daily management systems - pedrad.org - daily... · observe operations (gemba) during this time nch...
TRANSCRIPT
![Page 1: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/1.jpg)
Daily Management SystemsLane F. Donnelly MD
Nemours Children’s Hospital
![Page 2: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/2.jpg)
Culture “Sum of people’s
habits as to how they get their work done” Often focus of
discussion “need a culture of
improvement / safety”
![Page 3: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/3.jpg)
Culture But to create a culture of improvement,
you cannot focus on culture, you need to focus on your DMS To change culture, you need to change
your DMS – change the expectations of how your leaders lead and how daily escalation and solving of problems occurs
![Page 4: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/4.jpg)
![Page 5: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/5.jpg)
Daily Management Systems
![Page 6: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/6.jpg)
Daily Management Systems Designed so that problems are
quickly identified Front-line staff are empowered to fix
the problems that they can Problems that the front line
employees cannot fix are escalated and counter-measures created quickly
![Page 7: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/7.jpg)
Key Elements to DMS
Leadership Standard Work Visual Controls Daily Accountability Process Discipline
Mann D. Creating a Lean Culture – Tools to Sustain Lean Conversions, 2nd Ed, 2010
![Page 8: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/8.jpg)
Tiered Huddle Structure 1st – Front line Drive accountability for front line
problems Problem escalation to higher tiers
![Page 9: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/9.jpg)
Clinic Huddles
Peri-Operative Huddle
OutpatientHuddle
Hospitalists / Inpatient Units
Huddles
Integrated Huddle
ORHuddle
EmergencyHuddle
Materials - IT - Laboratory - Facilities - Radiology - Pharmacy - Facilities/Security -Family Centered Care - Rehab - Respiratory - Infusion Center - Construction
Critical CareHuddle
Patient Flow Huddle
![Page 10: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/10.jpg)
Short (10 – 15 minutes) Standing Occur between 7AM – 9:30AM At site of care Front of visual board Front line associates / leaders Standard Work: Scripting
Huddles
![Page 11: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/11.jpg)
![Page 12: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/12.jpg)
Approach
Metrics / Goals
Today’s Readiness Assessment
Problem Accountability
![Page 13: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/13.jpg)
![Page 14: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/14.jpg)
Metrics / Goals Quality & Safety Patient / Family
Experience Delivery Cost Engaged
Associates
![Page 15: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/15.jpg)
Today’s Readiness Assessment
MESA Methods Equipment Supplies Associates
![Page 16: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/16.jpg)
Problem Accountability “Quick Hits” Complex Issues
–Owner–Team–Report back date–Counter measure
![Page 17: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/17.jpg)
![Page 18: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/18.jpg)
No scheduled meetings 7 - 10:30 am NCH leaders attend huddles Observe operations (Gemba) during
this time
NCH Leadership Standard Work
![Page 19: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/19.jpg)
Traditional Management Over-sight highly variable and leader
dependent (calls) Management style shifts significantly
with change in person DMS – designed not to be dependent
on a particular person – more predictable / reliable over time
![Page 20: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/20.jpg)
Roles of Leaders
Make sure systems run as designed (maintenance Kaisen)
Continuously improve those systems (Improvement Kaisen)
![Page 21: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/21.jpg)
NCH – Opened October 22, 2013
Integration Huddle started June 2012 Data tracked February 2013
![Page 22: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/22.jpg)
Issues 252 Complex issues (28/month) Sept - 21, Oct - 63, Nov – 73 After opening: flow (41), supplies (17),
facilities (16), & IT (15) Mean time to resolution = 19.1 days
–(0 – 125 days) > 10 days (n = 9): IT (5), flow (2)
![Page 23: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/23.jpg)
Huddle Audits
![Page 24: Daily Management Systems - pedrad.org - Daily... · Observe operations (Gemba) during this time NCH Leadership Standard Work. Traditional Management ... Management style shifts significantly](https://reader031.vdocuments.us/reader031/viewer/2022022522/5b30dc247f8b9a55208e2e7f/html5/thumbnails/24.jpg)
DMS Rapidly identify and escalate
problems Team-building Leader inter-changeability Much improve coordination Elimination of the rumor-mill