Mais conteúdo relacionado Healthcare Kaizen1. Healthcare Kaizen:
The Suggestion Box is Dead
Guest Presenter: Mark Graban
August
21,
2012
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
2. §
Founder,
Karen
MarEn
&
Associates,
LLC
(1993).
§
Lead
Lean
transformaEons
&
develop
people
in
office,
service
and
knowledge
environments.
§
Teach
at
University
of
California,
San
Diego’s
Lean
Enterprise
program.
§
Author:
Karen
Mar1n,
Principal
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
3. Mark
Graban
• Currently:
• President,
Constancy,
Inc.
• Faculty
member,
Lean
Enterprise
InsEtute
• Chief
Improvement
Officer,
KaiNexus
• Author
of
Lean
Hospitals
(2008,
2011)
• Shingo
Research
and
Professional
PublicaEon
Prize,
2009
• Co-‐Author
of
Healthcare
Kaizen
(2012)
• With
Joseph
E.
Swartz
• BS
Industrial
Engineering,
Northwestern
University
• MS
Mechanical
Engineering
&
MBA,
MIT
www.leanblog.org
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
4. The
Sugges1on
Box
is
Dead!
Mark
Graban
President,
Constancy,
Inc.
Chief
Improvement
Officer,
KaiNexus
Faculty,
Lean
Enterprise
Ins1tute
August
21,
2012
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
5. ©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
6. ©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
7. Dysfunc1ons
of
Sugges1on
Systems
• Slow
/
No
Response
• Yes
/
No
Answers
• Not
CollaboraEve
• Not
Transparent
• Buy
Instead
of
Do?
• Complaints
Against
Others
• IncenEves
à
FighEng
• Quotas
à
Gaming
Builds
on
the
book
Ideas
are
Free!
by
Robinson
&
Schroeder
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
8. Kaizen
=
Change
for
the
BeRer
• ‘Kai’
means
“change.”
• ‘zen’
means
“good.”
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
9. Kaizen is Not Just Events
Very few
Large issues System
Kaizen
Six
Sigma
Few Project
Medium issues
Lean
Event
Many
Small issues
Daily Kaizen
Adapted from: “The Toyota” Way Fieldbook, Liker and Meier
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
10.
“What
Sets
Us
Apart?”
“Every
Toyota
team
member
is
empowered
with
the
ability
to
improve
their
work
environment.
This
includes
everything
from
quality
and
safety
to
the
environment
and
produc1vity.
Improvements
and
sugges1ons
by
team
members
are
the
cornerstone
of
Toyota's
success.”
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
11. Kaizen
is
for
Everyone!
“…
emphasizes
morale-‐
boos1ng
benefits
and
posi1ve
employee
par1cipa1on
over
the
economic
and
financial
incen1ves…”
-‐
Masaaki
Imai
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
12. Dr.
Berwick’s
Call
for
Kaizen
(1989)
• Kaizen
=
“the
conEnuous
search
for
opportuniEes
for
all
processes
to
get
beger”
• Dr.
Donald
Berwick
– Founder,
InsEtute
for
Healthcare
Improvement
– Former
Administrator,
Medicare
and
Medicaid
(CMS)
CitaEon:
Berwick,
DM,
“ConEnuous
improvement
as
an
ideal
in
health
care,”
New
England
Journal
of
Medicine,
1989
May
25;320(21):1424-‐5.
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
13. Barriers
to
Kaizen?
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Source:
Healthcare
Kaizen
14. Fear
of
Layoffs
Found
posted
in
a
hospital
lab
(during
ini9al
Lean
assessment)
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Source
unknown
15. “No
Layoffs
Due
to
Lean”
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
16. We
Don’t
Have
Time?
“Mikki
Gremp,
RN,
lel
one
hospital
because
a
number
of
policies,
including
its
pracEce
of
'flexing
down,'
lel
her
feeling
that
nurses
weren't
valued.”
AJN Report: The Other Side of Mandatory Overtime
Roxanne Nelson BSN, RN
Maureen Shawn Kennedy MA, RN, editorial director
AJN, American Journal of Nursing
April 2008, Volume 108 Number 4, Pages 23 - 24
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
17. People
Hate
Change?
“People
don’t
resist
change,
they
resist
being
changed.”
– Peter
Scholtes
(1938-‐2009)
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
18. Why
Not
Best
Prac1ces?
“People
support
what
they
create.”
-‐
Margaret
J.
Wheatley
See
YouTube:
hgp://bit.ly/Support-‐Create
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
19. Joint
Commission
Now
Says…
“it
may
be
Eme
for
hospitals
to
move
away
from
best
prac1ces
and
develop
comprehensive
process
improvement
tools
—
which
can
include
Lean,
Six
Sigma
or
other
emerging
methodologies
—
that
allow
for
deeper,
more
specific
analyses
of
their
pa1ent
safety
needs.”
-‐
Mark
Chassin,
MD,
President
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
22. “Quick
and
Easy”
Kaizen
Find
1. Find
2. Discuss
Discuss
3. Implement
Implement
4. Document
5. Share
Document
Share
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
23. Why
Kaizen?
Norman Bodek
1. Make your work easier
2. Make your work more
interesting
3. Develop your skills &
capabilities
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
24. Start
Small
• “There
are
no
big
problems,
there
are
just
a
lot
of
ligle
problems.”
– Henry
Ford
• Make
your
job
easier
• Save
a
few
seconds
• Improve
paEent
care
or
service
• Improve
safety
• Reduce
waiEng
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
25. Itera1ve
PDSA
Improvements
Improvements
Ideas
One
improvement
olen
leads
to
another
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Source:
Healthcare
Kaizen
26. Improvements
for
NICU
Moms
(1)
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Source:
Healthcare
Kaizen
27. Improvements
for
NICU
Moms
(2)
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Source:
Healthcare
Kaizen
28. Improvements
for
NICU
Moms
(3)
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Source:
Healthcare
Kaizen
29. Kaizen:
Real,
Daily,
Visual
(Visual
Idea
Board)
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Children’s
Medical
Center
Dallas
(Lab)
30. Kaizen:
Real,
Daily,
Visual
(Electronic
-‐
KaiNexus)
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
32. Kaizen
on
Her
FIRST
Day
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Source:
Healthcare
Kaizen
33. Kaizen
“Wall
of
Fame”
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Children’s
Medical
Center
Dallas
(Lab)
34. Innova1on
&
Kaizen
EHART
Blood
Pressure
Cuffs
Before After
Taking time digging through the bucket on top Place a small strip of Velcro® brand hook and loop fasteners on the
of the crash cart to try to find the correct size wall with different sizes of BP cuffs. Staff is able to quickly visualize
blood pressure cuffs. This can be problematic the different sized cuff and get the proper size for the patient, and the
during an EHART® when you want to get a blood pressure can be obtained quicker.
blood pressure (BP) in a hurry so that you can
get medications in the patients.
The Effect
Improved quality of care and faster response to the needs of the patient in an acute setting.
Name Supervisor Date Savings
Elizabeth Black Diana Brown, Manager 12-10-2008 Quality
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Source:
Healthcare
Kaizen
35. “Just
Do
Its”
&
Problem
Solving
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
37. What
Can
We
Do
as
Leaders?
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
38. ©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
39. ©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
40. What
Can
We
Do
as
Leaders?
• Ask
for
Kaizen
– Help
create
Eme
– Don’t
stop
asking
• Lead
by
example
–
parEcipate
– Get
involved
–
coach,
mentor,
lead
– Go
to
the
gemba
– Teach
root
cause
problem
solving
– Follow
the
PDSA
process
• Recognize
and
celebrate
Kaizen
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
41. Asking
Every
Day
• Are
there
any
problems
interfering
with
your
work?
• With
paEent
care?
• Have
you
had
any
ideas
for
improvement
lately?
• Do
you
have
what
you
need
to
do
your
job?
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
42. Coaching
on
Idea
Cards
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Source:
Healthcare
Kaizen
43. Before
/
Amer
Data
from
CMC
Lab
Before Lean 12 Months
After Starting
Lean
3. I have the opportunity to do what I do
best every day.
3.11 3.92
8. I feel free to make suggestions for
improvement.
2.84 3.48
10. I feel secure in my job.
2.32 3.42
13. Stress at work is manageable.
2.43 3.23
17. I am satisfied with the lab as a place
to work.
2.51 3.43
18. I would recommend my work area as
a good place to work to others.
2.38 3.46
Grand Average
2.96 3.69
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
44. KaiNexus
Data
/
Charts
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Whitepaper:
hgp://bit.ly/KaiNexus
45. Franciscan
Par1cipa1on
%
People
Par1cipa1ng
60%
50%
40%
30%
56%
46%
20%
10%
0%
2011
Since
2007
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Source:
Healthcare
Kaizen
46. #
of
Recorded
Kaizens
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
Source:
Healthcare
Kaizen
48. Ideas
vs.
Sugges1ons
“
SuggesEons
are
things
I
think
you
should
do…
Ideas
are
things
that
I
can
do.”
-‐
Norman
Bodek
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
49. Q&A
/
Contact
Info
• Email:
mark@LeanBlog.org
• Blog:
www.LeanBlog.org
• Startup:
www.KaiNexus.com
• TwiRer:
www.twiger.com/MarkGraban
• Books:
– www.LeanHospitalsBook.com
– www.HCkaizen.com
• www.Hckaizen.com/kaizenpreview
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
50. Upcoming Webinars
Date
Topic
Thu
Aug
23
Value
Stream
Mapping:
Think
Strategy
Before
TacEcs
Rapid
Improvement:
How
to
Change
Behaviors
and
Get
Stuff
Thu
Sep
13
Done
FAST
Thu
Oct
4
Put
an
End
to
OrganizaEonal
ADD:
Create
Your
2012
Strategic
Improvement
Plan
Thu
Nov
1
We’ve
Had
it
All
Wrong:
Manage
Processes,
Not
People
858.677.6799
ksm@ksmar1n.com
TwiRer:
@karenmar1nopex
Blog
&
newsleRer:
www.ksmar1n.com/subscribe
©
2012
Mark
Graban
and/or
Joseph
E.
Swartz.
All
Rights
Reserved.
50