rcg articles, books, speaking

transforming healthcare; pursuing perfection

www.ronaconsulting.com

Published works and speaking engagements

© 2016 rona consulting group.

ARTICLES/PUBLICATIONS Bevier, Jim. Using Takt Time in Healthcare. Qualitydigest.com. Quality Digest Magazine, 23 June 2015. Web. 5 April 2016. <http://www.qualitydigest.com/inside/health-care-article/060315-using-takt-time-healthcare.html>. Jackson, Thomas (2014). Time to reset your clockspeed? Dialogue: Among Leaders and Managers Across the World, Sep/Nov 2014, 70-71. Cohen, E. & Crome, P., Eds. (2011) Bringing Economics and Quality Together: Imperatives for Nurse Executives: Part Two “What’s Making a Difference at the Bedside?” Nursing Adminstration Quarterly, 35(2) (April-June). Rakita R. M., Hagar B. A., Crome P. J., Lammert J. K. (2010). Mandatory influenza vaccination of healthcare workers: A 5-year study. Infection Control Hospital Epidemiology, 31(9), 881-888. Rona, J. M. (2007). The American health care system: A wasteland of opportunity. Future State: The Journal of Competitive Lean Thinking, Summer. Rona, J. M. (2005). 97.1 percent perfect. Journal of Healthcare Management, 50(2) (March/April), 87-93. Crome P. J. (2009). Lean in healthcare: Letter from the leadership. Voice of Nursing Leadership: The American Organization of Nurse Executives’ Newsletter, January.


BOOKS Rona Consulting Group (2014) The Lean Healthcare Dictionary: An Illustrated Guide to Using the Language of Lean Management in Healthcare. Productivity Press. Boca Raton, FL: CRC Press. Jackson, T. L. (2006). Hoshin kanri for the lean enterprise: Developing competitive capabilities and managing profit. New York, NY: Productivity Press. *Winner of the 2007 Shingo Prize for Research How do you lead and manage a large workforce of people who at any moment may stop an unnecessary MRI or a wrong-side surgery in the operating room? Hoshin kanri is the answer. The lean healthcare organization is a different kind of animal that requires a new approach to leadership and management control. The method of hoshin kanri embodies both. Hoshin Kanri for the Lean Enterprise by RCG principal Thomas L. Jackson is a practical guide to implementing hoshin kanri to improve performance in the modern business organization. As the title indicates, the book focuses on hoshin kanri, known variously as policy deployment, strategy management, and the “balanced scorecard.” Hoshin is the master control methodology, geared perfectly to the management of the radically decentralized decision-making that characterizes lean companies such as Toyota and Canon and leading healthcare organizations such as the Virginia Mason Medical Center and Park Nicollet Health Services. The method works because it ensures that every single manager knows precisely what the company expects of him, and confirms that understanding by articulating exactly how he intends to support the company’s strategic goals. This commitment is crystalized in the form of a contract, called an A3. Hoshin Kanri for the Lean Enterprise explains how to use the A3 format to document a system of commitments that aligns organizational energies around a “hoshin” or small set of significant strategic targets. The outline of the book follows the hoshin process, which is based upon the Deming cycle of Plan Do Check Act (PDCA). The book incorporates the use of value stream maps and lean accounting and includes a chapter on the often-neglected topic of the president’s diagnosis. Finally, the book explains how hoshin is related to the core lean technique of standard work. Jackson, T.L. (Ed.). (2009–2013). Lean tools for healthcare series (Bks. 1–9). New York, NY and Boca Raton, FL: CRC Press, Taylor & Francis Group LLC. Transformational leaders need tools. The Lean Tools for Healthcare Series puts the classic tools of lean management in their hands, and the hands of every front-line clinician and staff member. Based upon the Shingo-prize winning Shopfloor Series by Productivity Press, Lean Tools for Healthcare makes the teachings of Shigeo Shingo, Taiichi Ohno, and other great innovators of Japan available to the healthcare audience. Informed by the clinical knowledge of


the rona consulting group team and edited by Shingo Prize-winning rona consulting group principal Thomas L. Jackson, these books are instructionally designed for comprehension and retention. Short, clear, and illustrated with numerous healthcare examples, these books are a great compliment to the lean executive programs. institution in San Francisco Carlson, MD, FACP, S. and May, M. (Eds.). (2015). Mistake proofing for lean healthcare. Boca Raton, FL: CRC Press, Taylor & Francis Group LLC. The principles of mistake proofing, long used to eliminate errors and defects across a range of industries, are now being applied in healthcare organizations around the world to help ensure patient safety, improve services, and eliminate waste. Jackson, T.L. (Ed.). (2013). Mapping clinical value streams. Boca Raton, FL: CRC Press, Taylor & Francis Group LLC. Tens of thousands of patients die unnecessarily every year as a result of errors and defects in our healthcare processes. Those that survive often pay too much for the privilege. The value stream mapping methods described in Mapping Clinical Value Streams will help you achieve more efficient health care processes and will pave the way to an improved medical system with significantly reduced medical errors and other costly waste. Jackson, T.L. (Ed.). (2013). Kaizen workshops for lean healthcare. Boca Raton, FL: CRC Press, Taylor & Francis Group LLC. Kaizen Workshops for Lean Healthcare walks you through the steps of conducting an effective kaizen workshop—one that is well planned, well implemented, and well monitored. The information is presented in an easy-to-assimilate format. Numerous illustrations reinforce the text and margin assists call your attention to key terms, healthcare examples, and how-to steps. Jackson, T.L. (Ed.). (2012). Standard work for lean healthcare. Boca Raton, FL: CRC Press, Taylor & Francis Group LLC. Proven to increase efficiencies in the manufacturing sector, Standard Work has become a key element in reducing process waste, ensuring patient safety, and improving healthcare services. Part of the Lean Tools for Healthcare Series, this reader-friendly book builds on the success of the bestselling, Standard Work for the Shopfloor. Jackson, T.L. (Ed.). (2009). 5S for healthcare. New York, NY: CRC Press, Taylor & Francis Group LLC. The first in a new series, Lean Tools for Healthcare, this book is based on Hiroyuki Hirano's classic 5 Pillars of the Visual Workplace and modeled after the Shingo Prize-winning Shopfloor Series for Lean Manufacturers, 5S for Healthcare adopts a proven reader-friendly format to impart all the information needed to understand and implement this essential lean methodology. Forthcoming: Just-in-time for healthcare Continuous flow for healthcare Kanban for lean healthcare Quick setup for lean healthcare


Crome, P. & Dotson, R. (2009). Zero defects: Patient safety. In Nancy Rollins Gantz (Ed.), 101 global leadership lessons for nurses: Shared legacies from leaders and their mentors (ch. 65, pp. 349–352). Indianapolis, IN: Sigma Theta Tau International.


BOOK REVIEWS Parry, S., Author of Sense and Respond. (2009, January 12). It's not spray on policy deployment. It’s the real stuff. [Review of the book Hoshin kanri for the lean enterprise: Developing competitive capabilities and managing profit]. Amazon.com. Retrieved from http://www.amazon.com/Hoshin-Kanri-Lean-Enterprise-Capabilities/product- reviews/156327342X/ “I am amazed at the quality of the ideas and the sheer practically of the methods Jackson sets out in this excellent book. I have read a number of books on Hoshin Kanri methods but this is the best I have seen, it's not spray on policy deployment, this is the real stuff and demonstrates how these methods should be used. There are so many companies (some blue chip) using Hoshin Kanri who are quite oblivious of their ineptitude when using these methods, and frankly they are more dangerous, they obviously need this book to learn how to do it properly. The material in the CD-ROM back-up the text very well so there is no excuse, you can start straight away. I am now using this with my company and recommend it to others.” M. and K. (2008, November 7). The definitive Hoshin Kanri book. [Review of the book Hoshin kanri for the lean enterprise: Developing competitive capabilities and managing profit]. Amazon.com. Retrieved from http://www.amazon.com/Hoshin-Kanri-Lean-Enterprise-Capabilities/product- reviews/156327342X/ “I've spent some time looking at several different Hoshin Kanri (hoshin - navigation or compass, kanri - control) texts, a.k.a "Policy Deployment." I personally think that this is overall the best one, hand's down. It's a tricky subject, with many "moving parts" and few examples available to view firsthand (I've seen it only a few times myself). I mention other books, but have not reviewed them, because they were so bad I couldn't even finish them and I have a rule to not review any book I haven't read. This review compares this to several other ones (as best I could), plus for consistency of philosophy with other lean/operational excellence concepts. Most lean texts I've read barely mention Hoshin, if at all. Even when they do, then do so poorly or with too little detail to help you other than to make you aware that it exists. This book helps fill a huge gaping void in the understanding and implementation of the lean enterprise.”


Martins, J. A. (2007, December 26). Conceptual and at the same time practical being powerful to enterprises. [Review of the book Hoshin kanri for the lean enterprise: Developing competitive capabilities and managing profit]. Amazon.com. Retrieved from http://www.amazon.com/Hoshin-Kanri-Lean-Enterprise-Capabilities/product- reviews/156327342X/ “This book is very didactic and conceptual and furthermore brings to the enterprise practical concepts on how to apply those in the companies in order to increase its profitability. The idea of organizing the company strategy and getting the track on how to apply on the processes flow is very worth and attractive and powerful. The teaching of how to identify the main wastes in the processes, those which in most of the times are hidden is essential. This book is indicated to those who are interested on how to increase the company efficiency and profitability in a consistent way. Flinchbaugh, J. (2006, September 9). The absolute best on hoshin kanri [Review of the book Hoshin kanri for the lean enterprise: Developing competitive capabilities and managing profit]. Amazon.com. Retrieved from http://www.amazon.com/Hoshin-Kanri-Lean-Enterprise-Capabilities/product- reviews/156327342X/ “Tom Jackson's practical and valuable insights are rivaled only by the importance and benefits of applying Hoshin Kanri. Hoshin Kanri as a practice has been applied as part of lean transformation efforts for quite a long time. But there were still very limited resources for people to learn more about it. Tom's work in this arena is extensive, and throughout all of his books (others are Implementing a Lean Management System and Corporate Diagnosis), he has focused on tools and systems for management to use in a lean company. This is the only book you'll need - I highly recommend picking it up. One of the things I most appreciate about this book is how it integrates hoshin kanri with the Plan-Do-Check-Act process. This of course is the intent of hoshin kanri, but the linkage was never presented so clearly.”


PRESENTATIONS, SPEAKING ENGAGEMENTS + WORKSHOPS Rona, J.M. (2016, March 30–31). Rekindling the heart of leadership: Respect for people. Sutter Health Management Symposium. Sacramento, CA. Iseman, M. and Mattson, S. (2016, February 18). Putting 3P into Action. At Central Coast Lean Summit 2016. Cal Poly, San Luis Obispo, CA. Jackson, T.L. (2015, February 20). Management Focus: Part One the Transformation Gap. At Central Coast Lean Summit 2015. Cal Poly, San Luis Obispo, CA. Jackson, T.L. (2013, October 30). Strategy deployment: control system of the future. At Shell Oil’s Americas Continuous Improvement Community. Houston, TX. Crome, P.J. (2013, October 29). Performance excellence. At Inspiration for Leading Times of Change, Legacy Health’s Annual Nursing Leadership conference. West Linn, OR. Jackson, T. L. (2013, October 3–5). Downshifting Lean Education for Healthcare At Fisher College of Business’ 2013 Lean Educator Conference “Next Steps in Lean Education.” Columbus, OH. Jackson, T. L. (2013, June 13). Calculating ROI on lean healthcare: How to monetize lead time reduction and cost of poor quality in terms that will dazzle your CFO. At SNI's Embedding Lean Convening. Oakland, CA. Jackson, T.L. (2013, June 6). A public health application of the ‘A3’ lean management principles. At UC Berkeley School of Public Health’s Innovative Leaders Speaker Series. Berkeley, CA. http://chl.berkeley.edu/events/2013-innovative-leaders/tom-jackson Rona, J.M. (2012, September 17). What is lean in health care? Keynote at “What does it mean to be LEAN?: Embracing a Culture of Process Improvement and Value Driven Outcomes”. The University of Utah, Salt Lake City, UT. http://stream.utah.edu/m/dp/frame.php?f=debe79fd2f124994577 Crome, P.J. (2011, November 3). Transforming healthcare; pursuing perfection. At McKesson Nursing Advisory Council. Denver, CO. Jackson, T.L. (2011, November 1–3). Building a New Culture at Chugachmiut. At the National Congress of American Indians. A talk about lean transformation in a Native American corporation in Alaska presented with Patrick M. Anderson, Executive Director, Chugachmiut. Portland, OR. Jackson, T.L. (2010, April 29). Lean management as a practice to overcome the crisis. At The European House—Ambrosetti. Milan, Italy. Jackson, T.L. (2010, April 29). Lean management in services. At The European House—Ambrosetti. Milan, Italy.


Jackson, T.L. (2010, April 30). 40 years of hoshin kanri: Where are we now? Where are we going? A private talk about the history and current state of hoshin kanri in the United States presented to the clients of Alberto Galgano. Milan, Italy. Jackson, T.L. (2009, November 11). Hoshin Kanri: Business Operating System of the Future At “Lean Society Summit 2009”, CUOA Lean Enterprise Center, Vicenza, Italy. http://www.youtube.com/watch?v=FVZsyiIUvSU&feature=youtu.be http://www.youtube.com/watch?v=5DobJS6IyRY&feature=youtu.be http://www.youtube.com/watch?v=eKtxpT9v1TY&feature=youtu.be Jackson, T.L. (2009, September 24). Hoshin Kanri: Business Operating System of the Future. At the Mexico Shingo Prize Conference—Shingo Prize for Operational Excellence Mexico. Monterrey, Mexico. Crome, P.J. (2009, June). The Toyota experience: How to improve quality and customer service. At American Organization of Nurse Executives: Transforming Care at the Bedside Learning Community, Chicago, IL. Crome, P.J. (2009, May). Transforming patient care using lean methodologies… Perspectives from the office of the chief nurse. At Annual National Patient Safety Foundation Patient Safety Congress, Washington, D.C. Jackson, T.L. From vision to action in the lean enterprise. At the Ohio State University’s Initiative for Managing Services and Center for Operational Excellence’s Fall 2008 Symposium—Service Operations Effectiveness, “Making the Voice of the Customer Available”. Columbus, OH. Rona, J.M. (2008, October). Leadership for lean transformation in healthcare. At Lean Healthcare Forum. Nashville, TN. Crome, P.J., Jackson, T.L., & Rona, J.M. (2008, October). Value stream mapping and Visual healthcare (5S+2) workshops. At Lean Healthcare Forum. Nashville, TN. Crome, P.J. (2008, November). Patient safety, quality improvement and measurement and Work-life balance. At Aspiring Nurse Leader Institute. Charleston, SC. Crome, P.J. (2008, May). The healthcare delivery care model. Panel discussion at “2008 Best Practices: Issues, Trends and Education in Allied Health/Health Sciences Conference”. Renton, WA. Crome, P.J. (2008, January). Patient safety, quality improvement and measurement; Work-life balance; and Shared leadership and shared governance. At Aspiring Nurse Leader Institute. Tampa, FL.

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