change agent training
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Change Agent Training. Day 1. Objectives of the course. Apply the Lean methodology to the workplace Apply practical principles through simulations Use knowledge gained to develop a Lean investigation in your own area Provide a network of support for each other. Agenda. - PowerPoint PPT PresentationTRANSCRIPT
Change Agent Training
Day 1
Objectives of the course
Apply the Lean methodology to the workplace Apply practical principles through simulations Use knowledge gained to develop a Lean
investigation in your own area Provide a network of support for each other
Agenda
09:15 Lean Simulation
10:30 Coffee
11:15 Transformation Approach Parts 1 and 2
12:00 Lunch
12:45 Transformation Approach Part 3
14:00 Coffee
16:30 Close
Reflection from Half Day Session Any thoughts you’d like to share with the group?
Lean Flow Game
Game Number 1!
Learning Points from Flow Game Types of ‘Waste’ what were they?
Transportation Waiting Re-work Motion
Kanban Flow Value Stream Single Piece Flow – no batching
Transformation Approach
1. Preparation Voice of the Customer
Defining Value
Project Scoping
Voice of the Customer
“Lean thinking …must start with a conscious attempt to precisely define value…. Through a dialogue with customers”
James P. Womack & Daniel T. Jones
Who are the customers? Who are the users of the service..
people upstream and downstream of you that receive what you deliver (patients are our customers)
payers/manager of the services provide the Voice of the Business
VoC and VoB can give rise to conflicting requirements
Can you identify your customers?
How would you identify what ‘value’ means for your customer?
Project Scoping A Project Charter is a simple tool for formalising
the nature and boundaries of the project.
It allows clear communication to all project team members and stakeholders.
No matter how small a project/idea its always good to draw up a project charter so everyone knows the scope
1. Preparation Voice of the Customer
Defining Value
Project Scoping
2. Value Stream Analysis Data Collection
Pareto Analysis
5 Whys
Value Stream Mapping (process mapping)
Data Collection Before you start any project you must look at
where you are now i.e. baseline measurement
What data do I need, where do I start?
Microsoft Excel Worksheet
Pareto Principle (80/20 rule) Italian economist Vilfredo Pareto observed that
for many events, roughly 80% of the effects come from 20% of the causes in 1906 he found that 80% of the land in Italy
was owned by 20% of the population
Pareto analysis is a very simple technique that helps you to focus efforts on the problems that offer the greatest potential for improvement.
Pareto Principle Pareto's principle, the 80/20 rule, should serve
as a daily reminder to focus your time and energy on the issues that really make a difference.
80 per cent of a nurse's time is spent on 20 per cent of the patients
80 per cent of the decisions made in meetings come from 20 per cent of the meeting time
When to use Pareto? A Pareto Chart breaks a big problem down into
smaller pieces, identifies the most significant factors, shows where to focus efforts, and allows better use of limited resources
A Pareto Chart is a good tool to use when the process you are investigating produces data that are broken down into categories
A Pareto diagram puts data in a hierarchical order, which allows the most significant problems to be corrected first.
Pareto Chart Exercise 1 Draw a Pareto Chart
Analysing the Data Ask the 5 whys
1. Why do TTAs take a long time to get to the ward?
Because pharmacy don’t get the list of TTAs in time for discharge 2. Why? Because doctors don’t order the TTAs in time 3. Why? They batch them up and do them at the end of the day 4.Why? TTA pads are at the nursing station and not used during the ward
round 5. Why? Because it’s always been done that way
Value Stream
“Wherever there is a product or service for a customer, there is a value stream. The
challenge lies in seeing it”
Value Stream Mapping What is Value?
In NHS terms – Value is any activity which improves the patient’s health, well being and experience
Why Value Stream?
Identifies the core set of actions required to deliver value for patients
Why Value Stream Analysis?
To align healthcare processes to facilitate the smooth flow or patients and information
Eliminate stop – starts and identify ‘hand-offs’
Value Stream Mapping
Value Stream Mapping
Value Stream Mapping
Value Stream Mapping Exercise You are an event organiser and have been
asked to organise a picnic for 10 clients in a week’s time.
This is the first time you’ve organised a picnic so you want to document the current state (what happens now) and test out the process with this client. Start of value stream: Client requests the picnic End of value stream: Deliver picnic to venue
Value Stream Mapping Analysis Step 2 Once you’ve mapped the process identify
the following; Who is the customer? Identify the value added and non value added
steps for the customer What’s the elapsed time? Min and max What’s the value added time?
2. Value Stream Analysis Data Collection
Pareto Analysis
5 Whys
Value Stream Mapping (process mapping)
3. Identify Constraints
Identify Bottlenecks
Root Cause Analysis
Variation
Introduction to Variation The extent or degree to which something varies
Too much variation in the workplace introduces risk, so reducing variation reduces risk. E.g. introduction of the Theatre WHO checklist
The variance is a measure of how far a set of numbers are spread out.
Variation Exercise Airplanes!
Reducing Variation Can you see variation in your work place?
How could you use the airplane principles to identify variation in your workplace? E.g. what could you measure
To understand variation in more detail you can use the fish bone tool
Root Cause Analysis
Problem Statement:
Man Materials Method
Mother Nature
Measurement Machine/Technology
Root Cause Analysis
Problem Statement:Variation in distance travelled by aeroplane
Man Materials Method
Mother Nature
Measurement Machine/Technology
Height and strength
One person throwing all planes
Different paper/texture/size
Same size paper
Different throwing techniques
Standardised operating instructions
Air pressure of room
Maintain temperature
Not clear what we were measuring
Measure and scale agreed in advance
Could we have used technology in this process
Technology to be investigated
3. Identify Constraints
Identify Bottlenecks
Variation
Root Cause Analysis
Human Dimensions of Change Circle of influence
Role of a Change Agent
Killer Phrases
Belbin
What is a change agent? Facilitator Continuous Improvement facilitator Service Improvement facilitator Champion of Change Internal or Lean Champion Other?
What is a change agent? A person within an organisation who has the requisite
knowledge, skills, desire and motivation to make improvements happen through change
Usually not in a position of authority within the areas of the organisation over which they make these improvements happen
Someone who achieves improvement results with and through other organisational members and stakeholders
Change Agent Experience
Planning your project Spend the next 20 minutes thinking about your
next steps Use the project charter template to think about a
problem and the desired solution
If you have already started a project think about which lean tools you might apply to the project
Summary of Learning – Day 1
Change Agent Training
Day 2
Overnight thoughts
Transformation Approach
Waste Walk In pairs visit each others department and
observe.
Note any of the 7 wastes using the waste template
When you introduce yourself to the department please say that you are observing the process not the people
Waste Walk De-Brief
4. Future State
Other Problem Solving Techniques
Ideal Future State
Future State Map
Motion Analysis
Exercise Draw a spaghetti diagram for round 1
Carrying out a Spaghetti Diagram Obtain department/hospital plans from Facilities Agree what you’re going to measure Agree on your measurements and scale You will need;
Red pen or pins and string Stop watch Pedometer Tape measure or measure wheel
Getting to the Ideal Future State“Think Different”
Steve Jobs (Apple’s CEO from 1996 – 2011) along with advertising executives coined the slogan ‘Think Different’.Converted the phone into a centre for music, film, photography, communication etc. Turned Apple into the most valuable public company in the world
Creative Thinking Divergent
Ideas generation
Convergent What will we test and how will we do it?
Exercises House
Paper Clip
Tools to think differently (Convergent Thinking)
Random Pictures
Random Words
Look to other industries
What’s the worst thing to do
Exploring an Issue RUH North
The RUH want to create an innovative and exciting space to house the new cancer centre
How creative are you?!
Look at the pictures and note what you see (outside of the obvious!)
Designing the Future State (Divergent Thinking)
What ideas could you realistically take forward?
Be achievable in 6 to 9 months (medium term) 12 months + (long term) balancing long term actions with quick wins
Designing The Future State Design a value stream for an outpatient
appointment within your new Cancer Building
Start: Patient enters the RUH End: Patient leaves having attended their
appointment
Think about pull, flow, value added and 7 wastes
4. Future State
Ideal Future State
Visual Management
Future State Map
5. Implementation Plan Action Plan
Deliver Findings
Effort Impact Analysis
Effort
Low High
Impact
Low
HighLow hanging fruit!
May not be worth investing the time
Delivering your Findings Project Team Meetings Communications Board Newsletter – Departmental Bulletin Intranet Show information collected – before and after
project – visual impact
Next Steps Define your project (using the project charter)
Talk to key stakeholders Get to a shared purpose
Start to gather evidence of current practice Speak to Lisa/Tricia or any of the change agents Plan your value stream mapping event (if
applicable)
Please complete your feedback sheets, we need to hear from you!
Feedback 2 mins feedback on your next steps
Summary of Training
QUIZ!
Any Questions?