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Your Instructor Provides Lean
transformation support to non-manufacturing settings. Co-author, The Kaizen Event Planner: Achieving Rapid Improvement in Office, Service, and Technical Settings Co-Developer, Metrics-Based Process Mapping: An Excel Solution Lean Enterprise Program Instructor University of California, San Diego Karen Martin, Principle, Karen Martin & Associates 2
Traditional vs. Lean Thinking Traditional
Lean Revenue-focused Margin-focused Improvement focus: optimizing value-added work Improvement focus: eliminating non-valueadded work Fire fighting is rewarded Fire prevention is rewarded Focus on financial metrics & lagging indicators Focus on operational metrics & leading indicators Suboptimization is rewarded Value stream performance is rewarded Specialized workers organized by function Cross-trained workers organized by value streams Complexity is the norm Simplicity is the norm Inspect in quality Build in quality Non-visual workplace / management Visual workplace / management Dynamic schedule and priorities Static priorities and schedule Unclear ownership & accountability Clear ownership & accountability Excessive reviews and approvals by leadership Decisions are made by those closest to the work Improvements identified by management Improvements identified by workers
Value Stream Mapping Process Products
(good or services) with common process steps Document Current State Repeat Define Product Family Foundation (the basis) for the future state; 70-80% accurate is acceptable (directionally correct) Design Future State Create flow by eliminating waste it is now obvious from your current state map); typically 3-6 months out Create Implementation Plan Implement! 3 Day Event Include accountability and timeframes for completion The goal of mapping!
Future State Value Stream Map
Outpatient Imaging Services Standard Work Work Balance Customer Demand: 15 patients perDay (Takt Time1920 seconds) 8 hours per day Co-locate Schedule appt Pre-register Referring Physician Hospital 3 Lead Time = 15 days 2 6 1 Lead Time = 45 mins. Cycle Time = 11 mins. Lead Time = 45 mins. % C&A = 98 % % C&A = 85 % Risk Reduction (Joint Commision) Symposium E Pay Excel Internet Waiting Room Management System Work Balancing Standard Work 3 35 mins. 4 Cycle Time = 1 mins. % C&A = 98 % 0.0833 hrs. 2 Complete Exam (Tech) 5 20 mins. Cycle Time = 10 mins. % C&A = 100 % 0.583 hrs. 1 mins. 2 Transmit Images (Tech) 6 5 mins. Cycle Time = 10 mins. % C&A = 90 % 0.333 hrs. 10 mins. Visual Workplace Set-up Reduction Prep Patient (Tech) Check-in Patient (Imaging) Fax Order Solutions PACS Auto Fax 80% Us Mail 15% MD Mailbox 5% 5S Value Stream Alignment Pull System (Supplies Kanban) Remove Check in and Reduce System Access 5 mins. Meditech CT=Cycle Time LT=Lead Time %C&A=% Complete & Accurate 2 7 120 mins. 2 Review Draft/Sign (Radiologist) 420 mins. Cycle Time = 15 mins. % C&A = 95 % 2 hrs. 2 mins. 8 Batch Reductions Voice Recognition Read/Dictate Exam (Radiologist) Cycle Time = 2 mins. % C&A = 100 % 0.0833 hrs. 10 mins. Continuous Flow 2 Print Reports (Imaging) 9 2 mins. Cycle Time = 1 mins. % C&A = 95 % 7 hrs. 15 mins. Rework Loop via Fax 10% of the time 2 30 mins. Cycle Time = 1 mins. % C&A = 99 % 0.0333 hrs. 1 mins. 10 Send Reports (Imaging) 6 0.5 hrs. 1 mins. 11 Cycle Time = 3 mins. % C&A = 90 % LT = 11.3 hrs. 3 mins. CT = 43 mins. CT/LT Ratio = 6.32% Rolled First Pass yield = 40%
Future State Implementation Plan Value
Stream Outpatient Imaging Implementation Plan Review Dates Executive Sponsor Allen Ward 11/1/2007 Value Stream Champion Sally McKinsey 11/21/2007 Value Stream Mapping Facilitator Dave Parks 12/13/2007 Date Created 10/18/2007 Block # 2 Goal / Objective Improve quality of referral Improvement Activity Type KE Implement standard work for referral process Owner Sean O'Ryan PROJ 1/10/2008 Implementation Schedule (weeks) 2 3 4 5 6 7 8 9 10 11 12 Dianne Prichard 3, 4 Reduce lead time beween schedulingand Cross-train and colocate work teams preregistration steps 5, 6 Eliminate the need for two patient checkins Collect copays in Imaging KE Michael O'Shea 6 Eliminate bottleneck in waiting area Balance work / level demand KE Dianne Prichard 9 Eliminate lead time associated with transcription step Implement voice recognition technology PROJ Sam Parks 10 Eliminate batched reading Reduce setup required KE Sam Parks 7 Reduce inventory costs, regulatory risk and storage needs 5S CT supplies area; implement kanban KE Michael O'Shea 12 Reduce delay in report delivery Implement additional fax ports PROJ Martha Allen 12 Reduce delay in report delivery Increase percentage of physicians receiving electronic delivery (rather than hard copy) KE 1 Martha Allen Approvals Executive Sponsor Value Stream Champion Value Stream Mapping Facilitator Signature: Signature: Signature: Date: Date: Date: Date Complete
I.T.R. Project – A3 Report
METHODS MACHINE Multiple entry methods no standard means PEOPLE IT access to equipment / user 1 stop shop ITR Form call friend fly by Customer/user process traning Inventory hard to manage Support resources (not enough staff) Only 8 techs to complete the work Inconsistent work close-out activities Manual processing / tracking Inability to define specific needs Lack of req'd product and accounting info Software installation takes too long to complete and close out Limited process tracking Accessibility Time until completion (due dates, completion dates) License procurement Support resources Work location ENVIRONMENT MEASURES MATERIALS 39
Kaizen Event Charter Event Scope
Value Stream Leadership Schedule Executive Sponsor Dates Specific Conditions Value Stream Champion Start & End Times Process Trigger Facilitator Location Team Lead Interim Briefings Event Name First Step Last Step Event Boundaries & Limitations Workforce Training Event Coordinator Event Drivers / Current State Issues Final Presentation Team Members Function 1 2 3 3 5 Contact Information 2 4 Name 1 4 Event Goals and Objectives 5 1 6 2 7 3 8 4 5 9 10 Potential Deliverables On-Call Support Function 1 2 2 4 Contact Information 1 3 Name 3 5 4 Possible Obstacles 1 Approvals Executive Sponsor Value Stream Champion Facilitator 2 3 4 Signature: Date: Signature: Date: Signature: Date:
Key Success Factors for Achieving
Results Tenacity Strategic improvement tied to business goals Value Stream Mapping Dedicated resources More on this in next month’s webinar Heavy use of Kaizen Events initially 46 With the goal of maturing to “daily kaizen”
Learning Objectives Participants will learn
how to help your leadership team understand their role in the improvement process, including: Setting improvement strategy Roles & responsibilities of project sponsors and A3 coaches “Letting go” of tactical decisions Briefing attendance Authorizing the frontline to make improvements Modeling lean behaviors Assumption – already familiar with principles and tools 47