Kata Deployment Developing Lean Management:...
Transcript of Kata Deployment Developing Lean Management:...
8/26/2016
1
Kata Deployment Developing Lean
Management: Case Studies
Beth Carrington
8/26/2016
2
Kata Deployment
• Mike Rother’s Presentation
• The Challenge of Developing Lean
management
• 8 Years experience Master Coaching
organizations in Kata Deployment
• Specific examples from the field
21st Century Lean
© Mike Rother
8/26/2016
3
Toyota Research Questions
© Mike Rother
Question 1 – This is what the Improvement Kata and Coaching Kata are about
© Mike Rother
8/26/2016
4
Improvement Kata
© Mike Rother
Changing Behavior Requires Practice
• Can not change behavior with explanation or convincing
• Knowledge does not equal understanding nor is knowledge alone gong to change behavior
8/26/2016
5
Build new Behavior as Automatic or Habitual
• To build automatic behavior or habit it requires practice
• Start with small routines, starter routines (kata) and build self efficacy
• Kata are basic routines practices to gain skill
Meta - Cognition
Let’s try it!
8/26/2016
6
4 Routines for Developing Skill
© Mike Rother
Coaching Kata
© Mike Rother
8/26/2016
7
C O
A C
H I N
G
K
A T
A
The Five Questions 1) What is the Target Condition?
2) What is the Actual Condition now?
----------------- Turn Card Over ------------------>
3) What Obstacles do you think are
preventing
you from reaching the target condition?
Which *ONE* are you addressing now?
4) What is your Next Step (next experiment)
What do you Expect?
5) How quickly can we go and see what we
Have Learned from taking that step?
Reflect on the Last Step Taken
1) What did you plan as your Last Step?
2) What did you Expect?
3) What Actually Happened?
4) What did you Learn?
Return to question 3--------->
Because you don’t actually know
what the result of a step will be!
< Front of card
Back of card >
Toyota Research Questions
© Mike Rother
8/26/2016
8
• The Coaching Kata deployed in all levels of the organization develops a catch-ball routine along the chain of accountability.
• A meta-routine or kata for all levels and all areas of an organization.
15
Developing Meta-Routines
Deployment Model
• Scouts
• Advance Group
• “3 Month” Coaching Capacity Development
• Month 1 – Practice
• Month 2 – Quality of Practice
• Month 3 – Skill Assessment
• Next Wave (s)
• Meta-Routine
8/26/2016
9
Scouts
• Go out front and learn
• Bring findings back to the organization
Advance Group
• 5 – 7 Middle Managers
• Executive Sponsorship
• Will practice first – in advance of the rest of the
organization
• They become the initial coaches for the organization
• Steer deployment - setting Challenges
• Kata the Kata!
8/26/2016
10
ADVANCE GROUPS
Advance Groups (AGs) are charged with
actively monitoring and guiding
the organization’s kata deployment
Additional Coaches
• Include others in the initial wave
• High potential coaches
• Lean Experts to become “Master Coaches”
8/26/2016
11
The Roles
Supervisor Owns the Target
Condition.
Manager Advises
and Supports
Manager Supervisor
21
“3 Month” Coaching Capacity Development
• Initial practitioners – Rotate through the roles
• “30 days” or 20 PDCA’s as Learner
• “30 day” or 20 Coaching Cycles as Coach
• “30 Days” or 20 2nd Coaching Cycles as 2nd
Coach
8/26/2016
12
Month 1 – Focus on Practice
Learner: 2nd Coach:
Process:
Date
Day # Reasons for no PDCA and Coaching Cycle
Coach:
PDCA & Coaching Cycles Tracking Record On Storyboard and then in Learners Notebook
Time spent on PDCA
(minutes)
Time Spent On Coaching
Cycle (minutes)
Time spent on
Refection (minutes)
2nd Coach Present
(X)
8/26/2016
13
Month 2 – Quality of Practice
• Active Advance Groups Review the Learner’s Storyboard for key Quality Characteristics
Process: Challenge:
Target Condition
Actual Condition Now PDCA Cycles Record
Obstacles Parking Lot
IK and CK Information
TC must align with Challenge
Establish Date:
Achieve By Date
1. Outcome Metric Value
learner predicts the
desired pattern will
achieve
2. Process Metric Value
learner predicts the
desired pattern will
achieve, this should
mathematically/logically
relate to Outcome Metric.
3. A desired pattern of work
in the form of a block
diagram.
4. Add any other pertinent
forms, information,
pictures, etc.…
CC should include
1. Current and up to
date Outcome
Metric Chart(s)
2. Current and up to
date Process Metric
Chart(s)
3. A description of the
current pattern of
work modified as
changes have
occurred over time.
1. Add any other
pertinent forms,
information,
pictures, etc.…
Up to date PDCA
Coaching Cycle
Tracking Record
PDCA Cycles Record any other
pertinent information, pictures,
etc.…
PDCA should address a specific
Obstacle to acheiving the TC
Obstacles listed, Indicating the
one learner is addressing.
Obstacles should be specific
not vague, nor should solutions
or lack of solutions be listed.
Obstacles need to relate to TC
Describe the Challenge achieve by date and what the learner is striving to achieve.
Describe the process the learner is learning about and striving to improve
Rev 2.0 Learner’s Storyboard Quality Checklist
(Date Set)
8/26/2016
14
Month 3 – Skill Assessment
Average:
Date: AssessedBy: Learner:
Skill ScoreGraspingCurrent
Condition
Needshelpingraspingthecurrentconditionfroma
coach
GraspsCCtoestablishTCwithlittlecoaching ConnectsCCtoChallengeandTC,andcanarticulateto
otherteammembers
ProcessAnalysis
Difficultyinfollowingthefivestepsofprocessanalysis
withoutguidance
Understandsandperformsprocessanalysiswithlittle
coachingratherthancopyingoldinformation
Usesbothdataandobservedfactstograspcurrent
conditionfollowingthefivestepsofProcessAnalysis-
visibleonstoryboard(example:noteswrittenon
metrics,changestopatternofwork,etc.)
PatternofWork
Currentpatternofworkisvague,lackingdetailssuchas
WIP,batchsizeand/ormissingkeyoperations/process
steps.
Currentpatternofworkupdatedaschangesaremade,
progressingtowardthedesiredpatternofwork
imbeddedwithintheTargetCondition.Changesare
notedanddatedwithcoachesguidance.
Currentpatternofworkupdatedaschangesaremade,
progressingtowardthedesiredpatternofwork
imbeddedwithintheTargetCondition.Changesare
notedanddated.
Observation
Assumetheyknowthecurrentcondition(i.e..Listof7
Wastesandsolutions)ratherthanusingobservablefacts
andmeasureddata.Reliesuponprocedures,computer
generateddataandopinions.
Candemonstrateanddescribecurrentconditionwith
observablefactsanddata,butmaynotrelateto
variationinpatternofworkandimpactofvariation
Identifiesandunderstandspatternsofwork,variationin
workprocessandoutcomemetrics,andtheeffectsof
variation
Process&Outcome
Metrics
Selectedoutcomeandprocessmetricsthatarenot
linkedmathematicallyand/ornotrelatedtothe
challenge
Usesprocessmetricsandoutcomemetricsthatcantrack
progressandlinkittothechallengewithsomeguidance
fromcoach
Usesoutcomeandprocessmetricsindependentlyof
coachmathematicallylinkingthetwoandlinkingtothe
challenge
DeterminingTarget
Condition
DifficultydeterminingwhatwouldbeanappropriateTC
withMetrics
IsabletoidentifyaTCbutmaybeutilizinga
predeterminedpathand/orsolutioninmind(Learner
NOTgoingoutsidetheirCurrentKnowledgeThreshold)
TCissetwithoutapredeterminedpathand/orsolution
inmindandissetbeyondCurrentknowledgethreshold
TargetConditionDerived
fromCurrentCondition&
AlignedtoChallenge
TCnotderivedfromCC(moreofabestguess).Difficulty
inexplaininghowtheTCwasderived.
EstablishesTCbasedonCCandcanexplainhowitwas
derived
TCIsbasedontheCCandalignedwiththechallenge.
ConnectsTCandCCtothechallengeandcanarticulate
tootherteammembers
TargetConditionDetailsTargetconditionshavelittledetailandisnotappropriate
fortimeframetocomplete.Toobroad,whichmakesit
difficulttoidentifyobstacles.
TCcontainssomeormostofthefollowing:Outcome
Metric(s)ProcessMetric(s),DesiredPatternofworkand
otherCharacteristics.
TCcontainsoutcomemetric,processmetric,desired
patternofworkandothercharacteristics.Relationships
arelinkedandcanclearlybeexplained.
DesiredPatternofWork
LinkedtoAchievingTarget
Condition
DesiredpatternofworknotidentifiedwithintheTC. DesiredpatternofworkisidentifiedwithinTC,but
achievingTCisstillnotconnectedtodesirepatternof
workand/orhowthevariationwilleffectTC.
DesiredpatternofworkisidentifiedwithintheTCand
understandsvariationinworkprocessandoutcome,and
theeffectofvariation.
SettingTargetCondition
Timeframe
NeedsreminderfromcoachaboutTargetConditiondue
date,progress&keepingtotimeline
AttimeswillestablishaTCthatisappropriateforthe
timeframeandknowswhenTCmetwithlittleassistance
fromcoach
OftenestablishesTCthatisappropriateforthetime
frameandknowswhenTCmet.
IdentifyingObstaclesObstaclesidentifiedareactuallyactions/solutions
insteadofatrueobstacle
Obstaclesareobservedinsteadof'wordofmouth' ObstaclesareobservedanddiscoveredduringPDCAs
ArticulatingObstaclesVagueobstaclethatcannotbeexperimentedagainst Obstaclesarebecomingmorespecific,butmaynot
articulatehowtheycanbemeasured
Veryspecific,canbearticulatedandaremeasurablefor
effectiveexperimentation
DocumentingObstaclesForgetstoupdateobstaclelistasPDCAsprogress.Does
notidentifyclearlywhichobstacleisbeingaddressed.
ObstacleParkingLotisupdatedasPDCAsprogress
sometimeswiththe"nudge"fromacoach
Activelylookingforobstaclesduringtheobservationof
theirPDCAcycleandlearningreflection
RelationshipBetween
ObstacleandTarget
Condition
ObstacledoesnotlinktoTargetConditionandPDCA Specificandcrispobstaclesthatareclearlylinkedtothe
TargetCondition
ObstaclesarestronglyconnectedtotheTargetCondition
andPDCA-eliminationoftheobstacletiesdirectlyto
results
RelationshipBetween
PDCA,Obstaclesand
TargetCondition
Experimentsarenotrelatedtoidentifiedobstaclesor
aremulti-factor
SometimesneedguidancetoestablishnextPDCA.
Usuallyrelatedtoobstacles.
CandesigngoodPDCAandexplainitsrelationshipto
currentobstacleandTC.
ThresholdofKnowledgeExperimentsarenotoutsideofthelearner'sthresholdof
knowledge
UsessomeSimulationandlearnsfromfailure Learnerisgettingcomfortablewithexperimentsoutside
ofthecertaintyzone
DeeperLearningMightnotbeabletoarticulatethedeeperlearning. Deeperlearningfromexperimentssometimesrequires
thehelpofacoachtopullout
Uncoversdeeperlearningfromexperimentationwithout
thehelpofthecoach.
PDCAExperimentDesignExperimentdesignnotthrourghlythoughtthroughand
articulated.Stepsaretoolargeandvague.
Experimentaldesignisimprovedandthoughtfulwith
vagueexpecationsarticulated.
Experimentaldesignthoughtfulwitheffective
expecationsarticulated..
LearningsLearningsarelistedasarepeatofobservations,deep
reflectionnotoccuringorrepresentedonthePDCA
record.
Learningsarevagueandoftenlistsobservationsas
learnings.
Learningswellarticulatedcomingfromthecomparison
ofexpectationsanddeep/detailobservationsmade
duringtheexperiment
ScientificExperimentation
Relieson"Go&see"typeofexperiments BecomingmorescientificwiththePDCAtypeswith
"exploratory"and"testahypothesis"-atminimum,
somepredictiononwhattheyexpectandwhatthey
expecttolearn
Reliesmostheavilyon"TestaHypothesis"PDCAtypes--
deepthinkingonwhattheyexpecttohappenandwhat
theyexpecttolearn.Canarticulatetheunderlying
hypothesissupportingtheirprediction.
PDCADocumentationLearner'sPDCAstepsarenotdocumentedappropriately.
Mightbeverybrief.
PDCA'stypicallydocumented,butcoachsometimesasks
formoredetailtobeadded.
Theyknowhowtheywillmeasureandhowtheywill
observetheresultsoftheirexperiment.Thoroughly
documented.
LinkingChallenge&VisionMaynotbeabletolinkChallengewithVision. UnderstandshowmostelementsoftheVisionand
Challengelinktohis/herarea.
CandefinehowthesiteVisionandChallengeislinkedto
theentireValueStream.
ChallengeDevelopmentCanrecitetheChallenge/Visionbutcannotexplain
anddoesnotunderstandwhereitcomesfrom.
UnderstandsthesiteVisionandChallenge,butmayhave
difficultyexplainingthemtoothers.
CanhelptheirleadershipdefinecredibleChallengeand
Vision,ifnecessary.AbletoeasilydevelopChallenge
fromValueStreamMap.
LinkingTCtoChallengeUnderstandsdefinition/differentiationofDirection;
Vision,ChallengeandTargetConditions
Onoccasion,demonstrateslinkageofChallenge,Target
ConditionandObstacles.
LinksprocessneedsandpatternstoChallenge,can
articulatewithdata.
ProgressTowards
Challenge
UnderstandstheVisionmaynotbeachievablebutalso
believestheChallengemaynotbeachievedandis
uncomfortablewithgoalsandobjectivesbeyondtheir
ThresholdofKnowledge.
UnderstandstheVisionmaynotbeachievablebutalso
believestheChallengemaynotbeachievedandis
becomingmorecomfortablewiththesegoalsand
objectivesbeyondtheirThresholdofKnowledge.
Abletoworktowardsaneffectivelongterm(1to3year)
ChallengeandiscomfortablewithChallengesandTarget
ConditionsbeyondtheirThresholdofKnowledge.
2-AdvancedBeginner 3-Competent
Direction
LearnerSkillAssessmentForm
PDCA
Obstacles
Current
Condition
(CC)
Target
Condition
(TC)
1-Novice
8/26/2016
15
Building Coaching Capacity
0
50
100
150
200
250
300
350
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Coaching Capacity Built Over Months
Coaches
First 3 months builds
initial coaching
Subsequent months
builds Addition
coaching capacity
under the direction
of the Advance
Group
Five Key Factor for Success
8/26/2016
16
• The Coaching Kata deployed in all levels of the organization develops a catch-ball routine along the chain of accountability.
• A meta-routine or kata for all levels and all areas of an organization.
31
Developing a Meta-Routine
FOR SUCCESS in deploying Toyota Kata
Mike Rother
FIVE KEY FACTORS
The Role of Advance Group
Through Deployment
8/26/2016
17
5 FACTORS
in the successful deployment of Toyota Kata
1. Relevancy
2. Right People in Right Roles
3. Close-in Target Conditions
4. Frequent and Rapid PDCA’s
5. Purposeful Coaching Cycles
Your “Advance Group”, who shepherds and PDCAs
your organization’s deployment, should assure
that these factors are in play
THE TIPPING POINT
The Advance Group is striving to achieve a
tipping point within the organization
The point in time when
kata activities are no
longer “something
extra” I have to do, but
just the “usual thing” I
do to manage my
processes and develop
my people.
Mike Rother
8/26/2016
18
A MOMENT
• A tipping point is a moment that signals the beginning of dramatic change.
• Malcolm Gladwell asserts that tipping points explain uncanny phenomena; the momentum behind the spread of AIDS or the murder rate in the NYC suddenly dropping in the mid 1990’s.
• More interestingly, it’s the basis of the idea that behaviors and ideas are contagious; in other words, they also have tipping points.
FACTOR 1 RELEVANCY
Improvement Kata activity has to be relevant
to the organization
to the 2nd Coach
to the Coach
to the Learner
8/26/2016
19
OUTCOMES ARE CRITICAL
Relevancy comes when the outcomes are critical…
Improvement Kata is deployed on critical organizational challenges and processes.
Coaches have a vested interest in the outcomes and are held accountable for the results.
Learners are the process owners and will personally benefit from the improvements achieved.
FACTOR 2 RIGHT PEOPLE IN RIGHT ROLES
Learner’s role is to apply the Improvement Kata following a scientific model to obtain innovative improvements.
Coach’s role is to teach the scientific model to obtain innovative improvements.
2nd Coach’s role is to the teach coaching kata to the primary coach.
8/26/2016
20
Learner
2nd Coach (not always
present)
Coach
REPORTING RELATIONSHIPS
The relationship between the Learner, Coach and 2nd Coach is a key factor to success
The relationship between a Learner and their Coach is the basis for development of people.
The development of people is how day-to-day improvement and innovation are delivered.
2nd Coach
Learner Learner Learner
Coach
8/26/2016
21
COACH AND LEARNER The Coach must have a vested interest in developing their
Learner along with obtaining improvement. The Coach is
interested in altering the thinking and acting of the Learner,
resulting in a new mindset
2ND COACH AND COACH
The 2nd Coach should have a vested interest in
developing the management skill set of the Coach
Novice
Avd Bgnr
Competent
Proficient
Expert
2nd Coach
Learner Learner Learner
Coach
8/26/2016
22
FACTOR 3 CLOSE-IN TARGET CONDITIONS
Target conditions, particularly with Novice learners and coaches, tend to be large and more complex then they should be.
This leads to large and complex PDCA’s. PDCA’s that could be target conditions in and of themselves!
ADVANCE GROUP TARGET CONDITION REVIEWS
Advance Groups should review target conditions to assure they are:
1. Of the proper distance into the future
2. Aligned to
organizational challenge
8/26/2016
23
NOVICE SKILL LEVEL TARGET CONDITIONS
For Novices, Target
Conditions should be
set 1 or 2 weeks out.
ADVANCED BEGINNER OR COMPETENT SKILL LEVEL
Process level
target conditions should be no more than 3 to 4 weeks out.
Value stream target conditions should be no more than 1 month to 3 months out.
8/26/2016
24
FACTOR 4 FREQUENT AND RAPID PDCA’S
With close-in target conditions, PDCA’s tend to be
smaller, single factor experiments that are performed
with laser focus set on overcoming
one obstacle at a time
Plan
Do Check
Act Plan
Do Check
Act Plan
Do Check
Act Plan
Do Check
Act Plan
Do Check
Act Plan
Do Check
Act Plan
Do Check
Act Plan
Do Check
Act
KEEP LEARNERS ENGAGED
Frequent and rapid PDCA’s keep the learning and
improvements coming at a fast pace, keeping the
Learner and their teams motivated and engaged.
8/26/2016
25
FACTOR 5 PURPOSEFUL COACHING CYCLES
Frequent and rapid PDCA’s give purpose to
frequent coaching cycles
Mike Rother
KEEP COACHES ENGAGED
• When fast-pace learning occurs, coaches and 2nd
coaches remain engaged and motivated to Go and See.
• On the flip side, if PDCA’s are long and learning is
happening at a slow pace, coaching sessions lose their
allure and value..
8/26/2016
26
Kata Skill @ Novice
Common Themes
Illustrated with a Healthcare Example
Beth Carrington
51
Kata Skill @ Novice
1. Target Conditions too far into the future.
2. Target Conditions too large, broad in scope and/or reach.
3. Metrics are unnecessarily complicated.
4. Obstacles large and/or vague, not directly observed.
5. PDCA’s too large, listed as Action Item not experiment.
52
Common themes new Learners and
Coaches demonstrate in their practice
Novice
Avd Bgnr
Competent
Proficient
Expert
Dreyfus Skill
Acquisition Model
LEANER &
COACH ARE
HERE
8/26/2016
27
Illustration Story Outline
1. Healthcare System
2. Organizational Vision and Challenge
3. Parse Organizational Challenge to Process Level 1. Vision
2. Challenge
3. Target Condition
4. Actual Condition
5. Obstacles
6. PDCA
53
Multiple Site Healthcare System
Part of 650 Leaders of the organization just
parsed the System’s goals and objective to site and department level goals and objectives.
Then an on site-initial coached practice Kata Workshop was conducted.
A couple of weeks later follow up contact was made
Healthcare System
54
8/26/2016
28
Top 10th percentile in Patient Satisfaction Scores
Top 10th percentile in Quality Rating
Top 10th percentile in Employee Engagement
Positive Operating Margin
Vision – System Level
55
THIS
STORY’S
FOCUS
Top 10th percentile in Patient Satisfaction Scores
• Quality - Protecting Patients From Harm
• Hospital Acquired Conditions (HAC)
• Patient Falls
• Pressure Ulcers
Challenge Development at System Level
56
CONTINUING TO
NARROW and
DEFINE THE
CHALLENGE
8/26/2016
29
Next step is to “parse” the organization’s goals to process level goals and objectives, asking and answering the question -
“How does this process have to perform to
meet the larger organizational goals?”
Site Specific and Process Level
57
Hospital acquired conditions (HACs) are
preventable and we will eliminate HACs at our
Hospital.
Vision – Site Specific
58
Challenge – Site Specific
By December 31, 2016
• 15 or fewer inpatient falls (moderate or major) and
HAPUs (Stage III, IV and Un-stageable) -- total inpatient
falls & HAPUs combined.
8/26/2016
30
Theme Development : Although prevention of
inpatient falls is important, we believe that HAPU
prevention is our first priority.
Target Condition (TC)
59
Date: 30-May-16 (75 Days in the future)
Outcome Metric: 8 or fewer HAPU events
Process Metric: % of limited mobility patients being
repositioned every 2 hours (baseline results TBD)
Target Pattern: Follow the S & K of S.K.I.N., Inspection
and Training across the site
Target Condition (TC)
60
8/26/2016
31
Date: 30-May-16 (75 Days in the future)
Outcome Metric: 8 or fewer HAPU events
Process Metric: % of limited mobility patients being
repositioned every 2 hours (baseline results TBD)
Target Pattern: Follow the S & K of S.K.I.N., Inspection
and Training across the site
Target Condition (TC)
61
Common Theme 1.
Target Conditions date
too far into the future,
Learners & Coaches
with Novice Skill set TC
dates. There is an
underlying assumption
and a sense of
confidence they can
accomplish something
with more time.
This TC date should be 7-14 days into the
future.
Date: 30-May-16 (75 Days in the future)
Outcome Metric: 8 or fewer HAPU events
Process Metric: % of limited mobility patients being
repositioned every 2 hours (baseline results TBD)
Target Pattern: Follow the S & K of S.K.I.N., Inspection
and Training across the site
Target Condition (TC)
62
Common Theme 2.
Target Conditions too large, broad in
scope and/or reach. Not sure in this
case which came first the TC date over
2 ½ months into the future or if this site-wide TC drove the date.
In establishing a TC set the date first,
with Novice Skill, 7-14 days out.
Then establish the TC, keep asking
yourself what TC can I set to learn what
I need so that I can achieve the
Challenge. Scope the TC so that you
can run experiments and observe
results. Site wide experiments will be
near impossible to grasp & observe the
results to determine cause and effect
relationship.
Find a “learning lab” area within the organization, learn what you need
within the smaller area or reach, in this case a single floor or area.
8/26/2016
32
Date: 30-May-16 (75 Days in the future)
Outcome Metric: 8 or fewer HAPU events
Process Metric: % of limited mobility patients being
repositioned every 2 hours (baseline results TBD)
Target Pattern: Follow the S & K of S.K.I.N., Inspection
and Training across the site
Target Condition (TC)
63
Common Theme 3.
Metrics are unnecessarily
complicated. In this TC the
process metric is a % of
instances over 2 hours. It is not
a directly observable – “in the
moment” metric. Simple is
better. An example would be
to create a run chart of each repositioning and the time since
the last move. Now each
instance of over 2 hour re-
positioning the question can be
asked and answered. What
prevented us from repositioning
this patient within the 2 hours.
This will generate a list of
observable obstacles that need
to be overcome. This leads us
to the common theme 4, go to
page 19 Obstacles Parking Lot.
Current Condition
64
FOCUS
on
THESE 2
We believe that the main gaps in our current
HAPU prevention plan (S.K.I.N.) are unclear
roles and responsibilities; unclear standards;
lack of training; and an inadequate
investigation process,. If we are able to close
these gaps, we will see improvement in our
HAPU harm rates.
8/26/2016
33
Process Metric – Baseline TBD
65
0
0.25
0.5
0.75
1Jan-1
6
Feb-1
6
Mar-
16
Apr-
16
May-1
6
Jun-1
6
Jul-16
Aug-1
6
Sep-1
6
Oct-
16
Nov-1
6
Dec-1
6
% of Patients Being Repositioned
actual target
Outcome Metric
66
6
15
0
5
10
15
20
Jan-1
6
Feb-1
6
Mar-
16
Apr-
16
May-1
6
Jun-1
6
Jul-16
Aug-1
6
Sep-1
6
Oct-
16
Nov-1
6
Dec-1
6
2016 YTD HAC Events
YTD actual 2016 target
8/26/2016
34
Variation in understanding of expectations for S.K.I.N. protocols (who, what, when)
Inadequate standard/expectation for "4 eyes on" skin assessment
Obstacles
67
Common Theme 4.
Obstacles large and/or
vague, not directly
observed. With a broad TC, obstacles typically become
fuzzy, not observed but
intuitively developed.
As stated in the prior
conversation box, with a
crisp/focused TC and a
directly measurable and “in
the moment” process
metric, obstacles are easily
recognized and observed.
I.E. What prevented us from
repositioning that patient
within 2 hour expectation.
PDCA Record
68
Common Theme 5.
PDCA’s too large, listed as
Action Item not experiment.
The TC date being set too far
out, the TC being too large in scope/reach and vague
obstacles lead to Action
Item list PDCA’s as opposed
to experimental PDCA
cycles and cycles that take
longer than the desired
Coaching Kata timeframe,
preferably Daily at this
process level.
With a narrow scope/reach
TC and observable Process
Metric then the obstacles
become observable and selecting one will be easier
to create an opportunity for
experimentation.
8/26/2016
35
Kata Skill @ Novice
1. Target Conditions too far into the future.
2. Target Conditions too large, broad in scope and/or reach.
3. Metrics are unnecessarily complicated.
4. Obstacles large and/or vague, not directly observed.
5. PDCA’s too large, listed as Action Item not experiment.
69
Common themes new Learners and
Coaches demonstrate in their practice
Novice
Avd Bgnr
Competent
Proficient
Expert
Dreyfus Skill
Acquisition Model
LEANER &
COACH ARE
HERE
Experience shows that creating an active and engaged Advance Group helps an organization create competent coaching
capacity more quickly.
Learners and Coaches @ Novice Kata Skill engaged with a Kata Master Coach also build their coaching capability (skill) to competent more quickly.
Avoid these Common Themes
70
8/26/2016
36
• The Coaching Kata deployed in all levels of the organization develops a catch-ball routine along the chain of accountability.
• A meta-routine or kata for all levels and all areas of an organization.
71
Developing Meta-Routines
Case Examples
• ZF in Brazil
• Kennametal in US
• Baptist Memorial Healthcare in TN, AR and MS
8/26/2016
37
Wishing you success in Developing 21st Century Lean Management!
Kata, kata, kata...
Beth Carrington