Wednesday's Words of Quality,
Lesson #1: Continuous Improvement and Lean
Lesson #1 of 13
What is Lean?
What is Lean?
We have shared that Lean is a business management system designed to engage the entire workforce in continuous improvement of the work that we all are charged with doing. "Do the work and improve the work" requires a mindset that monthly, weekly and daily team meetings scheduled by design for this specific purpose.
Metrics are devised to show the current condition to be improved and indicate improvement after countermeasures are implemented. Further, all actions are authorized and supported by leadership and quality management systems that have been designed and are routinely relied upon at all levels of the work to result in consistent execution of the defined business and improvement goals. (reference 1)
Improvement is a team sport and for continuous improvement to take place, you must schedule the time each week to focus the team's efforts on this goal. Otherwise, you will fail. So efficient meetings designed to improve the work with a defined purpose matter. Even if only 30 minutes each week.
In this manner, you are leading with your team through a focus on quality and metrics to ever improve the experience of the internal or external user of your service or product, the so-called customer. We are all customers and suppliers of each other. This is how you can focus on obtaining more efficient and highly reliable work that is ultimately experienced by the patient.
What does continuous improvement mean?
What does continuous improvement mean?
We start with the premise that everything can be better and that we are not performing a single task as well as it should be.... Those words are from Henry Ford himself in 1925. It was the case then and so it is today. This means that "how" we work evolves over time. Often in the current state, the "work outcomes" fail to meet the expectations of those for whom it is intended. In other words, the work is not perfect or it does not meet the customer expectation. It could be better. Therefore, how we do the work needs to be redesigned with knowledge of what good work looks like in order to satisfy the customer and achieve our any one of our business goals of better quality, efficiency, throughput, safety, consistency, reliability, productivity, satisfaction, and cost.
Continuous improvement is a daily goal, supported by an educated, trained workforce who understands what good work design is, and how it can be evaluated scientifically using data and then redesigned or modified to provide improved results. This is where education and training in the so-called tools of Lean are key to define how to assess and improve the current state of work.
People who do the actual work see and know what is not perfect and when educated and empowered can address quality issues at the source. This approach to improving the work continually must be supported by you who are leaders and managers by
relying on Lean management systems that engage people and structure their successful behaviors for continuous improvement.
How do I contribute to continuous improvement?
There are several basic roles in continuous improvement for each of us to contribute in some manner, whether leader, manager, staff.
Much of our improvement needs to occur from the level of the true work, where value is actually created. Therefore, the one who does the work is recognized as the subject expert as they are closest to the actual work. At a minimum, it is important that they involve themselves in 3 improvement related activities under the direction of their manager or supervisor.
1. 5S. “A work team that cannot do 5S, cannot do Lean”.
Good work comes from a visual, organized and standardized workplace. The management approach to achieving this state is called 5S, which stands for sort, set in order, shine, standardize, and sustain. This is a team-based endeavor. We have taught you various approaches to accountability in this discipline of daily work life.
2. Deviation Management. “No problem is a problem.” (reference 2)
Those who do the work must identify defects that are in countered in either receiving, doing or handing off the work. The management system that defines how this is captured is called deviation management. This is a sophisticated evolution of simple white boards, which is where most of you will start. Both approaches allows those who do the work to see and understand what to improve, how to document corrective actions taken and how to contribute to planned process changes that designed to eliminate the most common or the most severe deviations from expected work outcomes.
3. Daily Management. “QTIPS—Quality, Timeliness, Inventory, Productivity, Safety.” (reference 3)
Daily management refers to a formal problem-solving board to be used in brief team-based huddles to identify, track and resolve the most critical defective work processes. This daily focus begins the root cause analysis and assessment of
proposed interventions that will address the most important or prioritized deviations encountered within a 24-hour period. This mechanism accelerates problem solving today using data (PDCA).
So that's it.
1. Start with education of yourself and your team about the continuous improvement philosophy and the 3 expected activities that everyone will use, own and be accountable for.
2. Then, with your team create a visually managed workplace so that you as manager or supervisor are aware of the problems and the outcomes of your team-based interventions.
What to expect?
By doing improvement work continuously, work standardization is achieved by consensus of those who do the actual work.
Variation and deviation from expected work, otherwise known as waste or non-value added work, is continually reduced.
Over time, incremental changes that improve the work result in improved levels of quality, efficiency, throughput, safety, consistency, reliability, productivity, satisfaction, and cost.
References
1. Zarbo RJ. Management systems to structure continuous quality improvement. Am J Clin Pathol 2022;157:159-170. DOI: 10.1093/AJCP/AQAB109
2. Zarbo RJ, Copeland JR, Varney RC: Deviation Management: Key management subsystem driver of knowledge-
based continuous improvement in the Henry Ford Production System. Am J Clin Pathol 2017;148:354-367.
DOI: 10.1093/ajcp/aqx084
3. Zarbo RJ, Varney RC, Copeland JR, et al: Daily Management System of the Henry Ford Production System. QTIPS to focus continuous improvements at the level of the work. Am J Clin Pathol 2015;144:122-136.
DOI:10.1309/AJCPLQYMOFWU31C
Next WWQ: Lesson #2 - Manager’s Lean Journey
0 comments:
Post a Comment