keynote - shs conference february 2014

© 2014 The Karen Martin Group, Inc.

Building the Foundation for Everyday Excellence

The Outstanding Organization

Healthcare Systems Process Improvement ConferenceFebruary 23, 2014

Success with Improvement

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2001 – The Economist

None17%

Lasting20%

Temporary63%

…A Decade Later2010 – Accenture

69%

58%

33%

Minimal financial impact

Needs re‐evaluation, restart or complete 

makeover

Mixed to disappointing 

results3

Up to 98,000 deathsannually due tomedical errors.

Improvement goal:Reduce by 50%in 5 Years.

To Err is HumanInstitute of Medicine, 1999

Something Is Terribly Wrong…

2009

2005 2010

2010

2011

“Progress has been slow.”

Journal of the American Medical Association

“Annual death toll from medical 

errors is closer to 200,000.”

Dead by MistakeHeart Newspapers Special Report

“180,000 Medicare patients die annually from medical errors.”

Office of the Inspector General

“No significant change in rate of 

preventable errors.”New England Journal 

of Medicine

“33% hospitalized patients are harmed; 7% result in permanent 

injury or death.”Health Affairs 2013

“200,000‐400,000 deaths per year 

due to preventable harm in hospitals.”

Journal of                  Patient Safety

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7 in 10 American workers are “not engaged” or “actively disengaged” in their work.

Per Gallup, actively disengaged employees cost the U.S. $450‐$550 billion a year in lost productivity.

Employee Engagement – Gallup Findings

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15

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52

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59

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26

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2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

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ACTIVELY DISENGAGED

NOT ENGAGED ENGAGED0% 100%

© 2014 The Karen Martin Group, Inc. 8

© 2014 The Karen Martin Group, Inc.

Ineffective behaviors

CHAOS

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© 2014 The Karen Martin Group, Inc. 11

© 2014 The Karen Martin Group, Inc. 12

Ambiguity complicates, slows, frustrates…        and is dangerous

1. Organization purpose & vision2. Customers & products3. Business goals & priorities4. Policies5. Roles & responsibilities6. Work systems & process performance7. Problem solving & decision making8. Terminology & communication

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8 Ambiguity Wastes

Dept C Dept DDept BDept A

Core Value Streams

Support Value Streams

Support Value Streams

Silo‐Centric vs. Value Stream Thinking 

Gaining Clarity: Current State Value Stream MapOutpatient Imaging

Percent Complete & Accurate (%C&A)

Customer

Process 1

Process 2

Process 3

Process 4

80% 50%95%

75%

90%

Rework = Correcting, Adding, ClarifyingRolled %C&A = 26%

Gaining Alignment: Future State Value Stream MapOutpatient Imaging

Who Owns the           Value Stream?

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How are we performing?

Visualize Work Queues & Status

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© 2014 The Karen Martin Group, Inc. 21

There is no such thing as multitasking.*

* For cognitive tasks.

Task #1:  Focus Reduces ChaosTask #2:  1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 

Round 1 – Alternate between tasks : letter, number, letter, number, etc.

Round  2 – Write the full sentence, followed by the numbers 1‐17.

Sentence:

Numbers:

Sentence:

Numbers:

The Cost of Switch Tasking

Focus Law #1:STOP DOING

Focus Law #2:DO FEWER THINGS 

AT ONCE

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The Power of Focus:Projects Completed in One Year

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0

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Pre‐Focus Post‐Focus

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• No additional resources

• Higher quality output

• Lower stress

What is Your Improvement Strategy?

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Strategy Deployment Key Feature: Catchball

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Executive Team

What?Who?When?

Senior Mgmt

What?Who?When?

Middle Mgmt

What?Who?When?

FrontlinesWhat?Who?When?

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Actively Working On In Queue

Started & Stopped New Ideas

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Must Do, Can’t Fail Maybe

Delay Eliminate

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1. Increase sales 5%.3. Achieve 10% profit.

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec IT Mktg Ops HR Bob Fin PE Pario COM Direct 

CDs / AMs

PD Rec

PD Mgmt

BMD SWS

23,500 units  sold by 12/31/2013 through al l  channels  (approx. $700K)

X X X X X X X X X X X X Bob Dana 2 3 3 3 2 3 3 1 1 3 3 1 3

11 Develop & del iver tra ining to top 50 Dealers X X X X X X Bob Rex/Tim  3 3 3

21 Revised course  materia ls  by 6/30/2013 X X X Bob Josh R? 2 3 3 2 2

5Education: 1 school  dis trict spec'd/underperforming COM dis tributor (25) by 12/31 valued at min $35K each

X X X X X X X X X X X X Howard Michael   S 1 3 2 3 3

810 new dea lers  on board (net) ($500K per dealer this  year)

X X X X X X X X X X X X Howard Mike  B 2 3

95 new dis tributors  bringing $200K annual  rev (& 5 terminated)

X X X X X X X X X X X X Howard Howard 1 1 1 2 3

17 10 projects  spec'd  by 12/31; $300K rev by 12/31 X X X X X X X X X X Howard Dana 1 3 3 3

29 20 by year‐end X X X X X X X X X X X X Howard Mark H 2 3 3 3

32 TBD X X X Howard Howard

33 TBD X X X X X X X X X Howard Howard

10Useful  reporting and metrics  are  establ i shed and in place  

X X Jim Randal l 3 1 1 1 1 1 1

30 TBD X X X X X Jim Josh 3

31 TBD X X X X X X Jim Josh 1 1 1 3 1 1 1 1 1 1 1 1 1 1

25 TBD Jim  Shannon  3 3 1 1 1 1 1

26 System 7.0's  in place X X X Jim  Randal l 3 2 1 2 1

15100% accurate  payrol l ; 100% management sati s faction at Apri l  mgmt. meeting

X X X Josh Phyl l is 1 3

20Internet task l i s t i s  s impl i fied and streaml ined for PDs  then plan i s  rol led out to PDs  

X X X X Michael  M Michael  M 2 3 2 3

22Des ign Calculator i s  updated success ful ly and rol led out

X X X Neal l Matt D 3 1 1 3 2 2 3

24 Competi tive  Analys is  complete  and distributed for use X X X Neal l Dana 2 3 3 3 3 3 3

1 Des ign changed to solve  delam i ssue   long‐term X X X X X Susan David R 3 2 3

1230 parts  sourced in U.S.; completed plan for managing China ‐sourced parts

X X X X X X Susan Shannon 3 3 2 2

13Warehouse  la id out; kanban revised; Syspro implemented

X X X Susan Shannon 3

14 Lay out complete; equipment ins ta l led X X X Susan David  R 3 3

X = Planned

2013 Priorities

2013 Goals & Objectives4. Improve morale (metric TBD).2. Achieve 50% gross margin. Created: 01‐14‐13

Revised: Level of Effort/Involvement Required

Priority Goal or Measurable Objective Exec Owner

Plan review dates:

Tactical Owner

● =  Actual

< Company Name >

Conten

trem

oved

 for con

fiden

tiality 

Creating Organization‐Wide Focus:The Annual Work Plan

© 2014 The Karen Martin Group, Inc. 33

Train/Practice vs. Performance

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Athletes Businesses

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Train90%

Train1%

Perform 99%

Perform 10%

Jim Loehr & Tony Schwartz,  The Power of Full Engagement

© 2014 The Karen Martin Group, Inc. 35

Develophypothesis

Conduct experiment

Measure results

RefineStandardize Stabilize

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What problem are you trying to solve?

Why is it a problem?

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True Continuous Improvement

© 2014 The Karen Martin Group, Inc. 38

© 2014 The Karen Martin Group, Inc.

Engagement Drivers: The Three C’s 

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Connection

ControlCreativity

The Outstanding Organization, pp. 155‐158

To vision, annual goals, immediate supervisor, 

peers, customers

Heavy involvement in decisions that influence 

their work life

Full use of talents, capacities, 

potentialities, & skills

© 2014 The Karen Martin Group, Inc.

Leaders determine strategy (what)

Workers determine tactics (how)

Cross‐Functional Problem Solving & Improvement:Connecting, Using Creativity, Gaining Control

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Single Hits Add Up!

Doubles

Triples

Home Runs & Grand Slams

© 2014 The Karen Martin Group, Inc. 43

© 2014 The Karen Martin Group, Inc.

www.ksmartin.com

858.677.6799

Signing books immediately after               talk in exhibit hall