listening to voices the voice of the process measurement over time
TRANSCRIPT
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Listening to Voices
The voice of the process
measurement over time
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What are the voices?
Work AreasThe Staff
Staff Surveys
Media AttentionCustomer/Citizen
SurveysComplaints
WasteEfficiency
Outcome & Process Measures
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Wasting valuable management time
How much time do you spend trying to achieve targets?
• Trying to achieve everything• Writing reports• Holding meetings to sort perceived
performance issues
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Performance Reports?
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How often do you report?
• Month on month• This quarter compared to last quarter• This quarter compared to this quarter
last year• The average for the:
• Month• Quarter• Year
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Average Late Starts
6
7
8
9
10
11
12
13
14
Urology T&O Gen Surg
%Late start rates
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How can we compare, quantify or record changes if we cannot capture our data in some numerical form?
Without measurable data we are at the mercy of anecdote. If you make an assumption based on anecdote rather than data, it will nearly always be wrong because we remember the unusual, not the mundane.
Why collect data?
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What are we measuring ?
• What data is currently being collected?
• How do you interpret/use these?• Is this info fed back to those who
collect the data?
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Chasing Tails!!!
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Chasing Tails– learning points
• Any process contains variation
• Reacting incorrectly to variation is futile
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What is variation?
Nick TysonNick TysonNick TysonNick TysonNick Tyson
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“I drive to work every day. When asked, I say it takes 55
minutes. In fact, it takes about 55 minutes, but every day it is
slightly different”
What is variation?
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97.595.0
92.590
.087.5
85.082.5
80.077
.575.0
72.570.0
67.565.
062.5
60.057.5
55.052.
550.0
10
8
6
4
2
0
J ourney Time
Num
ber
of days
Time to drive to work
Histogram
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The importance of time
• Time is often the most important variable, but it is often lost in the aggregation of data
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Average Late Starts
6
7
8
9
10
11
12
13
14
Urology T&O Gen Surg
%Late start rates
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Run charts
• How to draw a run chart
Y axis The value (measure)
X axis Time period (e.g. days, weeks)
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Run Chart Exercise
• The raw data for the three departments are attached
• Roughly plot each directorate separately on the graph paper provided
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Three graphs
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Future gazing
• Can you predict how your process is likely to perform?
• How can you measure the context of YOUR variation?
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3128252219161310741
100
90
80
70
60
50
Day
Jou
rne
y T
ime
in
Min
ute
sSPC Chart
Range of the process
Upper control limit
Lower control limit
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• All processes contain variation
• The key in managing variation is to distinguish between
- variation caused by the process (common cause)
- variation that is caused by special events (special cause)
What is variation?
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3128252219161310741
100
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Day
Jou
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in
Min
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s
Common cause
One-off special causeSpecial cause leading to new process
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Match action to type of variation
TY
PE O
F A
CTIO
N
TYPE OF VARIATION
Common Cause Special Cause
Common Cause
Special Cause
Changing the process to deal
with one-off events is only
likely to increase variation and make things
worseInvestigate the occurrence and determine what
factor external to the process has
caused the variation
Investigating and correcting each
incidence of common cause
variation will be time consuming & won’t address the
system factors causing variation
Understand the process so that
changes introduced will
change the process
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Reduce the variation e.g. by avoiding rush hour
Move the centre line e.g. by changing route
Dealing with common cause variation
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Trends
• What is a change?• What is a trend?
• “Last month our waiting list was 453. This month it is 441. We’re getting better!”
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Point Outside Control Limits
Average
UCL
LCL
Indicates there is something different about this point
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A change in the process
8+ points in a row above or below the centreline indicates a process change
CentrelineProcess average
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Trends
Upward Trend Downward Trend
6+ points in a row increasing or decreasing indicates a trend in the process
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Example
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Example
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Dealing with rare events
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PARETO CHART: EXAMPLE
Cu
mu
lativ
e P
erc
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tag
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C E B D A Other0
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Cou
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Reasons
Action taken on the key causes
Focus on the most important (Pareto Principle)
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