MGH Gemba Walks Go and See

Transcription

1 MGH Gemba Walks Go and See Gerry Cronin Kaizen Promotion Office Manager Center for Comparative Medicine Massachusetts General Hospital Boston, MA Pre-AALAS Lean Management Satellite Symposium October 2, 2011

2 Go to Gemba Translation: The Real Place Japanese TV Crime Scene: Gemba Scene of the crime

3 Key Concepts of Gemba Walks Go See Senior management must spend time on the front lines Ask Why Use the 5-Why Technique Show Respect Show respect for your people Chairman Fujio Cho

4 The Gemba Walk Objective Daily Leadership Walks designed to bring problems to the surface Seek to understand the problems Build organizational Problem-Solving capability Improve the Standards Empower workers to solve problems Be visible, be available Be noticed noticing!

5 CCM Gemba Walk Evolution 2009: no structured walk process 2010: Murli Associates mandate: Go and see! Consistency Visibility Leadership knowledge Leadership support Lead by example CCM approach: Leadership Walk Focus: learn the walk process Understand the challenges Practice asking questions

6 CCM Leadership Walk 1 st Walk based on inspection Leadership focused on their specialty: Opportunities for innovation Standardization of processes Veterinary practices Personal expertise Facility Managers defended their processes Walk pushback; unprepared, too busy, frustrated, angry, avoidance Erratic staff attendance

7 Lessons Learned Discovery: Need to standardize the process Focus on one global initiative: Workplace Organization (5S) Eliminate confusion and frustration Everyone view from the same lens Everyone share the same language Clarify Expectations for all

8 Define the topic: 5S Standardizing the Walk Train the entire staff in 5S Process Set up a standardized schedule Rearrange meetings Walk : sacred time Identify roles who must participate Senior Leadership Facility Managers Team Leads Administrative Staff Facility hosts are now prepared Not an optional program 1+ week notice All roles provide real-time feedback Schedule

9 Standardizing the Walk Process Develop tools and guidelines for conducting walks What are we looking for? How many spaces? How much time? Empower facility staff to lead the walks Repetition: Answer the questions before they are asked Score according to work performed and their demonstrated knowledge Celebrate Victories!

10 Deep Dives & Pulse Points Deep Dives : Question processes to entice deeper problem solving Pulse Points : Checkpoints to verify improvements are sustained Walk Debrief What did we learn?

11 Deep Dive Questions What is the Standard? How clear is the Standard to those doing the work? How clear is the Standard to those not doing the work? What are we doing to meet the Standard? What can we do to improve the current condition? What can we do to make the abnormal condition immediately visual? Why do you think I am asking you these questions? What other questions would you have liked me to ask you?

12 Leadership Walk Logistics Weekly schedule Tuesday Friday 10:05am 10:50am; 55 minutes Roles Represented Senior Leadership Middle Managers Facility Managers Veterinarians Program Managers Team leads RAS Vendors / visitors Visual Process Performance Boards Start point of walks

13 Leadership Walk Form Evolution 3 2 1

14 Next Steps: Gemba Walk Why now? Lean Culture embedded Routines are established Employees are comfortable with the routine Employee knowledge validated They are Answering the questions before they are asked Leadership is ready for the next level of inquiry Asking deeper questions to develop problem solving capability VPP Boards established Provide structure

15 The New Gemba Walk Process Select a theme for the Walk Safety (employee / animal welfare) Customer Service (VOC and special services) Productivity (are we ahead / behind?) Cost (overtime / trends) Innovation & Learning (problemsolving capability) Listen carefully; understand problems Ask Why 5 Times Share knowledge of what was learned enterprise-wide Follow-up to see what progress has been made Celebrate victories

16 Visual Process Performance Kaizen Daily task assignments are non-standard Distrust that the work they are doing is valued Overall workplace inefficiency Customer focus lost Unmet customer needs Fire-fighting Reacting to issues Erratic information Word-of-mouth communication Staff confusion Duplication of effort

17 Visual Process Performance Launched July 2011 Team Lead Survey: 86%: Helps my Team focus on issues that affect my workday. 80%: Helps my morning meetings. 90%: refer to the board 2-5 times per day. 84% of RASs refer to the board 2-5 times per day. 50% of TLs experienced a Reduction in duplication of effort. Boards (VPP)

18 Sample Gemba Walk Form

19 Examples of Gemba Walk Questions Is our data/charts up to date? What are the problems you are trying to solve? Why is this a problem? Is there Standard Work? Is Standard Work being followed? Why? What is the goal you are trying to achieve with the process? Has the Team participated in all decisions? What have you done to determine the root cause of the problem? What is your next step? What do you intend to improve today? When can we go and see what you have learned from taking the next step? What is today s priority? Why? What help do you need to prioritize or remove barriers?

20 Things to avoid at the Gemba Doing harm! Harsh criticism Giving answers! If you have the answer; you own the problem! Management by walking around! Politician: shaking hands and kissing babies Going alone! Leadership as a united front

21 Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime. --Chinese proverb