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USING LEAN TO ENGAGE AND ALIGN THE ENTIRE ORGANIZATION
Didier Rabino, VP Lean Sensei
Julie Garrison, HR System Director
November 9, 2015
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2 Confidential. For internal use only. Not for distribution.
ABOUT THE PRESENTERS
Julie GARRISON
HR System Director
1999 – 2006: Aspen Medical Group
2006 – Present: HealthEast Care System
Didier RABINO
VP, Lean Sensei
2004 - 2012: Andersen Windows Corp.
1992 - 2004: Steelcase Inc.
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3 Confidential. For internal use only. Not for distribution.
HEALTHEAST CARE SYSTEM
Optimal health and well-being for our patients, our communities and ourselves
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4 Confidential. For internal use only. Not for distribution.
7,400 employees; 1,300 providers; 900 volunteers
14 primary care clinics; 4 hospitals; community services
Multiple specialty centers; comprehensive wellness program
ABOUT HEALTHEAST
1.1 Million Residents
63 Languages
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5 Confidential. For internal use only. Not for distribution.
LEAN AT HEALTHEAST: THE JOURNEY
2006 - First Lean flow projects and education
2011 - First department with frontline tools
2012 - First Value Based Improvement (VBI) system launched
20?? - Lean is our way of life
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6 Confidential. For internal use only. Not for distribution.
Better
Results • Better clinical quality
• Better patient experience
• Better staff engagement
• Improved cost effectiveness
Better Health Care Value:
Better
Processes • Less waste
• Less variation
• Less burden on employees and physicians
• Built-in qualityBetter Problem • Total employee and physician engagement
• PDCA and A3 Thinking expertise
• Making problems visible
• Learning organization
Solvers
Better
Management
System
• Focused strategy deployment
• Layered and supportive standard work
• Visual management
• Accountability system
LEAN AT HEALTHEAST: THE VBI CULTURE
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7 Confidential. For internal use only. Not for distribution.
Continuous Improvement
With Respect for People
VBI house built with 14 sub-systems:
First developed:
Frontline Management System
Gemba Walks
A3 Thinking
Strategy Deployment
Next developed:
Value Stream Management
Kaizen/3P Leadership
Standard Work
LEAN SYSTEMS
Why
VBI?
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8 Confidential. For internal use only. Not for distribution.
Experiment
Deploy
Assess
ContinuouslyImprove
LEAN ROADMAP
Organization
Development =
Support+
FY12 FY13 FY14 FY16 FY17 FY18 FY19 FY20
Value Stream Mgt
Standard Work
Strategy Deployment
A3 Thinking
Strategy Deployment
A3 Thinking
Strategy Deployment
A3 Thinking
Value Stream Mgt
Standard Work
Value Stream Mgt
Standard Work
Strategy Deployment
A3 ThinkingValue Stream Mgt
Standard Work
Strategy Deployment
A3 Thinking
Kaizen/3P Leadership
Shingo Model
Kaizen/3P Leadership
Shingo Model
Kaizen/3P Leadership
Shingo Model
Kaizen/3P Leadership
Shingo Model
Strategy Deployment
A3 ThinkingValue Stream Mgt
Standard Work
Pull Systems
Workplace Organization
Pull Systems
Workplace Organization
Pull Systems
Workplace Organization
Pull Systems
Workplace Organization
Strategy Deployment
A3 ThinkingValue Stream Mgt
Standard Work
Kaizen/3P Leadership
Shingo Model
Error Detection
Work Smoothing
Error Detection
Work Smoothing
Error Detection
Work Smoothing
Pb Solving Techniques
Equipment Reliability
Pb Solving Techniques
Equipment Reliability
Frontline Management
Gemba Walks
Frontline Management
Gemba Walks
Frontline Management
Gemba Walks
Frontline Management
Gemba Walks
Frontline Management
Gemba Walks
Frontline Management
Gemba Walks
Frontline Management
Gemba Walks
Frontline Management
Gemba Walks
*
* FY15: Focus on Epic DeploymentFY15: Focus on Epic Deployment
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9 Confidential. For internal use only. Not for distribution.
TOOL BASED ARCHITECTURE
1
2
3
4 What tools to we need?
• Improvement cards
• Huddle form
• Run-chart
• Audit form
• Etc.
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10 Confidential. For internal use only. Not for distribution.
SYSTEMS DRIVE BEHAVIORS
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11 Confidential. For internal use only. Not for distribution.
PRINCIPLE BASED ARCHITECTURE
1
4
3
2
What behaviors to we need?
• Huddles are interactive meetings
• Leaders use cards to coach PDCA
• Ideas are connected to causes
• Standards are created from ideas
• Etc.
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12 Confidential. For internal use only. Not for distribution.
TEAM STRUCTURE
Tier 1
300 teams
Tier 2
26 teams
Tier 3
7 teams
Tier 4
1 teamExecutive Leadership Team
Business Units
Entities
Frontline
Engage, align and support the whole organization
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13 Confidential. For internal use only. Not for distribution.
STRATEGY DEPLOYMENT SYSTEM
Instead of
ThisThis
Alignment
Focus
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STRATEGY DEPLOYMENT ROOMS
Entities, Business Units, Executive Leadership Team
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15 Confidential. For internal use only. Not for distribution.
STRATEGY DEPLOYMENT REVIEWS
ELT
BU’s
Entities
Frontline teams
Gemba walks
Clinical
QualityPatient
Experience
EngagementSmart Growth &
Financial Health
WEEKLY SCHEDULE PILLAR ROTATION
1 Pillar
per week
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16 Confidential. For internal use only. Not for distribution.
STRATEGY DEPLOYMENT ROOMS
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17 Confidential. For internal use only. Not for distribution.
STRATEGY DEPLOYMENT ROOMS
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18 Confidential. For internal use only. Not for distribution.
DAILY IMPROVEMENT BY FRONTLINE
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19 Confidential. For internal use only. Not for distribution.
18,203 VBI Ideas in FY13
28,016 VBI Ideas in FY14
33,025 VBI Ideas in FY15
Learning PDCA
Process Analysis
DEVELOPING THOUSANDS OF PROBLEM SOLVERS
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20 Confidential. For internal use only. Not for distribution.
PEOPLE DEVELOPMENT
Frontline Team Frontline Leader
2-Up Leader
1-Up Leader
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21 Confidential. For internal use only. Not for distribution.
0
1,000
2,000
3,000
4,000
Sep
-12
Oct
-12
No
v-1
2
De
c-1
2
Jan
-13
Feb
-13
Mar
-13
Ap
r-1
3
May-…
Jun
-13
Jul-
13
Au
g-1
3
Sep
-13
Oct
-13
No
v-1
3
De
c-1
3
Jan
-14
Feb
-14
Mar
-14
Ap
r-1
4
May-…
Jun
-14
Jul-
14
Au
g-1
4
Sep
-14
Oct
-14
No
v-1
4
De
c-1
4
Jan
-15
Feb
-15
Mar
-15
Ap
r-1
5
May-…
Jun
-15
Jul-
15
Au
g-1
5
FY13 FY14 FY15
Implementation of Improvement Ideas
78,772 ideas
and counting...
HOW ARE WE DOING?
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22 Confidential. For internal use only. Not for distribution.
LEAN AT HEALTHEAST – CULTURE
Leadership Commitment
- Involvement
- Role Modeling
- Doing
Education
- Create a desire and path to learn
Culture Alignment
- Engagement
- Readiness
- Considerations
- Alignment
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23 Confidential. For internal use only. Not for distribution.
LEAN AT HEALTHEAST – LESSONS LEARNED
Key Learning
- Engage discussions early on and keep those discussions moving
Key Stakeholders
- Make connections to why
- Make connections to the Employee Experience and Engagement
- Strong communications platforms
- Reinforce, Reinforce, Reinforce
- Senior Leaders Role Model and lead the way
- Leaders need humility
- Go to the Gemba AND keep engagement with employees
- Build Systems of support
- Be courageous, have fun, stay the course!
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24 Confidential. For internal use only. Not for distribution.
LEAN AT HEALTHEAST – WHAT TO DO
Go to Gemba, ask “why”, learn the process
Make problems visible and accept they exist
Develop people (everybody) and improve processes (all of them) simultaneously
Stabilize, Standardize, Simplify
Biggest of all: ongoing PDCA expertise
Leverage Senior Leaders
- Lead the way by Teaching
- Lean Bronze Certification
- Reward and Recognize
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25 Confidential. For internal use only. Not for distribution.
LEAN JOURNEY CONTINUES
Why
VBI?
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USING LEAN TO ENGAGE AND ALIGN THE ENTIRE ORGANIZATION
Continuous Improvement
With Respect for People