Driving a Culture of Change with Lean Six Sigma Sean Carey, LNHA essee Consulting sean@essee.us
Objectives Compare lean six sigma and culture change principles, philosophy and methods, and understand how LSS can improve quality while enhancing person-centered care practices. Collaborate with peers to understand and practice lean six sigma methodologies Apply lean six sigma learning to improvement activities through group activities and roleplaying
Lean Six Sigma is Systemic, Continuous Improvement L: The Far Side, Gary Larson R: http://performancemanagementcompanyblog.com/tag/lego-and-square-wheels-illustrations/
Culture Change Know each person Each person can and does make a difference Relationship is the fundamental building block of a transformed culture Risk taking is a normal part of life Put person before task Promote the growth and development of all Shape and use the potential of the environment in all its aspects: physical, organizational, psycho/social/spiritual Practice self-examination, searching for new creativity and opportunities for doing better Recognize that culture change and transformation are not destinations but a journey, always a work in progress
Lean Six Sigma Philosophy Lean and Six Sigma are complementary quality improvement programs developed in manufacturing and proven to work in healthcare Lean is the systemic approach to identifying and eliminating waste by flowing the product/ services at the pull of the customer in pursuit of perfection (Lean Enterprise Institute) Six Sigma is a project-based strategy to eliminate errors (99.99966% accuracy goal) Both strategies put the customer at the center of thinking
Lean Lean is a philosophy, a methodology, and a set of tools Lean is built on a deep respect for people Quality is built-in (systems thinking) but people are in control Problems are addressed closest to the source Organizations must practice continuous reflection and selfassessment Quality improvement and waste reduction are continuous
Operating Margin of Toyota vs. GM/ Ford
Waste: DOWNTIME Defects Failing to document care Improper cleaning of a catheter Preparing a meal tray with the wrong diet order Overproduction Preparing food in large batches that goes unused Setting up more tables or chairs than an event needs Waiting Residents waiting for an aide to be available for personal care Staff and resident waiting for a lift to be available Submitting orders to medical records and waiting for new MARs or TARs to be printed. Non-Utilized Talent Policies that limit who can enter resident rooms or other work areas (such as kitchens) Policies that restrict the scope of practice unnecessarily Inconsistent application of workplace practices Blaming employees for system errors
Waste: DOWNTIME Transportation Walking to another work area to check is a process is done or a resident is ready Walking to another neighborhood to retrieve a lift Inventory Medication supplies in excess of what can be used Overcrowded central supply rooms Food products that aren t used before spoilage Motion Room set ups that require excessive bending and twisting when completing tasks Shower/ spa rooms designed without ready access to soap, shampoo, towels, etc. Tray lines not optimized for movement Excess Processing Charting beyond what is needed Communicating more than what is needed, or more often than is needed Writing memos that aren t read
Value Added vs. Non-Value Added Value Added Wanted by the customer Changes through the process Done right the first time Non-value Added but Necessary Required by regulation Non-value Added Pure waste, convenience of the organization Value: Optimize Non-Value But Necessary: Minimize Non-Value: Eliminate
Value Stream Map A value stream map (VSM) is a type of visual flow chart that describes a process from the beginning request by a customer to the end result delivered to the customer. A VSM is a crucial tool to identify waste, reduce inventory and decrease process cycle times. Because it s a visual representation of a process, it makes complex activities very easy to examine and understand completely.
Value Stream Map A value stream map (VSM) is a type of visual flow chart that describes a process from the beginning request by a customer to the end result delivered to the customer. A VSM is a crucial tool to identify waste, reduce inventory and decrease process cycle times. Because it s a visual representation of a process, it makes complex activities very easy to examine and understand completely.
Cross-Functional Flow Maps A cross-functional flow map is a way to organize a process into swim lanes that represent different people/groups involved in the process. This type of map is useful to examine cases where a process flows back and forth between people (perhaps indicative of waste), as well as to look at how much time between steps a particular person might spend waiting (useful when trying to level out process flow).
Physical Process Map A physical process map shows how people and things in a process flow through the physical space. Because it generally uncovers a lot of waste around organization and layout, it s frequently referred to as a spaghetti map. The easiest way to create a map is to start with a copy of the floorplan.
5S Sort Sustain Set Standardize Shine
A3 Thinking
Mark Hamel, Kaizen Event Handbook
Questions? Sean Carey sean@essee.us http://www.essee.us @esseeconsulting