Hoshin Kanri in Saskatchewan, Canada Bonnie Brossart, Jim Rhode and Suann Laurent

Transcription

1 Hoshin Kanri in Saskatchewan, Canada Bonnie Brossart, Jim Rhode and Suann Laurent IHI National Forum Session C14 December 11, :30 pm 2:45 pm These presenters have nothing to disclose

2 Session Objectives Describe the key attributes of a strategic planning process that embraces continuous improvement principles and puts those who use the health system first Identify how a specific strategic planning process - Hoshin Kanri - can be used to build a shared narrative, create inspired cultures and facilitate health system transformation Apply these tools and learnings in other health systems 2

3 Who we are: Bonnie Brossart CEO Health Quality Council Jim Rhode Board Chair Saskatoon Health Region Suann Laurent President and CEO Sunrise Health Region 3

4 Some Context

5 Saskatchewan 5

6 Saskatchewan's health care system: 13 Regional Health Authorities 1 provincial Cancer Agency 5 hospitals in 2 cities with > 225K pop; 61 other hospitals in smaller centres 156 nursing homes 13 home care programs offered via RHAs approx physicians (mostly FFS) Aboriginal health services (federally funded) 6

7 Key events Quality as a Business Strategy ( ) 7

8 Key events Patient First Review (October 2009) Patient First must be embedded as a core value in health care Health care in Saskatchewan needs to function as a cohesive system Frontline providers must be empowered to deliver patientand family-centred care. 8

9 Key events Strategic and Operational Directions ( ) 9

10 Key events: expression of the health care system s strategic intent (2011) 10

11 Key Events: A commitment to establishing a World Class Management System (2011) Hoshin Kanri Daily Management Cross Functional Management Adapted from John Black and Associates, LLC 11

12 Implementing a World Class Management System Cross Functional Management Daily Management Hoshin Kanri Time Adapted from John Black and Associates, LLC 12

13 Saskatchewan s Implementation of a World Class Management System Hoshin Kanri Time Cross Functional Management Daily Management (Continuous Daily Improvement using LEAN) Adapted from John Black and Associates, LLC 13

14 What is Hoshin Kanri? It is an approach to planning that involves: Identifying a common vision Setting short- and long-term goals Executing plans to achieve those goals Tracking progress toward them Changing course as required

15 Hoshin Kanri = Management by Policy = Strategy Deployment = Hoshin Planning In Japanese, hoshin means shiny metal, compass, or pointing the direction; kanri means management or control. Purpose: Provide focus and direction; alignment throughout an organization Approach: Requires a high degree of participation through all levels of the organization. Operates in both a top-down and bottom-up fashion. 15

16 Hoshin Kanri in Action Goals were developed from the top down to all levels of the organization. The goals were few in number, but they enabled the enterprise to mobilize its total resources to achieve the desired results. The deployed goals plus the control of daily work moved the enterprise down the desired path. Each member of the organization understood the path the organization was taking. Bruce Gissing, Executive Vice-President Operations Boeing Commercial Airplane Group, 1991 Source: John Black and Associates, LLC 16

17 The straight goods The discipline of Hoshin Kanri is intended to help an organization: Focus on a shared goal Communicate that goal to all leaders Involve all leaders in planning to achieve the goal Hold participants accountable for achieving their part of the plan 17

18 Hoshin Kanri Characteristics Focus on a few key breakthrough improvements (or hoshins) Alignment of the entire organization (or health care system) around these breakthroughs Shared input and responsibility for plan and goals High participation throughout the organization Equal attention to end results and the methods for achieving them 18

19 Breakthrough vs daily improvement Characteristic Performance leverage Daily Management Improvement Projects Continuous improvements that change performance over time Breakthrough Improvement Projects Significant leverage changing performance Magnitude of Improvement Smaller Larger How many Many, incremental Few, most important How long? Improvement focus Year after year, ongoing 3-9 months; temporary Improvements made within daily work team Requires changes in cross functional processes and service delivery models Source: John Black and Associates, LLC 19

20 Breakthrough vs daily improvement Source: John Black and Associates, LLC 20

21 Hoshin Kanri in Saskatchewan 21

22 Hoshin Kanri 22

23 Diagnosis and Review Analysis of performance data; comparison of actual to expected results Joint problem solving and agreement on follow-up actions Determine what needs to continue, be improved, have correction action Are goals being achieved? 23

24 Reflection Reflect on the Saskatchewan health care system environment and the past year s performance. Answer the following: Where are we today? What barriers must we overcome? What opportunities await us? 24

25 Strategy Development 25

26 Catchball is about dialogue involves obtaining input on plans ensures an organization (or system) has the process capability to accomplish the goal(s) is a natural, healthy process of give and take when setting priorities, assigning resources, and specifying targets is messy and iterative process, at least to start 26

27 Finalize and deploy the plan Reflect on feedback received from the system and reach consensus on a final plan for the entire health system. Determine accountability for the plan and a system for course correction and reviewing progress on system targets and outcomes. Throughout organizations, ensure clarity and understanding of the final provincial plan, to deselect organizational work and update project plans accordingly 27

28 Ongoing monitoring Ongoing assessment and monitoring of progress towards desired results. Unit level: daily huddles Organizational: weekly wall walks Provincial Leadership Team: quarterly wall walks 28

29 What is a Strategy Deployment Matrix? A visual tool for outlining an organization s strategic destination over 3-5 years. It contains: foundational strategies, 3-5 year outcomes, necessary 3-5 year improvement targets and month breakthrough initiatives 29

30 Foundational Strategies Triple Aim Plus: Embracing The Betters 30

31 3-5 year Outcomes/Results Big Dot results the health system is trying to achieve. They describe the health system we want to see in the next 3-5 years. 31

32 3-5 year Improvement Targets Improvement targets specify what specific improvements or things need to be done to achieve the 3-5 year outcomes. 32

33 12-18 month Hoshins These are the short term (12-18 month) improvement projects and are the most important areas for focus and finish. 33

34 Saskatchewan s Implementation of Hoshin Kanri We are here 34

35 Saskatchewan s Implementation of Hoshin Kanri Vision without action is just a dream 35

36 Saskatchewan s Implementation of Hoshin Kanri Our commitment to and ambition of thinking and acting as one is unprecedented! 36

37 Saskatchewan s Implementation of Hoshin Kanri Working differently means we are embracing the complexity of Saskatchewan s health system and the challenges we face. 37

38 Saskatchewan s Implementation of Hoshin Kanri We are building and nurturing strong, respectful relationships with each other across our health system 38

39 Saskatchewan s Implementation of Hoshin Kanri We are cultivating the discipline required to stick to and be successful in attaining our ambitions 39

40 Saskatchewan s Implementation of Hoshin Kanri We are encouraging and embracing curiosity among each other and throughout our organizations 40

41 Some last words from our colleagues back home Insert video here

42 Over to you 42