per day Referring Physician % C&A = 65 % Hospital Schedule Appointment Cycle Time = 11 mins. Lead Time = 12 mins. % C&A = 98 % 6 Pre-register Patient Cycle Time = 30 mins. Lead Time = 990 mins. % C&A = 100 % 5 Lead Time = 12 mins.Lead Time = 990 mins.Lead Time = 24 days 1 23 4 CT=Cycle Time LT=Lead Time %C&A=% Complete & Accurate E Pay Excel ADSSymposium Internet Waiting Room Management System Fax Order Solutions PACSMeditech Auto Fax 50% Us Mail 25% MD Mailbox 25% Rework Loop via Fax 25% of the time Check-in Patient (Admitting) Cycle Time = 2 mins. % C&A = 90 % 5 Send Reports (Imaging) Cycle Time = 3 mins. % C&A = 90 % 6 5 mins. 0.0833 hrs. 2 mins. 0.0833 hrs. 1 mins. 0.75 hrs. 10 mins. 0.5 hrs. 15 mins. 0.0833 hrs. 3 mins. 4.13 hrs. 15 mins. 6.08 hrs. 5 mins. 16 hrs. 1 mins. 1.83 hrs. 1 mins. 2 hrs. 3 mins. LT = 32.5 hrs. CT = 56 mins. CT/LT Ratio = 2.87% Prep Patient (Tech) Cycle Time = 10 mins. % C&A = 100 % 2 Check-in Patient (Imaging) Cycle Time = 1 mins. % C&A = 98 % 3 Complete Exam (Tech) Cycle Time = 15 mins. % C&A = 90 % 2 Transmit Images (Tech) Cycle Time = 3 mins. % C&A = 100 % 2 Read/Dictate Exam (Radiologist) Cycle Time = 15 mins. % C&A = 95 % 2 Transcribe Report (MDI) Cycle Time = 5 mins. % C&A = 75 % 6 Review Draft/Sign (Radiologist) Cycle Time = 1 mins. % C&A = 95 % 2 Print Reports (Imaging) Cycle Time = 1 mins. % C&A = 99 % 2 30 mins. 5 mins. 248 mins. 365 mins. 960 mins. 110 mins. 120 mins.45 mins.5 mins.5 6 7 8 9 10 11 12 13 14 Rolled First Pass i ld 29% © 2011 Karen Martin & Associates 15 yield = 29%

Reducing Resistance – Improve Understanding Clear communication  Why is improvement needed?  Establish a sense of urgency  Data sells!  What’s our strategy?  What do you expect from us?  How will you support us? You may need to coach your leadership team. © 2011 Karen Martin & Associates 16

Pick your Crisis Shrinking margins Regulatory pressure / li iCustomer dissatisfaction Shrinking market share compliance issues Rising litigation Rising costs Rising competition Social, economic, environmental, or political pressures Desire to absorb growth without adding typical political pressures Downward performance trendscommensurate staffing Impending acquisition performance trends (in speed and/or quality) © 2011 Karen Martin & Associates Staff burnout q y)

V l St M i Ch t Reducing Resistance – Improve Understanding Clearly Communicate via Charters Value Stream Mapping Charter Event Scope Leadership / Coordination Schedule Value Stream Recruiting, Hiring, & Onboarding Process Executive Sponsor Sherrye Hutcherson Event Date(s)Oct 27, 28 & 29, 2009 Specific ConditionsExternal hires Value Stream Champion N/A Start/End Times Oct 27, 28 8:00 am - 4:30 pm Oct 29 7:30 am - 2:00 pm Customer Demand 100 per year Facilitator Karen Martin Location9 West SeminarFacilitator Karen Martin Location9 West Seminar Trigger Vacancy First Step Hiring manager completes VPA Team Lead N/A Meals Provided? Lunch, morning & afternoon snacksLast Step Employee completes NEI Boundaries & Limitations N/A Coordinator Andrew Peacock Interim Briefing(s) Oct 27 & 28 3:30-4:30 pm Oct 29 1-2 pm Improvement Timeframe Future state will be fully implemented by 2/15/2009 Briefing Attendees Tim Burke, Sherrye H and other Division ManagersTimeframe AttendeesDivision Managers Event Drivers Mapping Team 1 Cumbersome process as perceived by the customer. Function Name Contact Information 2 Need to free capacity and operate more effectively. 1Staffing Paula Pittman 3 2FCS HR Patty Yager 4 3Talent Management Tad Leeper 5 4HRIS Chris Ritz Measureable Objectives 5HR Compliance Carl Olsen 1 Reduce LT from req to offer acceptance from 45-55 days to 30 days. 6Comp & Benefits Nyla Cork 2 7Recruiting Sheila Love 3 8Diversity / Affirmative Action Joyce Cooper 4 9Hiring Manager, Call Ctr Deb Emerson 5 10Hiring Manager, Production Ops Planned Deliverables On-Call Support 1 Current State VSM Function Name Contact Information 2 Future State VSM 1IT Gary Van Osdel 3 Implementation Plan 2Fort Calhoun - Security Herb Childs 4 3 5 4 Potential Obstacles Approvals 1 Executive Sponsor Value Stream Champion Facilitator 2 3 Signature: Signature: Signature: 4 Date: Date: Date: 19

Reducing Resistance – Improve Understanding Waste is at the root of most workplace frustration d i t l d i t d t t l fli tand interpersonal and interdepartmental conflict. Use this reality to sell the need for improvement. “Think about the last time you left work feeling © 2011 Karen Martin & Associates y g frustrated? What was the real reason?” 20

Psychology 101 People resist change unless you address “WIIFM.” If change isn’t viewed as a personal improvement for the worker it’s unlikely to © 2011 Karen Martin & Associates be embraced and sustained. 21

Reducing Resistance – Improve Understanding The entire workforce must eventually be exposed to L i i l d t l d d t d h thiLean principles and tools, and understand why this approach is different. M d iMy advice:  Provide as much upfront training and exposure as possiblepossible.  Include a simulation – let them experience a transformation.  Provide leadership overviews that include discussions about their roles and responsibilities, and key success factors Help them gain alignment © 2011 Karen Martin & Associates factors. Help them gain alignment. 22

“Going to the gemba” heightens awareness and creates understandingg

Cynicism & Skepticism Goes with the Terroritory “How many improvement approaches have been attempted here over the past 10-20 years?” “Is the work environment fundamentally more pleasant than it was 10-20 yearsp y ago?”  Lower stress  More teamwork and comraderie  Greater fulfillment © 2011 Karen Martin & Associates  Greater fulfillment 25

Tactics for Dealing with Cynicism & Skepticism Don’t expect people to check it at the door. Draw it out – invite them to admit it. Ask them to “get in the car one more time and come along for a ride.” Acknowledge that the “proof’s in the pudding.” Make sure all changes are improvements and not merely changes. f ’ ’ If it doesn’t improve the worker’s ability to be successful, it’s merely change. © 2011 Karen Martin & Associates 26

Reducing Resistance – Invite / Require Involvement from All Stakeholders The workers know best! All i t t b hi hl f ti lAll improvement must be highly cross-functional. Cross-functional problem-solving builds a sense of b l i id th t it t b tibelonging, provides the opportunity to be creative, and generates a feeling of accomplishment. © 2011 Karen Martin & Associates 28

Maslow’s Hierarchy of Needs Aided by cross-functional improvement activities

Improvement Roles Who? Accountability ToolWho? Accountability Tool Senior What has to Value Stream rategic Leadership happen Mapping Middle Management Str Frontline Workers How it will happen Just-do-its Kaizen Events P j t Management actical Projects Ta © 2011 Karen Martin & Associates

Improvement Roles and Responsibilities Leadership – set strategy (what needs to happen) Frontline workers – determine tactics (how( it will happen) Improvement professionals – CoachImprovement professionals Coach, Teacher, Facilitator. Not Toyota like: “Getting your employeesNot Toyota-like: Getting your employees to buy into the change that you want to implement to improve the operation ” © 2011 Karen Martin & Associates implement to improve the operation. 31

Why people resist change Poor understanding Cynicism & skepticism (low trust/faith) Low involvement Change fatigue Lack of consensusLack of consensus Fear © 2011 Karen Martin & Associates 32

It’s a marathon, not a sprint Help leadership develop realistic expectations regarding results and the resources needed to getregarding results and the resources needed to get there.  “How long has this been a problem? It may not get How long has this been a problem? It may not get solved overnight.” Allow “absorption time”; schedule regular hanseip g sessions. Pacing is key - avoid “organizational implosion” by attempting too much too fast. Check in with the customer (workforce) frequently © 2011 Karen Martin & Associates and adjust accordingly. 34

Consensus-Building Tactics Alignment around strategy. Improvement is well-defined and well- communicated. Cross-functional teams. Upfront and periodic input from teamUpfront and periodic input from team member’s peer groups. R i d t ti t id th tReview and testing outside the team. Interim briefings between teams and © 2011 Karen Martin & Associates leadership. 36

Interim Briefings Periodic updates  Discoveries  Direction team is taking – process check Minimize the surprises; get buy-in as the team moves along; reduces rework by theg; y team Venue for challenging policiesVenue for challenging policies © 2011 Karen Martin & Associates

Types of Fear & Countermeasures Fear Countermeasure Job loss • “No one will lose a paycheck due to improvement ”improvement. • “Your job may change but your paycheck is assured.” • Job loss only due: to 1) poor f 2) k t d tperformance, 2) market downturns. Incompetence • Training, training, training • Confidence leads to competence Loss of control (leadership) • Adequate workforce skill development. • Help them see how freed time will enable them to be more effective leadersleaders. Improvement won’t be adequately resourced (workforce) • Leadership commitment Chaos sustainability permanence • Pilots; experiments 39 Chaos, sustainability, permanence, failure • Pilots; experiments • Monitoring • Continuous improvement

Creating New Experiences Scientific method (PDCA) Leadership setting clear strategy via hoshin kanri and value stream maps. Leadership staying out of the weeds – frontline workforce designs and implements tactical solutionssolutions. Cross-functional collaboration. D di t d ti f ki i tDedicated time for making improvements. Rapid, consensus-driven improvement. R l t ti iti ff ti t i i © 2011 Karen Martin & Associates Relevant, time-sensitive, effective training. 42

Observation #1 If it’s too hard to do, we will delay or avoid doing it  Builds up work-in-process  Prolongs lead times Aim for work simplification –p make it easy to be successful, difficult to fail., © 2011 Karen Martin & Associates 46

Observation #2 The more you create ay “safe haven” for people to tell thep p truth and share their feelings, the fasterg the improvement, the greater the results,g and the deeper the organizational healing. © 2011 Karen Martin & Associates g g

Observation #4 Most inspection (reviews, approvals, audits, t ) i d d i l k f t t fetc.) is grounded in lack of trust or fear.  Low faith in process reliability  Low confidence in people performing the work  Fear of losing control  High “need to know”  Risk aversion  Fear re: outcome © 2011 Karen Martin & Associates 49

Observation #5 People want to perform well Most people will do h t it t k twhatever it takes to get their jobs done, hi hwhich may cause them to:  Ignore policies and procedures I l i Ignore regulations  Cut corners © 2011 Karen Martin & Associates 50 The right process will produce the right results.

Observation #6 Poorly designed processes are typically behind interpersonal and interdepartmental tension – not personalities. Poorly designed processes are behind poor © 2011 Karen Martin & Associates process performance.

Observation #7 – Words Matter Words greatly impact “group think” and i di id l h lindividual psychology.  Help staff transform their thinking and speech f “N b ” t “Y if ”from “No, because…” to “Yes, if…”  Sensitize people about the word “can’t”: / “ ” Disempowers / creates “victim thinking”  Closes off possibilities  Stifles innovation and creativity Stifles innovation and creativity  They (and possibly you) will need to break habits © 2011 Karen Martin & Associates habits.

In Summary If used properly, Lean principles and tools are 100% grounded in leveraging human nature to achieve:  high functioning organizations  that perform optimally, and  that everyone wants to work for  and do business with. © 2011 Karen Martin & Associates 53

What can you do to become a better psychologist? Reflect Be fully present  Listen deeply – use every sense  Observe ExperimentExperiment Be an active learner Read Read  Take classes I l d h l i k di i © 2011 Karen Martin & Associates  Include psychology in work discussions 54

Learning Objectives Participants will learn:  How psychology affects the entire improvement process, from strategy to execution.  What you can do to ensure both short- and long- term success. H t t th b i d l h How to meet the basic needs people have through the improvement process. Specific tactics that leverage human nature to Specific tactics that leverage human nature to achieve optimal business performance. © 2011 Karen Martin & Associates 55

Lean Resources The Toyota Way, Jeffrey Liker Lean Thinking, Jim Womack Lean Hospitals, Mark Grabanp , The Kaizen Event Planner, Karen Martin & Mike OsterlingMike Osterling © 2011 Karen Martin & Associates 56

For Further Questions 7770 Regents Road #635 San Diego, CA 92122 858 677 6799858.677.6799 ksm@ksmartin.com Free monthl ne sletterFree monthly newsletter: www.ksmartin.com/subscribe Learn / Connect : 58

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