Getting to Everyday Improvement: How to Connect the Science and Culture of Problem Solving February 14, 2013 Judy Worth Beau Keyte
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Today s Presenter Judy Worth Faculty, Lean Enterprise Institute Partner Lean Transformations Group; focus: Organizational development & instructional design Co-facilitated value-stream improvement efforts in healthcare & other organizations Began lean journey as instructional designer on Mapping to See (LEI) Coauthor with Tom Shuker, Beau Keyte, et al, of Perfecting Patient Journeys
Today s Presenter Beau Keyte Faculty, Lean Enterprise Institute Partner, Lean Transformations Group; focus: Work & management processes Began lean journey in automotive; now healthcare & admin Coauthor Mapping to See & Shingo-Award winning book The Complete Lean Enterprise Coauthor with Judy Worth, Tom Shuker, et al, of Perfecting Patient Journeys
On Sale Now LEI s Latest Book Perfecting Patient Journeys Improving patient safety, quality, and satisfaction while building problemsolving skills By Judy Worth, Tom Shuker, Beau Keyte, Karl Ohaus, Jim Luckman, David Verble, Kirk Paluska, and Todd Nickel Download forms and excerpts at lean.org/store
Training Take a deeper dive into this methodology for whole valuestream improvement Register for the full-day workshop - From Fire Fighting to Continuous Improvement: Sharpening PDCA Problem- Solving Skills March 12, Lean Transformation Summit, Orlando (March 13-14) June 4, Lean Healthcare Transformation Summit, Orlando (June 5-6)
Typical Default Positions In Problem Solving Blanket solutions & best practices Boss/subordinate interactions: Directive solutions A Team Expert problem solvers
Why Don t Problems Get/Stay Solved? We assume: we know what the problem is without seeing what is actually happening we know how to fix a problem without finding out what is causing it we know what is causing the problem without confirming it the problem has only one cause
Why Don t Problems Get/Stay Solved? We don t engage the people closest to the work in solving the problem We lack a common methodology for solving problems We don t develop management systems to sustain the improvements
How Do We Improve Continuous Improvement? GTS ACT CHECK GRASP THE SITUATION PLAN DO
Connecting the Technical and Social Sides The gap we would like to discuss today: Traditional approaches to problem definition Solution-based improvements Minimal front line ownership Minimal management system linkage
The Technical Side: Small Reversible Experiments Systemic scientific thinking and acting Within the process Within the management of the process Quick cycles of learning Focus on learning, not implementing solutions
Why Small and Why Reversible? Frame proposed solutions as hypotheses about cause and experiments as tests of proof Prevent blanket solutions Prevent solutions that don t link to causes Encourage investigation of root cause(s) Remind us that big problems have multiple causes
Plan-Do-Check-Adjust Cycle of Problem Solving & Implementation GTS ACT CHECK GRASP THE SITUATION A P C D A P C D PLAN DO A P C D A P C D A P C D A P C D A P C D
Running Small Reversible Experiments
Running an Experiment Means: Developing a THEORY about what you expect to happen (GRASP THE SITUATION) Developing a way to TEST your theory (PLAN) Running the test and OBSERVE the results (DO) ANALYZ(ing) the results (CHECK) CONFIRMing (or REJECT) your theory (ACT)
To Plan Your Own Experiment, Remember: Who? What? When? Where? How? Who is going to try out the change? What specifically are they going to do? When are they to do it? What day? What time of day? How many times? Where are they going to do it? How will you know that whether the change(s) worked (solved or improved the problem)?
Running the Experiment: Some Tips Before you run the experiment, do a dry run and adjust Develop an elevator speech and inform everyone who needs to know. Run the experiment. Interview the participants and get their feedback. Review participant feedback and observer data and decide what happens next. Write a summary of your results and share with participants in the experiment and/or key stakeholders.
Questions? Reflections?
Why Don t Problems Get/Stay Solved? We assume. We don t engage the people closest to the work in solving the problem We lack a common methodology for solving problems We don t develop management systems to sustain the improvements
The Social Side: Engaging the Organization in Thinking Socialization is a cycle of communication, modification, and consensus building. each stakeholder an opportunity to hear, think, and respond the real reality and context become apparent
What Do You Need to Socialize? The need for change The problems to address and who is principally involved The role of others Information on the problem and gap...
What Do You Need to Socialize? Ideas generated within the problem-solving process Ideas and plans for experiments Results of experiments and thoughts for new processes Just about everything in the change process!!
Why Do You Need to Socialize? Engage the organization in problem solving Confirm assumptions and data Discover other views of reality Uncover hidden risks (technical or social) for different ideas Learn more, adjust our thinking to the problem
Before You Socialize, You Need to Agree on Who needs to: Agree (Authorize/Allow) Accept/Support/Contribute Know about What to Share How to Connect & Share formal and informal Roles Timing
What s Your Change Story 2) Why? Business need or purpose 1) What? Conditions need to be changed 3) How? Your idea but leave open for discussion 4) Why this How?
Socialization Methods: Formal and Informal Agenda items for regularly scheduled meetings Huddles (for shifts AND for problem solving) Key person assignments Food and fun Visual tools
Socialization: Be Sure You Close the Loop
What Difference Does ALL This Make for Healthcare? Reduced average length of stay (LOS) in a large emergency department by 30% and LWOBS BY 60%; increased independently gathered customer (patient) satisfaction scores by 73% Reduced Operating Room changeover time, which increased the number of surgical procedures performed by 20%, Reduced annual staff turnover from 30% to >1% Reduced in inpatient admissions for diabetic patients by 92% and physician interruptions by 90%; eliminated routine overtime, improved patient satisfaction by 40% Reduced LOS by 30% and LWOBS by 50%; increased patient satisfaction scores by 63% and produced widespread improvement in teamwork
What Difference Does ALL This Make for Office and Service? 400% productivity increase in back office financial services processing Improved Call Center quality by 19%, reduced operator hold time by 11% Reduced defects in external financial reporting by 95% Reduced emergency credit card replacement cycle time by 50%; increased customer satisfaction by 20%
What Difference Does ALL This Make for Manufacturing? $1.5 billion in annual savings in value streams outside plant facilities 50% reduction in product development lead time 30% increase in engineering capacity 60% improvement in customer satisfaction
Questions? Reflections?
Keep Learning After the Webinar Book: Perfecting Patient Journeys (hardcover, 161 pages) Download forms, templates, excerpts On sale now lean.org/ppj Workshop: From Fire Fighting to Continuous Improvement: Sharpening PDCA Problem-Solving Skills March 12, Lean Transformation Summit, Orlando (March 13-14) June 4, Lean Healthcare Transformation Summit, Orlando (June 5-6)
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