Strategy Deployment (aka Hoshin Kanri)

1. Strategy Development

2. Organizational Alignment

3. ExecutionHoshin

DirectionKanri

Management/control

Strategy Deployment (Hoshin Kanri)

"A strategic planning practice that

defines a direction and priorities,

aligns the organization around that

direction through dialog and detailed

plans, then implements the plans and

measures performance against those

plans in a disciplined way. "

Source: Lisa Boisvert, The Basics of Hoshin Kanri

• Deploys the long-term strategic plan throughout the organization.

• Aligns leadership and organization around a defined set of objectives.

• Creates a linkage between the organizational strategy, initiatives, and key metrics.

• Creates accountability

Source: Art Byrne, Lean Turnaround

Yearly Organizational Learning Cycles

Year 1 Year 2 Year 3 Year 4

It's the organizational version of the PDCA cycle.

• PLAN: Strategy

development/deployment

• Do: Execution of plans

• Check: Impact of the plans on goals

• Act: Based on data decide to

continue with the plans or take

corrective action to alter or develop

new plans.

Organizational Alignment

WHATImprove ED to IP Flow

HOWED to IP RN

Handoff

Level 1Executive Team

Level 2 Directors/Managers

Level 3 Direct Care Providers

WHATED to IP RN

Handoff

HOWImplement E-RN Handoff

WHATImplement E-RN Handoff

HOWUse E-RN Handoff

Cascading Priorities By Levels

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RNsMDs Techs Others

RN: LisaMD: Hugh Admin: Beth

DailyDoing FCOTS Process Improvements• RN Prepping Pt• MD Arriving on time

RNMD Admin: David

Leve

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Monthly, YTDImpact on FOCT performance

Status of RM Utilization

A bidirectional framework to link procedural department’s performance metrics with local departmental improvements.

Daily, Weekly, MonthlyMonitoring improvements

Impact on FCOTS performance

MonthlyStatus of FCOTS improvementsImpact on FCOTS performance

Impact on RM Utilization performance

AAM Metric• RM Utilization

Contribute to RM Utilization• FCOTS

AAM Metric• RM Utilization

Contribute to RM Utilization• FCOTS

FCOTS Process Metrics• Pt Prep on time• MD Arrival time

AAM Metric• RM Utilization

Contribute to RM Utilization• FCOTS

FCOTS Process Metrics• Pt Prep on time• MD Arrival time

FCOTS Process Improvement• Pt Prep• MD Arrival time

AAM Metrics• RM Utilization

Standard Work: Endoscopy Patient Prep

Endoscopy MD Arrivalon time arrival for first case (%)

56%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Purpose: Daily Management System1. Sustain improvements2. Problem solve3. Continue improving

Achieved by evaluating if…1. Process used as designed2. Intended outcome was achieved3. Learning

•What caused process to not work?•Celebrate what was achieved

BlameShame

Daily Management System

Endo whiteboard

Recorded dailyfor each room