At the peak of the Shingo Model pyramid is the principle “create value for the customer.” If an organization fails to deliver value to the customer, they will ultimately wind up out of business. Value is defined by the customer by what they are willing to pay for.
Here are some behaviors that can help create value for the customer:
In many healthcare organizations, you often see lofty strategic initiatives that are listed as reducing harm. For example, these objectives are listed as “Reduce CLABSI by 50%” or “Reduce Unplanned Readmissions by 25%.”
The words used in these statements can often represent an immature process and analytics mindset. In organizations that are more mature in their process thinking, these statements use a different verb than “reduce,” instead they use a verb like “prevent.” Continue reading →
The other morning as I was stuck in the crazy weekday morning ritual that is the elementary school drop off line, I started thinking about the Shingo Principle flow and pull value. I am not fond of this part of my morning routine; it seems like it takes much longer than it should, and I find it frustrating to be in the middle of the pure chaos of it all. Why is morning drop off such a disaster? Simple, because there is no flow.
Flow and pull value is a principle under the continuous improvement dimension of the Shingo Model. This principle is centered around the notion that “value for customers is maximized when it is created in response to real demand and a continuous and uninterrupted flow.” Continue reading →
Leader standard work is one of the elements in a lean management system. In his book Creating a Lean Culture, David Mann compares leader standard work to the engine of a car. While many of us might not know a whole lot about cars, we do know that the engine is a vital part. Likewise, leader standard work is critical for an effective lean management system because it supports and demonstrates successful leadership behaviors in a continuous improvement environment. Continue reading →
Each time I prepare to send out an electronic newsletter I follow a standard process that has been designed to ensure that a defect-free email goes out. The process includes proofreading copy before it goes into the newsletter format, testing links, and even testing the email format. Over the years we have refined this process multiple times to help us assure quality at the source.
The principle assure quality at the source is part of the continuous Improvement dimension on the Shingo Model. The way to assure quality at the source is through processes that are designed to make it easy to do things the right way and creating standards that produce the desired outcome. Assuring quality at the source is the opposite of a quality control department that is aimed at catching errors after they occur; it focuses on how to ensure that errors don’t happen in the first place; but if errors occur they are not passed down the line. If the end goal is to create value for the customer, it is important to focus on quality in all stages and areas of the business. Continue reading →
The principle “embrace scientific thinking” falls within the continuous improvement dimension of the Shingo Model. Each principle within this dimension is essential to improvement, innovation, and continuous learning. If an organization is truly embracing scientific thinking everyone in the organization works to generate repeated cycles of experimentation and improvement when faced with a problem.
Kamishibai, or process observation, is not only fun to say, but it is also an essential component of a lean management system. Process observation helps to ensure that you are maintaining standards and the standards you have in place are delivering on the expected outcome. If you walk away from processes that you improve, they will deteriorate by nature.
Here are some dos and don’ts to help you get started with process observation:
Focus on the Process is one of the Shingo Principles that highlights how all outcomes are the result of a process and consequently it is nearly impossible for people to consistently produce ideal results with a poor process. W. Edwards Deming captured this idea well when he said, “A bad system will beat a good person every time.” Understanding this is the first step to establishing a no blame work environment.
Like my colleague Stephanie Van Vreede’s reaction when asked to write about one of the Shingo Principles, I immediately jumped to my favorite, Focus on Process (I know, lean thinkers get excited about odd things don’t we?). When I was first exposed to lean thinking the phrase, “it’s the process, not the person” resonated with me because I feel that all too often people are accused of not doing their job when they were not at fault. And as one can imagine, this makes for a toxic environment. Continue reading →
The Shingo principle seek perfection is about challenging the status quo; always wanting to be better and do better. While perfection will never be obtained, the pursuit of perfection creates a mindset and culture of continuous improvement.
Over the years, I have seen many healthcare organizations who are striving to attain operational excellence by focusing on the Shingo Principles, and found they all have some behaviors in common in their pursuit of perfection.
A daily huddle can go by many names; improvement huddle, performance huddle, just a huddle, whatever you want to call it. No matter the name, there are many reasons to implement a daily huddle; for example, to facilitate continuous daily improvement, engage your team in problem solving, and help your team understand the importance of their work in achieving system objectives. One of the important characteristics about a daily huddle is that it gives an outlet to surface defects in daily flow.
If you are thinking about implementing a daily huddle in your area or unit here are some things you should keep in mind: