Process Improvement: How To Sell It

Why are leaders hesitant to focus on this?

As a leader, you are no stranger to making decisions. You have built your team and you have been the architect of the culture in your department. With this in mind, you should have no problem making the decision to try and hard wire a mindset of process improvement into your team. If successful, you and your team would have achieved better results that you’re currently seeing. What leader wouldn’t charge head long into this effort? I would challenge that the answer to that question is any leader who wants this changes to be sustainable and most effective. If that is you, then you must sell your team. Their buy in will be the key to lasting success.

What is the case for doing it anyway?

Process improvement is more than a series of tools or techniques that help you achieve better results. It’s a culture itself. It is a mindset. In order to achieve success, you have to find a way for the concepts of process improvement to be woven into the fabric of your team. The best way to do that is to sell your team and gain a consensus on the value that this will bring. A fully committed team will find success in places and in ways that a fragmented or disengaged team will never realize.

How can you do it?

  1. Identify key leaders. Find your allies on the team who will see the value you see.
  2. Welcome questions. Be open to feedback and constructive criticism from your team. They have to know that their opinions are welcome and will be heard.
  3. Seek the best idea. The best idea must win. If a team is going to work together, they must all believe that the objectives are worth striving for.

Thanks for journeying with me through this discussion about process improvement. I hope that you and your teams are able to take some of this information and help drive your culture to seek a better way.

Process Improvement: Lean Isn’t For Me

Why are leaders hesitant to focus on this?

If you have been following along with this blog series, you have probably thought that some (or a lot) of what I have been talking about sounds an awful lot like a manufacturing concept called LEAN. That’ because, process improvement is the singular objective of the lean concept. Many people have heard about lean. It isn’t all that new, but it is less common in industries outside of manufacturing. Someone might be tempted to think that lean won’t work for them because they work in healthcare. Or, even if one sees the value of its application to healthcare, they might be intimidated by the idea of lean. Perhaps they have heard people refer to it and use language that seems odd (Lean has its roots in Japanese culture) or its statistical applications seem over the head of many folks with a clinical background.

What is the case for doing it anyway?

I hope to convince you that by following the steps laid out in this recent series on Process Improvement that you can apply lean principles to your work place within the healthcare setting and achieve excellent results. I intentionally waited until the end of my series to make this case because I didn’t want you to be discouraged by any preconceived notions about lean. Instead, I hope that you have been able to see that there are many simple concepts that you can use to fill your leadership tool box that might help you and your team work to improve processes in your areas. Here at SOMC, a group of key leaders has worked hard to integrate these and many other principles into our areas of influence. We believed that a grass roots initiative of implementation was the best method to achieve cultural buy-in to these concepts. We also intentionally stay away from the work lean as well as the common language used by many organizations to describe lean and its associated processes. Instead, we use the phrase “A Better Way” as a cultural mantra to inspire leaders and teams to pursue excellence in their areas.

How can you do it?

  1. Understand your culture. A key to successfully establishing these principles is understanding how best to present them within your workplace. At SOMC, we felt simple and common language were keys to success for our efforts.
  2. Identify champions. Find a team of people who will embody the methodologies of process improvement. Insist that they lead within their areas by walking the talk of process improvement.
  3. Start small. Pick easy projects and get some wins under your belt before tackling broader organizational opportunities.

Next week I will talk about how to sell these ideas to your team directly. 

Process Improvement: Types of Waste

Why are leaders hesitant to focus on this?

When you boil it down, process improvement is about identifying waste and removing it from your processes. We dont always think of it this way, but once we do, we are able to see the opportunities right in front of us. Sometimes, we get so focused on a specific type of opportunity that we dont look for wastes that are right in front of us. This type of thinking can lead us into a process improvement rut. Once we are in the rut, we might even become very successful at identifying certain types of opportunities, but we can become blind to others that are right in front of us.

What is the case for doing it anyway?

In order to combat against this opportunity identifying rut, we can use an acronym to help us try and identify all the different types of waste that are robbing our processes of their productivity. All you have to do to remember the types of waste are to remember a name, Tim Woods.

T – Transport – The movement of people, products, and information.
I – Inventory – The storage of parts, pieces, and documentation in excess of what is required.
M – Motion – Any unnecessary physical activity.

W – Waiting – Time spent without one or more key components needed to complete a task.
O – Over production – The process of making more than is immediately required.
O – Over processing – The process of doing more than is required to complete the task.
D – Defects – Anything that results in a having to do rework or does not contribute to an acceptable outcome.
S – Skills – The act of under utilizing capabilities and/or delegating tasks to someone with inadequate training.

How can you do it?

  1. Get to know Tim Woods. Familiarize yourself with the different types of waste.
  2. Educate your teams. Introduce the people you work with to Tim Woods.
  3. Empower people. Give your staff permission to identify wastes in their areas.
  4. Involve them in the solution. Guided team participation in removing wastes will result in the best outcomes.

Have you ever used the Tim Woods method of identifying waste?

Process Improvement: PDSA Cycle (Act)

Why are leaders hesitant to focus on this?

Taking action is what we are called to do as leaders. The final step in the PDSA cycle is action. It is easy to want to jump directly to this step, but the purpose of the PDSA cycle is to facilitate an evaluation and decision making process that produces the best action. As leaders, we can be hesitant to let this process run it’s course. We must be intentional about following the steps to make sure that we make the best decision.

What is the case for doing it anyway?

Some times we will do a PDSA and the outcome will be exactly what we had anticipated. We will have a seamless transition to our new process and everything will be better because of it. However, the PDSA is even more valuable in scenarios where the initial outcome of our study was something other than what we anticipated. In these cases, we must take the proper action of starting the PDSA process over. Doing so will help us drill down into what caused the unexpected outcome and will get us back on the path to improvement.

How can you do it?

  1. Understand what your analysis is telling you. Having conducted the first three steps of your PDSA, you should be able to identify if your plan was successful.
  2. Choose between proceeding or rebooting. In most PDSAs, you’re left with two options for action. Continue with the new process or restart the PDSA to continue to seek a better outcome.
  3. Act. Once you know what you want to do, go for it.

Have you ever used a PDSA cycle?

Process Improvement: PDSA Cycle (Study)

Why are leaders hesitant to focus on this?

We are committed to producing results. We observe. We interpret. We take action. That is what we do as a leader. In some cases, we identify our opportunity, we solicit input from key stakeholders, we develop a plan, and we implement the plan. The temptation might be to think that our work is complete with respect to this specific opportunity. However, when using the PDSA cycle, we have two more steps to consider. The third step is the study step. Study is a hardwired check and balance for our interventions. It forces us to study or observe our change to make sure that it is in fact achieving our desired outcome. Some leaders may have already moved onto the next project before completing this phase.

What is the case for doing it anyway?

The study phase is vital to the success of intervention. It requires us to determine how to measure the success of our plan. If we fail to complete this phase, we will be placing all of our trust in the assumptions we made in developing our plan. This is why taking the time to analyze our outcomes is so important. It allows us to assess the success of our intervention and make an informed decision about whether or not to roll it out to all areas or pull it back and tweak the process again.

How can you do it?

  1. Know your plan. Be sure that you understand what you are trying to address and how your plan will help you achieve success.
  2. Know what you’re going to measure. What does success look like? How can you measure it? Be sure that you have measurable indicators related to your plan so that you can clearly analyze it.
  3. Collect data. Collect the data from your test.
  4. Analyze your data. How does the data stack up to what you expected? Is it evidence of a successful test? Did something happen that you didn’t expect? The answers to these questions will lead you into the final step of the PDSA cycle.

Have you ever used a PDSA cycle?

Process Improvement: PDSA Cycle (Do)

Why are leaders hesitant to focus on this?

Do we have the right plan? What if it could be better? Are you second guessing yourself? We are all prone to this second guessing. Perhaps it’s a fear of failure. Perhaps it’s the perfectionist inside of each of us. As leaders, this paralysis by analysis can cripple us and ultimately submarine our efforts to produce excellent results.

What is the case for doing it anyway?

If time wasn’t working against us, we might have a case against doing something until we have the perfect plan. As we know thought, time is a resource that we can’t make more of and for this reason, doing is our priority as a leader. Once you and your team have developed your plan, proceeding with the plan is the only way you will be able to further evaluate your performance.

How can you do it? 

  1. Choose your plan. Work with your team to determine the best plan to evaluate your process.
  2. Identify who is responsible. Be sure that your plan has a responsible party. Someone who can enact it and be accountable for how things unfold.
  3. Take action. Leadership is defined by the actions we choose in light of our responsibilities. In this case, enact your plan.

Have you ever used a PDSA cycle?

Process Improvement: PDSA Cycle (Plan)

Why are leaders hesitant to focus on this?

Once you have identified an opportunity for improvement using one of the tools we have discussed, you are ready to move onto the next phase. This phase is called the PDSA cycle. PDSA stands for Plan, Do, Study, Act. We are going to talk about the first step: Plan.

We may identify an opportunity so glaring or so obvious that we want to jump right into implementing the change. PDSA allows us to test the change on a small scale.

What is the case for doing it anyway?

Though we may want to dive right into a full scale correction, the test will help us ensure that our proposal is adequate for helping improve the process. The plan phase is the first step in the correction. Here you will craft a strategy for how to improve your process and develop a test for your intervention. This test will serve as a baseline for a broader deployment of your change. Because the scope will be small, it will allow you to identify issues with the plan without having too broad of an impact on your overall processes.

How can you do it? 

  1. Choose a process improvement tool. Using whichever process improvement tool best fits your opportunity, analyze your process.
  2. Identify your opportunity. Where are your gaps? What does your tool tell you needs improved? This will be the focus of your plan.
  3. Consult the experts. Don’t develop your plan in a silo. Invite experts into your process and people who can provide constructive feedback.
  4. Develop a plan. Using all of this information, finalize your plan to test your change. Consider what portion of your process you want to test and how your test can be measured.

Have you ever used a PDSA cycle?  We learn best from each other’s experiences.

Process Improvement: Benchmarking

Why are leaders hesitant to focus on this?

Why do we need to know how other people are doing it? We just need to worry about what we can control. These are some common refrains of isolationist thinking. While not too common, some leaders think it is best to focus all of their energy on what they can control and not to worry about what others are doing.

What is the case for doing it anyway?

When athletes compete, they compete against one another. It may be head to head or against a posted time or distance. Competing in business isn’t any different. We have to be able to measure ourselves against the best in our respective fields in order to move forward. Benchmarking is just that. It is a tool that allows us to use data to measure ourselves against the best in our fields. Data can be found in numerous locations. In some cases, data is publicly reported by each company. In other cases, we have to work harder to mine accurate data.

How can you do it? 

  1. Identify a measure. Identify a key measure of success for your organization. This should be a measurement that will help identify successful performance for your organization.
  2. Find out who does it best. If you want to be the best, you have to measure yourself against the best. Search your industry literature and see who is a high performer in the indicator that you have chosen.
  3. Compare. Once you have your data and the data from other organization, it’s time to see how you stack up.
  4. Evaluate. No tool is effective if we fail to evaluate the data it produces.

Have you ever used benchmarking to evaluate a process? Log on and join the conversation at www.somc.org/blog.  We learn best from each other’s experiences.

Process Improvement: Value Stream Mapping

Why are leaders hesitant to focus on this?

The value stream map is very similar to last week’s tool, the Spaghetti Diagram. Almost all jobs have processes that are considered routine. Most of the time, you might not even think that most of these processes are a candidate for improvement. However, if you do happen to consider one of these routine processes, your familiarity with the process might be your biggest barrier to improvement. It can blind you to gaps and opportunities because you think you already know everything that there is to know about it.

What is the case for doing it anyway?

In this case, the Value Stream Map is best applied to a process that is performed beyond the constraint of a singular location and therefore can’t be easily mapped visually. The tool will help you visually represent a process in a way that aims to help you identify wasteful or unnecessary steps in the process. It will require you to break each individual step down into one of two categories: value added step and non-value added step. This simple step is a powerful one that enables you as a leader to clearly sort through pieces of your process.

How can you do it? 

  1. Select a process. Identify a process that you want to evaluate. The best candidates for this tool are processes that can represented spatially.
  2. Create your flow chart. Almost all process can be represented visually. Create a visual representation of your process by identifying key steps or components into a flow chart style.
  3. Create value. Consider each step and whether or not it is necessary to achieve the desired procedural outcome. If it is, then it adds value. If it isn’t then it doesn’t add value.
  4. Evaluate. No tool is effective if we fail to evaluate the data it produces.

Have you ever used the value added concept to evaluate a process? Log on and join the conversation at www.somc.org/blog.  We learn best from each other’s experiences.

Process Improvement: Spaghetti Diagram

Why are leaders hesitant to focus on this?

Almost all jobs have processes that are considered routine. Most of the time, you might not even think that most of these processes are a candidate for improvement. However, if you do happen to consider one of these routine processes, your familiarity with the process might be your biggest barrier to improvement. It can blind you to gaps and opportunities because you think you already know everything that there is to know about it.

What is the case for doing it anyway?

Routines are necessary. They help us establish consistency in our processes. These consistencies help improve results. However, routines can also be where some of the worst inefficiencies hide. The spaghetti diagram is a tool that can help us find these opportunities. It is a simple visual tool that any team can use to map their processes and see if there are ways to make improvements.

How can you do it? 

  1. Select a process. Identify a process that you want to evaluate. The best candidates for this tool are processes that can represented spatially.
  2. Create your map. Almost all process can be represented visually. Create a visual representation of your process by identifying key steps or components. If a map of the physical space where your process take places is available, this is best for maximizing the effectiveness of this tool.
  3. Make spaghetti.The spaghetti in the diagram are the lines generated by drawing on your map to represent the steps of your process. Draw all possible iterations of the process. It may help to incorporate different colors into your diagram to enhance the visual effectiveness of your diagram.
  4. Evaluate. No tool is effective if we fail to evaluate the data it produces.

Have you ever used a spaghetti diagram to evaluate a process? Log on and join the conversation at www.somc.org/blog.  We learn best from each other’s experiences.