Model Cells to Start a Lean Journey
ThedaCare Center for Healthcare Value recently shared an interesting case study about a large California hospital system that found a unique way to replicate exceptional patient care across its many service sites. The Palo Alto Medical Foundation for Health Care, Research and Education (PAMF) is a well-respected health care organization serving the health needs of more than a million patients who live in four counties in the San Francisco Bay area. PAMF employs 1,500 physicians and approximately 5,000 employees across more than 40 different locations. Like many large health care organizations, PAMF’s rapid growth in recent years led to consistent care quality across the organization, but the patient experience varied. Yet patient satisfaction surveys showed that patients wanted the same experience no matter what location they went to for care. As these service conundrums continued to develop, PAMF’s leaders soon discovered that Lean Six Sigma tools could help them create a model of care that meets patient expectations and replicate it at their many locations. After benchmarking with ThedaCare and hiring leaders experienced in LSS, PAMF’s management team began to realign its primary care delivery system at 40 locations using lean principles. Borrowing from ThedaCare’s success, they started with the “model cell” concept to align everyone with the goal of improving the patient experience. What is a “model cell”? Let’s say you’re a large hospital system like PAMF. Is it realistic to find the training and financial resources to help the entire organization “go Lean” all at once? Probably not. But if you start with one department where the leaders are excited and eager to be the first, you can set a model for the rest of the system to learn from. The cell model becomes a demonstration project, a proof concept, that shows real change and real results. Otherwise, if you try to implement LSS across an organization without adequate training and support, you run the risk of spreading yourself too thin and accomplishing little. That is how LSS fails – by not showing results. PAMF found that the model cell was the best way to help staff learn about LSS principles. The leadership team used this approach to show the rest of the organization what “exceptional care” looks like. This generated excitement among staff, and best practices from the model cell began to spread organically. Ironically, one of PAMF’s initial successes had more to do with staff satisfaction than with bottom-line improvements. It turns out that juggling a million priorities was creating staff burnout. LSS helped alleviate the problem and get team members home for dinner with their families. They teamed up nurses and medical assistants to work more closely with physicians to quickly and efficiently identify patient concerns, communicate the concern with the physician and speed the process of actual patient care. This improved not only staff satisfaction, but patient satisfaction as well. If you haven’t read the case study, it’s definitely worth the read. Today, PAMF’s lean initiatives are focused on continuous improvement with a concentrated effort to bring daily engagement into the organization’s specialty care areas. Kudos to the PAMF team making LSS applicable in day-to-day work and improving care for its patients. How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreCommunicating Process Improvements
Have you ever noticed that sometimes those that are most involved in something are often the least informed? Here’s a case in point. I recently took a flight at a major U.S. airport. When we got to the airport, we checked the monitors and determined our gate. Not long after that, we just happened to check the monitor again. It showed that we were at a different gate. So, we dutifully gathered up our belongings and went to the new gate. Once there, we overheard staff talking about the need to perform maintenance on a plane and an expected 15 minute delay. After about 45 minutes, we noticed that the flight crew had mysteriously disappeared. We checked the monitor and our gate had changed again. We headed to our third gate at the other end of the terminal. While we were sitting at the gate, we overhead a gate agent ask another agent if she was going to be working the late night flight. Soon, we noticed that neither gate attendant was there. An overhead announcement notified us that our gate had been changed a fourth time. So, everyone in the gate area rushed to the new gate. Four gates, in two and half hours, and only one actual airport notification. Imagine how irritated I would have been if I had missed my flight because the airline made these changes, but forgot to tell the passengers. This often is the case in process improvement projects. The team develops a very good plan about what needs to be changed and how to implement those changes. They forget, however, to notify those individuals or groups that will be directly affected by these changes. It’s no wonder that many process improvement projects fail, because of lack of involvement or acceptance. Most people naturally do not like change, especially when it is change they are unaware of before it occurs. Just as we were moving multiple times within the airport, people can be seen moving in apparently random fashion trying to keep up with new processes. A good communication plan and involvement of key individuals is crucial to any successful PI project. The more people know, the more they want to help. The less they know, the more resistant they are. If you’re feeling resistance to your PI project, have you re-evaluated the way you are communicating the changes? A little communication goes a long way in obtaining buy in and support. How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreDoctors and Dynamite
I enjoy reading about how organizations began using Lean and Six Sigma (LSS) in their business. Often companies bring in consultants to plan and execute projects, train staff on LSS methodologies, or both. I find it more interesting to read how enterprises can find help from non-obvious sources. I recently read in the August issue of Quality Magazine about a teaching healthcare system that, with a little help from the Greater Boston Manufacturing Partnership, decided to think outside of the box on their LSS program. Ellis Medicine teamed up with a dynamite manufacturer in Cincinnati to have two of its staff members trained in LSS principles. These “Lean Leaders” then went back to Ellis Medicine looking for obvious projects (aka low-hanging fruit). Ellis’ first project focused on laboratory blood sample turnaround time (TAT). By reducing TAT, the team saved an estimated $600,000. Based on this success, Ellis established 6 team projects in various areas of the system. While each project had some savings, two in particular stand out. A critical shortage of IV pumps was resolved, resulting in savings of $500,000. Another team identified laboratory tests that could be performed in-house, providing savings of $1 million. As busy professionals we have a tendency to focus on what is happening within our own field. By exploring alternatives outside our main industry, we often find outside-the-box solutions and a greater appreciation for programs such as LSS. How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreCreativity and Lean Six Sigma = Oil and Water?
There’s a misperception that Lean Six Sigma’s (LSS) structured approach to quality, with its focus on reducing errors and eliminating waste, stifles creativity for companies desperately seeking to nurture a culture of innovation. But this line of reasoning assumes that there’s only one kind of creativity that leads to innovation — disorderly chaos. Methodology is mutually exclusive in the processes that lead to those eureka moments of real discovery and innovation. To the contrary, Colorado-based Arrow Electronics, Inc. is just one example of an organization that has embraced LSS to strengthen its innovative culture. In fact, for the second year in a row, Arrow walked away with “Innovation of the Year” honors at the 2017 Lean & Six Sigma World Conference, one of the leading conferences on business process improvement. Arrow, a global provider of products, services and solutions to industrial and commercial users of electronic components and enterprise computing solutions, won for its Lean Sigma Drones project. This project combines drone technology, video technology and a rapid-improvement methodology to observe Arrow’s extensive warehouse operations from a birds-eye view and more effectively identify areas for continuous improvement. The project has already increased the efficiency of targeted processes by 82 percent and eliminated more than 6.5 million walking steps in warehouse processes since Arrow launched it in late 2016. Employee feedback spurred the innovative drone project. Arrow warehouse employees reported it was much easier to observe processes and identify areas for improvement from a higher vantage point. Using drones, they can now see more than they ever could before, and all in 4K resolution. To ensure operational excellence and nurture a culture of innovation, Arrow offers regular LSS training to its employees. Aside from training, Arrow also conducts regular audits in every distribution center, making sure the problems are always identified and innovative best practices are widely shared, to improve operational performance and achieve high ROIs. Arrow’s team has creatively tackled other projects, like modifying a race car to be safely driven at speeds over 100 mph using just the head movements and breath from a quadriplegic driver. Or a pheromone-based pest control system that uses an insect’s own natural communication methods to prevent damage to fruit crops. Or transforming cargo containers into fully-equipped classrooms and health clinics to be used across Africa. Or even engineering sensors that help dairy farmers better manage livestock health and optimize milk production. And, smart smoke detectors that are designed to be a more effective early warning system. To say that LSS, because of its emphasis on planning and measurement, is incompatible with innovation isn’t necessarily the case. What may be an even bigger mistake is to assume that providing no framework for idea-generation supports, rather than limits, the entrepreneurial spirit, and that boundaries are just buzzkill. This view doesn’t recognize that the problem-solving that is foundational to LSS is a creative process itself. Furthermore, the LSS emphasis on collaboration and team-building unleashes the power of ideas and their synergies when cross-functional team members connect to think about possibilities rather than problems – and those teams rely on the imagination of each individual member. Creativity and LSS are a winning combination for any organization desiring a better way to conduct business. What’s been your experience with building a culture of innovation at your organization? I’d love to hear your observations! How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreUse Six Sigma to Plan Your Best Summer Vacation Yet!
As I continue to grow in my understanding and appreciation of process improvement (PI), I am convinced that these management tools can be used to improve your home life as much as your work life. For example, here are some tips and tricks to better organize your home using Lean and Six Sigma (LSS). These tools also can help you manage personal expenses or plan your spring cleaning. You can even utilize Six Sigma to help your kids with their chores. Who knew? Now that summer is here, one of the most timely examples is using Six Sigma methodology to plan your family vacation. Where else do you have the voice of the customer (three bright-eyed adorable children with their hearts set on Disney World) meet head-to-head with the voice of the business (mom and dad, who know they can only afford a camping trip to a nearby state park)? Here’s some helpful vacation planning tips from Philip Mayfield. Many PI tools lend themselves to usage in the planning of a vacation. The analytical hierarchy process (AHP) is useful to determine which variable(s) is/are the most important. A Pugh matrix can be used to determine the best vacation spot (i.e. beach versus mountain versus a mountain cabin overlooking the beach). And a good swim lane map and RACI chart can go a long way in helping everyone understand their part before, during, and after the trip (i.e. who cleans out the fast food crumbs from under the back seat of the car). If you’re a quality improvement practitioner at your workplace, how have you applied your Six Sigma skills at home to make life easier? Please email me and share your favorites! I’d love to hear from you. How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreShopping for Data at Your Local Grocery Store
With the vast amount of data now available to organizations, data science offers significant opportunities to complement a company’s continuous improvement efforts. Unfortunately, to quote business strategy and technology expert Geoffrey Moore, “Without big data analytics, companies are blind and deaf, wandering out onto the Web like deer on a freeway.” A 2017 American Society for Quality case study by Sivaram Pandravada and Thimmiah Gurunatha illustrates how data analysis helped a grocery chain reduce inefficiencies in its retail inventory and ordering process. The short shelf lives of fresh foods along with ever-changing consumer demand meant that the retail chain’s stores often had to hold clearance sales with zero or negative margins or write off inventory. Annually, the problem of shrinkage accounted for revenue losses of up to 20 percent. Although the ordering process was automated, it was better suited for longer shelf-life items. As a result, managers would often override the system and order manually. There were no defined limits in place. The organization needed an approach for monitoring and controlling this waste. Explorative data analysis and basic statistics helped the chain identify and reduce inefficiencies in its inventory and ordering process, minimizing the gap between quantities sold and quantities ordered. For example, to reduce excess ordering, the warehouse used color coding to monitor and track inventory. The colors of tags on the shelves helped ensure that department managers would see indications of stock levels during daily physical inspections. Red tags indicated Stock Keeping Units (SKUs) with high shrinkage. Blue tags signaled SKUs with high stock levels. Rainbow statistical process control (SPC) charts, a variation on traditional SPC, helped ensure ongoing monitoring of the stock-to-sales ratio and escalated corrective action in real time, bringing sustainable results within three months. Once the chain saw the difference that the data-based approach made in targeting waste and inefficiency in one store, it successfully replicated its process improvements to increase profitability throughout the organization. If you haven’t seen it, the case study is definitely worth the read. The project approach and lessons learned can also be applied in other retail settings. How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
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