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© 2012 Operational Performance Solutions, Inc.

Operational Performance Solutions, Inc. 77 East Main Street, Suite 402 Westminster, Maryland 21157

www.OPSgroupinc.com

August 22, 2012

Implementing Lean in

Healthcare Organizations:

“Roadmap for Success”

Presented by

John Beakes, Jr.

President and CEO, OPS, Inc.

© 2012 Operational Performance Solutions, Inc. 2

John Beakes, Jr. Background

Co-founder with John Beakes, III of OPS. Serving as President and CEO. Has led the development of the OPS Lean Healthcare Practice.

Co-founder, President, and leader of the Lean practice at RWD Technologies. Lean clients included Ford, Jaguar, Chrysler, and other Fortune 100 companies.

Annapolis graduate; served on nuclear submarines.

© 2012 Operational Performance Solutions, Inc. 3

OPS Webinar Series

April 11, 2012. Art Smalley. Advanced Issues in A3 Problem Solving

June 20, 2012. Russ Scaffede. Enterprise-wide Lean Implementation

These webinars are available for no charge at:

http://www.opsgroupinc.com/lean-process-improvement/webinars/

© 2012 Operational Performance Solutions, Inc. 4

Session Objectives

Learn how to develop:

A roadmap for successfully implementing Lean in your organization

Your organization’s Lean System Model

Review Lean System Models that have been key to successful implementation

Obtain practical lessons learned from successful Lean projects

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© 2012 Operational Performance Solutions, Inc. 6

Transformation Has Two Elements Technical and Cultural

Technical Tools and Techniques

Pursuit of Perfection

Value Stream Thinking

Disconnected Process Improvement

Tools Deployment

Leadership and Culture

Learning Organization

Advanced Teambuilding

Employee

Empowerment

Employee Engagement

Operational Excellence

Th

e P

ath

to

Le

an

6

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Quality “True North”

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Quality “True North”

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Denver Health and Quality

University Health System Consortium ranked Denver Health as one of the top 10 academic medical centers in the U.S. for key inpatient quality indicators 30-Day All Cause Readmission Rate was 8.7%

(ranking #7). Length of stay index, which compares observed

to expected length of stay, was 0.89 (ranking #8). Mortality index (observed to expected mortality

rate) was the best in the nation at 0.50.

Ref: Imperatives for Quality Report, July 2010 – June 2011.

Denver Health is NOT an OPS client. This data is from the 2011 Denver Health Annual Report.

© 2012 Operational Performance Solutions, Inc. 12

Denver Health Results from

Lean, 2006-2011

12

Denver Health is NOT an OPS client. This data is from the 2011 Denver Health Annual Report.

© 2012 Operational Performance Solutions, Inc. 13

Lean Deployment Guide

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Healthcare People “Get” Lean

Healthcare is the diagnosis and treatment of illness

Lean is the diagnosis and treatment of process imperfections

The goal is to give healthcare professionals a new way to look at their processes using a small Lean toolset

© 2012 Operational Performance Solutions, Inc. 15

Lean has About 160 Tools

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Healthcare Needs About 11

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Lean Tools for Healthcare

Waste Identification and Elimination Value Stream Analysis Process (VSAP) Standard Work Waste Walk/Spaghetti Diagram Quality Assurance/Mistake Proofing 5S/Visual Management One-Piece Flow (Continuous Flow)/Just-in-Time (JIT) Pull Systems Quick Changeover PDCA/A3 Problem Solving (Root Cause Analysis) Cascading Annual Planning Process

17

© 2012 Operational Performance Solutions, Inc. 18

Highest Quality - Lowest Cost - Shortest Lead Time - Best Safety - Highest Morale

Business Results

Toyota Production System

Just-In-Time Right part, right amount,

right time

• One-Item-Flow

• Takt Time

• Pull Systems

Zero Defects Make Problems Visible

• No defect passed

forward

• Stop and Fix

• Scientific Method

Leveled Schedule – Standard Work – 5S/Visualization

Stability

People Respect for the individual

• Integration of Continuous

Improvement with daily work

• Decisions made at lowest level

• Scientific Thinking

• Every person a problem solver

• Nothing is permanent

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Ref: Going Lean In Healthcare. Institute for Healthcare Improvement. 2005

© 2012 Operational Performance Solutions, Inc. 21

A Medical Center Management System Model

Medical Center

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Benefits of a System Model

Provides an integrating framework

Clarifies system interactions

Facilitates communications

Embodies “the story”

Promotes consistency of purpose

Enhances new employee training

© 2012 Operational Performance Solutions, Inc. 24

Benefits of a System Model

Provides an integrating framework

Clarifies system interactions

Facilitates communications

Embodies “the story”

Promotes consistency of purpose

Enhances new employee training

KEY TO SUSTAINMENT

© 2012 Operational Performance Solutions, Inc. 25

Questions?

© 2012 Operational Performance Solutions, Inc. 26

26

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Quality “True North”

© 2012 Operational Performance Solutions, Inc. 28

Leadership Commitment and Support Go See Ask Why Show Respect

- Culture Centered on Patient Care - Servant Leadership (EPIC) - Employee Engagement - Cascading Annual Planning Process

The Lean System of Patient Care

Quality “True North”

Principles Patient Centered

Quality at the Source

Standard Processes

Engaged Employees

Pursuit of Perfection

Supplier Partnerships

Objectives Defect Free

Without Waste

Just-in-Time

Continuous Flow

Continuous Improvement

Standard Work

5S/Visual Management Continuous Flow

Mistake Proofing

PDCA

Pull Systems

© Copyright 2008-2012. Operational Performance Solutions, Inc.

© 2012 Operational Performance Solutions, Inc. 29 © 2012 Operational Performance Solutions, Inc. 29

© 2012 Operational Performance Solutions, Inc. 30

Leadership Commitment and Support Go See Ask Why Show Respect

- Culture Centered on Patient Care - Servant Leadership (EPIC) - Employee Engagement - Cascading Annual Planning Process

The Lean System of Patient Care

Quality “True North”

Principles Patient Centered

Quality at the Source

Standard Processes

Engaged Employees

Pursuit of Perfection

Supplier Partnerships

Objectives Defect Free

Without Waste

Just-in-Time

Continuous Flow

Continuous Improvement

Standard Work

5S/Visual Management Continuous Flow

Mistake Proofing

PDCA

Pull Systems

© Copyright 2008-2012. Operational Performance Solutions, Inc.

© 2012 Operational Performance Solutions, Inc. 31

Leadership Commitment and Support

© 2012 Operational Performance Solutions, Inc. 32

Leadership Commitment and Support Go See Ask Why Show Respect

© 2012 Operational Performance Solutions, Inc. 33

Leadership Commitment and Support Go See Ask Why Show Respect

• Culture Centered on Patient Care • Servant Leadership (EPIC) • Employee Engagement • Cascading Annual Planning Process

© 2012 Operational Performance Solutions, Inc. 34

Principles

• Patient Centered

© 2012 Operational Performance Solutions, Inc. 35

ED

Pharm

acy

LAB

Radio

logy

Imagin

g

Hosp

ital

Flo

or

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Performance Review; Professional Recognition; Promotions

© 2012 Operational Performance Solutions, Inc. 36

ED

Pharm

acy

LAB

Radio

logy

Imagin

g

Hosp

ital

Flo

or

36

Performance Review; Professional Recognition; Promotions

Patient

© 2012 Operational Performance Solutions, Inc. 37

ED

Pharm

acy

LAB

Radio

logy

Imagin

g

Hosp

ital

Flo

or

W W W W W W= WASTE

37

Performance Review; Professional Recognition; Promotions

Patient

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Value Stream Analysis Process

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Principles • Patient Centered • Quality at the Source • Standard Processes

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Standard Work Chart

40

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Lead Checklist

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Principles • Patient Centered • Quality at the Source • Standard Processes • Engaged Employees

© 2012 Operational Performance Solutions, Inc. 43

Medication Sorting

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Medication Sorting

<----- Before

After ----->

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Principles • Patient Centered • Quality at the Source • Standard Processes • Engaged Employees • Pursuit of Perfection • Supplier Partnerships

© 2012 Operational Performance Solutions, Inc. 47

Leadership Commitment and Support Go See Ask Why Show Respect

- Culture Centered on Patient Care - Servant Leadership (EPIC)

- Employee Engagement - Cascading Annual Planning Process

The Lean System of Patient Care

Quality “True North”

Principles Patient Centered

Quality at the Source

Standard Processes

Engaged Employees

Pursuit of Perfection

Supplier Partnerships

Objectives Defect Free

Without Waste

Just-in-Time

Continuous Flow

Continuous Improvement

Standard Work

5S/Visual Management Continuous Flow

Mistake Proofing

PDCA

Pull Systems

© Copyright 2008-2012. Operational Performance Solutions, Inc.

© 2012 Operational Performance Solutions, Inc. 48

Objectives • Defect Free • Without Waste

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Current Rounds made by a Floor RN

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Roaming Supply Cart

Frequently needed supplies are stored in drawers.

Dietary items (i.e. spoons, applesauce, straws, thickener) are located in drawers separate from the linens.

© 2012 Operational Performance Solutions, Inc. 51

Objectives • Defect Free • Without Waste • Just-in-Time • Continuous Flow

© 2012 Operational Performance Solutions, Inc. 52

Continuous Flow

© 2012 Operational Performance Solutions, Inc. 53

Continuous Flow Before After

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Objectives • Defect Free • Without Waste • Just-in-Time • Continuous Flow • Continuous Improvement

© 2012 Operational Performance Solutions, Inc. 55

Continuous Improvement

• Lower the water level • Find rocks • Remove them • Lower the water level • Find new rocks • Remove them • Lower the water level • Etc., etc… • Seek perfection

(a never-ending process)

© 2012 Operational Performance Solutions, Inc. 56

© 2012 Operational Performance Solutions, Inc. 57

Leadership Commitment and Support Go See Ask Why Show Respect

- Culture Centered on Patient Care - Servant Leadership (EPIC) - Employee Engagement - Cascading Annual Planning Process

The Lean System of Patient Care

Quality “True North”

Principles Patient Centered

Quality at the Source

Standard Processes

Engaged Employees

Pursuit of Perfection

Supplier Partnerships

Objectives Defect Free

Without Waste

Just-in-Time

Continuous Flow

Continuous Improvement

Standard Work

5S/Visual Management Continuous Flow

Mistake Proofing

PDCA

Pull Systems

© Copyright 2008-2012. Operational Performance Solutions, Inc.

© 2012 Operational Performance Solutions, Inc. 58

The Key Processes for Lean Healthcare

A3 Problem Solving

Value Stream Analysis Process

© 2012 Operational Performance Solutions, Inc. 59

Leadership Commitment and Support Go See Ask Why Show Respect

- Culture Centered on Patient Care - Servant Leadership (EPIC) - Employee Engagement - Cascading Annual Planning Process

The Lean System of Patient Care

Quality “True North”

Principles Patient Centered

Quality at the Source

Standard Processes

Engaged Employees

Pursuit of Perfection

Supplier Partnerships

Objectives Defect Free

Without Waste

Just-in-Time

Continuous Flow

Continuous Improvement

Standard Work

5S/Visual Management Continuous Flow

Mistake Proofing

PDCA

Pull Systems

© Copyright 2008-2012. Operational Performance Solutions, Inc.

© 2012 Operational Performance Solutions, Inc. 60

Building a True Lean Culture

Means winning “one heart and soul at a time”

Each individual comes to a full commitment at their own individual pace

Be patient - some who embrace it slowly become the strongest advocates

You know you’re there when all employees are engaged in identifying and eliminating waste every day

© 2012 Operational Performance Solutions, Inc. 61 © 2012 Operational Performance Solutions, Inc.

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Quality “True North”

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64

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65

© 2012 Operational Performance Solutions, Inc. 66

Leadership Commitment and Support Go See Ask Why Show Respect

- Culture Centered on Patient Care - Servant Leadership (EPIC) - Employee Engagement - Cascading Annual Planning Process

The Lean System of Patient Care

Quality “True North”

Principles Patient Centered

Quality at the Source

Standard Processes

Engaged Employees

Pursuit of Perfection

Supplier Partnerships

Objectives Defect Free

Without Waste

Just-in-Time

Continuous Flow

Continuous Improvement

Standard Work

5S/Visual Management Continuous Flow

Mistake Proofing

PDCA

Pull Systems

© Copyright 2008-2012. Operational Performance Solutions, Inc.

© 2012 Operational Performance Solutions, Inc. 67

Contact Information

Operational Performance Solutions, Inc.

77 East Main Street, Suite 402

Westminster, MD 21157

(410) 871-0995

info@OPSgroupinc.com

www.OPSgroupinc.com

© 2012 Operational Performance Solutions, Inc. 68

Questions?

© 2012 Operational Performance Solutions, Inc. 69

What future webinar topics will be most helpful to you?

© 2012 Operational Performance Solutions, Inc. 70

Contact Information

Operational Performance Solutions, Inc.

77 East Main Street, Suite 402

Westminster, MD 21157

(410) 871-0995

info@OPSgroupinc.com

www.OPSgroupinc.com

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