USING LEAN TO ENGAGE AND ALIGN THE ENTIRE ORGANIZATION · USING LEAN TO ENGAGE AND ALIGN THE ENTIRE...

USING LEAN TO ENGAGE AND ALIGN THE ENTIRE ORGANIZATION

Didier Rabino, VP Lean Sensei

Julie Garrison, HR System Director

November 9, 2015

2 Confidential. For internal use only. Not for distribution.

ABOUT THE PRESENTERS

Julie GARRISON

HR System Director

1999 – 2006: Aspen Medical Group

2006 – Present: HealthEast Care System

Didier RABINO

VP, Lean Sensei

2004 - 2012: Andersen Windows Corp.

1992 - 2004: Steelcase Inc.


HEALTHEAST CARE SYSTEM

Optimal health and well-being for our patients, our communities and ourselves


7,400 employees; 1,300 providers; 900 volunteers

14 primary care clinics; 4 hospitals; community services

Multiple specialty centers; comprehensive wellness program

ABOUT HEALTHEAST

1.1 Million Residents

63 Languages


LEAN AT HEALTHEAST: THE JOURNEY

2006 - First Lean flow projects and education

2011 - First department with frontline tools

2012 - First Value Based Improvement (VBI) system launched

20?? - Lean is our way of life


Better

Results • Better clinical quality

• Better patient experience

• Better staff engagement

• Improved cost effectiveness

Better Health Care Value:

Better

Processes • Less waste

• Less variation

• Less burden on employees and physicians

• Built-in qualityBetter Problem • Total employee and physician engagement

• PDCA and A3 Thinking expertise

• Making problems visible

• Learning organization

Solvers

Better

Management

System

• Focused strategy deployment

• Layered and supportive standard work

• Visual management

• Accountability system

LEAN AT HEALTHEAST: THE VBI CULTURE


Continuous Improvement

With Respect for People

VBI house built with 14 sub-systems:

First developed:

Frontline Management System

Gemba Walks

A3 Thinking

Strategy Deployment

Next developed:

Value Stream Management

Kaizen/3P Leadership

Standard Work

LEAN SYSTEMS

Why

VBI?

HealthEast VBI 6-30-15-SD.mp4


Experiment

Deploy

Assess

ContinuouslyImprove

LEAN ROADMAP

Organization

Development =

Support+

FY12 FY13 FY14 FY16 FY17 FY18 FY19 FY20

Value Stream Mgt

Standard Work

Strategy Deployment

A3 Thinking

Strategy Deployment

A3 Thinking

Strategy Deployment

A3 Thinking

Value Stream Mgt

Standard Work

Value Stream Mgt

Standard Work

Strategy Deployment

A3 ThinkingValue Stream Mgt

Standard Work

Strategy Deployment

A3 Thinking


Shingo Model


Shingo Model


Shingo Model


Shingo Model

Strategy Deployment


Standard Work

Pull Systems

Workplace Organization

Pull Systems


Pull Systems


Pull Systems


Strategy Deployment


Standard Work


Shingo Model

Error Detection

Work Smoothing

Error Detection

Work Smoothing

Error Detection

Work Smoothing

Pb Solving Techniques

Equipment Reliability

Pb Solving Techniques

Equipment Reliability

Frontline Management

Gemba Walks


Gemba Walks


Gemba Walks


Gemba Walks


Gemba Walks


Gemba Walks


Gemba Walks


Gemba Walks

*

* FY15: Focus on Epic DeploymentFY15: Focus on Epic Deployment


TOOL BASED ARCHITECTURE

1

2

3

4 What tools to we need?

• Improvement cards

• Huddle form

• Run-chart

• Audit form

• Etc.


SYSTEMS DRIVE BEHAVIORS


PRINCIPLE BASED ARCHITECTURE

1

4

3

2

What behaviors to we need?

• Huddles are interactive meetings

• Leaders use cards to coach PDCA

• Ideas are connected to causes

• Standards are created from ideas

• Etc.


TEAM STRUCTURE

Tier 1

300 teams

Tier 2

26 teams

Tier 3

7 teams

Tier 4

1 teamExecutive Leadership Team

Business Units

Entities

Frontline

Engage, align and support the whole organization


STRATEGY DEPLOYMENT SYSTEM

Instead of

ThisThis

Alignment

Focus


STRATEGY DEPLOYMENT ROOMS

Entities, Business Units, Executive Leadership Team


STRATEGY DEPLOYMENT REVIEWS

ELT

BU’s

Entities

Frontline teams

Gemba walks

Clinical

QualityPatient

Experience

EngagementSmart Growth &

Financial Health

WEEKLY SCHEDULE PILLAR ROTATION

1 Pillar

per week


DAILY IMPROVEMENT BY FRONTLINE


18,203 VBI Ideas in FY13



Learning PDCA

Process Analysis

DEVELOPING THOUSANDS OF PROBLEM SOLVERS


PEOPLE DEVELOPMENT

Frontline Team Frontline Leader

2-Up Leader

1-Up Leader


0

1,000

2,000

3,000

4,000

Sep

-12

Oct

-12

No

v-1

2

De

c-1

2

Jan

-13

Feb

-13

Mar

-13

Ap

r-1

3

May-…

Jun

-13

Jul-

13

Au

g-1

3

Sep

-13

Oct

-13

No

v-1

3

De

c-1

3

Jan

-14

Feb

-14

Mar

-14

Ap

r-1

4

May-…

Jun

-14

Jul-

14

Au

g-1

4

Sep

-14

Oct

-14

No

v-1

4

De

c-1

4

Jan

-15

Feb

-15

Mar

-15

Ap

r-1

5

May-…

Jun

-15

Jul-

15

Au

g-1

5

FY13 FY14 FY15

Implementation of Improvement Ideas

78,772 ideas

and counting...

HOW ARE WE DOING?


LEAN AT HEALTHEAST – CULTURE

Leadership Commitment

- Involvement

- Role Modeling

- Doing

Education

- Create a desire and path to learn

Culture Alignment

- Engagement

- Readiness

- Considerations

- Alignment


LEAN AT HEALTHEAST – LESSONS LEARNED

Key Learning

- Engage discussions early on and keep those discussions moving

Key Stakeholders

- Make connections to why

- Make connections to the Employee Experience and Engagement

- Strong communications platforms

- Reinforce, Reinforce, Reinforce

- Senior Leaders Role Model and lead the way

- Leaders need humility

- Go to the Gemba AND keep engagement with employees

- Build Systems of support

- Be courageous, have fun, stay the course!


LEAN AT HEALTHEAST – WHAT TO DO

Go to Gemba, ask “why”, learn the process

Make problems visible and accept they exist

Develop people (everybody) and improve processes (all of them) simultaneously

Stabilize, Standardize, Simplify

Biggest of all: ongoing PDCA expertise

Leverage Senior Leaders

- Lead the way by Teaching

- Lean Bronze Certification

- Reward and Recognize


LEAN JOURNEY CONTINUES

Why

VBI?

https://www.youtube.com/watch?v=XVfO2Fry7dc&index=16&list=PL5rynlNJRt9CTtlcb-qdhCNGNn3HJsW-m


USING LEAN TO ENGAGE AND ALIGN THE ENTIRE ORGANIZATION

Continuous Improvement

With Respect for People

USING LEAN TO ENGAGE AND ALIGN THE ENTIRE ORGANIZATION · USING LEAN TO ENGAGE AND ALIGN THE ENTIRE...

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