Leveraging Lean Management: The System, Tools, and Teacher

Why us?

Margy Dayton, BSN, RN

Senior Process Excellence Consultant

Heather Toppen

Senior Process Excellence Consultant

Jenna Beckman

Process Excellence Coordinator

3

GRAND RAPIDS, MI

Current Condition: Our Journey

5

6

7

Coaching Cycles: Essential to the System

Vision: The Management System

9

Coaching Cycles

Experiential Learning

• Purpose: practice tools with coaching through real example

• Process: learn, practice, reflect for each tool

1. Breakout into groups of similar work2. Choose 1 or 2 key priorities in your

organization/work3. Practice tool using chosen priority

Organization SLT Quarter 1 date:Department Director Quarter 2 date:

Planning Cycle Quarter 3 date:Effective Date Quarter 4 date:

MISSION Goal 2014 Actual 2015 Goal Actual Goal

1

28 100% 2 # of LFDTs 36

62.9 90% 3

45

"Voice of the Customer"

CORE VALUES

Reverence

Justice Who My 1st Quarterly Priorities actual plan

Stewardship

Integri ty 1

GUIDING BEHAVIORS2

3

We are fully present.

We are all accountable. 4

5

In partnership with patients, physicians and others, we will transform our system of care to

provide high value and exceptional experiences to the community.

Critical # Critical # Critical #

We are continuous learners.

Accelerated Integration/System of Care - Develop an integrated system of care

supported by technology and partnerships.

DIFFERENTIATING COMPETENCIES

6

Physician Alignment/ Accountable Health Network - Partner with physicians, patients

and other key stakeholders to achieve patient centered excellence.

We will differentiate ourselves through:

-Excellence in implementation

-Physician engagement and leadership

-Patient-centered focus-Culture of safety and exceptional quality

-Engagement of associates

BHAGBig Hairy Audacious Goal

We trust and assume goodness in intentions. 5 Achieve operating performance targets through

appropriate cl inica l and va lue based program development

5 5

4

Financial Stewardship Develop and implement financial and operational

processes to address health care reform. 5

Best people/Spiritual Workplace Be recognized as culture that creates high

performance & attracts talent. 4 Create a standardized management system and culture of improvement

(As measured by: compliance to system)

4 4

3 Standardize daily problem solving huddle including coaching for use of

LFDTsStacie

3 a. Implement s tandardized da i ly problem solving huddle by 9-1-2014b. Use gemba rounding 1x1 to coach to LFDT's begin 9-1-2014 (8 times) 2

2 a. Develop system with workgroup by 8-15-2014b. Implement sys tem by 8-18-2014 2

We support each other in serving.

Excellence in Care Experience - Deliver the best care for every person, every time, in every location across our system of care.

We communicate openly, honestly, respectfully,

and directly.

3 Continual ly improve patient safety and cl inica l qual i ty

3

Community Benefit Ministry - Assure access to equitable care for all persons in our

community & improve health in measureable way. 2

Attract, Develop and Retain great people(As measured by: colleague engagement survey)

2Improve colleague engagement score for

"actively engaged" using colleague rounding

2Design colleague rounding system

including tool and visual tracking system

To Live Values, Purpose, BHAG 1Provide an exceptional Patient Care Experience

1 1

Steph

Gold Priorities (3-5 Years) Annual Key Priorities Quarterly Priorities "the Big Rocks of Life"

People: NDNQI People: Job Enjoyment Huddle Attendance

Quality:

1

Commitment to those who are poor.

We, CHE Trini ty Heal th, serve

together in the spiri t of the Gospel as a

compass ionate and transforming heal ing presence within our

communities .

Inspired by our Catholic-faith tradition, Trinity Health will be distinguished by an unrelenting focus on clinical and service capabilities as we

seek to create excellence in the care experience. Trinity Health will become the

most trusted partner for life.

Service: H-CAHPS/CG-CAHPS

Quarter 1

Purpose Future Date: Year End Measure Quarterly Measure Key Process Indicators

Finance: Productivity

Brand Promise

We empower you to be knowledgeable, informed and take an active role in your health

care decisions.

Personal Accountability

TH/CHE Foundation MHSM Strategic Direction 1 year 1 year Quarter 1

Core Values/Beliefs Purpose Organization Targets

One-Page Strategic Plan

Saint Mary's FY20157/1/2014

Manager(s)

Department Goals Department Actions

People: CoS People: Actively Engaged Colleague rounding

Actions

One Page Strategic Plan

Objective of tool: Define priorities and align efforts

•How easy/difficult was it for you to settle on one priority?

•Is it measurable?

•Does it connect to your organizations “True North”?

•At what frequency would you want to review/discuss this measure?

One Page Strategic Plan

Leader 1x1 Gemba Rounding

DURATION: 15 minutes COACH: LEADER: Manager Name

Week 1 Week 2 Week 3 Week 4

2 4 6 8

5 5 5 5

1 1 1 1

3 6 9 12

MONTH: August Leadership WEEKLY GEMBA 1 X 1 Agenda

Director Name

STRATEGIC OBJECTIVE: gather facts and data to support in coaching around leader standard work, personal value add, critical numbers, coaching

PREP: have all tools ready to discuss (One Page Quarterly Personal Plan Column, Personal LSW tracker & Action Item Lists)

Agenda item Meeting notes: Coaching (C), Action (A)

Quarterly Priorities *Update Action List

Develop and implement with workgroup by 8-15-2014question: Plan on target-ahead-behind?

Leader Standard Work (plan vs actual) *Barriers, prioritization, coaching

Review Previous Week Actions (LEADER'S OFFICE)Were there corrective action/coaching action items that needed to be addressed from previous week?

Colleague Engagement: # LFDT'sMonth to Date Totals (target 12)

Big Rock Driver Metrics - (HUDDLE BOARD)

Weekly Gemba 1x1 Rounding (actual/plan)

Colleague Rounding (# completed/cumulative total)

Daily Improvement Huddle (# attendance/weekly total)

*Barriers/Director help needed/ "need to knows"

Critical Number-Voice of Customer - (HUDDLE BOARD) *Barriers/coaching/corrective actions needed

At Gemba (Huddle Board) NEW #s TBD through improvement work-continue to

monitor current metric and LIST gaps to the right

Implement daily problem solving huddle by 9-1-2014question: Plan on target-ahead-behind?

Critical Number-Productivity (AT GEMBA--HOURLY CHART) *Barriers/coaching/corrective actions needed

What is the most recent Producitivity Index ?

Adjusting staff to volume any days this week? (# of Hours)

Review Action Item List (LEADER'S OFFICE) *Update Action List

Any new actions from this week?

Learning/Reflection---value of this experience; adjustments and corrective actions

Objective of tool: Establish rhythm of practice to achieve practice

•How did it feel to be in the coach/learner role?

•How easy/difficult was it for you to identify measurable behaviors?

•How easy/difficult was it to translate behaviors to daily/weekly measurement?

•What action as a leader would you take if the plan/actual is not met?

Leader 1x1 Gemba Rounding

Vision: The Management System

The System, Tools and Teacher

19

Daily LSW

4

Barriers: Area 1 Productivity Update: F/U Volume 8

Safety Concern

Barriers 9

Changes

Experiments 10

Metric/VoC

What's working 11

Area 2 Productivity Update: F/U

Volume 12

Safety Concern

Barriers 1

Changes

Experiments 2

Colleague Rounding Metric/VoC

What's working 3

Sustainability Audits Area 3 Productivity Update: F/U

Volume 4

Safety Concern

Barriers 5

Changes

Experiments

Metric/VoC

What's working

Area 4 Productivity Update: F/U

Volume

1 Safety Concern

Barriers

2 Changes

Experiments

3 Metric/VoC

What's working

Daily Leader Standard WorkLEADER: DATE:

STRATEGIC OBJECTIVE: Define value add; reduce waste; free up time for strategic priorities. Practice PDCA thinking around own work and must do's.

Available Hours Departmental Status Other

Schedule: (note interruptions)

Daily Standard Work

New Issues - Add to List:

Big Three

Revision_07_24_2014

Colleague Rounding

Birthdate: July – September 2014 October – December 2014 January – March 2015 April – June 2015

Personal question/relationship building

What is going well?

Who can I recognize for doing a good job?

What barriers are occurring that you have to work around to perform your job at its best?

SUMMARY/ACTIONS:

FY15 ROUNDING LOG Leader Name:

Colleague Name: Hire Date:

At the conclusion, please thank Colleague for making a difference.

What are you going to do now?

What are barriers/issues you need to resolve?

Who will be recognized?

Is there anything to add to colleague feedback report?

LSW Tracker

Leader Name:

MONTH: August

Daily M T W TH F Total M T W TH F Total M T W TH F Total M T W TH F Total M T W TH F Total

Daily Improvement Huddle(# attendance/weekly total) 1 1 1 1 1 5 1 1 1 1 1 5 1 1 1 1 1 5 1 1 1 1 1 5 1 1 1 1 1 5

Available Hours

Weekly Total Total Total Total Total

Weekly Gemba 1x1 Rounding (actual/plan) 1 1 1 1 1

Colleague Rounding2 4 6 8 10

Monthly Total

WEEK 1 WEEK 2 WEEK 3 WEEK 4 WEEK 5

Leader Standardized Work Tracker

Month 2 of Quarter

Week 1 Week 2 Week 3 Week 4 Week 5

Improvement Huddle