Seeking Perfection: Lean Operations in Non-Manufacturing Environments
What You Will Learn The definition and history of Lean Thinking The three phases of Lean implementation Lessons from a case study: Lean in the Health Care industry How to identify and reduce Waste How to Value Stream Map any process To understand change and how to manage people through it
This Is Not the Lean We Are Talking About
What Does the Boss think Lean Is? Is it cutting corners? Is it fewer people? Is it working harder? Is it making less?
Definition of Lean Thinking or Lean Management Doing more with less Providing customers with exactly what they want: Every time With no waste
Key Lean  Concepts Value streams Waste elimination Flow Pull Continuous improvement
Why Apply Lean? Impact of Lean Operations on Industry  11/02/09 Fertuck Enterprise Directions - 248.881.3244 - doug@fertuck.com - www.fertuck.com *Source: Virginia Mason Medical Center Validated Historical Industry Averages* % Changes Direct Labor Productivity Improved 45-75 Cost Reduced 25-55 Throughput Increased 60-90 Defects and Scrap Reduced 50-90 Inventory Reduced 60-90 Space Reduced 35-50 Lead-Time Reduced 50-90
History of Lean
Before Lean
After Lean In Modern Auto Assembly Plants
Lean Thinking Applies to Any Company in Any Business Womack and Jones of  The Machine That Changed the World  have spread the gospel to other sectors Health Care industry especially is adopting lean thinking Many of us are now applying lean methods to the office and other non-manufacturing environments Why is it spreading? It works! 11/02/09 Fertuck Enterprise Directions - 248.881.3244 - doug@fertuck.com - www.fertuck.com
Scope of Lean Operations Can Vary
Learning how to  stabilize ,  standardize , and  simplify   business  processes  using the power of  the Toyota Production System The Lean System
Stabilize Stabilize tools are : Understanding  Waste Leading Change Teaming 5S and Visual Controls Cycle Time Takt Time Data Collection Value Stream Mapping Brainstorming and Problem-solving Metrics
Standardize Standardize tools are : Just-In-Time Continuous Flow Pull Systems and Kanbans Standard Work Pitch Space Layout Work Load Balancing File System
Simplify Kaizen  – the process of improving “ Continuous improvement” Can be a single task or team project People are the foundation
Virginia Mason Medical Center: Seeking Perfection in Healthcare Founded in 1920 in Seattle Now consists of 336 bed hospital, group practice of 480 physicians, network of regional clinics In 2002, Virginia Mason embarked on an ambitious, system-wide program to improve the way it delivers safe health care.  It adopted the Toyota Production System (TPS), calling it the Virginia Mason Production system (VMPS).
Virginia Mason’s “Strategic Issues” Quality Safety Morale Cost  Profit
Design the Production System to Optimize the Seven Flows of Medicine
VMPS Action Tools Patient Safety Alert System Value Stream Development RPIW (Rapid Process Improvement Workshop) 5-S (Sort, simplify, standardize, sweep, self-discipline) Daily work life –Everyday Lean Idea System (ELI)
Example: Nursing Cells “ Less nursing time provided to patients is associated with higher rates of infection, GI bleeding, pneumonia, cardiac arrest and death.” Keeping Patients Safe: Transforming the Work Environment of Nurses  - Institute of Medicine 2004
Nurses’ Workshop Ideas
Nursing Cells Organize work of RN and patient care technician (PCT) in a geographic grouping of rooms (cell) Supplies at point of use One piece flow of documentation In room handoff with patients Standardize work for staff from 7AM –11 AM (First cycle of day) Increase nursing surveillance of our patients—make care safer
Nursing Cells: 90 day Results Metric Before After RN # of steps  5,818 846 PCT # of steps 2,664 1,256 Completion time for AM work cycle 240’ 126’ Patient dissatisfaction 21% 0% RN time spent in indirect care 68% 10% PCT time spent in indirect care 30% 16% Call light on between 7a-11a 5.5% 1%
Selected Results of VMPS Saved $11 million in planned capital investment  and freed an estimated 25,000 square feet of floor space Reduced the time it takes to report lab test results to the  patient by more than 85 percent. Reduced inventory costs by more than $1 million Reduced staff walking distance by 60 miles per day Reduced labor expense in overtime and temporary labor  by $500,000 in just one year VM was named a  2007 Leapfrog Top Hospital  , one of 41 hospitals in the nation and the only hospital in Washington state to receive this designation.
Stabilize Stabilize tools are : Understanding  Waste Leading Change Teaming 5S and Visual Controls Cycle Time Takt Time Data Collection Value Stream Mapping Brainstorming and Problem-solving Metrics
Stabilize – Understanding Waste Waste:  Anything that Adds Cost or Time without Adding Value
What is Value? Value is what,  in its entirety , the product and service does to fulfill the expectations of the  customer Elements of value: Performance Price Appearance Reliability Delivery Features Etc., etc.
Understanding Waste: Overproduction Overproduction  – producing work prior to it being required is waste and is the greatest of all the wastes Producing reports no one reads or needs Making extra copies E-mailing, faxing same document Entering repetitive information on multiple documents
Understanding Waste: Waiting Waiting  – for people, signatures, supplies, repairs, and information is waste.  This is “low hanging fruit” which is easy to reach and ripe for the taking.  Unnecessary signatures or approvals Waiting for others to complete tasks (bottlenecks) Slow computer operations Cross-departmental resource mismatches
Understanding Waste: Motion Motion  - any movement of people, paper, electronic exchanges that does not add value is waste Searching for computer files Searching for documents in file cabinets Repeatedly reviewing manuals for information Hand carrying paper to another process Walking to and searching for supplies or equipment
Understanding Waste: Transport Transport  - the time to deliver any work within an operation Locating commonly used equipment at a distance Distributing unnecessary copies Sending unnecessary attachments Hand-carrying paper to another process
Understanding Waste: Over-Processing Over-processing  - putting more effort than necessary into the work required by internal or external customers is waste  Duplicate reports or information Repetitive data entry Constantly revising documents Revisiting agenda items Specifying incomplete or unclear requirements
Understanding Waste: Inventory Inventory  - work piles, excessive supplies, and excessive signature requirements are waste  Files awaiting signatures or approvals Work awaiting task completion by others Inadequate training of back-ups Excessive office supplies Storing obsolete documents or files
Understanding Waste: Defects Defects  (or mistakes) - all processing required creating a defect or mistake and the additional work required to correct them  Data entry errors Pricing errors Shipping errors Forwarding incomplete documentation Lost files  Incomplete or incorrect customer service
The Eighth Waste: Underutilization of people Underutilization of People  – the result of not placing people where they can (and will) use their knowledge, skills, and abilities to the fullest Unbalanced work loads High absenteeism and turnover Diminished work capacity Stunted skills development
Stabilize – 5S
Example of Applying 5S: The Computer Desktop   Action Example Issues Sort Cluttered desktop; files everywhere Set in Order Inconsistent folder structure Shine or Scrub Old and obsolete files retained Standardize Each worker has his or her own folder scheme Sustain No audit system
Stabilize – Value Stream Mapping Value Stream Mapping  – the visual representation of the processes (work units and information) required to meet customer demand The core starting point for applying lean thinking Includes both value-added and non value-added activities Allows for “seeing” areas of waste in current state Current state becomes the basis for improved future state
Value Stream Mapping: Example of Current State
Elements of Value Stream Mapping Walk the product’s production path from beginning to end Identify every sub-process in the material and information flows Measure time of each operation within a sub-process Record all waiting times Draw a visual representation of how the material and information flows connect
Value Stream Mapping: Example of Current State
Creating the Future State of  the Value Stream Map Conduct a waste audit Brainstorm ideas Look for easy flow issues Review “common sense” remedies Use the basic Lean tools and update the map as you learn more Keep going
Value Stream Mapping: Example of Future State
Implementing Lean is a Big  Change Leadership must set the course and commit Involve all key people Provide the necessary training and resources Anticipate resistance and manage it Communicate, communicate, and deliver
If the “Horse Doesn’t Drink”, You Have Nothing
Three Elements of Success Water Lead the Horse Drink Situation Technique Behavior Opportunity Process Commitment Nikes Athletic Skills Just Do it! Tools Method Action
Thank You!

Webinar On Lean In Non Manufacturing Environments

  • 1.
    Seeking Perfection: LeanOperations in Non-Manufacturing Environments
  • 2.
    What You WillLearn The definition and history of Lean Thinking The three phases of Lean implementation Lessons from a case study: Lean in the Health Care industry How to identify and reduce Waste How to Value Stream Map any process To understand change and how to manage people through it
  • 3.
    This Is Notthe Lean We Are Talking About
  • 4.
    What Does theBoss think Lean Is? Is it cutting corners? Is it fewer people? Is it working harder? Is it making less?
  • 5.
    Definition of LeanThinking or Lean Management Doing more with less Providing customers with exactly what they want: Every time With no waste
  • 6.
    Key Lean Concepts Value streams Waste elimination Flow Pull Continuous improvement
  • 7.
    Why Apply Lean?Impact of Lean Operations on Industry 11/02/09 Fertuck Enterprise Directions - 248.881.3244 - [email protected] - www.fertuck.com *Source: Virginia Mason Medical Center Validated Historical Industry Averages* % Changes Direct Labor Productivity Improved 45-75 Cost Reduced 25-55 Throughput Increased 60-90 Defects and Scrap Reduced 50-90 Inventory Reduced 60-90 Space Reduced 35-50 Lead-Time Reduced 50-90
  • 8.
  • 9.
  • 10.
    After Lean InModern Auto Assembly Plants
  • 11.
    Lean Thinking Appliesto Any Company in Any Business Womack and Jones of The Machine That Changed the World have spread the gospel to other sectors Health Care industry especially is adopting lean thinking Many of us are now applying lean methods to the office and other non-manufacturing environments Why is it spreading? It works! 11/02/09 Fertuck Enterprise Directions - 248.881.3244 - [email protected] - www.fertuck.com
  • 12.
    Scope of LeanOperations Can Vary
  • 13.
    Learning how to stabilize , standardize , and simplify business processes using the power of the Toyota Production System The Lean System
  • 14.
    Stabilize Stabilize toolsare : Understanding Waste Leading Change Teaming 5S and Visual Controls Cycle Time Takt Time Data Collection Value Stream Mapping Brainstorming and Problem-solving Metrics
  • 15.
    Standardize Standardize toolsare : Just-In-Time Continuous Flow Pull Systems and Kanbans Standard Work Pitch Space Layout Work Load Balancing File System
  • 16.
    Simplify Kaizen – the process of improving “ Continuous improvement” Can be a single task or team project People are the foundation
  • 17.
    Virginia Mason MedicalCenter: Seeking Perfection in Healthcare Founded in 1920 in Seattle Now consists of 336 bed hospital, group practice of 480 physicians, network of regional clinics In 2002, Virginia Mason embarked on an ambitious, system-wide program to improve the way it delivers safe health care. It adopted the Toyota Production System (TPS), calling it the Virginia Mason Production system (VMPS).
  • 18.
    Virginia Mason’s “StrategicIssues” Quality Safety Morale Cost Profit
  • 19.
    Design the ProductionSystem to Optimize the Seven Flows of Medicine
  • 20.
    VMPS Action ToolsPatient Safety Alert System Value Stream Development RPIW (Rapid Process Improvement Workshop) 5-S (Sort, simplify, standardize, sweep, self-discipline) Daily work life –Everyday Lean Idea System (ELI)
  • 21.
    Example: Nursing Cells“ Less nursing time provided to patients is associated with higher rates of infection, GI bleeding, pneumonia, cardiac arrest and death.” Keeping Patients Safe: Transforming the Work Environment of Nurses - Institute of Medicine 2004
  • 22.
  • 23.
    Nursing Cells Organizework of RN and patient care technician (PCT) in a geographic grouping of rooms (cell) Supplies at point of use One piece flow of documentation In room handoff with patients Standardize work for staff from 7AM –11 AM (First cycle of day) Increase nursing surveillance of our patients—make care safer
  • 24.
    Nursing Cells: 90day Results Metric Before After RN # of steps 5,818 846 PCT # of steps 2,664 1,256 Completion time for AM work cycle 240’ 126’ Patient dissatisfaction 21% 0% RN time spent in indirect care 68% 10% PCT time spent in indirect care 30% 16% Call light on between 7a-11a 5.5% 1%
  • 25.
    Selected Results ofVMPS Saved $11 million in planned capital investment and freed an estimated 25,000 square feet of floor space Reduced the time it takes to report lab test results to the patient by more than 85 percent. Reduced inventory costs by more than $1 million Reduced staff walking distance by 60 miles per day Reduced labor expense in overtime and temporary labor by $500,000 in just one year VM was named a 2007 Leapfrog Top Hospital , one of 41 hospitals in the nation and the only hospital in Washington state to receive this designation.
  • 26.
    Stabilize Stabilize toolsare : Understanding Waste Leading Change Teaming 5S and Visual Controls Cycle Time Takt Time Data Collection Value Stream Mapping Brainstorming and Problem-solving Metrics
  • 27.
    Stabilize – UnderstandingWaste Waste: Anything that Adds Cost or Time without Adding Value
  • 28.
    What is Value?Value is what, in its entirety , the product and service does to fulfill the expectations of the customer Elements of value: Performance Price Appearance Reliability Delivery Features Etc., etc.
  • 29.
    Understanding Waste: OverproductionOverproduction – producing work prior to it being required is waste and is the greatest of all the wastes Producing reports no one reads or needs Making extra copies E-mailing, faxing same document Entering repetitive information on multiple documents
  • 30.
    Understanding Waste: WaitingWaiting – for people, signatures, supplies, repairs, and information is waste. This is “low hanging fruit” which is easy to reach and ripe for the taking. Unnecessary signatures or approvals Waiting for others to complete tasks (bottlenecks) Slow computer operations Cross-departmental resource mismatches
  • 31.
    Understanding Waste: MotionMotion - any movement of people, paper, electronic exchanges that does not add value is waste Searching for computer files Searching for documents in file cabinets Repeatedly reviewing manuals for information Hand carrying paper to another process Walking to and searching for supplies or equipment
  • 32.
    Understanding Waste: TransportTransport - the time to deliver any work within an operation Locating commonly used equipment at a distance Distributing unnecessary copies Sending unnecessary attachments Hand-carrying paper to another process
  • 33.
    Understanding Waste: Over-ProcessingOver-processing - putting more effort than necessary into the work required by internal or external customers is waste Duplicate reports or information Repetitive data entry Constantly revising documents Revisiting agenda items Specifying incomplete or unclear requirements
  • 34.
    Understanding Waste: InventoryInventory - work piles, excessive supplies, and excessive signature requirements are waste Files awaiting signatures or approvals Work awaiting task completion by others Inadequate training of back-ups Excessive office supplies Storing obsolete documents or files
  • 35.
    Understanding Waste: DefectsDefects (or mistakes) - all processing required creating a defect or mistake and the additional work required to correct them Data entry errors Pricing errors Shipping errors Forwarding incomplete documentation Lost files Incomplete or incorrect customer service
  • 36.
    The Eighth Waste:Underutilization of people Underutilization of People – the result of not placing people where they can (and will) use their knowledge, skills, and abilities to the fullest Unbalanced work loads High absenteeism and turnover Diminished work capacity Stunted skills development
  • 37.
  • 38.
    Example of Applying5S: The Computer Desktop Action Example Issues Sort Cluttered desktop; files everywhere Set in Order Inconsistent folder structure Shine or Scrub Old and obsolete files retained Standardize Each worker has his or her own folder scheme Sustain No audit system
  • 39.
    Stabilize – ValueStream Mapping Value Stream Mapping – the visual representation of the processes (work units and information) required to meet customer demand The core starting point for applying lean thinking Includes both value-added and non value-added activities Allows for “seeing” areas of waste in current state Current state becomes the basis for improved future state
  • 40.
    Value Stream Mapping:Example of Current State
  • 41.
    Elements of ValueStream Mapping Walk the product’s production path from beginning to end Identify every sub-process in the material and information flows Measure time of each operation within a sub-process Record all waiting times Draw a visual representation of how the material and information flows connect
  • 42.
    Value Stream Mapping:Example of Current State
  • 43.
    Creating the FutureState of the Value Stream Map Conduct a waste audit Brainstorm ideas Look for easy flow issues Review “common sense” remedies Use the basic Lean tools and update the map as you learn more Keep going
  • 44.
    Value Stream Mapping:Example of Future State
  • 45.
    Implementing Lean isa Big Change Leadership must set the course and commit Involve all key people Provide the necessary training and resources Anticipate resistance and manage it Communicate, communicate, and deliver
  • 46.
    If the “HorseDoesn’t Drink”, You Have Nothing
  • 47.
    Three Elements ofSuccess Water Lead the Horse Drink Situation Technique Behavior Opportunity Process Commitment Nikes Athletic Skills Just Do it! Tools Method Action
  • 48.