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The lean management system or management by process

A way to do it right the first time

A Community of Problem Solvers

Delivering MBV

5 10 15 ??

K

Lean “Grad”School

.We are Here

100% of employees are problem solvers 

improving something every 

day!!!

Time (years)

Educatio

n/Skill Level

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RESULTSCreate Value for the

Customer

True North Metrics

Leadership Behaviors

Focus on the Problems

CLEAR PURPOSEEnterprise Alignment

Align Strategy Align Systems Align Performance

SCIENTIFIC METHOD TO SEEK PERFECTION

Continuous ImprovementStabilize ProcessStandard ProcessVisual Management

Identify & Eliminate WasteFront Line Data

Integrate Improvement with Work

RESPECT FOR PEOPLECultural Enablers

Involve EveryoneDevelop People

Ensure a Safe EnvironmentBuild Teamwork

White coat leadership vs. Improvement

leadership

• All knowing

• “In charge”

• Autocratic

• “Buck stops here”

• Impatient

• Blaming

• Controlling

• Humility

• Curiosity

• Facilitator

• Teacher

• Student

• Communicator

• Perseverance

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Daily Stat Sheet

Daily Huddle

Leadership Team

Monthly Scorecard

Monthly Performance

ReviewMeeting

PDSA and

Countermeasures

LeaderStandard

Work

Visual Management

Unit Flow Waste Removal

SustainingImprovement

Thru

Trainingand Managing to SW

2011 copyright all rights reserved

Lean Management System

Ideal State Information Flow

Staff Staff Staff 

Lead

CEO

VP

Sr VP

Super‐visor

Level 1

StrategyGoalsPurpose•Mentoring•Teaching•Barrier Removal•Strategy•True North

Status of the Business:•Information•Continuous Improvement•Metrics•Escalation

Manager

Level 2

Level 3

Level 4

Level 5

Level 6

Level 7

•Goals•Tactical Management

•Control•Daily assessment

•50‐75% Standard Work

•Executive Functions•Strategic•Innovative

•Weekly/Monthly Assessment•10‐25% Standard Work

2011 copyright all rights reserved

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“The No Meeting Zone”

2011 copyright all rights reserved

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5

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VP Daily/Weekly Stat Sheet Kim B.

Dates

Monday Tuesday

Daily Measures

Safety

How many Patients/Families or staff are at Risk?

Quality

Any Quality Opportunities or concerns?Falls, bundles, med rec/errors

Patient complaints/Follow Ups

People : Any Staff with Problems/Barriers?

Who needs the most support today (weakest link)

Any Physician or Leadership issues?

Any thing, staff or provider to recognize or celebrate today?

Delivery

Any areas that Demand exceeeds Capacity

For Oncology- Any non- oncology pts on the floor ?

How many filled beds ? 16 beds 16 beds

ow is care management helping to progress care today

How many discharges planned today?

Department: Inpt OncologManager 3S Inpatient Oncology Daily Measures

Safety

How many patients or staff are at risk?

infections

interpreter concerns

employee injuries

Quality Any quality opportunities or concerns? falls, bundles, med. Rec/errors

Any patient complaints/Follow ups?

Any equipment or room concerns?

People

Any staff with special concerns or barriers?

Who needs the most support how can we help them?

Any physician or leadership concerns?

Any thing, staff or provider to recognize or celebrate today?

How are you planning on covering lunches and breaks?

Any care management concerns?

Delivery (Service and Timeliness)

Daily Stat Sheet Manager to VP

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Monthly Scorecard Manager to VP

These metrics were last updated on: 5/6/09

Measures

Source SD, Hosp watch or

Hosp Initiative YTD Status

HI

HI

Karen

Michelle VB

HI

SD

Drivers: The Performance we must respond to and focus daily improvements on.

Hold for Medication Administration Metric

People Reduce Clinical Staff Turnover percentage

Quality

Owner Peggy Laemmrich Manager Monthly Scorecard

People # of clinical staff competent/ total number of staff Michelle M

OwnerGoals

Cost Total Clinical Labor Costs / Unit of Service Jill

SafetyReduce Fall Rate (falls/1,000 patient days) by 20%

for 2009

Peggy

Measure of

Source SD,

HD, HW

YTD Status(Fill in Red/Green

Only No Numbers)

Owner: Kim Barnas VP Monthly Scorecard

Hospital Division Drivers: The Performance we must respond to and focus daily improvements on to move the System True North Metrics. Key: SD/Strategy Deployment HD/Hospital Driver HW/Hospital Watch

Hospital Drivers Sponsor/Owner

Safety SDIncrease the % of Patients with INR in the

safe range Wilson/ Berry

Safety HD

Reduce Patient Falls (in Acute care areas) by 20% - per 1000 patient Days Barnas/Adair

Quality SD

% First Pass Yield for Medications available to be given Decker/Malkowski

People SDReduce OSHA incident rate of sprains and

strains in the hospital by 50% Gautney/Collins

Cost HD

Increase Operating Margin at Theda Clark to x% Ross

Cost SD

Increase Operating Margin at Appleton Medical Center to x% Ross

Casewirth/E. Olson Cost HD

Achieve Budgeted Total Clinical Labor Cost per Unit of Service

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Use A3 ThinkingWhat is the problemare trying to solve?

2011 copyright all rights reserved

A3: What Are You Talking About?

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Video of Monthly Performance

Review

1411

5

11

3

2

1

12

0

5

10

15

20

25

30

Safety/Quality CustomerSatisfaction

People FinancialStewardship

Number of Drivers 

True North Driver Category 

2010 BPS Scorecard Driver Improvement 

NoimprovementImproved

88% 

85 %improved 

83% Improved 

48%improved 

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Day-Long Workshop:

Creating a Lean Management System

“Excellent! Loved the real life examples and explanations.”

“Practical examples I can take back to my clinical setting and implement.”

I learned the concepts that will help us improve our daily management system and begin to develop our leader standard work.”

Testimonials

Session Objectives:• Learn and experiment with the 10 

interconnected components of a lean managements system.

• Understand the leader standard work and cascades of information required to create and sustain a system of continuous improvement. 

• Integrate lean tools• Focus and align all improvement and 

communication flow amongst staff

8/20/2012

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Day-Long Workshop:

Creating a Lean Management System

Session Objectives:

• Learn and experiment with the 10 interconnected components of a lean managements system.

• Understand the leader standard work and cascades of information required to create and sustain a system of continuous improvement.

• Integrate lean tools• Focus and align all improvement

and communication flow amongst staff

WCHQ.org Cumulative Score

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Part A & B M

edicare Expenditure in

 Dollars

* 2008 Medicare Data* $57 Billion/yr in savings if all are at Outagamie spending levels