How to Manage Your Improvement Metrics More Efficiently and Effectively

1. How to Manage Your Improvement Metrics More Efficiently and Effectively @MarkGraban (Presenter) VP of Improvement & Innovation Services Mark@KaiNexus.com @Jeff_Roussel (Host) VP of Sales Jeff.Roussel@KaiNexus.com

2. Agenda & Logistics • Presentation (45 minutes) • Q&A (10 minutes) – Use the GoToWebinar Meeting Panel to submit a question at any time • Recording link & slides will be sent via email – Also – see the “Handouts” feature and Chat box

3. About Mark Graban • 20+ years practicing Lean – 10 years in manufacturing – 11+ years in healthcare • Books: – Lean Hospitals – Healthcare Kaizen (co-author Joe Swartz) • www.MarkGraban.com New 3rd Edition!

4. Why Measure?

5. Are We Improving?

6. My Most Favorite Book Ever http://www.spcpress.com/ http://amzn.to/2jJ4fiN Donald J. Wheeler, PhD

8. Daily Lean Management

9. Source: Thinking Lean at ThedaCare (DVD)

10. How Are We Doing Compared to Our Goal?

11. "Bowling Chart"

13. Can We Tell From This?

14. A Better Dashboard Limited information you need to make decisions

15. Easier to Tell From This? 400 450 500 550 600 650 Aug-05 Sep-05 Oct-05 Nov-05 Dec-05 Jan-06 Feb-06 Mar-06 Apr-06 May-06 Jun-06 Jul-06 Aug-06 Total Cases

16. In KaiNexus…

18. Need to Avoid Bad Conclusions “The average patient satisfaction increased from 87.2 to 89%” 86% 87% 88% 89% 90% Before After

19. Need to Avoid Bad Conclusions “The average patient satisfaction increased from 87.2 to 89%” 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Before After

20. Need to Avoid Bad Conclusions “The average patient satisfaction increased from 87.2 to 89%”

21. Need to Avoid Bad Conclusions “The average patient satisfaction DECREASED from 87.2 to 85%”??

22. Are We Improving? 76 78 80 82 84 86 88 90 92 Patient Satisfaction (Different Data Set)

23. Linear Trendlines are Easy

24. Can Linear Trends Be Misleading? 76 78 80 82 84 86 88 90 92 Patient Satisfaction

25. Same Chart Different Timeframe 78 80 82 84 86 88 90 92 Patient Satisfaction

27. How Can We Tell?

28. How Should We React?

29. 0 10 20 30 40 50 60 3/1/07 3/2/07 3/3/07 3/4/07 3/5/07 3/6/07 3/7/07 3/8/07 3/9/07 3/10/07 3/11/07 3/12/07 Responding to Daily Changes KB GOAL Daily Production Average Praise Team PT PT Are we helping? Is this process stable? KB Kick Butt

30. Isn’t it always the system? It’s (almost) always the system.

31. Signal vs. Noise? "While every data set contains noise, some data sets may contain signals. Therefore, before you can detect a signal within any given data set, you must first filter out the noise.

32. “X” Control Chart (Chart for Individual Values) Goal = 25 minutes Upper Control Limit Lower Control Limit

33. In KaiNexus…

34. Surgical Cases Table

35. Surgical Control Chart 0 100 200 300 400 500 600 700 800 Aug-05 Sep-05 Oct-05 Nov-05 Dec-05 Jan-06 Feb-06 Mar-06 Apr-06 May-06 Jun-06 Jul-06 Aug-06 Total Cases NOISE

36. Patient Satisfaction Run Chart “The average patient satisfaction increased from 87.2 to 89%”

37. Patient Sat. Control Chart 78 80 82 84 86 88 90 92 Nov-08 Dec-08 Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Patient Satisfaction NOISE

38. Lab Turnaround Time What Happened? SIGNAL

39. Another "Special Cause" What Happened? SIGNAL

40. X and MR Chart Combo

41. Does This Small Business Have Predictable Revenue? X chart MR chart SIGNAL

42. Is My Blog Traffic Increasing?

43. Evaluate Over Time 0 500 1000 1500 2000 2500 3000 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 LeanBlog.org Daily Page Loads

44. “Western Electric” Rules • Any single point above or below 3-sigma LCL or UCL • 8 consecutive points on same side of mean • 6 consecutive points moving same direction • 14 alternating up/down points in a row Full rules à http://bit.ly/WErules

45. Evaluate Over Time 0 500 1000 1500 2000 2500 3000 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 LeanBlog.org Daily Page Loads

46. Shift the Limits as Indicated 0 500 1000 1500 2000 2500 3000 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 LeanBlog.org Daily Page Loads

47. Example of Process Shift • If you made a change that you expected to improve the system, use a control chart to test the hypothesis 0 5 10 15 20 25 30 35 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 0 5 10 15 20 25 30 35 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 0 5 10 15 20 25 30 35 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 0 5 10 15 20 25 30 35 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 0 5 10 15 20 25 30 35 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 Process Shift Daily TAT

48. Example of Process Shift • If you did NOT make a change, you need to investigate to determine the cause of this signal 0 5 10 15 20 25 30 35 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 0 5 10 15 20 25 30 35 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 0 5 10 15 20 25 30 35 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 0 5 10 15 20 25 30 35 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 0 5 10 15 20 25 30 35 1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 Process Shift Daily TAT

49. Are We Hitting Our Goals?

50. Performance vs. Goals

51. System View vs. Reactive

52. Control Chart View

53. Another Example Goal

54. Control Chart View Goal

55. So We Should Do Nothing?

56. Improve the System!

57. NOT Understanding Variation Leads To… • Pressuring people to get better results by working harder within the same system • Wasting time looking for explanations of a perceived trend when nothing has changed • Not focusing on systemic improvements that would shift the mean

58. Our Next Webinar "The Intersection of Culture and Technology: Capturing Improvement Where it Happens" – Matthew Cannistraro – Thursday February 23, 1 PM ET • KaiNexus.com/webinars

59. Ask Us Anything! • Mark Graban & Dr. Greg Jacobson • Next Episode Feb 14, 1 pm ET • Register & submit questions via http://kainexus.com/webinars • Past episodes available on YouTube

60. Other Resources www.KaiNexus.com

61. Podcasts • www.KaiNexus.com/podcasts • Subscribe via: – iTunes – Google Play – Stitcher

62. Thanks! • Web: – www.kainexus.com – blog.kainexus.com – www.MarkGraban.com • Webinars on Demand: – www.kainexus.com/webinars • Social Media: – www.twitter.com/kainexus – www.linkedin.com/company/kainexus – www.facebook.com/kainexus @MarkGraban VP of Services Mark@KaiNexus.com @Jeff_Roussel VP of Sales Jeff.Roussel@KaiNexus.com BONUS RECORDING WILL BE SENT: HOW TO CREATE CONTROL CHARTS