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  • 8-1

    Continuous Performance Improvement Through Lean Six Sigma in the Military Health System

    Gaston M. Randolph, Jr.Director, Strategy ManagementUS Army Medical Command/Office of The Surgeon Generalgaston.m.randolph.civ@mail.milOffice: 703.681.3015

  • 8-2

    Disclosures

    Presenter has no financial interest to disclose.

    This continuing education activity is managed and accredited by Professional Education Services Group in cooperation with the MedXellence Program. PESG, MedXellence Staff, and accrediting organization do not support or endorse any product or service mentioned in this activity.

    PESG and MedXellence Program Staff have no financial interest to disclose.

  • 8-3

    Learning Objectives

    At the conclusion of this activity, the participant will be able to: Introduce Lean Six Sigma as a management system for

    achieving measurable results Understand the required infrastructure for Lean Six Sigma Understand the general structure of the DMAIC methodology

  • 8-4

    QDR Mandate

    Agenda

  • 8-5

    QDR Mandate Lean Six Sigma (LSS) Basics

    Agenda

  • 8-6

    QDR Mandate Lean Six Sigma (LSS) Basics LSS Fit in Strategic Performance Execution

    Agenda

  • 8-7

    QDR Mandate Lean Six Sigma (LSS) Basics LSS Fit in Strategic Performance Execution Linking Strategy to Performance Improvement

    Agenda

  • 8-8

    QDR Mandate Lean Six Sigma (LSS) Basics LSS Fit in Strategic Performance Execution Linking Strategy to Performance Improvement Lessons Learned

    Agenda

  • 8-9

    MHS QDR Mandate

    Everyone in DoD must adopt some form of

    Continuous Process Improvement

  • 8-10

    Select the CPI method most appropriate for the MHS

    MHS QDR Mandate

  • 8-11

    Select the CPI method most appropriate for the MHS common vocabulary, toolsets

    MHS QDR Mandate

  • 8-12

    Select the CPI method most appropriate for the MHS common vocabulary, toolsets

    Implement across all MHS components in a consistent fashion

    MHS QDR Mandate

  • 8-13

    Select the CPI method most appropriate for the MHS common vocabulary, toolsets

    Implement across all MHS components in a consistent fashion learn, grow together

    MHS QDR Mandate

  • 8-14

    Select the CPI method most appropriate for the MHS common vocabulary, toolsets

    Implement across all MHS components in a consistent fashion learn, grow together

    Accelerate MHS CPI journey from current stage

    MHS QDR Mandate

  • 8-15

    Select the CPI method most appropriate for the MHS common vocabulary, toolsets

    Implement across all MHS components in a consistent fashion learn, grow together

    Accelerate MHS CPI journey from current stage improve sooner rather than later

    MHS QDR Mandate

  • 8-16

    MHS Review

    High-Reliability Health Care: Getting There from Here. Mark R. Chassin and Jerod M. Loeb, The Milbank Quarterly, Vol. 91, No 3, 2013 (pp 459-490)

  • 8-17

    Three Changes for HRO

    Leadership commitment to zero patient harm Incorporation of all principles and practices of

    a Safety Culture throughout the organization Widespread adoption and deployment of the

    most effective of Process Improvement tools and methods (Lean, Six Sigma, Change Management)

  • 8-18

    Appropriate to roleRequired for all

    staffOnboardingCEMin

    Requirements for GB/BB

    Standardized toolkitStandard process

    for documentation: PowerSteering

    Routine performance monitoring Gap Identified

    Event ManagementSafetyErrorAdverse

    OutcomeNear MissComplaint

    Work section or Unit-wideProject TypeChange EventStandard WorkA3/RIEDMAIC

    Draft Project Charter

    Work section: Change event or Lean Project Unit-Wide:Assign Project

    Sponsor/BeltComplete Draft

    Project ChartersResourceExecute project

    Capture results in PowerSteeringCommunicate Monitor metricsCelebrate

    successes and replicate

    Train Organization

    1 PI Need Identified

    2 Document Event / Select

    Approach

    3 Prioritize, Resource,

    and Execute

    4 Capture, Share and

    Monitor

    5

    Project Dashboard

    Robust Process ImprovementEnabling a HRO

  • 8-19

    Lean Six Sigma Basics

  • 8-20

    LSS Builds Upon aFoundationof Continuous Performance

    Improvement!

    CraftProductionEli Whitney -

    ProductStandards

    Shewhart StatisticalMethods

    Juran ProcessAnalysis

    IndustrialProduction

    StatisticalProcess Control

    QualityControl

    Taguchi Customer

    Focus

    QualityEngineering

    Deming SystemsThinking

    TQM -Total QualityManagementSmith

    (Motorola) Statistical

    Rigor SixSigma v1

    Welch/Bossidy

    OrganizationalInfrastructure Six

    Sigma v2

    Taylor Time/Motion

    Studies

    ScientificManagement

    Ford Work

    Analysis

    AssemblyLine Manufacturing

    Sloan Modern

    Management

    OrganizedLabor Workers

    RightsMass

    Production

    Toyoda,Ohno,Shingo

    ToyotaProduction

    System

    Womack& Jones

    LeanEnterprise

    George, ITT Industries,

    CAT, Xerox

    Lean SixSigma v1

    Harry DMAIC

    SimplifiedManufacturing

    SimplifiedService/Process

    George & Wilson OptimizedComplexity

    Lean SixSigma v2

    Tunner Berlin Airlift

    SimplifiedProduct Line

    Zero Defects

    Gilbreth

  • 8-21

    LSS Basics Industry best practice management framework

    combines Lean and Six Sigma strategies

  • 8-22

    Industry best practice management framework combines Lean and Six Sigma strategies

    Lean methods

    LSS Basics

  • 8-23

    Industry best practice management framework combines Lean and Six Sigma strategies

    Lean methods Remove non-value added waste from processes Thus, reduce process lead time Happy customersreduced cost!

    LSS Basics

  • 8-24

    Industry best practice management framework combines Lean and Six Sigma strategies

    Lean methods Remove non-value added waste from processes Thus, reduce process lead time Happy customersreduced cost!

    Six Sigma methods

    LSS Basics

  • 8-25

    Industry best practice management framework combines Lean and Six Sigma strategies

    Lean methods Remove non-value added waste from processes Thus, reduce process lead time Happy customersreduced cost!

    Six Sigma methods Analyze and reduce variability in processes Thus, improve quality More happy customersmore reduced cost!

    LSS Basics

  • 8-26

    Whats Different About LSS?

  • 8-27

    Prescriptive frameworkvs descriptive framework

    Whats Different About LSS?This is

  • 8-28

    Prescriptive frameworkvs descriptive framework

    Trained experts leading trained project teamsvs reading a book and trying it on the fly

    Whats Different About LSS?This is

  • 8-29

    Prescriptive frameworkvs descriptive framework

    Trained experts leading trained project teamsvs reading a book and trying it on the fly

    Execution pervades the organizationvs thats the QA Departments job

    Whats Different About LSS?This is

  • 8-30

    Prescriptive frameworkvs descriptive framework

    Trained experts leading trained project teamsvs reading a book and trying it on the fly

    Execution pervades the organizationvs thats the QA Departments job

    Data-driven project selection and improvementsvs guessing, windage, shooting from the hip

    Whats Different About LSS?This is

  • 8-31

    LSS Basics: InfrastructureNeeded to Succeed!

    At each level of organizations:

    Green Belt(s)

    Black Belt Black Belt Green Belt Green Belt

    OrganizationsSenior Leader

    Process OwnerProcess Owner

    Project Team Member(s)

    Project Team Member(s)

    MasterBlack Belt

    Deployment Director

    Full-time Positions

    Process Owner

    Project SupportMentor

    Financial Analyst

    Financial Analyst

    Senior Leader Deployment Director Senior Financial Mgr Critical Process Owners Master Black Belt (Advisor)

    Executive Steering Committee

    Recommended LSS Infrastructure Based on Industry Best Practice

  • 8-32

    Multi-level/multi-phased training:Training: Training & Certification

    Executive Leader Green BeltProject Sponsor Black BeltProject ID/Selection Master Black BeltProject Team/Yellow BeltOrganizational Awareness

    LSS Basics: Training/Certification

  • 8-33

    LSS Basics: Training/Certification

    Project Sponsor Trng

    Assessment

    MBB Trng

    BB/GB Trng

    Project ID & Selection Wksp

    Harvest Results and Share Know

    ledge

    Contractor Mentoring & Consulting

    Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Month 12 Month 18 Month 24+

    Stand-up Program Perform Projects

    Organizational Awareness Trng

    Multi-level/multi-phased training:Training: Training & Certification

    Executive Leader Green BeltProject Sponsor Black BeltProject ID/Selection Master Black BeltProject Team/Yellow BeltOrganizational Awareness

    Executive Leader Trng

    Project Team Trng

  • 8-34

    Structured Project Selection

    ProjectCandidates

    Customer Issues/Opportunities Business Strategy Goals/Objectives Priorities

    LSS Basics: Project Execution

  • 8-35

    Prioritized by Leader/Mgmt

    TeamProject

    Candidates

    Customer Issues/Opportunities Business Strategy Goals/Objectives Priorities

    BEN

    EFIT

    Low

    Med

    Hig

    h

    EFFORTLow Med High

    Structured Project Selection

    LSS Basics: Project Execution

  • 8-36

    Prioritized by Leader/Mgmt

    TeamProject

    Candidates

    Customer Issues/Opportunities Business Strategy Goals/Objectives Priorities

    BEN

    EFIT

    Low

    Med

    Hig

    h

    EFFORTLow Med High

    Structured Project Selection

    Assign Projectto Sponsor and Select

    Belt

    LSS Basics: Project Execution

  • 8-37

    Prioritized by Leader/Mgmt

    TeamProject

    Candidates

    Customer Issues/Opportunities Business Strategy Goals/Objectives Priorities

    BEN

    EFIT

    Low

    Med

    Hig

    h

    EFFORTLow Med High

    Structured Project Selection

    Define Measure Analyze Improve Control

    Define project purpose and scopeMeasure current performanceAnalyze causes & confirm with dataImprove by removing variation and

    non-value added activitiesControl gains by standardizing

    DMAIC Project Management Framework

    Sponsor inspects deliverables & checkpoints for each phase

    Assign Projectto Sponsor and Select

    Belt

    LSS Basics: Project Execution

  • 8-38

    Prioritized by Leader/Mgmt

    TeamProject

    Candidates

    Customer Issues/Opportunities Business Strategy Goals/Objectives Priorities

    BEN

    EFIT

    Low

    Med

    Hig

    h

    EFFORTLow Med High

    Structured Project Selection

    Define Measure Analyze Improve Control

    Define project purpose and scopeMeasure current performanceAnalyze causes & confirm with dataImprove by removing variation and

    non-value added activitiesControl gains by standardizing

    DMAIC Project Management Framework

    Sponsor inspects deliverables & checkpoints for each phase

    Assign Projectto Sponsor and Select

    Belt

    LSS Basics: Project Execution

  • 8-39

    Prioritized by Leader/Mgmt

    TeamProject

    Candidates

    Customer Issues/Opportunities Business Strategy Goals/Objectives Priorities

    BEN

    EFIT

    Low

    Med

    Hig

    h

    EFFORTLow Med High

    Structured Project Selection

    Define Measure Analyze Improve Control

    Define project purpose and scopeMeasure current performanceAnalyze causes & confirm with dataImprove by removing variation and

    non-value added activitiesControl gains by standardizing

    DMAIC Project Management Framework

    Sponsor inspects deliverables & checkpoints for each phase

    Assign Projectto Sponsor and Select

    Belt

    LSS Basics: Project Execution

  • 8-40

    Prioritized by Leader/Mgmt

    TeamProject

    Candidates

    Customer Issues/Opportunities Business Strategy Goals/Objectives Priorities

    BEN

    EFIT

    Low

    Med

    Hig

    h

    EFFORTLow Med High

    Structured Project Selection

    Define Measure Analyze Improve Control

    Define project purpose and scopeMeasure current performanceAnalyze causes & confirm with dataImprove by removing variation and

    non-value added activitiesControl gains by standardizing

    DMAIC Project Management Framework

    Sponsor inspects deliverables & checkpoints for each phase

    Assign Projectto Sponsor and Select

    Belt

    LSS Basics: Project Execution

  • 8-41

    Prioritized by Leader/Mgmt

    TeamProject

    Candidates

    Customer Issues/Opportunities Business Strategy Goals/Objectives Priorities

    BEN

    EFIT

    Low

    Med

    Hig

    h

    EFFORTLow Med High

    Structured Project Selection

    Define Measure Analyze Improve Control

    Define project purpose and scopeMeasure current performanceAnalyze causes & confirm with dataImprove by removing variation and

    non-value added activitiesControl gains by standardizing

    DMAIC Project Management Framework

    Sponsor inspects deliverables & checkpoints for each phase

    Assign Projectto Sponsor and Select

    Belt

    LSS Basics: Project Execution

  • 8-42

    Prioritized by Leader/Mgmt

    TeamProject

    Candidates

    Customer Issues/Opportunities Business Strategy Goals/Objectives Priorities

    BEN

    EFIT

    Low

    Med

    Hig

    h

    EFFORTLow Med High

    Structured Project Selection

    Sponsor InspectsProgress

    Define Measure Analyze Improve Control

    Define project purpose and scopeMeasure current performanceAnalyze causes & confirm with dataImprove by removing variation and

    non-value added activitiesControl gains by standardizing

    DMAIC Project Management Framework

    Sponsor inspects deliverables & checkpoints for each phase

    Assign Projectto Sponsor and Select

    Belt

    LSS Basics: Project Execution

  • 8-43

    Prioritized by Leader/Mgmt

    TeamProject

    Candidates

    Customer Issues/Opportunities Business Strategy Goals/Objectives Priorities

    BEN

    EFIT

    Low

    Med

    Hig

    h

    EFFORTLow Med High

    Structured Project Selection

    Sponsor InspectsProgress

    Define Measure Analyze Improve Control

    Define project purpose and scopeMeasure current performanceAnalyze causes & confirm with dataImprove by removing variation and

    non-value added activitiesControl gains by standardizing

    Results are Captured and

    Sustained

    DMAIC Project Management Framework

    Sponsor inspects deliverables & checkpoints for each phase

    Assign Projectto Sponsor and Select

    Belt

    LSS Basics: Project Execution

  • 8-44

    Prioritized by Leader/Mgmt

    TeamProject

    Candidates

    Customer Issues/Opportunities Business Strategy Goals/Objectives Priorities

    BEN

    EFIT

    Low

    Med

    Hig

    h

    EFFORTLow Med High

    Structured Project Selection

    Sponsor InspectsProgress

    Define Measure Analyze Improve Control

    Define project purpose and scopeMeasure current performanceAnalyze causes & confirm with dataImprove by removing variation and

    non-value added activitiesControl gains by standardizing

    Results are Captured and

    Sustained

    DMAIC Project Management Framework

    Sponsor inspects deliverables & checkpoints for each phase

    Assign Projectto Sponsor and Select

    Belt

    LSS Basics: Project Execution

  • 8-45

    LSS Fits in Your Toolkit!

    Must have aligned organizational strategy

  • 8-46

    Must start with aligned organizational strategy LSS fits as a Strategy Improvement Engine

    LSS Fits in Your Toolkit!

  • 8-47

    Must start with aligned organizational strategy LSS fits as a Strategy Improvement Engine

    Evaluate objective targets, gaps to reach them

    LSS Fits in Your Toolkit!

  • 8-48

    Must start with aligned organizational strategy LSS fits as a Strategy Improvement Engine

    Evaluate objective targets, gaps to reach them ID initiatives to close gaps

    LSS Fits in Your Toolkit!

  • 8-49

    Must start with aligned organizational strategy LSS fits as a Strategy Improvement Engine

    Evaluate objective targets, gaps to reach them ID initiatives to close gaps Those initiatives become LSS projects!

    LSS Fits in Your Toolkit!

  • 8-50

    Must start with aligned organizational strategy LSS fits as a Strategy Improvement Engine

    Evaluate objective targets, gaps to reach them ID initiatives to close gaps Those initiatives become LSS projects

    Aligns commitment, resources, and effort against strategically-focused projects!

    LSS Fits in Your Toolkit!

  • 8-51

    The MHS is ahead of the rest of the DoD!

    LSS Fits in Your Toolkit!

  • 8-52

    The MHS is ahead of the rest of the DoD! Strategy and objectives defined

    LSS Fits in Your Toolkit!

  • 8-53

    The MHS is ahead of the rest of the DoD! Strategy and objectives defined Data-driven decision-making is ro...

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