Huddles, Tiers, and Accountability Boards: Lean Management in the Non-Profit Sector Presented by: Rebecca Clore, LMSW Ashley Kipp, TLLP Diane Marquess, LPC Lean Transformation Transforming performance by helping people improve process. Building durable cultures of continuous improvement. Jeff Fuchs Maryland World Class Consortia 1
The Evolution of Lean Thinking Lean Gov t Product Development Sales & Mktg Accounting Lean Healthcare Lean Office / Service Supply Chain Operations Lean Construction Lean Aerospace Lean Manufacturing / Service Lean Automotive 1960 1980 2000 Jeff Fuchs Maryland World Class Consortia Standard Work and Waste Standard work indicates: Do the work in a standard way that we create, not the way the work evolved. Be aware of things going wrong, as they will! Fix the problem now, for your co-worker and service recipient. Find and fix the root cause, so the problem is eliminated. 2
Creating Problem Solvers Help each person take initiative to find and fix the causes of problems: We all have 2 jobs: Do the work Improve the work Leader s Role: Support improvement work through time and mentoring Align improvements so value flows to the service recipient Waste Any element of production, processing, or distribution that adds no value to the final product Waste is found: In areas of rework Waste adds cost & time to a process! Areas experiencing long wait times Process steps requiring multiple reviews and revisions Areas where multiple handoffs occur within and across departments 3
More Waste Correction: Rework, work done because of errors in the previous process. Overproduction: Making more than necessary or making things faster than necessary. Motion: Unnecessary people motions, travel, walking, searching. Material Movement: Unnecessary handoffs, transfers, filing, distances of material and information. Waiting: People waiting for machines, information or people. Information waiting on people or machines. Inventory: Information or material waiting in queue. Processing: Redundant or unnecessary mental or physical work; work that is giving the customer more than he/she is willing to pay for. Variability: Flow of information or product processes that are not regular or constant; lack of consistency in schedules, products, and info (unevenness). Overburden: Pushing a machine or people beyond their capabilities or what is considered reasonable. Standard Work The current one best way to safely complete an activity with the proper outcome and the highest quality, using the fewest possible resources. Enables a flexible workforce Reduces errors Improves efficiency Enables new initiatives to launch with greater success 4
Standard Work Let s Practice! Using the paper in front of you, draw a pig! You have 30 seconds. Get ready, go! 5
Discussion: What do you notice among the pigs at your table? Do the pigs look like one another? Which one is the correct pig? Round 2 I m going to read a set of instructions to you. Using a new sheet of paper, follow my instructions exactly. I will move fairly quickly, so please try to keep up. 6
Discussion: What do you notice among the pigs at your table? Do the pigs look like one another? Which one is the correct pig? What was different about this round? Round 3 7
Discussion: How was this round different? Do our pigs more closely resemble one another? Did anyone experience less frustration or angst over drawing the pig? Coming Home The Toyota Effect https://www.youtube.com/watch?v=uywxhznyvg4 8
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~33,000 employees worldwide 100+ countries where Stryker products are sold Stryker is one of the world's leading medical technology companies and, together with our customers, we are driven to make healthcare better. The Company offers a diverse array of innovative products and services in Orthopedics, Medical and Surgical, and Neurotechnology and Spine that help improve patient and hospital outcomes. Stryker is active in over 100 countries around the world. How we got started: Chad and Bruce met with Leadership and Program Managers Mentoring and coaching Several joint meetings = current process and future state (what/how do we want it to be) pain points or opportunities Where is the data? Do we just think it take a long time to hire someone? Do we know? If we don t know, we need to find out before it gets solved (avoid solving the wrong thing) Our process is visible, not hidden away in order to support accountability 10
New Program Development resulted in: Tier 3 meetings New procedures (make the work standard) Frequent updates What s up next? Visual Increased communication, greater sense of all knowing which way to row the boat, increased morale Tier 1 & Tier 2 Glen s House: Crisis Residential and Crisis Respite Glen s House services provide a safe and therapeutic environment for youth ages 5-17 with a primary mental health diagnosis and experiencing an acute psychiatric crisis. Short term length of stay, includes psychiatric, mental health assessment and treatment planning, nursing, medication management, individual, family and group counseling. 11
Glen s House: Crisis Residential and Crisis Respite 12
Glen s House Tier 2 Focus on: Outcomes Safety Budget/Occupancy System Issues Tier 1 Topics Tier 1 Daily Huddle 13
Tier 1 and Tier 2 Huddles We continued to meet, both at Tier 1 and Tier 2 Tier 1 (Daily) with a focus on communication between shifts, clinical staff, and on-call (as needed). Who needed to know what when? Tier 2 (Weekly) with a focus on outcomes, contractually required services, budget, health and safety, and program operations. More Problem-Solving: Scheduling Competing demands: Facility cleaning, shopping, drills Clinical intakes, psychiatrist appointments individual therapy, group therapy, target Organizational staff meetings, training Not enough time as initially structured to get it all done! 14
Visual Management 15
Lessons Learned: Lean is a system/organizational transformation Requires discipline Ask why Next Steps: Strategic Planning and NPD Board Revamp Agency-wide CI Process Foster Care and Adoption 16
Questions? Rebecca Clore, Quality Services and Compliance Manager rebecca.clore@fcsource.org Ashley Kipp, Program Supervisor, Link and Crisis Services ashleyk@fcsource.org Diane Marquess, Behavioral Health Program Director dianem@fcsource.org Resources Lean Thinking by James Womack and Daniel Jones Managing to Learn by John Shook Getting the Right Things Done by Pascal Dennis Michigan Lean Consortium http://michiganlean.org Lean Enterprise Institute http://www.lean.org Lean Blog www.leanblog.org Maryland World Class Consortia www.mwcmc.org 17