Problem Solving and Daily Management for Lean Healthcare



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Problem Solving and Daily Management for Lean Healthcare

Introductions Mike Hoseus 859-699-2235 Mike.hoseus@gmail.com

What is a Problem in Lean? No one has more trouble than the person who claims to have no trouble. Taiichi Ohno Having no problems is the biggest problem of all.

Do you have Daily Problem Solving at all Levels? Policies Annual Objectives Improvement Plans Supervisors Staff Cross Organizational Problem Solving Process Improvement Objectives & Budget Management Management Directed Kaizen Top Management Manager Daily Problem Solving Standardized Work Kaizen 5S Problem Solve

3 Stages of Problem Solving Goal Maintenance Kaizen Reaching Maintaining Kaizen Raising New Goal Problem Solving that results in getting to the goal. Problem Solving that focuses on maintaining the goal. Problem Solving that focuses on increasing capability beyond the goal - Kaizen.

PDCA Cycle ACT PLAN CHECK DO

PDCA Cycle ACT PLAN CHECK DO

Traditional Method vs. PDCA Elements Traditional PDCA Plan Do Check Act Generally reactive (put out fire) Wing it; figure it out as you go Hesitancy to discuss problems Frequent use of band aids Proactive: responsive to long term goals Use of Pilot activities before full blown implementation Specific input/output measures identified for measuring success Standardization

Different types of problems New Ideal Situation PROACTIVE Current Ideal Situation GAP Meeting the Expectation Setting Type of Problem Raising the bar to purposely create a GAP GAP Current Situation Event Type of Problem A GAP develops between the ideal and current situation REACTIVE 23

Snapshot of the 8 steps P l a n Step 1 Clarify the Problem Step 2 Breakdown the Problem Step 3 Target Setting Step 4 Root Cause Analysis Step 5 Develop Countermeasures Step 6 See Countermeasures Through Step 7 Monitor Process & Results Step 8 Standardize & Share Best Practices Do Check Act

Step 1: Clarify the Problem Purpose of Your Work Value added ness Measurable Contribution Ultimate Goal/Purpose Ideal Situation or Standard Where you want to be. NOT Quantifiable So What Factor Visualizing Quantifiable GAP Problem Measurable Comparison Current Situation Plan 25

Step 2: Breakdown the Problem Gap from Step 1 (Larger Problem) Problem Problem Problem Problem Prioritized Problem Problem Problem Problem Problem Go through the process Point of Occurrence (POO) Plan 26

Step 2a: How to Divide the Problem Separate into division points using the 4W s What? When? Where? Who? Divide Continue breakdown using Genchi Genbutsu 4W Division points and prioritizing Divide 2 1 1 2 3 Prioritize Problem to Prioritize Plan

Step 3: Target Setting Prioritized Problem Specify: How much? = # or % When? = specific date Point of Occurrence Target Step 1 POO Step 3 Always set your Target to address the POO!! Plan 28

Why? Step 4: Root Cause Analysis Point of Occurrence Potential Cause Potential Cause Therefore Potential Cause Actual Cause Actual Cause Potential Cause Potential Cause Potential Cause Actual Cause Potential Cause Root Cause Plan

Step 5: ID Countermeasures Root Cause Countermeasure Countermeasure Countermeasure What are the risks? Framework of Experiences Can We Eliminate? Countermeasure Countermeasure Who will be impacted? Framework of Scope Plan

Step 5a: Develop Countermeasures Choose most practical and effective counter measure using a criteria matrix Cost Risk Assessment Countermeasure #1 Countermeasure #2 Countermeasure #3 Build consensus and create a detailed action plan (Gantt Chart) What Action Action 31 Who Joe Mary When Plan

Step 6: See Countermeasures Through Timely Reporting Never give up Informing (Update) Proper Checking Speedy action Consulting with others As a team Japanese: Nemawashi 32 Do

Step 7: Monitor Both Processes & Results Process Japanese: Hansei Repeatability In the Eye Of the Customer Was the Target in Step 3 achieved? In Your Company s Viewpoint In Your Own Viewpoint X Results Good results = luck 33 Check

Step 8: Standardize Successful Processes Ideal Situation or Standard Where you want to be. Overall Company Own Work & Responsibility Standardization Success Standardization Standardization Japanese: Yokoten Implementation 34 Act

Strategy Objective: Realize new revenue streams via alliances, experiments and exisiting capabilities Value Stream or Major Process: Strategy Deployment Leader: Allison Phillips Updated: 12/02/2008 12/11/2008 I. Problem statement and business case - Why are we talking about this? Problem Statement - What is the gap?: V. The target condition - What will the improved state look like? We will have a steady stream of EBIT available to help fund growth initiatives Marketing, R&D, SFC & GBD project spend has declined at a CAGR of X.X% over the past 5 years - down $X.XMM in last 12 months We will have new partnerships that extend Avery's consumer reach and Marketing Project Spend as % of Sales Net Sales has declined at a CAGR of -X.X% over the past 5 years - $XX.XMM in last 12 months generate business revenue - ie HP, Visa, IBM 3.0% 2.7% 2.5% Marketing project spend as % of sales has declined from avg of X.X% during 2005-2008 to a projected X.X% for 2009 AOP We will gather new consumer insights that can be applied to our growth and 2.5% 1.9% Economic environment continues to limit the cash available to fund growth initiatives productivity initiatives - buying patterns, new services, etc 2.0% 1.8% 1.8% Increased project spend funds generated by new revenue stream 1.4% 1.5% We need to find new ways to fund investments in Marketing, R&D, SFC & GBD to help drive Net Sales growth We will broaden our distribution channels - ie HP, Dell, Google, avery.com, etc 1.0% to drive increased business revenue 0.5% Business Case - What is the customer or business need?: 0.0% 2005 2006 2007 2008 2009 AOP w/ $2.5MM We have assets and consumer access that are valuable but have not been monetized to their full potential new EBIT Finding ways to derive more direct revenue from these existing assets can help fund growth initiatives quickly We need to develop a stream of investment income to bring Marketing, R&D, SFC & GBD funding to sufficient levels - X% of sales VI. Action Plan - What must be done to implement the strategy? Functions Tactics Implementation Activities Implementation Checkpoints Who When Status Required email Mktg, Legal, Benchmark best practices; rates & find II. Current condition reflection and analysis - What have we learned, where are the problems, what are the causes? A. Monetize consumer reach vehicles 3rd Party email Sponsorships, Affiliates J.Do, CE Q2 Brand partners email Mktg, Legal, Benchmark best practices; rates & find (Ehrenhalt/Do) 3rd Party Newsletter Sponsorships, Affiliates J.Do, CE Q2 Brand partners Existing assets not fully monetized 33MM software & template downloads 60MM targeted e-mails Metrics with targets: $X.XMM EBIT B. Develop strategic alliances & affiliates (Kingsley/Ehrenhalt) Marketing Project Spend ($MM) Net Sales ($MM) Metrics with targets: $X.XMM Rev. ($1MM in AOP) 850 825.5 830.8 25 22.1 ** 2009 AOP includes $2.2MM marketing productivity savings 800 C. Drive ecommerce revenue on avery.com 19.4 764.4 20 750 15.3 (Maxson) 13 689.1 695.8 15 700 10.1 650 10 600 Metrics with targets: $X.XMM Rev. ($XMM in AOP) 5 550 D. Monetize S/W downloads & capabilities 0 500 2005 2006 2007 2008 2009 AOP 2005 2006 2007 2008 2009 AOP (Dillon) Metrics with targets: $X.XMM EBIT ($XXk in AOP) istockphoto initiative success opened our eyes to new revenue streams Execution was complex, disruptive to ops, & resource heavy E. Monetize patents and brands Identified new ways to increase direct to consumer sales on the web Limited number pursued due to fear of negative customer reaction (Santhanam/Ehrenhalt) Avery consumer-facing marketing communications targeted & reach many Difficult to balance competing internal & external demands for space Metrics with targets: $X.XMM EBIT Identified a range of ways to drive new revenue 30 MM website visits 40MM packages 2MM samples 2.2MM names Cash flow value potential =??? Two people assigned to find partnerships, develop them & execute 3rd Party Packaging In-Packs 3rd Party Advertising on avery.com 3rd Party Advertising in software HP ecommerce, Retail, Pdct, sub-logo licensing Dell.com Bundles & Q3 Staples Ret. USPS On-line Store, Label Universe Affiliate Marketing Program Free Shipping with minimum order Affiliate links/rev share to non-avery products Toolbar with downloads Brand & Sub-brand Licensing Opps Consumer interactive marketing platforms completely renovated Platform fixed costs a higher % of budget & challenging in soft econ VII. Improvement Metrics - How will we measure the improvement? Allison Phillips Todd Thompson Sign-off's to Ensure Firm Commitment to Resource and Support Channel Intell. Lead Generation Unique Bundles & Active Cross Sell License DesignPro engine Patent Licensing Opps Pkging,Legal, Supply Chain a.com Mktg, Legal, Brand S/W Mktg, Legal, Brand BU's, Sales, S/W, Action Staples collaboration; 1 at a time label a.com offering and ecommerce - eval other options Alliance, BU's, Sales Alliance, BU's Sales Alliance, BU's, Sales, Search a.com Mktg, DR, Sales a.com Mktg, Sales, CI a.com Mktg, BU's, Integrate cross-sell, up-sell and unique Sales bundles in the shopping area of web site a.com Mktg, BU's, Evaluate linking program from avery.com to Sales sell branded ink cartridges Avery.com, Bus Dev, Legal SW Dev, Bus Dev, Legal Pursue istock or similar deal Benchmark best practices; rates & find Q1 SMB mailing bundle; Q2 CE bundle; Q4 mailing bundle; Q3 Staples program Roll-out on-line postal store test more broadly; pursue Label Universe business Launch Q1 test with scrapbooking; roll out to ASB if successful. Alliance, Fin, Contract with LMCA in Q1 to bring in potential CE Brand, Legal opportunities for assessment PDev, Fin, Brand, Assess current unused IP portfolio and RS Legal identify potential licensees; pursue HP in Q1 Multiple companies are seeking access to our database, techs, & brand Concern over gving away competitive advantages & hurting brand Portfolio Operating Metrics: Target Financial Target Summary: Revenue Re-Invest Status Portfolio Payback 100% in 12 months/break-even current yr Target Target Recap key problems and opportunities Causes to address Benefit/effort ratio Greater than 0.8 A. Monetize consumer reach vehicles 1.5 MM Selling existing products directly to consumers bears upside & some risk Parameters on what's OK and what's not aren't clear B. Develop strategic alliances & affiliates 2.0MM Many creative ways to derive revenue identified, but execution is slow Limited human resources, competing business priorities, ops complexity C. Drive ecommerce revenue on avery.com 2.5MM Amy Ladwig Avery capabilities and assets have value to consumers & 3rd parties Fear of hurting Avery brand, competitive advantage & consumer experience D. Monetize S/W downloads & capabilities 0.5 MM There are near term revenue opps, but also longer term opps Solely focusing on quick cash in 2009 could compromise 2010-2011 opps E. Monetize patents and brands 0.5 MM III. Strategy goal statement and hypothesis - What are we planning to achieve? TOTAL: 4.5MM 2.5MM In 2009, we will find $X.XMM in incremental EBIT to reinvest in our business growth initiatives and an incremental $X.XMM in revenue by Incremental to AOP: 1.5MM 2.4MM finding new ways to monetize our brand, consumer access, digital and physical assets, and partnerships while laying the foundation for a 3-5 year pipeline of investment and revenue dollars. VIII. Requests to senior management / Follow-up on unresolved Issues - What other needs or concerns exist? IV. Rationale for updated strategy, evaluation of alternatives - Why is this the right strategy and approach? Action WHO WHEN Each initiative will be evaluated on its own merit for return on financial investment and human effort Develop parameters/guidelines for selling existing products directly to consumers via the web Robert W. & David M. with Amy 1/31/2009 & Todd We will focus on delivering our 2009 objective, but will have a longer term line of sight Ensure cross-functional resource strategy exists for execution Todd, steering team 1/31/2009 We will fund our initiatives from the revenue that we bring in Gain alignment on appropriate level of global versus OPNA support Todd, steering team 1/31/2009 We assume that the appropriate resources will be made available to execute new revenue model opps Develop parameters/guidelines for acceptable brand and partner affiliations Bruce, steering team 1/31/2009 We will have a bias to longer term partnerships that are compatible with our brand versus short term "opportunistic" partnerships Create clear valuation targets for Avery's media assets Bruce, steering team 1/31/2009 We will be globally opportunistic, but our primary focus will be OPNA Steve Burns Ramin Heydarpour Joe Moffa Brian Daly Tim Bond partners Benchmark best practices; rates & find partners Promote "free shipping" more actively on site Increase visibility of data available from CI channel partners - esp Staples Evaluate various options (ask.com, google, msn), choose partner, implement Renew contract with Nova, identify and pursue other possible licensees. CE, TA CE, DM CE, BD JK, DM, SB JK, MC, SR, KP JK, MC, RW CE, JM, BAP BAP, RP DM, RW MC, SR, BAP BAP, RP, RW CE, BD BD Q2 Q2 Q2 Q1-Q4 Q1-Q4 Q1-Q4 Q1 Q1 Q1 Q2 Q2 Q1 Q3 Q1 Q2 A3 s A3 Thinking and Management Understanding Agreement Alignment Office Products North America Fostering effective dialogue Encouraging initiative Developing problem solvers Enabling effective execution Keys to effective A3: 1. Does the A3 tell a problem solving story, using both words and visuals? 2. Is the importance to the business and/or customer evident? 3. Has the current condition been observed directly and understood? 4. Is the A3 being discussed with colleagues, stakeholders, people involved in the process? 5. Has the problem been broken-down and analyzed to root causes using facts and data? 6. Do the countermeasures and actions address the identified root causes? 7. Have success measures been established? 39

Roadmap Start by knowing the destination Hoshin Kanri True North: Ideal Mid-Range Plan Annual Policy &Objectives Plant Annual Plan Manager Annual Plans Everyone knows the destination!!

Months Hoshin Review- PDCA Cycle Result Check Intervals Entire Company Individual Process Check Sr. Mgmt Dept Mgmt Subsection Group Individual Day Week 1 6 12 Grasping the gap between the daily plan and actual performance Direction

Management System 1. What do we need to do? (Targets) 2. How should we do it? (Process) 3. How are we doing? (Results) Problem solving linked to direction

Daily Management System Components Effective Shop Floor Management Focuses on building an effective visual management system to help the group achieve Hoshin targets. Member Skill Development Activities and tools to help develop members capabilities to perform Standardized Work and achieve daily production goals with safety and quality.

Team Board-Floor Management Development System Problem solving linked to direction

Quality Section of Team Board for Floor Management Development System

Fujio Cho, Chairman, Toyota Motor 3 Keys to Lean Leadership Senior Management must spend time on the plant floor. Use the Why? technique daily. Respect your people. Problem solving linked to direction