Over the past several months, I have analyzed and discussed the Shingo Model™ on this blog and in private meetings with thought leaders. This has led to a lot of feedback from various people – both in response to Shingo blog posts, to my personal LinkedIn account, and in one-on-one conversations. I deeply appreciate the passion and commitment of so many people to the Shingo Model™!
Any recommendations made by me were based entirely on direct observation of the learning process during the Shingo workshops. In other words, how could we change the Model that would help people learn it better or faster in that setting? As we all know, there are many other considerations to take into account than just the classroom learning experience. The feedback has helped clarify some of these other considerations which must be taken into account.
Let me do my best to articulate different concerns that have been raised:
I liked the recent Catalysis blog post on “How to Create an Area Scorecard,” but I’d like to use this blog post to build upon the helpful thoughts that were shared there.
The previous blog post focused on the important question of “what should we measure?” The recent book Measure What Matters by John Doerr has been popular with readers in many industries, even though the roots are from Silicon Valley. Healthcare organizations have an incredibly powerful “true north” (as we’d say in the Lean approach) that includes safety for patient and staff, quality and outcomes, timely access to care, staff morale, and cost.
There are dozens or hundreds of things we could measure related to our own personal health, and the same is true with measures of organizational health. We also ask, “What is the gap between actual performance and ideal performance?” It’s possible to prioritize the metrics we are focused on, based on where the performance gaps are the largest or the most meaningful. Is a gap in patient safety more important than a gap in appointment waiting times? Having more measures doesn’t necessarily lead to more improvement. Having too many measures can distract us from working on what matters most.
Part of my role at Catalysis is to work with our Catalysis Healthcare Value Network members to help them accelerate the cultural transformation at their organizations. One way we do this is through what we call the discovery process. The goal of the process is to get a broad perspective on how an organization is progressing on their lean journey. The resulting report identifies gaps and facilitates Catalysis and the organization co-creating a plan to close those gaps. During the discovery visit, the Catalysis team gains perspective by going to gemba, having conversations with, and observing the members of the senior leadership team, operations managers, and support managers. Continue reading →
It was a hot and humid day in Singapore. I had two big bags of groceries in my hand and was trying to herd my kids to the bus stop. If I missed this bus, I would need to wait at least 15 minutes. Simultaneously running and juggling my bags while egging my 10-year-old on and literally pulling my toddler, it happened. My 3-year-old started yelling, and lay down. He wouldn’t budge as much as I tried. I was at my wits end. My 10-year-old calmly suggested, “Mom, tell him Jonty’s story.” Continue reading →
Throughout my career, I’ve come across many healthcare organizations that struggle with performance management. What I hear and see are intelligent, dedicated people all trying to help their organization improve. Most EMR implementations do not include a clinical business intelligence strategy. Vendors have come in and convinced the organization’s leaders that their software can somehow automatically improve performance. The software is so easy to use it will be self-service. The vendor will demonstrate the ad-hoc data discovery capabilities that anyone can do. All the organization has to do is submit their data and the improvements will begin. Oh, there’s also a large expense of at least $250,000 just to start. Many organizations have spent much more than that and are not seeing any significant improvement. Why? Continue reading →
Often people are doing improvement work, but they are not entirely sure whether those improvements are having an impact. One way to see the impact is with a scorecard. This element of the lean management system allows us to understand our performance at a unit level, prioritize improvement, and respond to underperformance. All elements of the lean management system are connected and interdependent on one another. The scorecard is connected to many other components including; performance review meetings, the unit-based leadership team, and visual management. Ultimately, the area scorecard helps us align our work to the system True North metrics.
Here are some things to keep in mind when creating an area scorecard.
At the end of 2018 we began posting weekly blogs to inspire healthcare leaders and accelerate change throughout the healthcare industry. We strive to share knowledge that will help transform organizations to a culture of improvement, delivering continually higher value outcomes for patients, staff, and communities.
As 2019 comes to an end, we thought it would be fitting to reshare the best blog posts of 2019:
The overall objective of a lean management system is to develop people to solve problems and improve performance. A lean management system can help an organization learn and understand their business, create alignment within the organization, enable problem-solving in the gemba, and sustain improvements.
The lean management system is made up of ten interdependent components that work together to become the way of life with an organization. We like to think of the lean management system as a brick wall, if one brick is removed, the wall would crumble. The same is true for the management system, all the components are necessary to keep the system strong.
As 2019 comes to a close, it is a good time to pause and reflect on events from the year. Reflection is integral to the learning and personal development process. This important part of the PDSA cycle helps us take stock of what went well and what we can improve on in the future.
The Catalysis staff has taken time to share their reflections from working with customers and one another as we work to transform healthcare. Continue reading →
We have all heard the saying, “a picture is worth a thousand words.” That is the best way to sum up visual management. The purpose is to make it easy to access and understand performance. In Creating a Lean Culture, David Mann compares visual management to the transmission of an automobile. The transmission is vital to making the car run, just as visual management is a principle element in a lean management system.
There is no one way to do visual management. In fact, there are many different types or varieties of visual management and each organization or team should choose what works best for their needs. No matter what design visual management takes, there are some common benefits visual management provides: Continue reading →
