Lean in Public Services: Is it just for Efficiency?

1. ORCan it only ever be just for Efficiency? Lean in Public Services: Is it just for Efficiency? Dr Zoe Radnor Associate Professor (Reader) in Operations Management Warwick Business Schoool AIM Management Practice Fellow

2. Lean not just for the Private Sector… Plus Local Government, Fire and Rescue Services………

3. A Brief History of Lean • Who “invented” Lean? • Taiichi OhnoVice President of Manufacturing, Toyota Motor Corporation • Toyota Production System • 1950s, after WW2 • External factors; small market, culture and difficulties in equipment purchase. • Inspired by USA supermarkets

4. Understand Value

5. Value-Stream Thinking

6. Patient is seen, treated and given advice by doctor or nurse practi-tioner and discharged Patient is Patient is Patient arrives Patient is booked in Patient Patient is Patient is Treatment WAIT WAIT WAIT WAIT WAIT seen by discharged arrives triaged booked in by nurse doctor by doctor Flow: The Process for assessment, minor treatment discharge was redesigned to achieve lower waits

7. Reduction of Waste 1 4 Over-production - 60% of computer generated post printed in the post room was discarded Over-processing -Sorting post in 21 categories when 4/5 were enough 2 5 Waiting - Post delivered by Royal Mail did not always arrive at 7:45 am Inventory – 15+ days of work on shelves 3 6 Transport - Post moved 500 metres before any value-added work was performed Rework - Post transferred between offices; Frequent redirection due to mis-sorting 7 • Motion -In post room the operator moved from desk to scales to measure a single item of post

8. Use of Tools and Techniques within Lean in Public Services • Assessment: • To assess the processes at organisational level e.g. value stream mapping, process mapping • Improvement: • Tools implemented and used to support and improve processes e • Monitoring: • To measure and monitor the impact of the processes and their improvement e.g. control charts, visual management, benchmarking, work place audits • Measures in terms of quality, time, costs, satisfaction levels e.g. 5S, structured problem solving

9. Assessment: Reviewing the work From Current State to Future State

10. Improvement: Structured and systematic use of problem-solving Day-to-day problem solving: 3Cs document This is the basic method of Problem Solving used by teams to address day-to-day issues affecting performance. The process has 3 steps: Concern:Define the Problem clearly – doing this is essential, as it will help to ensure that you don’t try to put the whole world right in one go. CauseThink carefully – try to get to the “ROOT CAUSE” of the problems,rather than just dealing with the symptoms. CountermeasuresTry to fix the problem once and for all, but if that’s not possible, then do everything you can to mitigate the impact on the customer. More challenging problems: Structured Approach

11. SEIRI Sort Improvement: 5S SEITON Set in order SEISO Sweep and Shine SHITSUKE Standardise SEIKETSU Sustain

12. Monitoring: Visual Management Team Board Team Communications Hub Resource Planning

13. Cultural change Technical change Lean Transformation – A Two Pronged Attack

14. House of Lean for Public Services ©Zoe Radnor Visual Management: Managed by the front line staff Regular Structured Problem Solving Monitoring of end to end Service/Process Delivery Rapid Improvement Events: Process Mapping and 5 ‘s Leadership Challenging: Go, See and Do Identifying and managing variation and demand Developing Local/ Internal Champions and Facilitators Workplace Audits Understanding Demand and Capacity Understanding Value Strong committed Leadership Linking activity to the Strategy Having a Process View Communication Strategy Training and Development Whole system view Embedded improvement behaviours Focused stable robust processes Steering Group and Project Team

15. HM Court Services Case Study • Conducted between November 2009 and April 2010 • Site visits to 15 courts across England and Wales, the Central Programme Office • Individual interviews and focus groups with 191 individuals across all sites. • A quantitative analysis of specific responses to the interview questions • Informal discussions with 20 change agents • A survey of all change agents across all HMCS regions (71% response rate) • Informal discussions with 11 legal advisors Radnor ZJ and Bucci G (2010) “Evaluation of the Lean Programme in HMCS”,HM Court Services, London, May 2010.

16. Lean in HMCS • “We were talking about how we do [Lean] for ourselves…. how we build up our own capacity via the Lean Academy style approach and manifest it for ourselves and then take a step back from consultancy” • Lean event led by Change Agents • Lean reviews leading to ‘tipping point’ • "The point at which a court has fully grasped the concepts of Lean and is able to extend such thinking to all areas of their work without external direction.“ • Standard Operating Procedures (SOPs) • Team Information Boards (TIBs) • Daily Meetings

17. Key Achievements • Lean Programme has created significant impact within HMCS • Key element has been the dedicated leadership of the programme, programme team and the support of a Programme Board • Vehicle in meeting the efficiency challenges • Staff now have an understanding of the need to change, revising processes and practices which had been untouched for years • Three quarters of the sites visited there was enthusiastic support for Lean • Engaging the workforce to the point where there is now an enthusiasm for challenging • SRO and the Chief Executive showed a good understanding, high engagement and recognition of the work related to the Lean programme • The pace of the Lean programme over the last eighteen months has been relentless and has touched nearly 50% of locations and staff. • Exceptional impact with the project breaking even within 6 months. • No differences across the courts, location and size

18. Key Findings • The biggest impact staff highlighted was more efficient revised processes and, visual management. • The continuing role of change agents was critical for the future of the Lean programme. • There was a correlation between court manager enthusiasm and drive towards Lean and positive experience of Lean. • Staff acknowledged that the working environment had improved for them but could not quite see the impact this was having upon the delivery of the service to the customer. • Many staff used phrases such as “when Lean was here” or “after Lean had gone” giving the impression is that Lean was being seen by staff as something external to the site done by the change agents. • There was very little recording of performance over time to identify trends or to predict the workload. • There was a lot of variability in problem solving both within and across all sites.

19. Case Studies: Lean in Higher Education

20. Foundation: Training and Development • NBS: • ‘Blanket training’ approach for all 250 staff in Lean techniques. NBS is trying to enable every member of staff to work in a Lean environment. • Three day training programme in mixed groups consisting of academic, administration and clerical. • “If staff are trained, they become more familiar with Lean and are more willing to become integrated with it” • Wales University: • Lean Skills for Leaders Programme for middle and senior managers. • To equip managers with the ability to apply Lean thinking and to give them the skills to do continuous improvement work. • “We need key skilled managers and key senior admin staff with good Lean knowledge and understanding to help …keep the momentum of Lean going.”

21. Building Blocks: Organisational Readiness • Senior Management Commitment: • Lean at NBS is being led by the Dean. • This involves initial set up for the programme, specifying the training required for staff, reviewing the projects on a weekly basis (A3) and setting a direction to the rest of the school that this is how business is done at NBS (‘unblocking’). • “To become a Lean school, the top management needs to be on board and drive it. This is not an add-on. Its about getting the entire operation of the school adopt Lean.” • Link to Strategy: Wales University has a Strategy map. • Communication Strategy: Two of the Universities had an area of their web sites detailing the purpose of Lean, projects and achievements.

22. Pillars: Tools and Techniques • 3 Business Schools using Rapid Improvement Workshops. • Developing Internal Facilitators: Midland Business School • To equip its own staff with the skills to be able to lead on improvement work. • External company X run the RIWs, staff shadowing, followed by training for staff and, then running workshops themselves. • Staff have volunteered to become facilitators and at the moment there is a waiting list for staff to be trained. • Lean is still over and beyond the normal duties of staff and is a real commitment. • Process Mapping/ Value Stream Mapping used by all organisations. • Problem Solving tools used by 2 Business Schools. • Sporadic use of visual management in two organisations to make Lean information visual in public areas.

23. Target = 20 days PG Admissions Process Review To communicate all initial decisions on postgraduate applications within 4 weeks of receipt. • Volume increasing but fixed resource (67% increase in applications since 2005) • Pressure from stakeholders to increase pace of decision-making Before After Why? From submission to creation of student record 6% same day 99% in 2 hours How? From SITS to form sent to department 2% same day (post) 93% same day (electronic) • Analysis variation • 5 whys • 7 wastes • Improve flow • Run charts / histograms • CTS Tree • SIPOC • Opportunity Statement • Map process (3 walls of post-it notes and brown paper!) 25 days mean 20 days mean Department decision Additional benefits? Quality assurance, transmission of decision 11 days mean 9 days mean • ownership • team building • continuous improvement • challenging what we do • control • greater understanding from a wider perspective • reduced paper • scope now extended • better awareness and use of data 7000 emails 10 weeks+ 200 emails 3 weeks+ Emails at peak

24. Publication Progress Board VISUALIZING THE STATUS OF THE PUBLICATION PROGRESS 1. Print the front page of the paper (A6 format) 2. Attach a birthday sticker and write the date when level 1 was reached (date when you started to work on the paper) 3. Attach progress stickers given the current level of the publication progress UPDATING THE STATUS OF THE PUBLICATION PROGRESS - Update the progress sticker to the new level - The birthday sticker indicates the freshness of the paper and its publication progress - The progress stickers indicate the current and reached level of the publication progress Birthday sticker Progress stickers = level 7 © Niklas Modig, Stockholm School of Economics

25. © Niklas Modig, Stockholm School of Economics

26. © Niklas Modig, Stockholm School of Economics

27. Approaches to Lean Implementation • ‘Rapid Improvement Events/ Workshops (RIE) • “RIW provides a way of making improvement manageable by cutting problems into bite-sized chunks. RIW works because it is a process which delivers quick and visible wins.” • Full Implementation is embedding the principles through a broad use of the tools. • “Lean gives an opportunity to give suggestions and question why? The days of ‘the way things are done’ have gone”

28. RIEs Vs. Full Implementation CULTURE CHANGE Lean Improvement Opportunity Greater, sustained results achieved Improvement levelled off and eventually stopped due to lack of realizing “true” lean opportunity Lost and repeated results due to no sustainability Short term gains made Kaizen Blitz Rapid Improvement Events Time Awareness, education, organization structure created to support lean Source: Chris Craycraft, Whirlpool

29. Defining Lean • Lean as a management practice based on the philosophy of continuously improving processes by either increasing customer value or reducing non-value adding activities (Muda), process variation (Mura), and poor work conditions (Muri). • Some key assumptions of Lean: • It is possible to determine ‘value’ and ‘waste’ from a customer's point of view, so that wasteful activities in the process can be defined. • There is a defined and measurable benefit to the organisation in reducing non-value adding activities; in the private sector this has been a reduction in cost, or an increase in competiveness against the peers • Freeing up resources helps the business grow and flow of material, customers or information.

30. Public versus Private Sector

31. Conclusions • Although there are initial efficiency gains of Lean in public services, there is a question whether the - unadapted - transfer of Lean tools and techniques will continue to deliver further gains at the systems level. • Two crucial assumptions are violated when directly transferring Lean, at the systems level, into public services: Clear understanding of who the customer is: Defining value Reinvestment of released capacity: Developing flow • Lean in Public Services currently focused on efficiency and cost cutting: Reduction of waste • Lean is not context-free • Not manufacturing to service but private to public