USING LEAN TO ENGAGE AND ALIGN THE ENTIRE ORGANIZATION. Didier Rabino, VP Lean Sensei Julie Garrison, HR System Director November 9, 2015

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1 USING LEAN TO ENGAGE AND ALIGN THE ENTIRE ORGANIZATION Didier Rabino, VP Lean Sensei Julie Garrison, HR System Director November 9, 2015

2 ABOUT THE PRESENTERS Julie GARRISON HR System Director : Aspen Medical Group 2006 Present: HealthEast Care System Didier RABINO VP, Lean Sensei : Andersen Windows Corp : Steelcase Inc. 2 Confidential. For internal use only. Not for distribution.

3 HEALTHEAST CARE SYSTEM Optimal health and well-being for our patients, our communities and ourselves 3 Confidential. For internal use only. Not for distribution.

4 ABOUT HEALTHEAST 1.1 Million Residents 63 Languages 7,400 employees; 1,300 providers; 900 volunteers 14 primary care clinics; 4 hospitals; community services Multiple specialty centers; comprehensive wellness program 4 Confidential. For internal use only. Not for distribution.

5 LEAN AT HEALTHEAST: THE JOURNEY First Lean flow projects and education First department with frontline tools First Value Based Improvement (VBI) system launched 20?? - Lean is our way of life 5 Confidential. For internal use only. Not for distribution.

6 LEAN AT HEALTHEAST: THE VBI CULTURE Better Management System Better Problem Solvers Better Processes Better Results Better Health Care Value: Better clinical quality Better patient experience Better staff engagement Improved cost effectiveness Less waste Less variation Less burden on employees and physicians Built-in quality Total employee and physician engagement PDCA and A3 Thinking expertise Making problems visible Learning organization Focused strategy deployment Layered and supportive standard work Visual management Accountability system 6 Confidential. For internal use only. Not for distribution.

7 LEAN SYSTEMS VBI house built with 14 sub-systems: First developed: Frontline Management System Continuous Improvement With Respect for People Gemba Walks A3 Thinking Strategy Deployment Next developed: Value Stream Management Kaizen/3P Leadership Why VBI? Standard Work 7 Confidential. For internal use only. Not for distribution.

8 LEAN ROADMAP FY12 FY13 FY14 * FY16 FY17 FY18 FY19 Experiment Deploy Assess Continuously Improve Frontline Management Gemba Walks Strategy Deployment A3 Thinking Frontline Management Gemba Walks Value Stream Mgt Standard Work Strategy Deployment A3 Thinking Frontline Management Gemba Walks Kaizen/3P Leadership Shingo Model Value Stream Mgt Standard Work Strategy Deployment A3 Thinking Frontline Management Gemba Walks Pull Systems Workplace Organization Kaizen/3P Leadership Shingo Model Value Stream Mgt Standard Work Gemba Walks Strategy Deployment A3 Thinking FY15: Focus on * Epic Deployment FY15: Focus on Frontline Management Error Detection Work Smoothing Pull Systems Workplace Organization Kaizen/3P Leadership Shingo Model Frontline Management Gemba Walks Strategy Deployment A3 Thinking Value Stream Mgt Standard Work Pb Solving Techniques Equipment Reliability Error Detection Work Smoothing Pull Systems Workplace Organization Frontline Management Gemba Walks Strategy Deployment A3 Thinking Value Stream Mgt Standard Work Kaizen/3P Leadership Shingo Model Organization Development = Support + 8 Confidential. For internal use only. Not for distribution.

9 TOOL BASED ARCHITECTURE 1 4 What tools to we need? 3 Improvement cards Huddle form Run-chart Audit form Etc. 2 9 Confidential. For internal use only. Not for distribution.

10 SYSTEMS DRIVE BEHAVIORS 10 Confidential. For internal use only. Not for distribution.

11 PRINCIPLE BASED ARCHITECTURE What behaviors to we need? Huddles are interactive meetings Leaders use cards to coach PDCA Ideas are connected to causes Standards are created from ideas Etc Confidential. For internal use only. Not for distribution.

12 TEAM STRUCTURE Engage, align and support the whole organization Tier teams Tier 2 26 teams Tier 3 7 teams Tier 4 1 team Frontline Entities Business Units Executive Leadership Team 12 Confidential. For internal use only. Not for distribution.

13 STRATEGY DEPLOYMENT SYSTEM This Instead of This Alignment Focus 13 Confidential. For internal use only. Not for distribution.

14 STRATEGY DEPLOYMENT ROOMS Entities, Business Units, Executive Leadership Team 14 Confidential. For internal use only. Not for distribution.

15 STRATEGY DEPLOYMENT REVIEWS WEEKLY SCHEDULE Frontline teams Gemba walks Clinical Quality Smart Growth & Financial Health PILLAR ROTATION 1 Pillar per week Patient Experience Engagement Entities BU s ELT 15 Confidential. For internal use only. Not for distribution.

16 STRATEGY DEPLOYMENT ROOMS 16 Confidential. For internal use only. Not for distribution.

17 STRATEGY DEPLOYMENT ROOMS 17 Confidential. For internal use only. Not for distribution.

18 DAILY IMPROVEMENT BY FRONTLINE 18 Confidential. For internal use only. Not for distribution.

19 DEVELOPING THOUSANDS OF PROBLEM SOLVERS 18,203 VBI Ideas in FY13 28,016 VBI Ideas in FY14 33,025 VBI Ideas in FY15 Learning PDCA 19 Confidential. For internal use only. Not for distribution. Process Analysis

20 PEOPLE DEVELOPMENT Frontline Team Frontline Leader 1-Up Leader 20 Confidential. For internal use only. Not for distribution. 2-Up Leader

21 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May- Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May- Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May- Jun-15 Jul-15 Aug-15 HOW ARE WE DOING? 4,000 Implementation of Improvement Ideas 78,772 ideas and counting... 3,000 2,000 1,000 FY13 FY14 FY Confidential. For internal use only. Not for distribution.

22 LEAN AT HEALTHEAST CULTURE Leadership Commitment - Involvement - Role Modeling - Doing Education - Create a desire and path to learn Culture Alignment - Engagement - Readiness - Considerations - Alignment 22 Confidential. For internal use only. Not for distribution.

23 LEAN AT HEALTHEAST LESSONS LEARNED Key Learning - Engage discussions early on and keep those discussions moving Key Stakeholders - Make connections to why - Make connections to the Employee Experience and Engagement - Strong communications platforms - Reinforce, Reinforce, Reinforce - Senior Leaders Role Model and lead the way - Leaders need humility - Go to the Gemba AND keep engagement with employees - Build Systems of support - Be courageous, have fun, stay the course! 23 Confidential. For internal use only. Not for distribution.

24 LEAN AT HEALTHEAST WHAT TO DO Go to Gemba, ask why, learn the process Make problems visible and accept they exist Develop people (everybody) and improve processes (all of them) simultaneously Stabilize, Standardize, Simplify Biggest of all: ongoing PDCA expertise Leverage Senior Leaders - Lead the way by Teaching - Lean Bronze Certification - Reward and Recognize 24 Confidential. For internal use only. Not for distribution.

25 LEAN JOURNEY CONTINUES 25 Confidential. For internal use only. Not for distribution. Why VBI?

26 USING LEAN TO ENGAGE AND ALIGN THE ENTIRE ORGANIZATION Continuous Improvement With Respect for People 26 Confidential. For internal use only. Not for distribution.

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