Organizational Excellence and Lean. Tom Reiter-CEO & Justin Lewis-VP of Org Development

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1 Organizational Excellence and Lean Tom Reiter-CEO & Justin Lewis-VP of Org Development

2 Before we get started A very callous act was committed on Sunday. We could use your help in identifying the culprits who so callously uploaded a tasteless photo on the Whova App. There will be an reward for the names of the people responsible for this dastardly act.

3 Evidence..

4 A note of caution.. Please do not try to apprehend these people of interest. They are armed with useless knowledge and are considered dangerous. It is highly recommended that you let Tom Reiter and Rob McCommons know that you DO NOT support inappropriate pictures uploaded on the WHOVA app.

5 We are at an exciting time in the history of healthcare; service improvement, affordable care act, all inclusive healthcare and innovative thinking Leana Wen, MD NPA Conference October 2015

6 What is Lean? Lean is a strategy of seeking to provide exactly what your customers want, when they want it, with as little waste as possible.

7 Where did Lean come from and why bring it to Healthcare? No one has to change. Survival is optional. W. Edward Deming 8

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9 Why healthcare? Biggest industry in America Cost in 2002: $1.7 trillion Cost in 2006: $2.1 trillion Cost in 2008: $2.3 trillion Cost in 2009: $2.5 trillion Projected cost in 2020: $4.6 trillion Demographics: 80 million Baby boomers 46 million Gen-Xers 78 million Generation Y 10

10 How Good are we in Health Care? Study: quality of health care McGlynn, et al: The quality of health care delivered to adults in the United States. NEJM 2003, 348: (June 26, 2003) 439 indicators of clinical quality of care 30 acute and chronic conditions, plus prevention Medical records for 6712 patients Participants received 54.9% of scientifically indicated care Conclusion: the defect rate in the technical quality of American health care is approximately 45% 11

11 Why implement Lean at RMHCS? (Better, Faster, Cheaper) Growth Develop tools and methods for interacting with each other Improvement of employee satisfaction Relentless commitment to eliminating waste and continually improving Develop our staff 12

12 Vision: Improving Lives, Optimizing Wellness, Promoting Independence Respect for People Reflect Act Learn Plan Study Do Apply Continuous Improvement Serving with compassion, fairness, and integrity by making decisions based on the welfare of the people we serve. Committing to positive change and constant improvement, with the highest degree of moral character, quality and competence visible in what we do. Respecting all individuals of every race, religion, gender and background, because people respond to us as well as we treat them. Investing in our staff (our greatest asset) and caring for their professional and personal wellbeing. Seeing our opportunity to serve our community as a privilege. We strive to be mindful of this every day. RMHCS House of Lean of Lean

13 What does Respect for People look like? Treating people as our most valuable resource System Thinking: one person / department will not gain at the expense of others

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15 Systems Thinking

16 Monkey Illusion Re-cap

17 Have it your way

18 All are we are doing is looking at the time line from the moment the customer gives us an order to the point where we collect the cash. And we are reducing that time line removing the non-value-added wastes. Taiichi Ohno, Father of the Toyota Production System, Toyota VP To become mainstream, we need to learn to enroll significantly more people than 5 a month. It also takes 90 days to enroll one person (too slow). Shawn Bloom President and CEO of NPA October

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20 Continuous Improvement Value vs. Waste Lean Tools The four rules of Lean improvement

21 Value Value? Who Defines it? What is value to them? How do you create Value? What are the things that are preventing you from providing value?

22 PDSA Model: A quick glance

23 Lean Methodologies used with PDSA cycles If experiment is not producing anticipated results, adjust process as needed or repeat full cycle Update Training Material Update Quality Standard Complete Standard Work (if in draft mode) Establish feedback and suggestion systems After Action Review (of improvement process) Communication Celebration/Recognition 5% 80% A3 Charter Document Gather Baseline Data Direct Observation Spaghetti Diagram 5 Whys/Fishbone/Affinity Exercise Process Mapping Communication Value Stream Mapping Check data Direct Observation/audits Gather feedback from customers/staff Update project documents Schedule Check Meetings Communication 5% 10% Implement Action Plan Draft Standard Work Communication Update Storyboard Update Huddles Staff Meetings

24 Four Rules of Lean Improvement From Decoding the DNA of the Toyota Production System, Harvard Business Review, 1990

25 Rule 1: Structure Every Activity

26 Rule 2: Clearly Connect Customers and Suppliers

27 Rule 3: Specify and Simplify Work Flow

28 Rule 4: Experiment Rule #4: Experiment 30

29 FAIL FASTER

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31 Questions?