Implementing a Kaizen

Suggestion SystemPart 1/3

• Principal, Leonardo Group Americas LLC.• Co-Author of Fundamentals of Flow Manufacturing,

Aerospace Flow, In the OR series of Lean Hospital books.

• VP of Technology, John Costanza Institute of Technology.

• MBA, University of Colorado and APICS CPIM certified.

• Trained over 5,000 Lean professionals since 1994.• Lean Hospital work since 2002.• Creator of the Lean Operations track for the

Aerospace Supplier Excellence Alliance (SEA).• 16 years of manufacturing management at Storage

Technology Corporation and Ball Corporation prior to consulting career.

• Bilingual Spanish-English.

RichardRahn

Webinar Overview

An important element in the creation of a culture of continuous improvement is the engagement of the entire hospital

staff in sharing and implementing improvement suggestions. These ideas

should be easy to think up, easy to approve, and easy to do. The approach is

called “Quick and Easy Kaizen”.

What is the Plan? Webinar 1: Training and

Setting Up a Kaizen Management System.

Webinar 2: How to conduct a Kaizen Department meeting.

Webinar 3: How to implement and sustain improvement suggestions.

Learning About Lean

Webinar Schedule

Kaizen Implementation Steps

Webinar 1: Training and Setting Up a Kaizen Management System.

Webinar 2: How to conduct a Kaizen Department meeting.

Webinar 3: How to implement and sustain improvement suggestions.

ASSESS O.R.OPERATIONS

START LEAN HOSPITAL TRANSFORMATION

SET UP PERFORMANCE

DASHBOARD

TRAINLEADERSHIP

TEAM

CONDUCTPILOT PROJECTS

TRAIN HOSPITAL STAFF

IMPLEMENTGOAL DEPLOYMENT

TOOLS

CONDUCT INITIAL KAIZEN EVENTS

IMPLEMENTSUSTAINABILITY

ROADMAP

INSTITUTE UNIT CPI TEAM

KAIZEN MENTORCERTIFICATION

TRAINING

IMPLEMENT KAIZEN SUGGESTION SYSTEM

ROADMAP COMPLIANCE AUDIT

SUSTAINEDPERFORMANCE

The Lean Hospital Master Plan includes a definition of identified

improvements, resources required, implementation timeline,

estimated benefits, and ROI for the selected value streams.

Conduct a comprehensive, lean-focused audit, with the objective of advancing the Lean Culture at the Hospital.

Each team leader presents the status of completed Kaizen projects to ensure results and sustained performance.

Train a team of Hospital Staff to become internal Lean Mentors.

Organize a local Continuous Process Improvement Team to identify, evaluate, and implement improvements.

To support the Hospital’s Lean journey, Leaders must understand the tools and culture of Continuous Process Improvement.

A Lean Hospital embraces a participative model of Continuous Improvement. All Lean Hospital employees must be trained to be a part of this culture. Conduct Value Stream analysis for each

unit and department to identify opportunities for improvement. Create a unit-level Master Plan.

Roll-out unit and department process improvement activities per the Lean Hospital Master Plan.

Formalize the process of soliciting, receiving, evaluating, and implementing process improvement suggestions for the entire hospital.

Select highly visible areas for proof of concept and buy-in. Follow

Kaizen methodology to achieve results in less than 5 days.

KAIZEN MENTORCERTIFICATION

Certify all Internal Lean Mentors through completion of actual projects and Knowledge Checks.

VALUE STREAM ANALYSIS AND MASTER PLAN

DEVELOP UNITMASTER PLANS

Establish lean performance metrics and method for reporting, analysis,

and follow-up.

Lean Hospital Implementation Roadmap

109

111213

1415

1

2

An initial assessment of current hospital operations, including future vision and level of process improvement maturity. Includes

analysis of potential benefits.

3

4

5

6

7 8

Train Leadership Team in the principles of Hoshin Kanri (Goal Deployment) and formalize internal process. Use A3-X chart and Team Charter forms for all Master Plans.

Download at www.flowpublishing.com under “Resources”.

COMPLETE A3 PROJECT STATUS

CONDUCT Q&E KAIZEN

TRAINING

START KAIZEN SUGGESTION SYSTEM

LEAN HOSPITAL KAIZEN SUGGESTION SYSTEM

Quick and Easy (Q&E) Kaizen is the soliciting, documenting,

reviewing, approving and implementing small

improvement suggestions by hospital staff. Initial training

will be needed.

SET UP KAIZEN MANAGEMENT

DATABASE

ENTER SUGGESTIONS FOR IMPROVEMENT

REVIEW AND APPROVE KAIZEN

PROJECTS

PRIORITIZE SUGGESTIONS

CONDUCT KAIZEN EVENT

COMMUNICATE RESULTS TO HOSPITAL

COMPLETE KAIZEN EVENT PREPARATION

COMPLETE KAIZEN PLANNING

CONDUCT STAFF CPI MEETINGS

POST RESULTS OF A3 PROJECT STATUS

FUNCTIONAL KAIZEN SUGGESTION SYSTEM

1

Continuous Process Improvement (CPI) meetings are led by a

department manager, and take place at least weekly. Suggestions are captured during this meeting.

An electronic database is needed, with ability to

manage and share data across the hospital system

and submit ideas easily.

Capture suggestions during the Kaizen meetings and enter into KMS. Suggestions will also come from Value Stream Mapping and independent input.

Prioritize ideas according to your hospital’s unit priorities or KPIs.

Use KMS to document detailed tasks, key participants, value

streams affected and expected benefits. Use A3 Team Charter format for a consistent format.

Establish activity date.

Good preparation is a key to success, including coordinating with all staff members, gathering required data

and securing resources.

Conduct the event according to the Kaizen Event Roadmap.

Keep hospital informed on the latest suggestions approved and projects available. Update dashboard and status report. Show results to all employees.

The Kaizen Leader will prepare the final Kaizen

Event summary in A3 Project Status format.

The A3 Project Status Report documents the Pre and Post-Kaizen state with an explanation of the tools applied and the benefits achieved.

2

4

5

PROCESS Q&E SUGGESTIONS

Review, approve and implement ideas at the unit or department level. In most cases the submitter is also the implementer. Provide feedback within 24 hours.

For non-Q&E suggestions, identify the financial benefits and qualitative benefits. These suggestions will require planning.

5

7 8 9

10

11

121314

6

CONDUCT MANAGEMENT

KAIZEN TRAINING

2

3

Kaizen Suggestion System Roadmap

Download at www.flowpublishing.com under “Resources”.

QUICK AND EASY KAIZENNORMAN BODEK

Guidelines1. Get prepared to process

suggestions. Set up your KMS.

2. Train your Leadership Team.

3. Participation is voluntary for staff. Encourage Positive Deviants.

In A Nutshell

Kaizen Implementation Strategy

Shunryu Suzuki Roshi

The Speed of Change

“After you have practiced for a while, you will realize that it is not possible to make rapid, extraordinary progress. Even though you try very hard, the progress you make is always little by little. It is not like going out in a shower in which you know when you get wet. In a fog, you do not know you are getting wet, but as you keep walking you get wet little by little. If your mind has ideas of progress, you may say, "Oh, this pace is terrible!" But actually it is not. When you get wet in a fog it is very difficult to dry yourself. So there is no need to worry about progress. “

The Q&E Kaizen Cycle

IReceive

Ideas

IIReview and

Approve

IIIImplement

Quickly

IVPromote

and Publicize

VBuild

Enthusiasm

Actual Experience at TMHU Initial Assumption:

Announce the suggestion system and everyone will get on board.

Actual Experience: Very little participation. Wary of management motivation.

Revised Strategy. Build participation slowly, by encouraging early adapters.

It’s Not Like Twisting Your Arm

Case History

Phase 1: Train Management Team

Conduct Management

Kaizen Training

Leadership and Staff Point of Contact

Vision andManagement

Executive Team

DepartmentManager

Tele Floor Staff

Surgical Floor Staff

DepartmentManager

Emergency Department

Staff

DepartmentManager

Imaging Department

Staff

Lean Coordinator

Kaizen Lean Management System

Engine: Leader Standard Work

Fuel:Discipline

Gas Pedal and Steering: Daily Accountability

Transmission:Visual Controls

Leader Habit When Following Up• What did you do last

week?• What will you do this

week?• What problems or

roadblocks are you finding?

• What can I do to help?

The Four Questions

Kaizen Lean Management System

• Lead from the Top• Organization reflects

Leaders behavior.

• Kaizen Status Board• KMS Dashboard

• Daily Gemba Walk• KMS Shared Access• Weekly Management

Meeting

• Daily Review• Daily/Weekly Kaizen

Meetings

Standard Work

Account-ability

DisciplineVisual

Controls

Creating A Unit Target Condition

Current State

Unknown Steps

Target Condition Vision

Example of Weekly Kaizen

Fix it Fridays

Getting Penquins In A Row Who Does What

The Management Habit

Common View: Managers Are Responsible for Management Duties

Progressive View: Managers Are Responsible for Management Duties Plus Continuous Improvement

Lean View: Management = Managing and Improving Processes

Phase 2: Train Staff

Train Staff in Kaizen

What A Surprise!

Training Does Not Change Behavior!

Learning By Doing

Training Maturity Levels

Classroom Training Only

Classroom Training With Exercises and Simulations

Classroom Training with Exercises and Simulations Followed by Doing

Awareness Training Followed by Application under Mentor Guidance

It’s A Marathon, Not A Sprint Sports, Science, Religion, Art

The Meaning of “Training”

Continually practicing a skill or discipline under the guidance of a personal trainer or mentor.

“Excellence is an art won by training and habituation. We do not act rightly because we have virtue or excellence, but we rather have those because we have acted rightly. We are what we repeatedly do. Excellence, then, is not an act but a habit.”-Aristotle

Aristotle History of Philosophy

The Wisdom of Aristotle

The PDCA Cycle

CPI

Q&E Kaizen Rules

1. Ideas need to easy to write down.75 words or less.

2. Ideas should be easy to approve.Approval in 24 hours or less.

3. Ideas should be easy to implement.Done by the person who submitted the idea.

Phase 3: Set Up Database

Set Up Kaizen

Management Database

Can You Handle It?

• What if it is only 1 per year?

• What if you get 5 per year?

• Goal: you should expect 1 per month as a target.

How Many Ideas Can We Expect?

Expected Volume of Suggestions

Home-Grown System• Easy to set up. Low cost.• Rely on single point manual

data entry.• Security is a concern.• Backup is a concern.• Capacity is a concern.

Excel-Based System

• Access / Sharepoint / Other• IT involvement needed.• Can be very expensive.• Long-term maintenance

needed.• No leverage for system

improvement.

Kaizen Database Option

Formalization Step• Easy to set up. Low cost.• Minimal IT maintenance

needed.• Benefit from system

improvements across multiple users.

• Access benchmarking data from multiple hospitals.

Cloud-Based System

Cloud-Based Systems

Real-Time Status

Case in Point

A Call to Action

Conduct Initial Planning

Consensus on Action

Research Requirements

Conduct Leadership

Training and Master Plan

Execute Master Plan

COMPLETE A3 PROJECT STATUS

CONDUCT Q&E KAIZEN

TRAINING

START KAIZEN SUGGESTION SYSTEM

LEAN HOSPITAL KAIZEN SUGGESTION SYSTEM

Quick and Easy (Q&E) Kaizen is the soliciting, documenting,

reviewing, approving and implementing small

improvement suggestions by hospital staff. Initial training

will be needed.

SET UP KAIZEN MANAGEMENT

DATABASE

ENTER SUGGESTIONS FOR IMPROVEMENT

REVIEW AND APPROVE KAIZEN

PROJECTS

PRIORITIZE SUGGESTIONS

CONDUCT KAIZEN EVENT

COMMUNICATE RESULTS TO HOSPITAL

COMPLETE KAIZEN EVENT PREPARATION

COMPLETE KAIZEN PLANNING

CONDUCT STAFF CPI MEETINGS

POST RESULTS OF A3 PROJECT STATUS

FUNCTIONAL KAIZEN SUGGESTION SYSTEM

1

Continuous Process Improvement (CPI) meetings are led by a

department manager, and take place at least weekly. Suggestions are captured during this meeting.

An electronic database is needed, with ability to

manage and share data across the hospital system

and submit ideas easily.

Capture suggestions during the Kaizen meetings and enter into KMS. Suggestions will also come from Value Stream Mapping and independent input.

Prioritize ideas according to your hospital’s unit priorities or KPIs.

Use KMS to document detailed tasks, key participants, value

streams affected and expected benefits. Use A3 Team Charter format for a consistent format.

Establish activity date.

Good preparation is a key to success, including coordinating with all staff members, gathering required data

and securing resources.

Conduct the event according to the Kaizen Event Roadmap.

Keep hospital informed on the latest suggestions approved and projects available. Update dashboard and status report. Show results to all employees.

The Kaizen Leader will prepare the final Kaizen

Event summary in A3 Project Status format.

The A3 Project Status Report documents the Pre and Post-Kaizen state with an explanation of the tools applied and the benefits achieved.

2

4

5

PROCESS Q&E SUGGESTIONS

Review, approve and implement ideas at the unit or department level. In most cases the submitter is also the implementer. Provide feedback within 24 hours.

For non-Q&E suggestions, identify the financial benefits and qualitative benefits. These suggestions will require planning.

5

7 8 9

10

11

121314

6

CONDUCT MANAGEMENT

KAIZEN TRAINING

2

3

Kaizen Suggestion System Roadmap

Questions?

Leonardo GroupPrincipals: Gerard Leone & Richard D Rahn303-494-4404Boulder, Co 80303

PowerHealth OnDemandScott Calvert VP Business Development

303-683-8239Greenwood Village, Co 80111