Daily Visual ManagementVisibility Wall Training

June 18, 2014

Kaizen Promotion Office

Session Agenda:

Session Agenda

1.Presentation/training (35 minutes)

2.Video (10 minutes)

3.Group work creating your draft walls (45 - 50 minutes)

4.Group report-outs (15 – 20 minutes)

5.Q&A (5 minutes)

6.Wrap-up and evaluation forms

Strategic Hierarchy

Government of Saskatchewan

Ministry of Health

Regina Qu’Appelle Health Region

Provincial Health System

Reporting and Accountabilities

Strategic Framework

RQHR Strategic Planning and Reporting Cycle

Daily Visual Management

Strategy Deployment/ Hoshin

Kanri

DailyVisual Management

(DVM)

Cross-FunctionalManagement

(CFM)

The system used by the

organization to perform its

daily activities by:

• establishing standard

operations

• identifying and

eliminating waste

• using data to ensure

processes, products

and services are

continuously improved

Daily Visual Management- Link to Strategy

Daily Visual Management Consists of:

1. A Visual Workplace where abnormalities are seen

2. An environment where staff test their own ideas

3. Transparency of objectives and metrics

4. Managing by measures that change regularly

5. Connects accountability throughout the organization

What you cannot see, you cannot manage!- Visual Management

Respect for People

Staff are the problem-solvers:

Staff are a valued source for improvement ideas.

Staff help test and determine whether a new process works.

When errors occur, the process is wrong, not the person.

No blame, no shame!

Quality must be built into every step.

Anyone can, and is expected to, stop the process to prevent a defect from continuing downstream.

“Before cars, make people.”

—Eiji Toyoda, former chairman of Toyota

Alignment

Better Care

Zero Waits in Emergency

VP / ED / Dir.

Front Line Managers

why why

whywhy

whywhy

Pasqua ED RGH ED

1-5 Year Outcome Targets

VP/ ED/ Director Wall

Unit / Department Wall

Corporate Wall

You Don’t Need to know Lean to get started on Daily Visual Management!

• It is critical to understand the current situation first, before applying Lean techniques and tools to make improvements

• Use 5 “whys” to get to the root causes and make improvements

• Use Plan, Do, Study, Act (PDSA) to do improvements

• As you learn Lean, you will make faster progress to achieving your targets

Elements of the Daily Visual Management System

• Understand your business and daily improvement activities

• Create daily actions when issue/challenges occur.• Data is classified into common categories on your

unit’s visibility wall – Quality, Cost, Delivery, Safety, Morale (QCDSM)

• Data and information is key:– Choice of data– Visual display and charts used– Method and frequency of collection determined– Method and frequency of reporting determined– Only measure something you can action

What Should I Do?

1. Go and see – learn from the workplace

2. Make the workplace visual

3. Spend significant time developing people

4. Teach staff to see, create solutions and improve

5. Provide standard work that staff can use as a basis for improvement, and develop your own standard work

6. Never stop improving

7. Be accountable and hold others accountable

Setting Up a Daily Visual Management Visibility Wall: Step-By-Step

Purpose statement: Who are we from the patient perspective?

Core Processes

Team communication

   

Improvement  

Quality

Example: improve wait time by 50% by September 2013

Cost

Example: Reduce OR supplies by 20% by December 2013

Delivery

Example: Reduce the wait list by 20% by February 2014

Safety

Example: Reduce surgical site infections to 0% by 2014

Morale

Example: Improve attendance by 10% by July 2013

 

Team Calendar

Upcoming This Week

Improvement ideas

•~~~~~~~~•~~~~~~~~•~~~~~~~~•~~~~~~~~•~~~~~~~~

Standard Work

•~~~~~~~~•~~~~~~~~

5S•~~~~~~~~•~~~~~~~~•~~~~~~~~•~~~~~~~~

Name Date Name Date Name Date Name Date Name Date

Corporate Memo’s

Training Staff Bouquets

Admit Treat Discharge

Steps to Creating a Daily Visual Management Visibility Wall

1. Articulate the Purpose Statement of the service area• i.e. Our purpose is to support teams through Lean methodology

to create a world-class Saskatchewan Healthcare System, which provides high quality, safe and timely care.

• Don’t forget the patient perspective in your Purpose Statement

2. Identify the primary process in your service area and draw a value stream or process map

3. Create your Team Communications• What’s important for your team to know on a weekly basis?• When will you have your weekly huddles, weekly wall walks?• What other information are you going to post on your wall?

• Training schedule?• Staff bouquets?• Corporate communication's/memo’s?

Steps to Creating a Daily Visual Management Visibility Wall

4. Improvement Ideas• Generate improvement ideas that will directly help improve what

you are measuring.• You can use Lean tools like Standard Work and 5S to help.

5. What are one or two measures that best describe how you are meeting the core purpose?

• Classify your measures under: Quality, Cost, Delivery, Safety, Morale (QCDSM)

• Only measure what you can directly improve• Coming soon: there will be some corporate standard measures

Measuring World-Class Quality

World-Class Quality

Quality

Cost

Delivery

Safety

Morale

Full Customer* Satisfaction

Everyone Cares

For Provider

For Patient

Right Amount

Right Time

Right Place

Cost Effective

Reliability Responsiveness

ConsistentEmpathyEquitable

Ass

uran

ce o

f Q

ualit

y

* Patient

Purpose statement: Who are we from the patient perspective?

Core Processes

Team communication

   

Improvement  

Quality

Example: improve wait time by 50% by September 2013

Cost

Example: Reduce OR supplies by 20% by December 2013

Delivery

Example: Reduce the wait list by 20% by February 2014

Safety

Example: Reduce surgical site infections to 0% by 2014

Morale

Example: Improve attendance by 10% by July 2013

 

Team Calendar

Upcoming This Week

Improvement ideas

•~~~~~~~~•~~~~~~~~•~~~~~~~~•~~~~~~~~•~~~~~~~~

Standard Work

•~~~~~~~~•~~~~~~~~

5S•~~~~~~~~•~~~~~~~~•~~~~~~~~•~~~~~~~~

Name Date Name Date Name Date Name Date Name Date

Corporate Memo’s

Training Staff Bouquets

Admit Treat Discharge

Photos: Pasqua Cardio Neuro

Photos: WRC Children’s Program

Photos: WRC Extended Care/Veterans Program

Photos: Pasqua Radiology

Photos: RGH Surgical 6A

15 Minute Daily Huddle

• Select a consistent time of day for wall walks

• Start on time

• Designate a time keeper so that you can end on time

• All staff stand up in front of the visibility wall

• Manager leads or designated leader

– Consider having other staff be reasonable for some pieces of the data and have them report-out out on the data

15 Minute Daily Huddle: Agenda

• Ask 4 questions: – have any patients/residents fallen, – were any employees injured, – is there anyone off sick today, – is there anyone here on overtime today (1 minute)

• Review communications/events (2 minutes)

• Update on projects (2 minutes)

• Review improvement ideas (2 minutes)

• Report out on your QCDSM measures- are they green or red (meeting or not meeting your targets) ( 1 minute each)

• Update and review actions (3 minutes)

Keep In Mind…

• The Visibility Wall is not in itself the goal – the discussions, actions and accountability are what is important

• PDSA (Plan, Do, Study, Act) – keep pressure on your team to get out and try implementing improvement ideas

• The more people informed and trained in changes made, the better chance that changes will be sustained

• If the team is stuck, go back to the purpose statement and process steps for direction

More Information

If you have any questions or want more information, contact:

-Sandra Lynn at sandra.lynn@rqhealth.ca

or 306-766-6421

More information can also be found on the Intranet at: http://rhdintranet/qi/public/VisibilityWallsKit/VisibilityWallsKit.htm

(Departments > Kaizen Promotion Office > Visibility Wall Kits)

Or at www.RQHRLean.com