visual management - leadership support for the front line
DESCRIPTION
Visual Management is a lean communication tool to help keep focus on priority initiatives in the workplace as well as keeping your thumb on the pulse of daily operations. I will take you through the evolution of one areas visibility management system and how this has now spread through all divisions of our Pathology and Laboratory Medicine Department to become standard work. You will take away ideas and inspiration to incorporate this communication system in your workplace. Success comes from ensuring the loop of communication goes full circle from leadership to front line and back to leadership for full understanding.TRANSCRIPT
Daily Visual Management System Leadership Support for the Front Line
Lenore Howey – Laboratory Manager
www.qualitysummit.ca
#QS14
BETTER TEAMS
SHR Laboratory Lean Journey Continues …
Implementing Daily Visual Management into Standard Work
2006 ... 2010 … 2014…
Define Value
Value Stream
Create Flow Establish Pull
Pursue Perfection
Lean Principles
Define Value Performance
Value Stream process understanding
Create Flow eliminate
bottlenecks
Establish Pull continual beat
Takt time
Pursue Perfection continual
improvement
Lean Principles
Visual Management System Lean Communicational Tool
Visual Priorities – Goals
Visual Indicators of Performance
All are tied to a System at different levels
STEVEN R COVEY the community – empowering your greatness
https://www.stephencovey.com/community/resources/companion_films.php?f=12&s=l
Visual Boards• The end result must work for the area (level)• Different is OK• It is not about the board, it is about results• Objective of this presentation is to give you ideas to try
(PDSA) for your daily visual management system.
No involvement = No commitmentFront line produces the Bottom Line
Value StreamProcess + People + Measurements
Value = Customer (Patient)Goal = Performance Target
Leadership Development Understand your Value Stream of service
Base = system understanding
ProcessIntegrated steps/procedures in a system
• Each step/procedure is separate and unique• Each step/procedure is connected
The whole is only as good as the sum of the parts
c
People• Education – skills, ability and knowledge• Right person doing the right job
Tools • Standard Operating Procedures• Competence reviews• Performance Capacity and Variation• Schedule assignments to workload
Measurement/Data/Performance
Data required for objectivity of understanding
Some is not a numberSoon is not a time
SPH HV LabPhysician
Order
Specimen Management
HematologyChemistry
Results
Patient
Acute Care Wards
Patient Collection
Centres
Physician
• High Volume Laboratory• Delivery of Test Results• 5 areas of work• Each area has internal processes• Each area is connected • Customer only feels the system results
PEOPLE
Who does What? When? How?= Standard Work
People = Scheduled to Workload - Level the Load
Data Entry Report Dist.
HematologyChemistry
Patient Collections
Acute Care Wards
10 Storm (7-9am) 4 Days 3 Evenings 1 Nights
3 (8-12)2 (12-230)
5 Days 3 Evenings 1 Nights
7 Days 3 Evenings 1 Nights
Patient Collections
SPH Test Centre
5 Days 3 Evenings
Specimen Management
2 x 12hr1 x 8hr (T,W,Th)
Measurement – TAT
April
May Aug Nov Dec Fe
bM
arJu
ne July
Aept
Oct
2014
70%
80%
90%
100%
SPH Emergency Phlebotomy- Collected to Rec'd in Lab Target: Stats<15mins Urgents<30mins
TA
T P
erc
en
t
Focused initiative to ensure timely
return of Emergency
samples
Thumb on the Pulse – Daily Measure
Timely review of outliers
• Equipment• Training • 5S + Safety• Celebrations• Process Improvement Monitoring• Rock in your Shoe – front line identified concerns/constraints
Additional Components of Visual Management System
Step out of Comfort - PDSA• How can we learn if we don’t try• Failures teach us• Not always about the success• Predict and test the theory• Reflection and refocus
• Cycles repeat
Base = System Thinking Learning
Know
Quality is a Systematic ProcessSystem of Profound Knowledge
Theory of Knowledge
Psychology of Change
Understand Variation
Application of a System
System Thinking
Know
Let’s put it all together
forVisual Management
1st PDSA of Daily Management – Fall 2012
3rd PDSA – Jan 2013
5th PDSA – June 2013
Daily Management April 2014
Process + People
System Monitoring
Daily Management System
Connection of all parts = System
Standard work to ensure Front Line is supported
“The Front Line produces the Bottom Line”
Daily Huddle Communication CascadeTime Mon Tues Wed Thurs Fri
0800 Daily Leadership – daily review system - people/process/measurement
0830 Daily Managers/Director – daily conference call SPH Site SHR *SLT Lab *LOC
1000 General staff Huddle – SPH Laboratory
1300 Hematology
1500 Chemistry Front Line daily huddles – area specific
1500 Spec. Mgmt
0800hrs = Front Line Leadership Huddle
30 min max
0830hrs = Manager/Director Conference CallDaily LMM Report Out
Lori Goldie Lenore Diane Betty Lorrie
RRS Histology Cytology Clerical Autopsy LIS SP Man DE Chemistry Hematology Chemistry Phlebotomy Bacteriology Virology Molecular TBProcess Workers, MOA Immuno TML HLA Cytogenetics RUH Hem HMG
Saturday
OT (hrs)
Sick Time/Family Leave (# of staff)
Shifts above Base
Shifts NOT replaced
Operational Issues
Staff Injuries-type
Sunday
OT (hrs)
Sick Time/Family Leave (# of staff)
Shifts above Base
Shifts NOT replaced
Operational Issues
Staff Injuries-type
Monday
OT (hrs)
Sick Time/Family Leave (# of staff)
Shifts above Base
Shifts NOT replaced Operational Issues
Staff Injuries-type
Tuesday
OT (hrs)
Sick Time/Family Leave (# of staff)
Shifts above Base
Shifts NOT replaced
Operational Issues
Staff Injuries-type
Wednesday
OT (hrs)
Sick Time/Family Leave (# of staff)
Shifts above Base
Shifts NOT replaced
Operational Issues
Staff Injuries-type
Thursday
OT (hrs)
Sick Time/Family Leave (# of staff)
Shifts above Base
Shifts NOT replaced
Operational Issues
Staff Injuries-type
Friday
OT (hrs)
Sick Time/Family Leave (# of staff)
Shifts above Base
Shifts NOT replaced
Operational Issues
Staff Injuries-type
30min max total
Standard Template for ReportLenore
SP Man DE Chemistry HematologyOT (hrs) Sick Time/Family Leave (# of staff)
Shifts above Base
Shifts NOT replaced
Operational Issues
Staff Injuries-type
All Laboratory staff SHR System connection communication SHR –Leaders Connected Sharing SPH – 0830 Monday site huddle Regional Laboratory – previous week LOC SPH Laboratory – staffing, lab specifics Celebrations – from staff, site, region
Notes sent via internal mail message
1000hrs = General Huddle - Monday30min max
Chemistry
1500hrs –Front Line Huddle
15min Target30min Max
Hematology1300hrs –Front Line Huddle
15min Target30min Max
Spec. Management15min Target30min Max
1500hrs – Front Line Huddle
Week 1 = Quality and SafetyWeek 2 = DeliverablesWeek 3 = CostWeek 4 = Strategic Projects
Clinical Department HeadDirectorManagersClinical Dyad Leaders
0830hrs *LOC = ThursdayLab Operations Committee
1 hour Max – 3 min takt \ report 5 Divisions 3 Urban + Rural
SHR Leadership Visibility BoardSenior Leadership (SLT) HuddleSaskatoon City HospitalOrganizational review of Goals/Progress
Week 1 – Quality and SafetyWeek 2 - DeliverableWeek 3 - CostWeek 4 – Strategic Plans/Reports
Tuesday
Huddles = Regroup/Refocus
Visual Boards Eye on the GOALCommunication
Each level connected Cascades
Feedback
Dr. Andrew Lyon (Clinical Biochemist - SPH Lab)- it is in a high traffic area and everyone coming in and out of the
department can check it at a glance.- ‘easy?'........some days when problems are repetitive, it is a bit harder- It makes me feel more 'connected' to the lab staff- Don't forget to put up celebrations & fun things
Feedback
RUH Phleb – Staff feel the board is theirs – they write down items they feel should be “huddled”
Manager – Thankful our huddle system was in place when Level 4 organism was suspected. Daily communication system was already standardized
Director – • feels better connected to what is going on even when I’m not at the
huddles• “Rich” conversations are vital to understand• Not about the look of the board, it’s the conversations, interaction• See progress “at a glance” when on Gemba walks
l
Pursuing Perfection
PredictableReliable
Defect freeNo Harm
We are all on the same roadImagine what we can do
Make it VISUAL - Communicate
Through focus we will reach our Goals Together
Visual Management System
