Tài liệu Healthcare kaizen

The  Sugges)on  Box  is  Dead…   But  Staff  Improvement  Ideas   Live  On     Mark  Graban   President,  Constancy,  Inc.   Chief  Improvement  Officer,  KaiNexus   Faculty,  Lean  Enterprise  Ins)tute     August  23,  2012   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Dysfunc)ons  of  Sugges)on  Systems   •  •  •  •  •  •  •  •  Slow  /  No  Response   Yes  /  No  Answers   Not  CollaboraDve   Not  Transparent   Buy  Instead  of  Do?   Complaints  Against  Others   IncenDves  à  FighDng   Quotas  à  Gaming   Builds  on  the  book  Ideas  are  Free!  by  Robinson  &  Schroeder   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Kaizen  =  Change  for  the  BeTer     •  ‘Kai’  means  “change.”   •  ‘zen’  means  “good.”     ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Kaizen is Not Just Events   Very few Large issues Few Medium issues System Kaizen Six Sigma Project Lean Event Many Small issues Daily Kaizen Adapted from: “The Toyota” Way Fieldbook, Liker and Meier ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.            “What  Sets  Us  Apart?”   “Every  Toyota  team  member  is   empowered  with  the  ability  to   improve  their  work  environment.   This  includes  everything  from  quality   and  safety  to  the  environment  and   produc)vity.    Improvements  and   sugges)ons  by  team  members  are   the  cornerstone  of  Toyota's  success.”   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Kaizen  is  for  Everyone!   “…  emphasizes  morale-­‐ boos)ng  benefits  and   posi)ve  employee   par)cipa)on  over  the   economic  and  financial   incen)ves…”     -­‐  Masaaki  Imai   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Dr.  Berwick’s     Call  for  Kaizen  (1989)     •  Kaizen  =  “the  conDnuous  search  for   opportuniDes  for  all  processes  to  get  beYer”       Dr.  Donald  Berwick   •  –  Founder,  InsDtute  for  Healthcare  Improvement   –  Former  Administrator,  Medicare  and  Medicaid  (CMS)   CitaDon:  Berwick,  DM,  “ConDnuous  improvement  as  an  ideal  in  health  care,”  New  England   Journal  of  Medicine,  1989  May  25;320(21):1424-­‐5.     ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Barriers  to  Kaizen?   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Source:  Healthcare  Kaizen     Fear  of  Layoffs   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Found  posted  in  a  hospital  lab  (during  ini9al  Lean  assessment)   Source  unknown   “No  Layoffs  Due  to  Lean”   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     We  Don’t  Have  Time?   “Mikki  Gremp,  RN,  lef  one   hospital  because  a  number   of  policies,  including  its   pracDce  of  'flexing  down,'   lef  her  feeling  that  nurses   weren't  valued.”   AJN Report: The Other Side of Mandatory Overtime Roxanne Nelson BSN, RN Maureen Shawn Kennedy MA, RN, editorial director AJN, American Journal of Nursing April 2008, Volume 108 Number 4, Pages 23 - 24 ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     People  Hate  Change?   “People  don’t   resist  change,   they  resist  being   changed.”     –  Peter  Scholtes   (1938-­‐2009)   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Why  Not  Best  Prac)ces?   “People   support  what   they  create.”    -­‐  Margaret  J.  Wheatley   See  YouTube:  hYp://bit.ly/Support-­‐Create   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Joint  Commission  Now  Says…   “it  may  be  Dme  for  hospitals   to  move  away  from  best   prac)ces  and  develop   comprehensive  process   improvement  tools  —  which   can  include  Lean,  Six  Sigma   or  other  emerging   methodologies  —  that  allow   for  deeper,  more  specific   analyses  of  their  pa)ent   safety  needs.”    -­‐  Mark  Chassin,  MD,  President     ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     A  Proposed  Formula   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Completed  Kaizen  Example   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     “Quick  and  Easy”  Kaizen   1.  Find   2.  Discuss   3.  Implement   4.  Document   5.  Share   Find   Discuss   Implement   Document   Share   ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.     Why  Kaizen?   Norman Bodek 1.  Make your work easier 2.  Make your work more interesting 3.  Develop your skills & capabilities ©  2012  Mark  Graban  and/or  Joseph  E.  Swartz.  All  Rights  Reserved.