Daily Visual Management Visibility Wall Training June 18, 2014

1. Daily Visual Management Visibility Wall Training June 18, 2014 Kaizen Promotion Office

2. Session Agenda: Session Agenda • Presentation/training (35 minutes) • Video (10 minutes) • Group work creating your draft walls (45 - 50 minutes) • Group report-outs (15 – 20 minutes) • Q&A (5 minutes) • Wrap-up and evaluation forms

3. Strategic Hierarchy Government of Saskatchewan Ministry of Health Provincial Health System Regina Qu’Appelle Health Region

4. Reporting and Accountabilities

5. Strategic Framework

6. RQHR Strategic Planning and Reporting Cycle

7. Daily Visual Management • The system used by the organization to perform its daily activities by: • establishing standard operations • identifying and eliminating waste • using data to ensure processes, products and services are continuously improved Strategy Deployment/ Hoshin Kanri Cross-Functional Management (CFM) Daily Visual Management (DVM)

8. Daily Visual Management- Link to Strategy

9. Daily Visual Management Consists of: • A Visual Workplace where abnormalities are seen • An environment where staff test their own ideas • Transparency of objectives and metrics • Managing by measures that change regularly • Connects accountability throughout the organization What you cannot see, you cannot manage! - Visual Management

10. Respect for People Staff are the problem-solvers: Staff are a valued source for improvement ideas. Staff help test and determine whether a new process works. When errors occur, the process is wrong, not the person. No blame, no shame! Quality must be built into every step. Anyone can, and is expected to, stop the process to prevent a defect from continuing downstream. “Before cars, make people.” —Eiji Toyoda, former chairman of Toyota

11. Alignment Better Care 1-5 Year Outcome Targets Zero Waits in Emergency why why CorporateWall VP/ ED/ Director Wall why why VP / ED / Dir. why why Pasqua ED Unit / Department Wall RGH ED Front Line Managers

12. You Don’t Need to know Lean to get started on Daily Visual Management! • It is critical to understand the current situation first, before applying Lean techniques and tools to make improvements • Use 5 “whys” to get to the root causes and make improvements • Use Plan, Do, Study, Act (PDSA) to do improvements • As you learn Lean, you will make faster progress to achieving your targets

13. Elements of the Daily Visual Management System • Understand your business and daily improvement activities • Create daily actions when issue/challenges occur. • Data is classified into common categories on your unit’s visibility wall – Quality, Cost, Delivery, Safety, Morale (QCDSM) • Data and information is key: • Choice of data • Visual display and charts used • Method and frequency of collection determined • Method and frequency of reporting determined • Only measure something you can action

14. What Should I Do? 1. Go and see – learn from the workplace2. Make the workplace visual3. Spend significant time developing people4. Teach staff to see, create solutions and improve5. Provide standard work that staff can use as a basis for improvement, and develop your own standard work6. Never stop improving7. Be accountable and hold others accountable

15. Setting Up a Daily Visual Management Visibility Wall: Step-By-Step

16. Upcoming This Week Team Calendar • Improvement ideas • ~~~~~~~~ • ~~~~~~~~ • ~~~~~~~~ • ~~~~~~~~ • ~~~~~~~~ • Standard Work • ~~~~~~~~ • ~~~~~~~~ • 5S • ~~~~~~~~ • ~~~~~~~~ • ~~~~~~~~ • ~~~~~~~~ Corporate Memo’s Staff Bouquets Training Discharge Treat Admit Name Date Name Date Name Date Name Date Name Date

17. Steps to Creating a Daily Visual Management Visibility Wall 1. Articulate the Purpose Statement of the service area • i.e. Our purpose is to support teams through Lean methodology to create a world-class Saskatchewan Healthcare System, which provides high quality, safe and timely care. • Don’t forget the patient perspective in your Purpose Statement 2. Identify the primary process in your service area and draw a value stream or process map 3. Create your Team Communications • What’s important for your team to know on a weekly basis? • When will you have your weekly huddles, weekly wall walks? • What other information are you going to post on your wall? • Training schedule? • Staff bouquets? • Corporate communication's/memo’s?

18. Steps to Creating a Daily Visual Management Visibility Wall 4. Improvement Ideas • Generate improvement ideas that will directly help improve what you are measuring. • You can use Lean tools like Standard Work and 5S to help. 5. What are one or two measures that best describe how you are meeting the core purpose? • Classify your measures under: Quality, Cost, Delivery, Safety, Morale (QCDSM) • Only measure what you can directly improve • Coming soon: there will be some corporate standard measures

19. Cost Effective Right Place Right Time Right Amount For Patient For Provider Everyone Cares Measuring World-Class Quality Reliability Responsiveness Consistent Empathy Equitable Quality Cost World-Class Quality Full Customer* Satisfaction Assurance of Quality Delivery * Patient Safety Morale

20. Upcoming This Week Team Calendar • Improvement ideas • ~~~~~~~~ • ~~~~~~~~ • ~~~~~~~~ • ~~~~~~~~ • ~~~~~~~~ • Standard Work • ~~~~~~~~ • ~~~~~~~~ • 5S • ~~~~~~~~ • ~~~~~~~~ • ~~~~~~~~ • ~~~~~~~~ Corporate Memo’s Staff Bouquets Training Discharge Treat Admit Name Date Name Date Name Date Name Date Name Date

21. Photos: Pasqua Cardio Neuro

22. Photos: WRC Children’s Program

23. Photos: WRC Extended Care/Veterans Program

24. Photos: Pasqua Radiology

25. Photos: RGH Surgical 6A

26. 15 Minute Daily Huddle • Select a consistent time of day for wall walks • Start on time • Designate a time keeper so that you can end on time • All staff stand up in front of the visibility wall • Manager leads or designated leader • Consider having other staff be reasonable for some pieces of the data and have them report-out out on the data

27. 15 Minute Daily Huddle: Agenda • Ask 4 questions: • have any patients/residents fallen, • were any employees injured, • is there anyone off sick today, • is there anyone here on overtime today(1 minute) • Review communications/events (2 minutes) • Update on projects (2 minutes) • Review improvement ideas (2 minutes) • Report out on your QCDSM measures- are they green or red (meeting or not meeting your targets) ( 1 minute each) • Update and review actions (3 minutes)

28. Keep In Mind… • The Visibility Wall is not in itself the goal – the discussions, actionsand accountability are what is important • PDSA (Plan, Do, Study, Act) – keep pressure on your team to get out and try implementing improvement ideas • The more people informed and trained in changes made, the better chance that changes will be sustained • If the team is stuck, go back to the purpose statement and process steps for direction

29. More Information If you have any questions or want more information, contact: • Sandra Lynn at sandra.lynn@rqhealth.ca or 306-766-6421 More information can also be found on the Intranet at: http://rhdintranet/qi/public/VisibilityWallsKit/VisibilityWallsKit.htm (Departments > Kaizen Promotion Office > Visibility Wall Kits) Or at www.RQHRLean.com