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Lean Leadership:
Helping Leaders Understand Their
Role in the Improvement Process

Company

LOGO
Your Instructor
 Provides Lean transformation
support to non-manufacturing
settings.
 Co-author, The Kaizen Event
Planner: Achieving Rapid
Improvement in Office, Service, and
Technical Settings
Co-Developer, Metrics-Based
Process Mapping: An Excel Solution
Lean Enterprise Program Instructor
University of California, San Diego
Karen Martin, Principle,
Karen Martin & Associates
2
Learning Objectives
Participants will learn how to help your leadership
team understand their role in the improvement
process, including:










Setting improvement strategy
Roles & responsibilities of project sponsors and A3
coaches
“Letting go” of tactical decisions
Briefing attendance
Authorizing the frontline to make improvements
Modeling lean behaviors

Assumption – you’re already familiar with Lean
principles and tools
© 2011 Karen Martin & Associates

3
Genesis for this webinar
Increasing numbers of improvement
professionals expressing frustration with the
level of leadership support they receive.
Increasing numbers of leaders expressing
frustration with their improvement teams.


“Help us help you.”

Personal experience working with leaders who
want direction and education about how they
provide the best support.

© 2011 Karen Martin & Associates

4
Evidence re: Leadership Commitment
– Observe the degree of:

Intellectual curiosity re: Lean / change
(number of books read, conferences
attended)
Integration into communications
Proclivity to advance change
“Walking the talk”

© 2011 Karen Martin & Associates

5
Our Vital (and often forgotten) Role

One of the key roles of an improvement
professional is to educate and coach
leadership to help them develop into
the improvement-minded leaders you
wish them to be.

© 2011 Karen Martin & Associates

6
Range of Leadership Commitment
Resistance



Active (overt) resistance
Passive (covert) resistance

Neutral – “lame duck”
Commitment


Intellectual
 Understand & conversant about Lean
 Believe the organization needs it



Emotional
 Will expend “discretionary effort”

© 2011 Karen Martin & Associates

7
It All Begins with Education

© 2011 Karen Martin & Associates

8
Improvement Philosophy
A minimum of 10-20% organizational effort
spent working on the business


vs. in the business

There’s never a “good time” for improvement.

OR

© 2011 Karen Martin & Associates

?

9
Components for Effective Change
Vision

Skills

Vision

Incentives

Resources

Action Plan

Effective
Change

Incentives

Resources

Action Plan

Confusion

Incentives

Skills

Resources

Action Plan

Anxiety

Resources

Action Plan

Gradual
Change

Action Plan

Frustration

Vision

Skills

Vision

Skills

Incentives

Vision

Skills

Incentives

Resources

False Starts
© 2003, Enterprise Mgmt Ltd.
Leadership’s Learning Needs
What is Lean?


How is Lean different?

What can we expect in terms of results?



What will it take to get them?
How long will it take?

What’s my role?






Education
Setting strategy
Assuring alignment
Participating / supporting
Modeling Lean behavior

© 2011 Karen Martin & Associates

11
Leadership’s Learning Needs
What is Lean?


How is Lean different?

What can we expect in terms of results?



What will it take to get them?
How long will it take?

What’s my role?






Education
Setting strategy
Assuring alignment
Participating / supporting
Modeling Lean behavior

© 2011 Karen Martin & Associates

12
What Lean Is….
A highly effective business approach that
results in fiscal strength, customer and
employee loyalty, and organizational agility.

© 2011 Karen Martin & Associates

13
What Leaders Must Understand
Lean isn’t merely a process design technique – it’s
a business management philosophy.

© 2011 Karen Martin & Associates

14
How is it Different?
Holistic – value stream-focused
Methodical – PDCA
Visual management


“Operational transparency”

High degree of frontline involvement
Requires significant cultural transformation




Learning to see waste and take action
Learning how to problem-solve
Learning how to engage the frontlines

© 2011 Karen Martin & Associates

15
Traditional vs. Lean Thinking
Traditional

Lean

Revenue-focused

Margin-focused

Improvement focus: optimizing value-added
work

Improvement focus: eliminating non-valueadded work

Fire fighting is rewarded

Fire prevention is rewarded

Focus on financial metrics & lagging
indicators

Focus on operational metrics & leading
indicators

Suboptimization is rewarded

Value stream performance is rewarded

Specialized workers organized by function

Cross-trained workers organized by value
streams

Complexity is the norm

Simplicity is the norm

Inspect in quality

Build in quality

Non-visual workplace / management

Visual workplace / management

Dynamic schedule and priorities

Static priorities and schedule

Unclear ownership & accountability

Clear ownership & accountability

Excessive reviews and approvals by
leadership

Decisions are made by those closest to the
work

Improvements identified by management

Improvements identified by workers
What Leaders Must Understand
Lean is 90% culture / people-based and 10%
tools-based.
Tools

People / Culture

© 2011 Karen Martin & Associates

17
Improvement Roles & Tools

Strategic

Who?
Senior
Leadership

Accountability

Tool

What has to
happen

Value Stream
Mapping

How it will
happen

Kaizen Events

Tactical

Middle
Management

Frontline
Workers

© 2011 Karen Martin & Associates

18
Leadership’s Learning Needs
What is Lean?


How is Lean different?

What can we expect in terms of results?



What will it take to get them?
How long will it take?

What’s my role?






Education
Setting strategy
Assuring alignment
Participating / supporting
Modeling Lean behavior

© 2011 Karen Martin & Associates

19
Performance Measures

Quality
Morale

Cost
Optimal
Performance

Safety
© 2011 Karen Martin & Associates

Delivery
20
Typical Benefits Realized

0

25

50

75

100

Lead Time Reduction
Productivity Increase
WIP Reduction
Quality Improvement
Space Utilization

© 2011 Karen Martin & Associates

21
Mis-Use of Lean

Using Lean for headcount reductions
is a recipe for failure.

© 2011 Karen Martin & Associates

22
What Lean Isn’t…

Lean doesn’t
solve all
problems.

23
Transformation Takes Time
Lean requires long-term
thinking.
The transformation process
morphs over time as the
organization matures.

© 2011 Karen Martin & Associates

24
How Long Will it Take?
Lean is a journey, not a
destination.
2-5 years of “persistent
patience” to reach the
first “tier” of measurable
results.


The larger the
organization, the longer it
takes.

10 years to see
significant changes.
© 2011 Karen Martin & Associates

25
What Leaders Must Understand
Transforming into a Lean Enterprise is disruptive.

© 2011 Karen Martin & Associates

26
Improvement Pacing

Evolution or revolution?

© 2011 Karen Martin & Associates

27
Critical Question

How will we define success?

© 2011 Karen Martin & Associates

28
Leadership’s Learning Needs
What is Lean?


How is Lean different?

What can we expect in terms of results?



What will it take to get them?
How long will it take?

What’s my role?






Education
Setting strategy
Assuring alignment
Participating / supporting
Modeling Lean behavior

© 2011 Karen Martin & Associates

29
Educating Leaders
Executive Overviews


Simulations help

Regular meetings with Leadership


Lean Steering Committee or Advisory Board?

Ongoing “Check-ins” / Training Sessions




How are we doing?
What needs to be adjusted?
What are our learning needs?

© 2011 Karen Martin & Associates

30
Building a Lean Enterprise
Establishing an Improvement Strategy –
The Value Stream Map

32
Value Stream Mapping Process
Products (good or services) with
common process steps

Document Current
State

Repeat

Define
Product Family

Foundation (the basis) for the
future state; 70-80% accurate is
acceptable (directionally correct)

Design Future
State

Create flow by eliminating waste
it is now obvious from your
current state map); typically 3-6
months out

Create
Implementation Plan

Implement!

3 Day
Event

Include accountability and
timeframes for completion

The goal of mapping!
Future State Value Stream Map
Outpatient Imaging Services
Standard
Work

Work
Balance

Customer Demand:
15 patients perDay
(Takt Time1920 seconds)
8 hours per day

Co-locate
Schedule appt
Pre-register

Referring
Physician

Hospital

3
Lead Time = 15 days

2

6

1

Lead Time = 45 mins.

Cycle Time = 11 mins.
Lead Time = 45 mins.
% C&A = 98 %

% C&A = 85 %

Risk
Reduction
(Joint
Commision)

Symposium

E Pay

Excel

Internet

Waiting Room
Management
System

Work
Balancing

Standard
Work

3

35 mins.

4

Cycle Time = 1 mins.
% C&A = 98 %
0.0833 hrs.

2

Complete
Exam
(Tech)

5

20 mins.

Cycle Time = 10 mins.
% C&A = 100 %

0.583 hrs.
1 mins.

2

Transmit
Images
(Tech)

6

5 mins.

Cycle Time = 10 mins.
% C&A = 90 %

0.333 hrs.
10 mins.

Visual
Workplace

Set-up
Reduction

Prep
Patient
(Tech)

Check-in
Patient
(Imaging)

Fax Order
Solutions

PACS

Auto Fax 80%
Us Mail 15%
MD Mailbox 5%
5S

Value Stream
Alignment

Pull System
(Supplies
Kanban)

Remove
Check in
and Reduce
System Access

5 mins.

Meditech

CT=Cycle Time
LT=Lead Time
%C&A=% Complete & Accurate

2

7

120 mins.

2

Review
Draft/Sign
(Radiologist)
420 mins.

Cycle Time = 15 mins.
% C&A = 95 %

2 hrs.
2 mins.

8

Batch
Reductions

Voice
Recognition

Read/Dictate
Exam
(Radiologist)

Cycle Time = 2 mins.
% C&A = 100 %

0.0833 hrs.
10 mins.

Continuous
Flow

2

Print
Reports
(Imaging)

9

2 mins.

Cycle Time = 1 mins.
% C&A = 95 %

7 hrs.
15 mins.

Rework Loop
via Fax 10% of
the time

2

30 mins.

Cycle Time = 1 mins.
% C&A = 99 %

0.0333 hrs.
1 mins.

10

Send
Reports
(Imaging)

6

0.5 hrs.
1 mins.

11

Cycle Time = 3 mins.
% C&A = 90 %

LT = 11.3 hrs.
3 mins.

CT = 43 mins.
CT/LT Ratio = 6.32%
Rolled First Pass
yield = 40%
Future State Implementation Plan
Value Stream Outpatient Imaging

Implementation Plan Review Dates

Executive Sponsor Allen Ward

11/1/2007

Value Stream Champion Sally McKinsey

11/21/2007

Value Stream Mapping Facilitator Dave Parks

12/13/2007

Date Created 10/18/2007
Block
#
2

Goal / Objective
Improve quality of referral

Improvement Activity

Type
KE

Implement standard work for referral
process

Owner
Sean O'Ryan

PROJ

1/10/2008
Implementation Schedule (weeks)
2 3 4 5 6 7 8 9 10 11 12

Dianne
Prichard

3, 4

Reduce lead time beween schedulingand
Cross-train and colocate work teams
preregistration steps

5, 6

Eliminate the need for two patient checkins

Collect copays in Imaging

KE

Michael
O'Shea

6

Eliminate bottleneck in waiting area

Balance work / level demand

KE

Dianne
Prichard

9

Eliminate lead time associated with
transcription step

Implement voice recognition technology

PROJ

Sam Parks

10

Eliminate batched reading

Reduce setup required

KE

Sam Parks

7

Reduce inventory costs, regulatory risk
and storage needs

5S CT supplies area; implement kanban

KE

Michael
O'Shea

12

Reduce delay in report delivery

Implement additional fax ports

PROJ

Martha Allen

12

Reduce delay in report delivery

Increase percentage of physicians
receiving electronic delivery (rather than
hard copy)

KE

1

Martha Allen

Approvals
Executive Sponsor

Value Stream Champion

Value Stream Mapping Facilitator

Signature:

Signature:

Signature:

Date:

Date:

Date:

Date
Complete
Building a Lean Enterprise
Interim Briefings
Who: Improvement team and ALL involved
leadership
Purpose





Share discoveries
Process check – is the team moving in the right direction?
Minimize surprises; gain consensus
Discuss policy issues

Leadership may not veto tactical decisions


Give them the “rules” upfront

Schedule improvement activities around leadership
schedules.
© 2010 Karen Martin & Associates

37
What is A3?
A structured method for applying the PDCA (plando-check-act) approach to problem-solving.


Workforce development into Lean thinkers

International designation for 11 x 17” paper.
A concise “storyboard,” which visualizes the
problem solver’s discoveries and thought process
along the way.




Communication
Consensus building
Organizational learning

© 2010 Karen Martin & Associates

38
I.T.R. Project – A3 Report

METHODS

MACHINE
Multiple entry methods
no standard means

PEOPLE
IT access to equipment / user

1 stop shop ITR Form
call friend
fly by

Customer/user process traning

Inventory hard to manage

Support resources (not enough staff)
Only 8 techs to complete the work
Inconsistent work close-out activities

Manual processing / tracking
Inability to define specific needs
Lack of req'd product and
accounting info

Software installation takes too long to
complete and close out
Limited process tracking

Accessibility

Time until completion
(due dates, completion dates)

License procurement
Support resources

Work location

ENVIRONMENT

MEASURES

MATERIALS

39
A3 Roles & Responsibilities
Problem Owner – Person(s) accountable for
results; authorized to engage any and all
parties needed
Problem Coach – Person(s) “developing” the
process owner into a skilled problem-solver;
typically leadership.



They must be proficient problem-solvers first!
Requires leadership development

© 2010 Karen Martin & Associates

40
Kaizen Event Charter
Event Scope
Value Stream

Leadership

Schedule

Executive Sponsor

Dates

Specific Conditions

Value Stream
Champion

Start & End
Times

Process Trigger

Facilitator

Location

Team Lead

Interim
Briefings

Event Name

First Step
Last Step
Event Boundaries &
Limitations

Workforce
Training

Event Coordinator

Event Drivers / Current State Issues

Final
Presentation

Team Members
Function

1
2
3

3

5

Contact Information

2

4

Name

1

4

Event Goals and Objectives

5

1

6

2

7

3

8

4
5

9
10

Potential Deliverables

On-Call Support
Function

1
2

2

4

Contact Information

1

3

Name

3

5

4

Possible Obstacles
1

Approvals
Executive Sponsor

Value Stream Champion

Facilitator

2
3
4

Signature:
Date:

Signature:
Date:

Signature:
Date:
Role of the Improvement Sponsor
 Authorize the activity, scope, objectives, and boundaries



Participate in Charter formation
Authorize resources (negotiate with peers, as necessary)

 Attend briefings
 Remove obstacles to the team’s success




Gain leadership alignment
Mediate policy debates
“Negotiate” for resources (if needed) with peers and Execs
 People, time, funding, materials/technology, space
 Authorize modifying the objectives if the organization can’t
support the improvement

 Accountable for results


Regular check-ins to assure appropriate progress and re-direct if
needed

© 2010 Karen Martin & Associates

42
Lean Steering Committee /
Advisory Team’s Role
 Gather improvement ideas from across the enterprise.
 Evaluate & prioritize improvement opportunities (closely
tied to annual business goals).
 Enable alignment across leadership team.
 Communicate upcoming improvements and outcomes.
 Aid in necessary culture shift.
 Assure ongoing process measurement and continuous
improvement is occurring.
 Determine ongoing workforce development needs.
 Stay informed about competing priorities and shift
improvement focus accordingly.
 Allocate resources.
 Assess progress and adjust as needed.
© 2010 Karen Martin & Associates

43
Modeling Lean Behaviors
Encourage leaders to:







Go to the Gemba
Clearly define problems and conduct thorough
root cause analysis
Allow workers time for improvement
Stick to the strategy that’s been set

© 2010 Karen Martin & Associates

44
Take the Lead
One of the things that I’ve noticed is…
Would you be open to…?
I was reading …. and they mentioned that…
Could we get together to discuss…?

© 2010 Karen Martin & Associates

45
Key Success Factors for
Achieving Results
Tenacity
Strategic improvement tied to business
goals


Value Stream Mapping

Dedicated resources


More on this in next month’s webinar

Heavy use of Kaizen Events initially


46

With the goal of maturing to “daily kaizen”
Learning Objectives
Participants will learn how to help your leadership
team understand their role in the improvement
process, including:







Setting improvement strategy
Roles & responsibilities of project sponsors and A3 coaches
“Letting go” of tactical decisions
Briefing attendance
Authorizing the frontline to make improvements
Modeling lean behaviors

Assumption – already familiar with principles and tools
47
Resources
Leadership-Focused






Leading the Lean Enterprise Transformation,
George Koenigsaecker
The Lean Manager, Michael & Freddy Ballé
(business novel)
Toyota Kata, Mike Rother

The “Classics”




The Toyota Way, Jeff Liker
Lean Thinking, Jim Womack

© 2010 Karen Martin & Associates

48
For Further Questions

7770 Regents Road #635
San Diego, CA 92122
858.677.6799
ksm@ksmartin.com
Free monthly newsletter:
www.ksmartin.com/subscribe
Learn / Connect :

49

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Lean Leadership: Helping Leaders Understand Their Role In The Improvement Process

  • 1. Lean Leadership: Helping Leaders Understand Their Role in the Improvement Process Company LOGO
  • 2. Your Instructor  Provides Lean transformation support to non-manufacturing settings.  Co-author, The Kaizen Event Planner: Achieving Rapid Improvement in Office, Service, and Technical Settings Co-Developer, Metrics-Based Process Mapping: An Excel Solution Lean Enterprise Program Instructor University of California, San Diego Karen Martin, Principle, Karen Martin & Associates 2
  • 3. Learning Objectives Participants will learn how to help your leadership team understand their role in the improvement process, including:       Setting improvement strategy Roles & responsibilities of project sponsors and A3 coaches “Letting go” of tactical decisions Briefing attendance Authorizing the frontline to make improvements Modeling lean behaviors Assumption – you’re already familiar with Lean principles and tools © 2011 Karen Martin & Associates 3
  • 4. Genesis for this webinar Increasing numbers of improvement professionals expressing frustration with the level of leadership support they receive. Increasing numbers of leaders expressing frustration with their improvement teams.  “Help us help you.” Personal experience working with leaders who want direction and education about how they provide the best support. © 2011 Karen Martin & Associates 4
  • 5. Evidence re: Leadership Commitment – Observe the degree of: Intellectual curiosity re: Lean / change (number of books read, conferences attended) Integration into communications Proclivity to advance change “Walking the talk” © 2011 Karen Martin & Associates 5
  • 6. Our Vital (and often forgotten) Role One of the key roles of an improvement professional is to educate and coach leadership to help them develop into the improvement-minded leaders you wish them to be. © 2011 Karen Martin & Associates 6
  • 7. Range of Leadership Commitment Resistance   Active (overt) resistance Passive (covert) resistance Neutral – “lame duck” Commitment  Intellectual  Understand & conversant about Lean  Believe the organization needs it  Emotional  Will expend “discretionary effort” © 2011 Karen Martin & Associates 7
  • 8. It All Begins with Education © 2011 Karen Martin & Associates 8
  • 9. Improvement Philosophy A minimum of 10-20% organizational effort spent working on the business  vs. in the business There’s never a “good time” for improvement. OR © 2011 Karen Martin & Associates ? 9
  • 10. Components for Effective Change Vision Skills Vision Incentives Resources Action Plan Effective Change Incentives Resources Action Plan Confusion Incentives Skills Resources Action Plan Anxiety Resources Action Plan Gradual Change Action Plan Frustration Vision Skills Vision Skills Incentives Vision Skills Incentives Resources False Starts © 2003, Enterprise Mgmt Ltd.
  • 11. Leadership’s Learning Needs What is Lean?  How is Lean different? What can we expect in terms of results?   What will it take to get them? How long will it take? What’s my role?      Education Setting strategy Assuring alignment Participating / supporting Modeling Lean behavior © 2011 Karen Martin & Associates 11
  • 12. Leadership’s Learning Needs What is Lean?  How is Lean different? What can we expect in terms of results?   What will it take to get them? How long will it take? What’s my role?      Education Setting strategy Assuring alignment Participating / supporting Modeling Lean behavior © 2011 Karen Martin & Associates 12
  • 13. What Lean Is…. A highly effective business approach that results in fiscal strength, customer and employee loyalty, and organizational agility. © 2011 Karen Martin & Associates 13
  • 14. What Leaders Must Understand Lean isn’t merely a process design technique – it’s a business management philosophy. © 2011 Karen Martin & Associates 14
  • 15. How is it Different? Holistic – value stream-focused Methodical – PDCA Visual management  “Operational transparency” High degree of frontline involvement Requires significant cultural transformation    Learning to see waste and take action Learning how to problem-solve Learning how to engage the frontlines © 2011 Karen Martin & Associates 15
  • 16. Traditional vs. Lean Thinking Traditional Lean Revenue-focused Margin-focused Improvement focus: optimizing value-added work Improvement focus: eliminating non-valueadded work Fire fighting is rewarded Fire prevention is rewarded Focus on financial metrics & lagging indicators Focus on operational metrics & leading indicators Suboptimization is rewarded Value stream performance is rewarded Specialized workers organized by function Cross-trained workers organized by value streams Complexity is the norm Simplicity is the norm Inspect in quality Build in quality Non-visual workplace / management Visual workplace / management Dynamic schedule and priorities Static priorities and schedule Unclear ownership & accountability Clear ownership & accountability Excessive reviews and approvals by leadership Decisions are made by those closest to the work Improvements identified by management Improvements identified by workers
  • 17. What Leaders Must Understand Lean is 90% culture / people-based and 10% tools-based. Tools People / Culture © 2011 Karen Martin & Associates 17
  • 18. Improvement Roles & Tools Strategic Who? Senior Leadership Accountability Tool What has to happen Value Stream Mapping How it will happen Kaizen Events Tactical Middle Management Frontline Workers © 2011 Karen Martin & Associates 18
  • 19. Leadership’s Learning Needs What is Lean?  How is Lean different? What can we expect in terms of results?   What will it take to get them? How long will it take? What’s my role?      Education Setting strategy Assuring alignment Participating / supporting Modeling Lean behavior © 2011 Karen Martin & Associates 19
  • 21. Typical Benefits Realized 0 25 50 75 100 Lead Time Reduction Productivity Increase WIP Reduction Quality Improvement Space Utilization © 2011 Karen Martin & Associates 21
  • 22. Mis-Use of Lean Using Lean for headcount reductions is a recipe for failure. © 2011 Karen Martin & Associates 22
  • 23. What Lean Isn’t… Lean doesn’t solve all problems. 23
  • 24. Transformation Takes Time Lean requires long-term thinking. The transformation process morphs over time as the organization matures. © 2011 Karen Martin & Associates 24
  • 25. How Long Will it Take? Lean is a journey, not a destination. 2-5 years of “persistent patience” to reach the first “tier” of measurable results.  The larger the organization, the longer it takes. 10 years to see significant changes. © 2011 Karen Martin & Associates 25
  • 26. What Leaders Must Understand Transforming into a Lean Enterprise is disruptive. © 2011 Karen Martin & Associates 26
  • 27. Improvement Pacing Evolution or revolution? © 2011 Karen Martin & Associates 27
  • 28. Critical Question How will we define success? © 2011 Karen Martin & Associates 28
  • 29. Leadership’s Learning Needs What is Lean?  How is Lean different? What can we expect in terms of results?   What will it take to get them? How long will it take? What’s my role?      Education Setting strategy Assuring alignment Participating / supporting Modeling Lean behavior © 2011 Karen Martin & Associates 29
  • 30. Educating Leaders Executive Overviews  Simulations help Regular meetings with Leadership  Lean Steering Committee or Advisory Board? Ongoing “Check-ins” / Training Sessions    How are we doing? What needs to be adjusted? What are our learning needs? © 2011 Karen Martin & Associates 30
  • 31. Building a Lean Enterprise
  • 32. Establishing an Improvement Strategy – The Value Stream Map 32
  • 33. Value Stream Mapping Process Products (good or services) with common process steps Document Current State Repeat Define Product Family Foundation (the basis) for the future state; 70-80% accurate is acceptable (directionally correct) Design Future State Create flow by eliminating waste it is now obvious from your current state map); typically 3-6 months out Create Implementation Plan Implement! 3 Day Event Include accountability and timeframes for completion The goal of mapping!
  • 34. Future State Value Stream Map Outpatient Imaging Services Standard Work Work Balance Customer Demand: 15 patients perDay (Takt Time1920 seconds) 8 hours per day Co-locate Schedule appt Pre-register Referring Physician Hospital 3 Lead Time = 15 days 2 6 1 Lead Time = 45 mins. Cycle Time = 11 mins. Lead Time = 45 mins. % C&A = 98 % % C&A = 85 % Risk Reduction (Joint Commision) Symposium E Pay Excel Internet Waiting Room Management System Work Balancing Standard Work 3 35 mins. 4 Cycle Time = 1 mins. % C&A = 98 % 0.0833 hrs. 2 Complete Exam (Tech) 5 20 mins. Cycle Time = 10 mins. % C&A = 100 % 0.583 hrs. 1 mins. 2 Transmit Images (Tech) 6 5 mins. Cycle Time = 10 mins. % C&A = 90 % 0.333 hrs. 10 mins. Visual Workplace Set-up Reduction Prep Patient (Tech) Check-in Patient (Imaging) Fax Order Solutions PACS Auto Fax 80% Us Mail 15% MD Mailbox 5% 5S Value Stream Alignment Pull System (Supplies Kanban) Remove Check in and Reduce System Access 5 mins. Meditech CT=Cycle Time LT=Lead Time %C&A=% Complete & Accurate 2 7 120 mins. 2 Review Draft/Sign (Radiologist) 420 mins. Cycle Time = 15 mins. % C&A = 95 % 2 hrs. 2 mins. 8 Batch Reductions Voice Recognition Read/Dictate Exam (Radiologist) Cycle Time = 2 mins. % C&A = 100 % 0.0833 hrs. 10 mins. Continuous Flow 2 Print Reports (Imaging) 9 2 mins. Cycle Time = 1 mins. % C&A = 95 % 7 hrs. 15 mins. Rework Loop via Fax 10% of the time 2 30 mins. Cycle Time = 1 mins. % C&A = 99 % 0.0333 hrs. 1 mins. 10 Send Reports (Imaging) 6 0.5 hrs. 1 mins. 11 Cycle Time = 3 mins. % C&A = 90 % LT = 11.3 hrs. 3 mins. CT = 43 mins. CT/LT Ratio = 6.32% Rolled First Pass yield = 40%
  • 35. Future State Implementation Plan Value Stream Outpatient Imaging Implementation Plan Review Dates Executive Sponsor Allen Ward 11/1/2007 Value Stream Champion Sally McKinsey 11/21/2007 Value Stream Mapping Facilitator Dave Parks 12/13/2007 Date Created 10/18/2007 Block # 2 Goal / Objective Improve quality of referral Improvement Activity Type KE Implement standard work for referral process Owner Sean O'Ryan PROJ 1/10/2008 Implementation Schedule (weeks) 2 3 4 5 6 7 8 9 10 11 12 Dianne Prichard 3, 4 Reduce lead time beween schedulingand Cross-train and colocate work teams preregistration steps 5, 6 Eliminate the need for two patient checkins Collect copays in Imaging KE Michael O'Shea 6 Eliminate bottleneck in waiting area Balance work / level demand KE Dianne Prichard 9 Eliminate lead time associated with transcription step Implement voice recognition technology PROJ Sam Parks 10 Eliminate batched reading Reduce setup required KE Sam Parks 7 Reduce inventory costs, regulatory risk and storage needs 5S CT supplies area; implement kanban KE Michael O'Shea 12 Reduce delay in report delivery Implement additional fax ports PROJ Martha Allen 12 Reduce delay in report delivery Increase percentage of physicians receiving electronic delivery (rather than hard copy) KE 1 Martha Allen Approvals Executive Sponsor Value Stream Champion Value Stream Mapping Facilitator Signature: Signature: Signature: Date: Date: Date: Date Complete
  • 36. Building a Lean Enterprise
  • 37. Interim Briefings Who: Improvement team and ALL involved leadership Purpose     Share discoveries Process check – is the team moving in the right direction? Minimize surprises; gain consensus Discuss policy issues Leadership may not veto tactical decisions  Give them the “rules” upfront Schedule improvement activities around leadership schedules. © 2010 Karen Martin & Associates 37
  • 38. What is A3? A structured method for applying the PDCA (plando-check-act) approach to problem-solving.  Workforce development into Lean thinkers International designation for 11 x 17” paper. A concise “storyboard,” which visualizes the problem solver’s discoveries and thought process along the way.    Communication Consensus building Organizational learning © 2010 Karen Martin & Associates 38
  • 39. I.T.R. Project – A3 Report METHODS MACHINE Multiple entry methods no standard means PEOPLE IT access to equipment / user 1 stop shop ITR Form call friend fly by Customer/user process traning Inventory hard to manage Support resources (not enough staff) Only 8 techs to complete the work Inconsistent work close-out activities Manual processing / tracking Inability to define specific needs Lack of req'd product and accounting info Software installation takes too long to complete and close out Limited process tracking Accessibility Time until completion (due dates, completion dates) License procurement Support resources Work location ENVIRONMENT MEASURES MATERIALS 39
  • 40. A3 Roles & Responsibilities Problem Owner – Person(s) accountable for results; authorized to engage any and all parties needed Problem Coach – Person(s) “developing” the process owner into a skilled problem-solver; typically leadership.   They must be proficient problem-solvers first! Requires leadership development © 2010 Karen Martin & Associates 40
  • 41. Kaizen Event Charter Event Scope Value Stream Leadership Schedule Executive Sponsor Dates Specific Conditions Value Stream Champion Start & End Times Process Trigger Facilitator Location Team Lead Interim Briefings Event Name First Step Last Step Event Boundaries & Limitations Workforce Training Event Coordinator Event Drivers / Current State Issues Final Presentation Team Members Function 1 2 3 3 5 Contact Information 2 4 Name 1 4 Event Goals and Objectives 5 1 6 2 7 3 8 4 5 9 10 Potential Deliverables On-Call Support Function 1 2 2 4 Contact Information 1 3 Name 3 5 4 Possible Obstacles 1 Approvals Executive Sponsor Value Stream Champion Facilitator 2 3 4 Signature: Date: Signature: Date: Signature: Date:
  • 42. Role of the Improvement Sponsor  Authorize the activity, scope, objectives, and boundaries   Participate in Charter formation Authorize resources (negotiate with peers, as necessary)  Attend briefings  Remove obstacles to the team’s success    Gain leadership alignment Mediate policy debates “Negotiate” for resources (if needed) with peers and Execs  People, time, funding, materials/technology, space  Authorize modifying the objectives if the organization can’t support the improvement  Accountable for results  Regular check-ins to assure appropriate progress and re-direct if needed © 2010 Karen Martin & Associates 42
  • 43. Lean Steering Committee / Advisory Team’s Role  Gather improvement ideas from across the enterprise.  Evaluate & prioritize improvement opportunities (closely tied to annual business goals).  Enable alignment across leadership team.  Communicate upcoming improvements and outcomes.  Aid in necessary culture shift.  Assure ongoing process measurement and continuous improvement is occurring.  Determine ongoing workforce development needs.  Stay informed about competing priorities and shift improvement focus accordingly.  Allocate resources.  Assess progress and adjust as needed. © 2010 Karen Martin & Associates 43
  • 44. Modeling Lean Behaviors Encourage leaders to:     Go to the Gemba Clearly define problems and conduct thorough root cause analysis Allow workers time for improvement Stick to the strategy that’s been set © 2010 Karen Martin & Associates 44
  • 45. Take the Lead One of the things that I’ve noticed is… Would you be open to…? I was reading …. and they mentioned that… Could we get together to discuss…? © 2010 Karen Martin & Associates 45
  • 46. Key Success Factors for Achieving Results Tenacity Strategic improvement tied to business goals  Value Stream Mapping Dedicated resources  More on this in next month’s webinar Heavy use of Kaizen Events initially  46 With the goal of maturing to “daily kaizen”
  • 47. Learning Objectives Participants will learn how to help your leadership team understand their role in the improvement process, including:       Setting improvement strategy Roles & responsibilities of project sponsors and A3 coaches “Letting go” of tactical decisions Briefing attendance Authorizing the frontline to make improvements Modeling lean behaviors Assumption – already familiar with principles and tools 47
  • 48. Resources Leadership-Focused    Leading the Lean Enterprise Transformation, George Koenigsaecker The Lean Manager, Michael & Freddy Ballé (business novel) Toyota Kata, Mike Rother The “Classics”   The Toyota Way, Jeff Liker Lean Thinking, Jim Womack © 2010 Karen Martin & Associates 48
  • 49. For Further Questions 7770 Regents Road #635 San Diego, CA 92122 858.677.6799 ksm@ksmartin.com Free monthly newsletter: www.ksmartin.com/subscribe Learn / Connect : 49