Dramatic results through adopting ‘Lean’ - uclh.nhs.uk Results Steve Boam UCLH … ·...

This document is confidential and its circulation and use are restricted. © KM&T Ltd. All rights reserved .This document is confidential and its circulation and use are restricted. © KM&T Ltd. All rights reserved .

Dramatic results through adopting ‘Lean’

Presented By:Steve Boam

April 3rd 2014

This document is confidential and its circulation and use are restricted. © KM&T Ltd. All rights reserved .


Introduction

My Lean & transformation Journey …

Manufacturing

Financial Services

Healthcare

Public Sector

Maintenance & Overhaul

LeanExperience


Patient

Process(Pathway)

Care Planning

Innovation & Technology


Evolution of change

in the NHS


Value Stream/Pathway

Visualising the flows to identify non value added operations and maximise value added activities

Joining up activity flow: Patients, information, Processes

Process Control

Information

Excellence


Point

Point

Point

Dept/Area

Organ (E2E)Community

Operational Areas

Cross Divisional

Multi Layer

Supply/Cust Across Org

•RIE•One-off Projects

•Pathway•Full Systems Deployment

•Scalable Deployment•Joined Up approach

•Whole System & integrated care

Specialities/Services

ServiceService

•Alignment to Objectives•Pilot to Roll-out approach

Process evolution of change in the NHS


Productivity in the NHS


Evolution of change

in Industry

Products & Innovation

Mark

etin

g L

ed

Morally Led – Environment & CSR

Life

style

Led

Needs Analysis LedINNOVATION

Innovation & Vision•Good Products/Services•Desirable Products/Services•Vision to develop for the future


The Automotive Sector

Automotive has always been a leading and ‘cut-throat’ industry sector. Automotive has led most industries due to the customer demand, volume, complexity and competition.

1900 – Model T Ford 2010 – GM Concept 2012 – BMW Concept

• 1970’s Traditional mass production & automotive unionisation

• 1990’s Drive to produce Volume and reduce cost Mass Production leading to overcapacity 27%; 22m unitsCut-Backs, Down Time, Lay-offs – to reduce stock

• 2000’s Economic pressures (Exchange Rates, Interest rates, pricing)(Only 8 of 17 top auto companies generated earnings greater than investment & costs)

• 2008 GFC (General Financial Crisis) – Chapter 11

• Today Customer Demand and expectations


1880 / 90’s

“Taylorism”

Process Mgt

Scientific Mgt

1980 / 90’s

“TQM”

“Re-engineering”

1970’s

Oil Crisis

LEAN moves to other

manufacturing sectors

1950’s

Toyota near bankruptcy

Toyota Production

System introduced

(TPS)

T aiichi Ohno

Post 1918 to 1960’s

“Fordism”

Assembly lines

Std Work

Mass production

Reduced skills

2000 +

“LEAN” in…

Public Sector

Banking

Healthcare

Defence

TIME

Lean timeline within Industry

1980 +

TPS within supply base

NUMMI (1984)

TPS transfer to USA with GM


"It is not necessary to change Survival is not mandatory"

W. Edwards Deming – Quality Guru

PDCA (Plan Do Check Act)P

DC

A

PLAN

DOCHECK

ACT


Toyota way

Quality ReliabilityFlexibilityAgility

LEAN = =

= COST & PERFORMANCE

BENEFIT


Toyota’s Approach

The Lean thinking is a methodology developed by TOYOTA 70 years ago to manage the company. It is based on the following key values

Continuous

improvement

Challenge

Kaizen (Change for the better)

Genchi Genbutsu(Go and see)

Mutual Trust & Respect

Respect of colleagues,

clients, suppliers..

Team work

‘Lean is the elimination of waste, maximisation of safety & quality and

efficiency of resource parts and process’

PEOPLE

PROCESS


Toyota’s Success

$11.2bn

$0

- $13.0bn

Profit

- $2.0bn

2006, 2007, 2008, 2009, 2010, 2011 & 2012 Net Profit Comparisons

$13.bn

- $38.7bn

- $2.7bn

Sources: automotiveworld.com; autoindustry.co.uk; about.com; latimes.com; nytimes.com; japantimes.co.jp

- $5.7bn

$3.8bn

- $9.6bn

Ch 11

- $14.6bn

$2.7bn$2.3bn

2006 2007 2009 2010

2008 2006 2007 2009

2010

$4.7 bn

$8.3 bn

2008 2006 2007 2008

2009 2010

US Government intervention32% owned by state $50bn bail out

Major restructure & cost reduction

Major restructure & cost reductionGovernment investment $5.9bn

$6-8bn

Suggested costof recalls

2011 2012

$9.5bn

$3.6bn

$6.1bn

$8.8bn

2011 2011

March 2011Earthquake

2011 GM sold 9m vehicles to take volume lead; Toyota sold 7.9m (-6% to previous year)

Highest since 1997

2012

$4.9bn

2012

$8.1bn

Toyota – Biggest car company in the world 2008-2010 & 2012


Translating ‘Best Practice’ & ‘World Class’ into healthcare


Patient Experience Transformation

Dire

cto

rate

Division/CBU

Dire

cto

rate

Dire

cto

rate

Dire

cto

rate

CIPs

Patient flow

Tra

nsfo

rmatio

n(L

ea

n &

Ch

an

ge

Ma

na

ge

me

nt)

Top down % approach

• End to End patient flows (Pathways) within Acute • Supports integrated care (Upstream and Downstream processes) • Support patient costing & performance measures (SLR/SLM, PLICS, etc)

Traditional Approach

Division/CBU Division/CBU Division/CBU

Specialities & Depts


To achieve £20 or 30bn we need to move from transaction to transformation

undertaking a journey from cost cutting, through service redesign to service

rationalisation, integrated care/pathways and looking system wide

Transformation vs Cost cutting

Cost Cutting Service Redesign Transformation

Reduce Waste

Improve Quality

Maximise

opportunities

Standardised

processes

End to end flow

New ways

of working

Health system

partnerships

Appropriate care

settings

Whole system

alignment

Transformation – ‘a marked improvement for the better’


CIPs

CIPs

CIPs

CIPs

CIPs

Trans

Trans

Radical

Trans

RadicalCIPs

Transformation

Radical

3-4%

4-5%

+5%

time

Transformation to radical thinking

+20%

Additional

Income

savings


“Inverting the Triangle”

TRADITIONAL DIRECTIVE CULTURE

Head of Head of Head of Head of BusinessBusinessBusinessBusiness

BusinessBusinessBusinessBusiness

AreaAreaAreaAreaManagerManagerManagerManager

Ward ManagerWard ManagerWard ManagerWard Manager

Staff

ManagerManagerManagerManager

ExecExecExecExec

LEAN SUPPORTIVE

CULTURE

ExecExecExecExec

Head of Head of Head of Head of BusinessBusinessBusinessBusiness

BusinessBusinessBusinessBusiness

AreaAreaAreaAreaManagerManagerManagerManager

Ward ManagerWard ManagerWard ManagerWard Manager

Staff

ManagerManagerManagerManager

Lean vs Traditional Leadership


Translating ‘Best Practice’ & ‘World Class’ into UCLH


Maintain & improve

performance

Continue to specialise & invest in services

Build and use brand &

reputation

Implement transformation to become an NHS exemplar

Benchmark & Learn; NHS/Other healthcare

Other industries & professions

UCLH – A few things to consider

‘World class’

Strategy

Research, innovation and enhanced care

Steve BoamEmail: [email protected]

Phone: (+44) 7739 156226web:www.kmandt.com

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