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Lean Leadership

Lean Leadership

Problem

When one Medical Center found that they were not able to sustain the performance gains they had achieved with their initial work in Lean, they issued a competitive procurement to find a provider who would use a "True Lean" approach to truly transform their entire organization and develop a culture of continuous improvement.

Solution

The OPS team worked with the Medical Center's Leadership team and Lean Office personnel in three key areas: Leadership Development, Employee Training, and Improvement Activities, which have been implemented in a coordinated and mutually supportive manner to accelerate implementation and provide sustainability. Over the past few years, this Medical Center is well launched on the path to operational excellence, based on the principles, philosophies, and appropriate tools of the Toyota Production System adapted to healthcare. This approach offers an effective model for building and sustaining a culture of continuous improvement in healthcare.

Results

• Leadership Development.
  The Executive Team developed and is implementing the Medical Center Management System, with the goal of:
  
  
  • All employees performing continuous, incremental, and measurable process improvement on their work.
  • This model is an important element in the transformation process, as it provides the Executive Leadership Team and all employees with a powerful, straightforward representation of the improvement processes, and how they fit together in mutual support. It is essential that this model be developed by the Executive Leadership Team, and that every leader reinforce it in all interactions. The principles and philosophies in this Center's model are:
    
    

    Principles Veteran Centric Employee Development & Engagement Standardized Processing Standardized Problem Solving

    Philosophies Defect Free Without Waste Just-In-Time Continuous Flow

  • Achieving improvement in the work place requires making these principles real for all employees, helping them understand the expectations, and learning the tools they will need, including how to use them to achieve the goal. For example, the Philosophies of Defect Free and Without Waste are further defined as:
    
    At the point of processing, delivery of care/service will be performed with no harm in a safe and efficient manner with the minimal use of material, energy, and other resources, including human.
    
    
  • The tools currently used to achieve this are the Value Stream Analysis Process, 5S, and Visual Management.


• Employee Training.
  Process improvement occurs in the workplace, not in the classroom, so the training at this Medical Center is very hands-on and action oriented, with the goal of enabling employees to engage in front-line activities as soon as possible. Classes in an Introduction to Lean, Problem Solving I and Problem Solving II are one-to-two days each, and have a strong "do it" flavor.


• Improvement Activities.
  This Medical Center has achieved significant and measurable performance improvement by using the tools of A3 Problem Solving and the Value Stream Analysis Process (VSAP). Process improvement projects have been conducted in Primary Care, Behavioral Health, Nursing, Urgent Care, Pharmacy, Laboratory, Radiology, and support areas including the Mail Room, Cafeteria, and Purchasing. Projects are thoughtfully executed, with appropriate Executive Leadership engagement.

Lean Healthcare: ED

Lean Healthcare: Emergency Department

Problem

Patients were not receiving timely care because ambulances were being diverted to other hospitals as a result of ED overcrowding.

Solution

The Lean team developed a Process Map (VSAPsm) of the flow through the ED which Identified bottlenecks in the ED and supporting processes. Lean tools and philosophies were used to eliminate those bottlenecks and improve throughput.

Results (First year of implementation)

• 25% decrease in length of ED stay
• 80% decrease in yellow diverts
• 90% decrease in red diverts
• 50% decrease in patient wait time for an EKG
• 50% decrease in time from Bed Request to Patient in Bed
• No need to add more beds, expand, or renovate

Lean Healthcare: SPD

Lean Healthcare: Sterile Processing Department

Problem

The Operating Room was receiving instruments that did not meet quality standards.

Solution

Solution: A number of layout and process improvements were implemented based on a 5-day Value Stream Analysis Processsm, which documented the current state, designed the future state, and developed a project plan to manage the improvements. OPS provided on-site implementation support and helped manage the execution of the Implementation Plan, including regular progress reviews with the customer.

Results (First 6 months of implementation)

• 41% Reduction in Cycle Time
• 45% Improvement in Quality
• 100% Improvement in Nurse Satisfaction
• 200% Improvement in Surgeon Satisfaction
• 45% Decrease in Replacement Tool Costs
• 44% Reduction in Agency Staffing Costs
• Financial Results

• Saved more than the cost of the project in the first 3 months of implementation
• Essentially doubled productivity by reducing lead time without investing any capital or hiring additional staff

Update

• Improvement in Quality over 75% and it continues to improve everyday
• 100% reduction in Agency Staffing Costs
• Sustained Lead Time improvements

Lean Healthcare: Nursing Unit

Lean Healthcare: Nursing Unit

Problem

There were many falls in the Pulmonary Unit largely associated with the nurses' lack of availability to the patient's bedside due to other demands including medication preparation.

Solution

The Lean team conducted a Value Stream Analysis (VSAP) to map the flow through the Pulmonary Unit which identified waste in their processes. Lean tools and philosophies, such as 5S, were used to eliminate those wastes and improve the value-added time for all involved.

Results (First 6 months of implementation)

• 45% decrease in patient falls
• 21% increase in nurses' time at patients' bedside
• 98% increase in minutes at beside per patient per hour
• 18% decrease in time spent on medications

Client Comments

• "It is gratifying to see much improvements and the validation of the Lean project. I feel the Pulmonary team has done a superb job and their front line pragmatic ideas are paying off and we see huge gains."
• "Love the changes and it gives me more time with my patients. It is less stressful, less travel time to find things and the meds are better organized."
• "The other day I could take time, about 10-15 minutes and talk to a patient and the patient responded, 'Thank you, I really needed that.' "

Updated Results

• Another 40% reduction in patient falls
• Maintained a high rate of assisted falls
• The Lean training and implemented countermeasures are being rolled-out to all nursing units hospital-wide

Lean Healthcare: Utilization Review

Lean Healthcare: Utilization Review

Problem

Less than 100% of daily Utilization Reviews (UR's) are being submitted before 5pm each day.

Solution

Solution: The Lean team conducted a problem solving using the A3 as a guide to take a deep dive to understand the problem from all perspectives that affect the Utilization Review process. Using the PDCA methodology, there was a lot of analysis of data, front-line observation and information gathering. Many areas were identified for improvement based on the information gathered and performing a waste analysis on their process. Lean tools and philosophies, such as Standard Work, were used to eliminate those wastes and improve the ability to complete the daily requirement for UR's.

Results

• Reduced morning set-up time by 50%, saving up to 1 hour per Care Manager
• Developed and implemented a Standard UR process for all Care Managers, which reduced the time to complete an average UR by at least 30% based on a typical work load for a Care Manager equates to 1.8 hours per Care Manager per day
• Standardized clinical content for each UR
• Developed a consistent and defined training process for new Care Managers
• Started daily huddle with each Care Manager Service line.

Lean Manufacturing: Auto

Lean Manufacturing: Automotive Components

Problem

Customer was producing low-volume, specialty components for the automotive industry, and desired to strengthen operational processes to prepare for a broadening product mix and greater production capacity. This required efforts to streamline production, decrease lead times, reduce costs, and improve quality.

Solution

A number of layout and process improvements were implemented based on a 5-day Value Stream Analysis Processsm, which documented the current state, designed the future state, and developed a project plan to manage the improvements. Additionally, on-site full-time plant implementation support, monthly kaizen support and quarterly leadership reviews were provided to the customer.

Results (First 3 months of implementation)

• Total lead time reduced from 19 days to 8 days (58% improvement)
• Man-hours per unit decreased from 8.1 hours to 6.7 hours (17% improvement)
• Total Rejects decreased by 50%
• Safety Incidents decreased by 90%

Estimated Financial Results

• Increased capacity $2.6 million in potential additional revenue per year
• Benefit to cost ratio of greater than 10 to 1

Update

• Operations have transitioned from craft production to a robust Lean Manufacturing process.
• Contract awards have tripled future annual revenue..
• A large automotive OEM credits the successful Lean implementation with the increase in quality and100% on-time delivery that formed the basis for awarding substantial new business.

Lean Manufacturing: Armor

Lean Manufacturing: Armor Components for Military Vehicles

Problem

Customer had been required to ramp up production of armor components for military vehicles very quickly. Improvements in the process and layout were desired to produce a high quality product with optimal cycle time and minimal waste. A major issue was the process bottleneck, the heated vessel in which the parts are cured, which is called an autoclave.

Solution

A number of layout and process improvements were implemented based on a 3-day Value Stream Analysis Processsm, which documented the current state, designed the future state, and developed a project plan to manage the improvements.

Results

• Total throughput increased from 70 units per week to 262 units per week. (374% improvement)
• Man-hours per unit decreased from 6.85 hours to 2.75 hours (60% improvement)
• Reduced time product spent curing in the autoclave by 19% with no reduction in quality.
• Reduced time to prepare parts before going into the autoclave by 17%
• Reduced hours f required for 'layup' of parts by 17%
• Estimated Financial Results

• Increased capacity $1.7 million in potential additional revenue per year
• Benefit to cost ratio of greater than 10 to 1

Update

• Total throughput capacity increased from 262 units per week to 660 units per week.
• Man-hours per unit decreased from 2.75 hours to 1.27 hours (60% improvement).
• Freed up staff was able to assist on other Mission-Critical tasks and/or help improve other processes around the facility.

Lean Government: WC

Lean Government: Workforce Center

Problem

Unemployed citizens were not receiving the training necessary to help them become "job ready" in an appropriate amount of time, largely as a result of cultural issues between State and Local employees.

Solution

A number of process improvements were implemented based on a 3-day Value Stream Analysis Processsm, which documented the current state, designed the future state, and developed a project plan to manage the improvements. Coaching and support were provided to assist with the implementation and sustainment of the changes.

Results

• Lead time of the process was reduced by over 50%
• Customer wait time was reduced by over 75%
• Value-Added time for a new customer was increased by over 49%

Lean Government: Science Center

Lean Government: Science Center

Problem

The process for school group reservations and arrival was not efficient or effective, leaving a bad initial impression on visitors, as well as having a ripple effect that made the problem even worse for groups that arrived later in the day.

Solution

A number of process improvements were implemented based on a 3-day Value Stream Analysis Processsm, which documented the current state, designed the future state, and developed a project plan to manage the improvements.

Results

• Lead time of the process was reduced by over 50%
• Variation for customers in the process was virtually eliminated
• Customer comments: "Wow! This is so much better than last year. You really have it together. You guys are so organized. This runs like a well oiled machine!"

Lean Training

Lean Training for Rapid Deployment

Problem

A large healthcare system was attempting to roll-out a Lean transformation and implementation across its entire organization.

Solution

An efficient and effective Training program was developed for several hundred Executives, Directors, Managers and Employees that has initiated dozens of improvement projects across the organization. The OPS team also coaches, supports and holds students accountable through the completion of those projects using Toyota's A3 Problem Solving process Approximately 10% of these initial students have been selected for further training as Lean Facilitators. After completing the Facilitator Training and passing the certification examination administered by OPS, these individuals will be fully capable of supporting continuous improvement activities across the organization.

Results

• Rapid deployment of Lean awareness, understanding and implementation across the entire organization
• Significant improvements in Quality, Efficiency and Cost are a result of the projects
• A growing internal capability to implement, sustain and continuously improve processes through teamwork and empowered employees

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Lean Process Improvement

True to the Principles of the Toyota Production System (TPS)

What is a Lean Enterprise?

A Lean Enterprise is an organization that achieves operational excellence by empowering people to continuously improve performance by relentlessly focusing on the elimination of waste. By Every Person, At Every Level, On Every Process, Every Day.

Leadership Development:

An organization must have effective leadership to achieve operational excellence. Experienced OPS coaches help individual leaders and leadership teams develop the skills and knowledge to lead and sustain a successful Lean transformation.

The leadership principles of Mr. Fujio Cho, former Chairman of Toyota and one of Taichi Ohno's original students, have been summarized as "Go See, Ask Why, Show Respect".

Training:

Front-line employees must be able to effectively use key Lean tools to achieve and sustain a successful Lean transformation. OPS has proprietary learning systems and highly experienced Lean coaches to help client employees acquire and utilize the needed Lean skills in the shortest possible time. Our unique process achieves this through practical, hands-on, results-oriented training programs that enable rapid skills deployment and utilization across the client organization.

Implementation:

OPS uses proprietary process improvement tools originally developed by the Toyota Supplier Support Center and refined over many years of successful practice. Our highly experienced Lean coaches work shoulder-to-shoulder to achieve significant operational improvements while transferring skills and knowledge to client employees for sustainment.

Typical Lean Operating System Mode

Consulting, IT, Training

Small Business Consulting
The OPS leadership team has many years of successful experience in growing small companies. We use our proven methodologies to help companies improve operations and prepare for substantial and sustainable growth.

Information Technology Support
OPS leaders have extensive experience in the aspects of enterprise IT system design, development and implementation that complement continuous process improvement.

Training Development
OPS has developed significant high impact training programs that help people and teams master Lean Process Improvement skills in the shortest possible time. We make this expertise available to our clients in a variety of industries to help them address key operational issues and develop effective leaders and leadership teams.

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