process excellence executive seminar series quick and ...€¦ · process excellence executive...

PROCESS EXCELLENCE EXECUTIVE SEMINAR SERIES

"" Quick and Effective Ways to Continuously Transform People Development in Your Laboratory" "

Mark GrabanSenior Lean ConsultantValuMetrix Services

Author, “Lean Hospitals: Improving Quality, Patient Safety, and Employee Satisfaction”(Productivity Press, 2008)

Ortho-Clinical Diagnostics, Inc.Confidential - Not for Further Distribution - Rev. 06/19/2007

Kanban

Standard

ized W

ork

Poka-Yoke

Kaizen

Andon

What Lean is Not: Just Tools

Adapted from Toyota, 2000



What Lean Is: Tools and Culture


The Lean “House”



Toyota Expression:

“Building people before building cars…”


Hospital Expression???

“Building people before building cars…”fixing patients…”



TPS

Toyota

Production

System

Thinking


Thinking Production System“An environment where people have to think

brings with it wisdom, and this wisdom brings with it kaizen…

It's a basic characteristic of human beings that they develop wisdom from being put under pressure.

Perhaps the greatest strength of the Toyota Production System is the way it develops people.

This is why the T actually stands for ‘Thinking’as well as for ‘Toyota.’”

– Teruyuki Minoura, Toyota



What Sets Us Apart?

• Similar Design

• Same Machines

• Same Layout

• Same People (starting point)


“What Sets Us Apart?”

“Every Toyota team member is empowered with the ability to improve their work environment. This includes everything from quality and safety to the environment and productivity. Improvements and suggestions by team members are the cornerstone of Toyota's success.”



What Lean Is:

1. Continuous improvement and the elimination of waste

2. “Respect for humanity”

WASTE


ContinuousImprovement

“Respect for People”

Adapted from Toyota, 2000

“Equally Important Pillars” of TPS



Before Lean:

“With all of the automation,

I feel like a robot.”• Medical Technologist, 25 yrs


Lean Team Member (RN)

“I’ve worked here for six years and this is the first time anyone has asked me what I think

about anything.”



Do Work Improve Work


Do Work Improve Work



How to Engage Staff in Improvements

• Dedicated Lean efforts– Lean Team

– Entire Lab

• Suggestion / Idea Systems– Lean problem solving

– “Kaizen” and continuous improvement

– Measuring performance and auditing processes


“Lean Teams”



Case Example: Sandy

• Micro MT

• Newly found confidence & skills– Less reserved, less quiet

– “…one who leads shift standup meetings with something starting to resemble enthusiasm.”

– “I wouldn’t have expected that.”


Daily Standup Meetings



Entire Lab Staff


Ideas vs. Suggestions

“ Suggestions are things I think you should do…

Ideas are things that I can do.”

- Norman Bodek



Visual Tracking of Ideas

Ideas Flow Right to Completion

Posted right in the Lab


$4,000 per employee

per year



Lean Problem Solving

• Manager as coach and teacher

• Identify the root cause

• Focus on process, not people

• Prevent the fire, don’t just fire fight


Early Idea Cards



Early Idea Cards

Problem Planes crash sometimes

Suggestion Be more careful when taking off, flying, and landing


Early Idea Cards

Problem Leave house without zipping up pants

Suggestion Verify EVERY zipper before leaving the house



Dealing with “Bad” Ideas

• Treat each idea as a gift– Don’t be disrespectful to anybody’s idea, ever

• If an idea seems impractical– Make sure there is a clearly defined problem

statement

– Discuss other ways of solving the problem


Case Example: John

• MT, CMC employee since 1992– “competent, dependable, technically superb,

responsible, and known for helping colleagues”



Be a Supervisor?

• Resisted moving to supervisor position for many years– Opportunities were available

– Encouraged to consider

• Why not?


After Lean Began, 2007

• John became Hematology supervisor, Feb 2009

• Why?– Shift to no-blaming culture

– Environment focused on process and systems

– Renewed focus on “taking care of kids”



Traditional:• Controlling

• “Bossy”

• Going to “dark side”

Lean:• Helping

• Understand and meet “legitimate needs”

• Facilitating success

Different Style of Supervisor

“… great example of how one can transition to a supervisor role without offending and alienating

colleagues.”


Daily Visual Metrics & Audits



Different Style of Auditing

• Traditional:– “Caught you” and “write you up”

• Lean:– Inquiring

– Different = better?

• NO “OK, let’s follow the standardized work, but thanks for trying”

• “YES Hey! Let’s write up an idea card, pilot, and verify if it’s an improvement”


Identifying Future Leaders

• “You’re going to have this office someday.”– VP of Nursing to Lean Team RN

• “We’ve found one of our future leaders.”– C.O.O. (and RN)

• Who can lead change, influence others, communicate, persevere, grow, and learn?

• Who rises to the top and proves themself?



Case Study: Abby

• RN, 3 years experience– Developed good negotiating and listening skills

– Looks for win/win opportunities

– Respectful of budget concerns

– Will not hesitate to push for staff or patient needs

– Sees more of the “big picture” of healthcare


Case Study: Abby

• RN, 3 years experience– Now more data driven

– Can tie Lean to patient outcomes and staff concerns

– Easier for her to confront co-workers about tough issues

– Better at bringing a group together for a common goal



What to Expect?

• Will everyone be like John or Abby?

• Does everyone have the capabilities?

• Does everyone have the drive?

• Why might some not take this leap?


We Need Leadership Support

“Improvement usually means

doing something that we have

never done before.”

- Shigeo Shingo



“Embrace Your Problems!”

• Problems are not to be hidden – Problems are an opportunity for fix a problem

– Prevent it from ever occurring again

• “No problems is a problem”


Shift the Mindset

• It’s always been that way

• That won’t work!

• Be careful!

• Yell about bad results and pressure people

• Putting up with problems, being a hero

• Blame others

• The boss knows more and has formal power

• Why does it have to be that way?

• Let’s make it work!

• Fix the process

• Proactively manage the process

• Fix the root cause and prevent fires

• Work together

• Coach, lead, ask questions –“boss” has different role

Traditional Lean



What Can We Do as Leaders?

• Lead by example

• Teach root cause problem solving

• Follow the PDCA / PDSA process


An Inadvertent Lean Role Model?

“I’m going to make mistakes and I wouldn’t

trade that for anything because I always

say the minute you stop making

mistakes is the minute you stop

learning…”



Questions?

• [email protected]

• 817-372-5682

• www.leanhospitalsbook.com– Book available through:

• Amazon.com

• Productivitypress.com

• www.valumetrixservices.com

• www.leanblog.org

• www.twitter.com/leanblog

process excellence executive seminar series quick and ...€¦ · process excellence executive...

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