Oregon Healthcare Lean Community of Practice September 12, 2014
WELCOME Norm Gruber, CEO
Why the Decision to Adopt Lean The changing healthcare environment Need for culture change Involvement of our Board of Trustees Commitment of senior leadership Opportunity to develop a long term system for quality and safety improvement in the healthcare environment Lean as an integral part of an effective strategy deployment process
Two Approaches Approach to Lean Transformation Plan 1 Conduct RPIWs in product lines of Inpatient, Surgical Services, ED, Ambulatory, Corporate Svcs Conduct 3P events Training for leaders in Kanban and 3P methods Current Strategy Deployment to develop alignment in the organization Standardize and Stabilize by implementing Lean Fundamentals such as: 5S, Visual & Daily Management, Leader & Frontline Standard Work, Quick & Easy Kaizen, Four-Step Problem Solving
Lessons Learned How to involve the medical staff is a big hurdle in Healthcare Without senior leaderships ongoing support and involvement, Lean will fail Lean is about culture transformation
Leadership People often equate Lean with the tools used to create efficiencies and standardize processes Implementing tools is 20% of the effort in Lean transformations 80% of the effort is changing leaders practices and behaviors, and ultimately their mindset Mann, D. (2009). The Missing Link: Lean Leadership. Frontiers of Health Services Management
LEAH MITCHELL, VICE-PRESIDENT, KAIZEN, QUALITY & SAFETY
Kaizen Quality and Safety Division Structure Continuous Improvement Care Management Kaizen Promotion Office Project Management Office Kaizen, Quality & Safety Division Quality & Safety Service Excellence Employee Health Infection Prevention Peer Review Patient Safety Accreditation Clinical Decision Support Service Excellence Interpreter Services Patient Advocates Pastoral Care Corporate Integrity Risk Corporate Integrity Safety Institutional Review Board
Lean Management System Lean Processes Respect for People Respect for Time Continuous Improvement Strategy Deployment /A3 Thinking Reinforce Company Values and Standards (Rounding) Role of Lean Leader Value for the Patient Quality Care at Affordable Cost Develop Capability in Team Lean Fundamentals * 5S Deliver Business Results in Q&S, Finance, Pt Exp, Engage * Visual Management * Huddles * 4SPS * Quick and Easy * Leader Standard Work * Mental Models * Standard Work
Strategy Deployment Aligned with heart of Lean system: create value for the patient Development and execution of guiding strategic principles PDCA Cycles Deployment is the hard part Selection Selection Deployment Deployment Dennis, P. (2006). Getting the Right Things Done
Salem Health Strategy Deployment Model
Strategy Deployment Process
Organizational Alignment and Achievement of Business Results Alignment 7 Year Plan CEO, BoT VP of Strategy Hoshin COO site Operational A3 5 Year Plan/SD Plan VP Quality and Safety Financial Performance Patient Experience Engagement Annual SD Plan Deployment Leader Quality and Safety Financial Performance Patient Experience Engagement AP AP AP AP Baby A3s & Action Plans Strategy Captains AP AP AP AP Divisional Annual A3 Director Division A3s Unit Level Annual A3 or Action Plan Manager Unit Level A3/Action Plans Specialty Practice Teams R&I Bucket - From R&I Process - Local R&I work - Goals R&I
Leadership Connected Checking Tool Mother A3 Mother A3 Mother A3 Mother A3 Mother A3 Baby 3 or Action Plan Division A3 COO Dashboard Unit A3 or Action Plan Strategy Deployment Visual Management Board
Leadership Connected Checking Tool- Page 1 Lean Fundamentals expectations
Example: Strategy Deployment Visual Management Board-pg 1 Expectation
Leadership Connected Checking Tool- Page 2 Individual leader expectations
Executive Rounding Standard Work
GO AND SEE: VISIBILITY ROOM AND TO THE GEMBA LATER