lean healthcare how to build a lean sensei army for ... · vernon, new hampshire is a lean master...

*Lean Healthcare**Lean Healthcare*

How to Build a Lean Sensei How to Build a Lean Sensei

Army for Continuous Army for Continuous

Improvement!Improvement!

February 23, 2008February 23, 2008Presented To: IIE, SHSPresented To: IIE, SHS

1:101:10--2:30pm2:30pm

OverviewOverview

�� How do you create an ideal Lean Sensei How do you create an ideal Lean Sensei program that spreads Lean quickly, achieves program that spreads Lean quickly, achieves ROI, and enables lasting change?ROI, and enables lasting change?

�� Grow internal change agents that teach, Grow internal change agents that teach,

© 2008 More Effective Consulting, LLC. All Rights Reserved.2

�� Grow internal change agents that teach, Grow internal change agents that teach, promote and empower promote and empower –– what we call what we call –– a lean a lean Sensei.Sensei.

Why Sensei’s?Why Sensei’s?

A Good Sensei . . .A Good Sensei . . .

What makes a good Sensei training curriculum?What makes a good Sensei training curriculum?

AgendaAgenda

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What makes a good Sensei training curriculum?What makes a good Sensei training curriculum?

Real Hospital examples: growing a Lean ArmyReal Hospital examples: growing a Lean Army

1.1. SWMC, Washington (350 beds)SWMC, Washington (350 beds)

2.2. Millinocket, Maine (25 beds)Millinocket, Maine (25 beds)

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�� The Japanese word sensei literally means:The Japanese word sensei literally means:

"one who has gone before”"one who has gone before”

�� It is a poetic way to denote someone who has walked It is a poetic way to denote someone who has walked

Definition of a SenseiDefinition of a Sensei


�� It is a poetic way to denote someone who has walked It is a poetic way to denote someone who has walked

along the way before you and who may now show along the way before you and who may now show

you the path.you the path.

I took what I was given and made it I took what I was given and made it better.better.

What What I made better I then I made better I then improved.improved.

What What I improved I now strive to perfect.I improved I now strive to perfect.

--unknown Senseiunknown SenseiHow many

people have

some type of

Sensei program?

�� Hospitals can take a variety of avenue’s to train and Hospitals can take a variety of avenue’s to train and

encourage change. Why a Sensei approach?encourage change. Why a Sensei approach?

�� Consistent message and methodsConsistent message and methods

�� Every hospital has hundreds and thousands of employees. Every hospital has hundreds and thousands of employees.

Why use a Sensei approach?Why use a Sensei approach?


�� Every hospital has hundreds and thousands of employees. Every hospital has hundreds and thousands of employees.

One person or department can’t do it alone.One person or department can’t do it alone.

�� Reinforces the hospital’s commitment, rather than the edict Reinforces the hospital’s commitment, rather than the edict

for the quality department to “explore”.for the quality department to “explore”.

�� Consultants/Trainers shouldn’t be a crutch, but a catalyst Consultants/Trainers shouldn’t be a crutch, but a catalyst

and content and deployment expert Wait. Did I just say that?and content and deployment expert Wait. Did I just say that?

�� There are many traits. Here are the categories we There are many traits. Here are the categories we

judged by:judged by:

What makes a good SenseiWhat makes a good Sensei

�� SpeakingSpeaking

�� CommunicationCommunication


�� PersonalityPersonality

�� FocusFocus

�� Knowledge and RetentionKnowledge and Retention

�� SkillSkill

�� There are many departments and employees. How There are many departments and employees. How

do you pick ‘do you pick ‘emem??

What makes a good SenseiWhat makes a good Sensei

�� DepartmentDepartment

�� Criteria aloneCriteria alone


�� Most broken area Most broken area

�� SolicitedSolicited

�� Volunteer’sVolunteer’s

�� Characteristics of a good Sensei curriculum:Characteristics of a good Sensei curriculum:

What makes a good CurriculumWhat makes a good Curriculum

�� Lean BasicsLean Basics

�� Fast learning curve means more handsFast learning curve means more hands--on learning on learning

�� Sensei’s develop the upcoming training contentSensei’s develop the upcoming training content


Sensei’s develop the upcoming training contentSensei’s develop the upcoming training content

�� Materials: Materials: Mix of books, articles, simulation, closed Mix of books, articles, simulation, closed

book quizzes, “Sensei Toolbox”, networked master book quizzes, “Sensei Toolbox”, networked master

folder with easy access by allfolder with easy access by all

�� Weekly meetings with Master Sensei (like a Weekly meetings with Master Sensei (like a

steering committee)steering committee)

�� Shadowing (training and Shadowing (training and kaizenskaizens))

�� Simplifying Sensei administrative work and keeping Simplifying Sensei administrative work and keeping

information consistent:information consistent:

Sensei ToolboxSensei Toolbox

��PrePre--Kaizen Kaizen

ToolsTools


ToolsTools

��PostPost--Kaizen Kaizen

ToolsTools

�� Characteristics of a good Sensei deployment:Characteristics of a good Sensei deployment:

What makes a good DeploymentWhat makes a good Deployment

1.1. Parallel deployment efforts:Parallel deployment efforts:

�� Lean 101 training to general populationLean 101 training to general population


�� Lean communication throughout hospital systemLean communication throughout hospital system

�� Kaizen events 1Kaizen events 1--2 per month2 per month

�� Sensei training by consultant/trainerSensei training by consultant/trainer



2.2. Balanced Deployment:Balanced Deployment:

�� Work with Sensei’s schedule, but obtain 10Work with Sensei’s schedule, but obtain 10--20% 20%

commitment of their available timecommitment of their available time


�� Utilize less than 10 Sensei’s per “wave” of Sensei Utilize less than 10 Sensei’s per “wave” of Sensei

training and development. Don’t saturate your training and development. Don’t saturate your

healthcare system.healthcare system.

�� Only 1 Only 1 –– 2 kaizen’s per month (per group of 10 2 kaizen’s per month (per group of 10

Sensei’s)Sensei’s)

�� No preferential treatment to Sensei overNo preferential treatment to Sensei over--

achievers. Sensei group is treated as a team.achievers. Sensei group is treated as a team.



3.3. Timely Deployment:Timely Deployment:

�� Sensei selection and “jumpSensei selection and “jump--start” begins immediatelystart” begins immediately


�� Sensei learns Lean basics month 1Sensei learns Lean basics month 1--66

�� Sensei learns advanced Lean month 6Sensei learns advanced Lean month 6--1212

�� Sensei shadowing training and kaizen’s after Sensei shadowing training and kaizen’s after

observing only observing only oneone..

�� Millinocket, MaineMillinocket, Maine

�� Rural setting, Rural setting, critical accesscritical access, 25 beds, 300 employees, 25 beds, 300 employees

�� Key process attributes for Sensei’s planning Kaizen’s:Key process attributes for Sensei’s planning Kaizen’s:

Hospital Sensei Program ExamplesHospital Sensei Program Examples


�� Only 1 Ortho and General Surgeon, 1 RadiologistOnly 1 Ortho and General Surgeon, 1 Radiologist

�� On and off campus surgical and family practice officesOn and off campus surgical and family practice offices

�� Sensei Deployment . . .Sensei Deployment . . .

�� Millinocket Regional HospitalMillinocket Regional Hospital

�� Lean Sensei’sLean Sensei’s

Hospital Sensei Program ExamplesHospital Sensei Program Examples

CEOCEO


CQOCQO CFOCFO CNOCNO

•• MtrlsMtrls MgmtMgmt•• Utilization Utilization

Mgmt, Mgmt, CustCust. .

Sat.Sat.

•• Director of Director of

Inpatient Inpatient

NursingNursing

PPMPPM

�� The CEO wanted to be a Sensei (and still wants to be one)!The CEO wanted to be a Sensei (and still wants to be one)!

�� 5 Sensei’s, each with different backgrounds5 Sensei’s, each with different backgrounds

�� Alternate Kaizen event participationAlternate Kaizen event participation

�� Kaizen events occur monthlyKaizen events occur monthly

�� Sensei’s started as Kaizen Preparation and Follow up Sensei’s started as Kaizen Preparation and Follow up

Millinocket Sensei DeploymentMillinocket Sensei Deployment


�� Sensei’s started as Kaizen Preparation and Follow up Sensei’s started as Kaizen Preparation and Follow up

resources as they shadowed events and obtained resources as they shadowed events and obtained

coachingcoaching

�� Need knowledge depth and exposure to a variety of Need knowledge depth and exposure to a variety of

different Kaizen eventsdifferent Kaizen events

�� 6 Kaizen events completed in ‘07, 10 planned for 6 Kaizen events completed in ‘07, 10 planned for

2008 2008

�� Kaizen ExampleKaizen Example

�� Mammography to Biopsy Lead Time (Dec. ‘07)Mammography to Biopsy Lead Time (Dec. ‘07)

�� 2 Sensei’s. One co2 Sensei’s. One co--facilitating. One observing.facilitating. One observing.

�� Average of 31Average of 31--72 days72 days

�� Approx. 25 Biopsy’s performed annuallyApprox. 25 Biopsy’s performed annually

Millinocket Sensei DeploymentMillinocket Sensei Deployment


�� Approx. 25 Biopsy’s performed annuallyApprox. 25 Biopsy’s performed annually

�� Outcomes:Outcomes:

�� Pull System implemented where scheduling “Reserves” Pull System implemented where scheduling “Reserves”

a spot.a spot.

�� Improved communication that reduced “time to notify Improved communication that reduced “time to notify

patient” and scheduling prepatient” and scheduling pre--surgery consultsurgery consult

�� Last 3 patients were 5 days, 7 days, 6 daysLast 3 patients were 5 days, 7 days, 6 days

�� How to build a Sensei army depends on commitmentHow to build a Sensei army depends on commitment

�� Different size hospitals require a scaling of an armyDifferent size hospitals require a scaling of an army

�� Keep communication channels open on successes, Keep communication channels open on successes,

upcoming Kaizen events, Kaizen audit results, Kaizen upcoming Kaizen events, Kaizen audit results, Kaizen

savings, Sensei roster, and intra ‘Army’ strengths and savings, Sensei roster, and intra ‘Army’ strengths and

SummarySummary


savings, Sensei roster, and intra ‘Army’ strengths and savings, Sensei roster, and intra ‘Army’ strengths and

weaknessesweaknesses

�� Keep a consistent engine of change. Don’t stop Kaizen’s!Keep a consistent engine of change. Don’t stop Kaizen’s!

�� No Magic Bullet. Sorry . . .No Magic Bullet. Sorry . . .☺☺☺☺☺☺☺☺

Thank You . . .Thank You . . .

Reach Dana at:Reach Dana at:

[email protected]@swmedctr.com

Reach Matt at:Reach Matt at:

[email protected]@MoreEffective.com

Q & AQ & A

Lean Healthcare Thanks!Lean Healthcare Thanks!


[email protected]@swmedctr.com

Vancouver, WAVancouver, WA

[email protected]@MoreEffective.com

Mont Vernon, NHMont Vernon, NH

SpeakersSpeakers

�� Matt Morrissette, President of More Effective Consulting, LLC. in Mont Matt Morrissette, President of More Effective Consulting, LLC. in Mont

Vernon, New Hampshire is a Lean Master Sensei, 6Sigma Green Belt, Vernon, New Hampshire is a Lean Master Sensei, 6Sigma Green Belt,

Industrial Engineer, member of IIEIndustrial Engineer, member of IIE--SHS, and President of the Boston SHS, and President of the Boston

Chapter of IIE. Matt consults with executives and leads front line Chapter of IIE. Matt consults with executives and leads front line

employees through customized Lean Healthcare initiatives. He has employees through customized Lean Healthcare initiatives. He has

helped more than 25 hospitals embark and continue their continuous helped more than 25 hospitals embark and continue their continuous

improvement efforts that save money and build lasting change. improvement efforts that save money and build lasting change.


improvement efforts that save money and build lasting change. improvement efforts that save money and build lasting change.

�� Dana Webb, Director, Care Management & Continuous Improvement at Dana Webb, Director, Care Management & Continuous Improvement at

Southwest Washington Medical Center in Vancouver, WA is a Lean Southwest Washington Medical Center in Vancouver, WA is a Lean

Sensei, Registered Nurse, and has her Masters in Business Sensei, Registered Nurse, and has her Masters in Business

Administration. Dana has responsibility for care management Administration. Dana has responsibility for care management

activities, hospitalist relations, and oversees the Lean Sensei activities, hospitalist relations, and oversees the Lean Sensei

deployment. deployment.

*lean healthcare* how to build a lean sensei army for ... · vernon, new hampshire is a lean master...

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