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Innovation, Action and Quality Improvement Lean Thinking

OU School of Community Medicine Summer Institute. Innovation, Action and Quality Improvement Lean Thinking. Changing our culture with…. Quality Improvement Initiatives. √. Lean Thinking. The two pillars of Toyota way. Lean Thinking Concepts and Tools. √.

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Innovation, Action and Quality Improvement Lean Thinking

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  1. OU School of Community Medicine Summer Institute • Innovation, Action and • Quality Improvement • Lean Thinking

  2. Changing our culture with…

  3. Quality Improvement Initiatives √

  4. Lean Thinking • The two pillars of Toyota way

  5. Lean Thinking Concepts and Tools √ • Increasing customer value • Reducing waste√ and costs • Improving speed√ of processes • Designing process for mistake proofing √ • Focusing on continuous improvement√

  6. Lean Thinking– The Five Steps… • Value – Specify value. • Value Stream – Identify the value stream and eliminate waste. • Flow – Ensure work flows smoothly from one stage to another. • Pull – Implement standard work and pull. • Perfection – Implement workplace organization and continue reducing waste.

  7. Lean Thinking - The first two steps:Value and Value Stream • Step 1 - Value – Specify value. • Who is the customer? • (Typically the final customer of our work..) • “Value” is defined from the • customer’s point of view?

  8. So…what is “value”for a customer?[Patients? Students? Faculty? Others in our community?] • Value occurs when your work: • provides service customer wants • done correctly first time • customer requests it The Test: Would the customer complain if you stopped?

  9. Step 2 - Value Stream – Identify value stream and eliminate waste. • Waste (muda) adds no value for the customer. • Value Stream Mapping shows where we • have value-added and non-value added work.

  10. Seven Forms of Waste [1] (muda) • 1. Confusion[Confusion-laden activities; looking up things] • 2. Motion/Conveyance[Moving products or people] • 3. Waiting[Waiting for anyone or anything] • 4. Overprocessing[Doing more than is necessary] • 5. UnnecessaryInventory[Too many supplies] • 6. Defect[Mistake that does not meet customer needs] • 7. Overproduction[Doing more work than is necessary] • Think about examples of these forms of waste… • [1] Jimmerson – Value Stream Mapping for Healthcare Made Easy - 2010

  11. Symbols for Value Stream Map

  12. Steps to Create a Value Stream Map • 1. Give the process a name. • (Such as: Student Enrollment Process) • 2. Create a list of the major process stages and estimate the time to complete each stage. • 3. Put process stages and times on Post-It notes. • (Categorize each stage as value added, non-value • added or necessary non-value added.) • 4. Identify waste you see in the process.

  13. Steps to Create a Value Stream Map (continued) • 5. Create the current-state value stream map. • (Put Post-It notes of process stages on a poster sheet • using value stream map symbols.) • 6. Analyze waste on a separate sheet of poster paper: • a. Identify causes and root causes of waste. • b. List ideas to eliminate waste. • 7. Create a future-state value stream map. • (Implement your improvements to reduce waste.)

  14. Step 3 - Flow – Ensure work flows smoothly between process stages. • Flow No waiting, interruptions or • delays in the value stream • “Mura”  Uneven workload, • (MOO rah) variation and fluctuation

  15. Flow – Ensure work flows smoothly from one stage to another.

  16. Visual Work Placeto improve flow • Implement the 5S workplace: • 1. Sort – Remove unnecessary items from area. • 2. Set in Order– Organize items that remain. • 3. Shine – Clean, paint, replace or cover up. • 4. Standardize – Use standardized procedures to • maintain benefits. • 5. Sustain – Ensure discipline occurs to maintain • the workplace; audit and improve the area.

  17. Creating visual workplace tools…OU Bedlam Longitudinal Clinic

  18. Concepts of Mistake ProofingMistake proofing can be a visual control…

  19. Step 4 – Pull – Customer pulls what is needed. • Pull – Pull only what you need for flow. • Pull people… pull equipment…pull material… • Opposite of Pull is “Push.” Push triggers movement whether the next stage is ready or not!!

  20. Pull example of supplies using a “kanban” (signal or card) system…

  21. Step 5 – Perfection - Continue reducing waste. • 1. We continually improve our work. • 2. Always look to reduce waste. • 3. Set up Continuous Improvement “events.” (Called “Kaizen events” or rapid-cycle events.) • 4. Use visual controls. • (White boards, graphs and color codes). • 5. Conduct 5S audits.

  22. Lean Thinking– The Five Steps… • Value – Specify value. • Value Stream – Define value stream and eliminate waste. • Flow – Ensure work flows smoothly from one stage to another. • Pull – Implement standard work and pull. • Perfection – Implement workplace organization and continue reducing waste.

  23. We are changing our culture through…

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