Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ Iowa Primary Care Association 2015 Annual Conference Des Moines, Iowa Lean concepts Elements of a lean foundation Lean process steps Common techniques and tools and other continuous improvement efforts 2 Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ 1
A systematic approach of analyzing the flow of information, process, and materials in order to eliminate waste while striving for continuous improvement to achieve enhanced value to the customer AKA: The elimination of wasteful processes and waste within processes 4 A method to reduce the organization s headcount For companies where control of employees is #1 for leadership A one-shot quick fix for problems 5 From the employee s perspective Everyone receives Lean training People are given authority to make changes No embarrassment or retribution for admitting problems Encourage creativity Reward innovativeness Make it fun! 6 Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ 2
Delivery (Time) Quality Cost 7 Cycle Plan Do Study Act Deming philosophy Toyota - Cycle Value and Waste Mapping Flow Tools Standard Work Easy to use 8 A highly disciplined process that focuses on developing and delivering near-perfect products and services Why "Sigma" A statistical term that measures how far a given process deviates from perfection Measure of how many "defects" in a process systematically eliminate defects get as close to "zero defects" as possible 9 Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ 3
Increased customer service levels Lean, agile, and connected to the actual patient demands Improved customer retention Improving continuously to enhance all stakeholders values Reduced service lead time Responsive to the patient needs for new products and services Improved productivity Employees value and are connected to their work Growth in earnings Transforming culture to sustain improvement and profitable growth Flow vs Function Climate of healthy dissatisfaction 10 Leadership Involvement Culture change Teamwork 12 Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ 4
Where the work is being done Observe directly how things are done Solicit barriers from staff Obtain improvement ideas from staff Functional barriers will dissolve Responsibilities Coach vs Authority Power to the people vs Manager Decisionmaking Mindset of big picture vs Functional focus Continuous improvement vs reactive nature and fighting fires 13 Communication Teach and engage workgroups hold employees accountable Respect people Confidence in them Focus on process Empower teams - Support and recognize staff Lead by example Deploy policy and examples Commit to standards and resources Provide long-term vision and principles Understand / Support Lean and the change process 14 CEO Upper Management Middle Management Staff Traditional Support Staff Middle Management Upper Management CEO Lean Support S. Pavelka - Ia Primary Care 15 Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ 5
Lean Produce only what and when needed Overproduction is bad Never be satisfied If it ain t broke, improve it. Never pass on a defect Work on root causes Supervisors are responsible for enabling workers Non-Lean Production based upon anticipated need Eliminate bottlenecks by increasing inventory More and faster is better If it ain t broke, don t fix it Don t stop production Fire fight problems Front line staff are responsible for output 16 Necessary Elements Results Vision Skills Incentives Resources Implement Success Missing Elements Skills Incentives Resources Implement Confusion Vision Incentives Resources Implement Anxiety Vision Skills Resources Implement Slow change Vision Skills Incentives Implement Frustration Vision Skills Incentives Resources False starts October 2015 17 S. Pavelka - Ia Primary Care Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ 6
S. Pavelka - Ia Primary Care 19 Customer defines value MAP the value stream (process) Flow the process Waste elimination Standard work operations and baseline measures (indicators) Continuously improve 20 Value Added Any activity that increases the market for or function of the service (the products the customer is willing to pay for) Non-Value Added Any activity that does not add form or function or is not necessary Necessary Non-Value Added 21 Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ 7
Storage (excess inventory, decisions in process) Transportation (moving) Overproduction (forms) Unnecessary processing ( re-, Non-value added) Waiting Excess movements (handoffs) Defects (errors & rejects, loop-backs) 22 Definition The best arrangement of people, materials, work stations, and methods within a work area to eliminate waste Creating a consistent method for work flow to improve quality, speed, and cost in addition to reducing variation 23 Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ 8
Time observation - metrics Simple Process Map Complex Process Map swim lanes Value Stream Map Spaghetti/Layout Diagram 5S RPIW/mini-RPIW (Kaizen) A3 Documentation 25 26 S. Pavelka - Ia Primary Care 27 Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ 9
October 2015 S. Pavelka - Ia Primary Care 28 Increased customer service & retention More options for the customer Increased productivity & decreased cycle time Quicker response time Increased internal and external satisfaction Quality requirements Increased employee & earnings growth Price pressures- Costs 30 Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ 10
Plan, Do, Study/Check, Act (PDSA) Lean Six Sigma Baldrige ISO Joint Commission / Magnet Patient Centered Medical Home Others. 31 Strategy for competitive advantage- Quality, Cost, Delivery Performance targets and monitored- Matrix Daily performance management and visual control 32 Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ Pavelka s Point Consulting, LLC 641-780-0810 pavelkaspointconsulting@gmail.com Sarah Pavelka, MHA, OTR/L, CPHQ, FNAHQ 11