keynote - shs conference february 2014

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© 2014 The Karen Martin Group, Inc. Building the Foundation for Everyday Excellence The Outstanding Organization Healthcare Systems Process Improvement Conference February 23, 2014

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To subscribe: http://www.ksmartin.com/subscribe To buy the book: http://bit.ly/TOObk These are slides from a keynote given on 2/23/14 in Orlando, Florida at the Healthcare Systems Process Improvement Conference which was organized by The Society for Health Systems.

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Page 1: 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

Page 2: Keynote - SHS Conference February 2014

Success with Improvement

2

2001 – The Economist

None17%

Lasting20%

Temporary63%

Page 3: Keynote - SHS Conference February 2014

…A Decade Later2010 – Accenture

69%

58%

33%

Minimal financial impact

Needs re‐evaluation, restart or complete 

makeover

Mixed to disappointing 

results3

Page 4: Keynote - SHS Conference February 2014

Up to 98,000 deathsannually due tomedical errors.

Improvement goal:Reduce by 50%in 5 Years.

To Err is HumanInstitute of Medicine, 1999

Page 5: Keynote - SHS Conference February 2014

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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6

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.

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Employee Engagement – Gallup Findings

18

19

19

18

20

20

15

15

17

17

17

16

18

52

52

53

54

51

50

55

59

54

55

53

54

58

30

29

28

28

29

30

30

26

29

28

30

30

26

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

7

ACTIVELY DISENGAGED

NOT ENGAGED ENGAGED0% 100%

Page 8: Keynote - SHS Conference February 2014

© 2014 The Karen Martin Group, Inc. 8

Page 9: Keynote - SHS Conference February 2014

© 2014 The Karen Martin Group, Inc.

Ineffective behaviors

CHAOS

Page 10: Keynote - SHS Conference February 2014

10

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© 2014 The Karen Martin Group, Inc. 11

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© 2014 The Karen Martin Group, Inc. 12

Ambiguity complicates, slows, frustrates…        and is dangerous

Page 13: Keynote - SHS Conference February 2014

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

13

8 Ambiguity Wastes

Page 14: Keynote - SHS Conference February 2014

Dept C Dept DDept BDept A

Core Value Streams

Support Value Streams

Support Value Streams

Silo‐Centric vs. Value Stream Thinking 

Page 15: Keynote - SHS Conference February 2014

Gaining Clarity: Current State Value Stream MapOutpatient Imaging

Page 16: Keynote - SHS Conference February 2014

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%

Page 17: Keynote - SHS Conference February 2014

Gaining Alignment: Future State Value Stream MapOutpatient Imaging

Page 18: Keynote - SHS Conference February 2014

Who Owns the           Value Stream?

18

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19

How are we performing?

Page 20: Keynote - SHS Conference February 2014

Visualize Work Queues & Status

20

Page 21: Keynote - SHS Conference February 2014

© 2014 The Karen Martin Group, Inc. 21

Page 22: Keynote - SHS Conference February 2014
Page 23: Keynote - SHS Conference February 2014

There is no such thing as multitasking.*

* For cognitive tasks.

Page 24: Keynote - SHS Conference February 2014

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

Page 25: Keynote - SHS Conference February 2014

Focus Law #1:STOP DOING

Focus Law #2:DO FEWER THINGS 

AT ONCE

Page 26: Keynote - SHS Conference February 2014

26

Page 27: Keynote - SHS Conference February 2014

The Power of Focus:Projects Completed in One Year

27

0

10

20

30

40

50

60

70

80

Pre‐Focus Post‐Focus

73

24

• No additional resources

• Higher quality output

• Lower stress

Page 28: Keynote - SHS Conference February 2014

What is Your Improvement Strategy?

28

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Strategy Deployment Key Feature: Catchball

29

Executive Team

What?Who?When?

Senior Mgmt

What?Who?When?

Middle Mgmt

What?Who?When?

FrontlinesWhat?Who?When?

Page 30: Keynote - SHS Conference February 2014

30

Actively Working On In Queue

Started & Stopped New Ideas

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31

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

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© 2014 The Karen Martin Group, Inc. 33

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Train/Practice vs. Performance

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Athletes Businesses

34

Train90%

Train1%

Perform 99%

Perform 10%

Jim Loehr & Tony Schwartz,  The Power of Full Engagement

Page 35: Keynote - SHS Conference February 2014

© 2014 The Karen Martin Group, Inc. 35

Develophypothesis

Conduct experiment

Measure results

RefineStandardize Stabilize

Page 36: Keynote - SHS Conference February 2014

36

What problem are you trying to solve?

Why is it a problem?

Page 37: Keynote - SHS Conference February 2014

37

True Continuous Improvement

Page 38: Keynote - SHS Conference February 2014

© 2014 The Karen Martin Group, Inc. 38

Page 39: Keynote - SHS Conference February 2014

© 2014 The Karen Martin Group, Inc.

Engagement Drivers: The Three C’s 

39

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

Page 40: Keynote - SHS Conference February 2014

© 2014 The Karen Martin Group, Inc.

Leaders determine strategy (what)

Workers determine tactics (how)

Page 41: Keynote - SHS Conference February 2014

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

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42

Single Hits Add Up!

Doubles

Triples

Home Runs & Grand Slams

Page 43: Keynote - SHS Conference February 2014

© 2014 The Karen Martin Group, Inc. 43

Page 44: Keynote - SHS Conference February 2014

© 2014 The Karen Martin Group, Inc.

www.ksmartin.com

858.677.6799

Signing books immediately after               talk in exhibit hall