© 2014 The Karen Martin Group, Inc.
Building the Foundation for Everyday Excellence
The Outstanding Organization
Healthcare Systems Process Improvement ConferenceFebruary 23, 2014
Success with Improvement
2
2001 – The Economist
None17%
Lasting20%
Temporary63%
…A Decade Later2010 – Accenture
69%
58%
33%
Minimal financial impact
Needs re‐evaluation, restart or complete
makeover
Mixed to disappointing
results3
Up to 98,000 deathsannually due tomedical errors.
Improvement goal:Reduce by 50%in 5 Years.
To Err is HumanInstitute of Medicine, 1999
Something Is Terribly Wrong…
2009
2005 2010
2010
2011
“Progress has been slow.”
Journal of the American Medical Association
“Annual death toll from medical
errors is closer to 200,000.”
Dead by MistakeHeart Newspapers Special Report
“180,000 Medicare patients die annually from medical errors.”
Office of the Inspector General
“No significant change in rate of
preventable errors.”New England Journal
of Medicine
“33% hospitalized patients are harmed; 7% result in permanent
injury or death.”Health Affairs 2013
“200,000‐400,000 deaths per year
due to preventable harm in hospitals.”
Journal of Patient Safety
6
7 in 10 American workers are “not engaged” or “actively disengaged” in their work.
Per Gallup, actively disengaged employees cost the U.S. $450‐$550 billion a year in lost productivity.
Employee Engagement – Gallup Findings
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20
15
15
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18
52
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55
59
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58
30
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26
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26
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
7
ACTIVELY DISENGAGED
NOT ENGAGED ENGAGED0% 100%
© 2014 The Karen Martin Group, Inc. 8
© 2014 The Karen Martin Group, Inc.
Ineffective behaviors
CHAOS
10
© 2014 The Karen Martin Group, Inc. 11
© 2014 The Karen Martin Group, Inc. 12
Ambiguity complicates, slows, frustrates… and is dangerous
1. Organization purpose & vision2. Customers & products3. Business goals & priorities4. Policies5. Roles & responsibilities6. Work systems & process performance7. Problem solving & decision making8. Terminology & communication
13
8 Ambiguity Wastes
Dept C Dept DDept BDept A
Core Value Streams
Support Value Streams
Support Value Streams
Silo‐Centric vs. Value Stream Thinking
Gaining Clarity: Current State Value Stream MapOutpatient Imaging
Percent Complete & Accurate (%C&A)
Customer
Process 1
Process 2
Process 3
Process 4
80% 50%95%
75%
90%
Rework = Correcting, Adding, ClarifyingRolled %C&A = 26%
Gaining Alignment: Future State Value Stream MapOutpatient Imaging
Who Owns the Value Stream?
18
19
How are we performing?
Visualize Work Queues & Status
20
© 2014 The Karen Martin Group, Inc. 21
There is no such thing as multitasking.*
* For cognitive tasks.
Task #1: Focus Reduces ChaosTask #2: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Round 1 – Alternate between tasks : letter, number, letter, number, etc.
Round 2 – Write the full sentence, followed by the numbers 1‐17.
Sentence:
Numbers:
Sentence:
Numbers:
The Cost of Switch Tasking
Focus Law #1:STOP DOING
Focus Law #2:DO FEWER THINGS
AT ONCE
26
The Power of Focus:Projects Completed in One Year
27
0
10
20
30
40
50
60
70
80
Pre‐Focus Post‐Focus
73
24
• No additional resources
• Higher quality output
• Lower stress
What is Your Improvement Strategy?
28
Strategy Deployment Key Feature: Catchball
29
Executive Team
What?Who?When?
Senior Mgmt
What?Who?When?
Middle Mgmt
What?Who?When?
FrontlinesWhat?Who?When?
30
Actively Working On In Queue
Started & Stopped New Ideas
31
Must Do, Can’t Fail Maybe
Delay Eliminate
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1. Increase sales 5%.3. Achieve 10% profit.
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec IT Mktg Ops HR Bob Fin PE Pario COM Direct
CDs / AMs
PD Rec
PD Mgmt
BMD SWS
23,500 units sold by 12/31/2013 through al l channels (approx. $700K)
X X X X X X X X X X X X Bob Dana 2 3 3 3 2 3 3 1 1 3 3 1 3
11 Develop & del iver tra ining to top 50 Dealers X X X X X X Bob Rex/Tim 3 3 3
21 Revised course materia ls by 6/30/2013 X X X Bob Josh R? 2 3 3 2 2
5Education: 1 school dis trict spec'd/underperforming COM dis tributor (25) by 12/31 valued at min $35K each
X X X X X X X X X X X X Howard Michael S 1 3 2 3 3
810 new dea lers on board (net) ($500K per dealer this year)
X X X X X X X X X X X X Howard Mike B 2 3
95 new dis tributors bringing $200K annual rev (& 5 terminated)
X X X X X X X X X X X X Howard Howard 1 1 1 2 3
17 10 projects spec'd by 12/31; $300K rev by 12/31 X X X X X X X X X X Howard Dana 1 3 3 3
29 20 by year‐end X X X X X X X X X X X X Howard Mark H 2 3 3 3
32 TBD X X X Howard Howard
33 TBD X X X X X X X X X Howard Howard
10Useful reporting and metrics are establ i shed and in place
X X Jim Randal l 3 1 1 1 1 1 1
30 TBD X X X X X Jim Josh 3
31 TBD X X X X X X Jim Josh 1 1 1 3 1 1 1 1 1 1 1 1 1 1
25 TBD Jim Shannon 3 3 1 1 1 1 1
26 System 7.0's in place X X X Jim Randal l 3 2 1 2 1
15100% accurate payrol l ; 100% management sati s faction at Apri l mgmt. meeting
X X X Josh Phyl l is 1 3
20Internet task l i s t i s s impl i fied and streaml ined for PDs then plan i s rol led out to PDs
X X X X Michael M Michael M 2 3 2 3
22Des ign Calculator i s updated success ful ly and rol led out
X X X Neal l Matt D 3 1 1 3 2 2 3
24 Competi tive Analys is complete and distributed for use X X X Neal l Dana 2 3 3 3 3 3 3
1 Des ign changed to solve delam i ssue long‐term X X X X X Susan David R 3 2 3
1230 parts sourced in U.S.; completed plan for managing China ‐sourced parts
X X X X X X Susan Shannon 3 3 2 2
13Warehouse la id out; kanban revised; Syspro implemented
X X X Susan Shannon 3
14 Lay out complete; equipment ins ta l led X X X Susan David R 3 3
X = Planned
2013 Priorities
2013 Goals & Objectives4. Improve morale (metric TBD).2. Achieve 50% gross margin. Created: 01‐14‐13
Revised: Level of Effort/Involvement Required
Priority Goal or Measurable Objective Exec Owner
Plan review dates:
Tactical Owner
● = Actual
< Company Name >
Conten
trem
oved
for con
fiden
tiality
Creating Organization‐Wide Focus:The Annual Work Plan
© 2014 The Karen Martin Group, Inc. 33
Train/Practice vs. Performance
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Athletes Businesses
34
Train90%
Train1%
Perform 99%
Perform 10%
Jim Loehr & Tony Schwartz, The Power of Full Engagement
© 2014 The Karen Martin Group, Inc. 35
Develophypothesis
Conduct experiment
Measure results
RefineStandardize Stabilize
36
What problem are you trying to solve?
Why is it a problem?
37
True Continuous Improvement
© 2014 The Karen Martin Group, Inc. 38
© 2014 The Karen Martin Group, Inc.
Engagement Drivers: The Three C’s
39
Connection
ControlCreativity
The Outstanding Organization, pp. 155‐158
To vision, annual goals, immediate supervisor,
peers, customers
Heavy involvement in decisions that influence
their work life
Full use of talents, capacities,
potentialities, & skills
© 2014 The Karen Martin Group, Inc.
Leaders determine strategy (what)
Workers determine tactics (how)
Cross‐Functional Problem Solving & Improvement:Connecting, Using Creativity, Gaining Control
42
Single Hits Add Up!
Doubles
Triples
Home Runs & Grand Slams
© 2014 The Karen Martin Group, Inc. 43
© 2014 The Karen Martin Group, Inc.
www.ksmartin.com
858.677.6799
Signing books immediately after talk in exhibit hall
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