Lean For The Public Sector

Welcome to…

LEAN
Efficient Processes for the Public Sector

PRESENTED BY E-ZSIGMA (CANADA) INC.
CANADA’S LEADER IN LEAN, SIX SIGMA AND INNOVATIVE PRACTICES

CHALLENGES FOR CANADIAN HEALTHCARE?
Primary care reform
the way in which primary care and primary health care services
can be organized to best serve population health needs
Health human resource planning
the way in which a variety of health professions should be
deployed to provide health care services to the population
Cost and sustainability
the way in which health care services are funded and the costs for
the future
Role of the private sector
the way in which health care is delivered and funded privately
Quality of Care and Measurement
the way in which decisions about healthcare interventions are
based on evidence of effectiveness to improve quality.
Source: Canadian Policy Research Networks, January, 2004

2 Lean & Six Sigma: Efficient Processes for the Public Sector Thursday September 9, 2010

THE DEMAND CURVE WE ARE FEELING

Source: Understanding Canada’s Health Care Costs, Health Canada, 2000


DEMAND ACCELERATORS & RESPONSES
ACCELERATORS
Emerging and New Technologies
major joint surgery, neonatal and fetal technologies, dialysis, organ transplantation, genetic testing and therapy
Increased Incidence and earlier onset of Chronic and New Diseases
heart disease, diabetes, tuberculosis, Hepatitis C, HIV, and AIDS
Increased demand from an aging population
New Pharmaceuticals
Declining Productivity Gains & Changing Expectations

RESPONSES
Improved management of health care systems and delivery
modes
Increased process and treatment efficiency and effectiveness
A public that is capable of making informed & appropriate
choices
aka “Help me to help you”, Movie: Jerry Maguire, TriStar Pictures 1996

SOME OF TODAY’S PARTICIPANTS
City of Surry
Financial Services Commission of Ontario
Government of Alberta
Government of Saskatchewan
Government of Yukon
House of Commons
Industry Canada
Ministry of Community and Social Services
Ministry of Community Safety and Correctional Services
Ministry of Health & Long Term Care
Province of Manitoba
The Regional Municipality of York
Dept of Health, PEI


SO... WHAT’S KEEPING YOU UP AT NIGHT?


THE 5W2H TOOL
Ask 5W questions & 2H questions to ensure you have
covered all the key information:

1. What is the problem?
2. Why is it a problem? Highlight the “pain”
3. Where do we observe the problem? (location, products)
5W
4. Who is impacted? (customers, businesses, functions)
5. When did we first observe the problem?

1. How did we observe the problem? Symptoms
2H 2. How often do we observe the problem? How many defects do we
observe? Magnitude and trend.


EVER-INCREASING CUSTOMER FOCUS
Organizations provide goods and services for customers – they
define needs, quality and price
Customer focus drives such questions as:
Why are we in business?
Where do we need to be in the future?
What is the source of our “Competitive Advantage”?
Customers bring alignment to cross-functional organizations:
What drives purchasing behaviour?
What is a defect; what constitutes value for the customer?

8 Thursday September 9, 2010

QUANTIFYING NEEDS

I hope I don’t have
to wait too long to
see the doctor!

Quantitative: “total
minutes lapsed until
meeting the doctor”
Subjective: “Too Long”


MEETING TARGETS BASED ON CT’S?...
Capability to meet/exceed customer
expectation?
Reliability and stability of key
(process) inputs resulting in
predictable outcomes for
customers?
Need to “shift” the average?
Increase production rate/capacity
Reduce cycle time and cost

Need to reduce variation?
More “robust” processes
Less non-conforming results (eliminate defects)


TWO POWERFUL APPROACHES…
Six Sigma & Process Variation Lean & Process Efficiency
• Describe variation! • Define customer value!
• Analyze it! Y = f(x) • Identify waste!
• Reduce it! • Eliminate waste!
• Control it! • Increase flow of value!

Example
• wait times
Reduced Reduced • cost
variation average • handling
• minutes, hours,
days…

After Lean
Before Lean
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
Before 6S After 6S
Predictable, Controlled, Capable Efficient, High-Value, Low Cost

Breakthrough Improvement!

LEAN & SIX SIGMA
LEAN
Customer/Community Focused
A Paradigm Shift in the Way Value is Defined
5 Key Principles & Eight Associated Sources of Waste
A Value-Stream Based Approach: The “Flow” of Value (velocity)
Tools & Techniques to Improve Value Creation
Turn everyone’s “waste radar” on
Reduce or Eliminate the Inhibitors to Value Creation
Extremely Participative Problem-Solving , Event Driven, & Culturally Transforming

SIX SIGMA
Focus on process “problems”: Errors, Quality, Robust Process Design
Key to Success: Focus on Understanding Process Variation
Emphasis on data and analysis: Profound Knowledge!
Project-Centric: Well Defined Goals & Measurable Results
Rich & Diverse “Tool Box” for Analysis and Problem-Solving

“At e-Zsigma, we teach people to do Six Sigma and we CHANGE people to do Lean”

LEAN 101: FIVE PRINCIPLES OF LEAN


LEAN 101: DEFINING VALUE
Lean Thinking: Any process step, activity or task that transforms the deliverables of a
process such that the customer is aware of it AND is willing to pay for it is considered
value added. Value is always stated in the eyes of the customer.
© 1996 “Lean Thinking”, Womack & Jones
Healthcare? Any activity or task that moves the patient through the diagnosis,
treatment and prevention process, is performed correctly the first time, and the
customer and/or community is willing to pay/fund for that activity or task since it does
create value.
Public Service? Any process step, activity or task that transforms the deliverables of a
process such that the customer and the community is aware of it and is willing to fund
and/or pay for it is considered value added.
How do you or your organization define value? Because… If it is not value-added, then it
is waste (aka “Muda”)


NON-VALUE ADDED: WASTE
Waste is defined as anything that does not add value
for the customer.

“Lean Thinking” requires an organizational
culture that is intolerant of all forms of
waste.

The goal of Lean is to banish waste.


LEAN 101: THE EIGHT SOURCES OF WASTE
Inventory & Storage: Brochures/booklets printed, stored and perhaps becoming obsolete
(scrapped)
Waiting or Delays: Delay in getting security clearance for a new hire
Over-producing:
Transportation: The movement of people, equipment, materials etc between building, cities,
regions, provinces, etc
Motion: Poor office layout (departments) resulting in people having to move around to get their
regular work done
Errors/Mistakes: Missing or incorrect information on a form or application resulting in rework
and delays or even lost opportunity
Over-processing: Producing reports in advance of when the information is needed, or
information that may not be needed at all
Underutilized human capability: People working on non-value added (see above) and not
leveraging their talent and capability
9th Waste? Reprioritization


LEAN 101: MAKING WASTE MORE VISIBLE

Process Flow Maps
Spaghetti Diagrams
Value Stream Maps
Cause and Effect Diagrams
Five “Whys?”
Pareto Charts
Workplace Organization
5S (Sort, Set, Shine, Standardize, Sustain)
Visual Workplace
Process Reports, Audits and Assessments


LEAN 101: PROCESS MAPS


LEAN 101: SPAGHETTI DIAGRAMS


LEAN 101: VALUE STREAM MAPPING

• Current state?
• Future State?

Observing the process, Capturing data & Looking for waste….


LEAN 101: CAUSE & EFFECT


LEAN 101: FIVE WHY’S
A simple, investigative line of questioning to begin understand
any problem.
Start with an effective problem statement (current situation)
Start asking the questions… the “Five Whys”… (doesn’t have to be five
questions – could be more)
Usually done in a team problem-solving environment consisting of
subject-matter experts
Keep asking exploratory questions until you
arrive at the ROOT CAUSE
“Test” the answers by asking such questions
as, “If that didn’t happen, would the problem
go away?”


LEAN 101: PARETO CHARTS


LEAN 101: THE 5S EVENT
1. Sort: Separate what is needed in the work area from what is not. Then…
get rid of what isn’t needed!
2. Set in order: Organize what remains – in the order that it is required for
the process or task
3. Shine: Clean and inspect the work area/workplace
4. Standardize: Standardize the cleaning, inspection,
and safety practices – make it part of the job
5. Sustain: Establish an environment, including audits and visual cues, that
ensure the culture of 5S “sticks”
Note: Lean organizations have a standard that any “tool” must be able to be found within X
seconds (example: 60 seconds). A tool can be a piece of equipment, a document, a file, etc.
necessary for the work to proceed and value to be created.


LEAN 101: VISUAL WORKPLACE
The Challenge: People not having access to the knowledge they need to do
their jobs effectively and efficiently. What tasks? What priority? What
target? The “correct” way? Which tools and where can I find them?
Waste: Searching, asking, waiting, retrieving, reworking!
Visual workplace: Providing vital information when and where it is needed.
Easily understood & unambiguous work instructions on what to do,
when, and how.
Tools and methods to easily and reliably identify process errors ad
omissions as quickly as possible - at the source.
Real-time performance feedback so employees know where they stand in
terms of meeting goals or targets.
Encourage alignment of activities across and up and down the
organization so that they congruent with strategic goals and objectives.
Promote and communicate cultural change in the organization,
specifically the lean evolution.


EXAMPLE: VISUAL WORKPLACE

“Access to information and tools to do the job”

LEAN 101: ASSESSMENTS & AUDITS
Creates accountability & encourages shared commitment for
performance
Tracking trends and (lean) improvement activities
“We measure our performance”: a part of our culture
“You can’t manage what you don’t measure”
Measures help control the processes
Metrics aligned to corporate goals and strategy
Ex. Customer survey data
Using & reporting the “wrong” metric can be more damaging
than having no metric at all!


LEAN 101: ELIMINATE WASTE BY…

• Reduction/elimination of batches • Five S – Visual Workplace
• Single piece flow • Quick Changeover
• Continuous flow • Standardized Work
• Improved process control • Andon System, Pitch
• Reduced process variation • Materials replenishment
• Faster reaction to problems • Kanban, FIFO
• Shorter lead times • Supermarket Pull System
• Reduced forecasts • Total Productive Maintenance
• Takt time and demand leveling • Cellular Design/Layout
• Just in Time • Work cells
• Touch once principle • Error Proofing
• “Pull” systems design • Kaizen improvement events


YOUR EXPECTATIONS FOR LEAN
Improved customer experience and satisfaction
Faster response to client needs
Increased job satisfaction & reduced stress for staff
Improved, standardized & repeatable processes that are more predictable
Reduction in Process Cycle Time
Ability to focus resources on more value-added activities
Improved asset utilization: people, equipment & technology
Improved flow through elimination of bottlenecks (delays) and constraints
(limiters)
Dramatic improvement in scheduling predictability – better process
management
Participative problem-solving
Engaging the people who know and do the work… the team
Recognition of the “human” side of lean and the need to manage change


E-ZSIGMA (CANADA) INC.
Canada’s leader in Lean, Six Sigma & Innovation strategy,
consulting and training
Canada’s only Certificate in Lean Six Sigma for Public Service
Schulich School of Business Lean Six Sigma Centre of
Excellence
Some of our Public Service clients;
Government of New Brunswick • Lean Six Sigma Strategic Deployment
Government of Alberta • On-site Lean Six Sigma Training
Government of Saskatchewan • Lean Six Sigma Project Management
Health Canada • Open Enrollment (Public) Training
• Process Design, Modeling & Simulation
Ministry of Transportation • Master Black Belt Project Coaching
Service Canada & Mentoring
Office of the Auditor General • Lean Six Sigma Certification
WSIB • Comprehensive e-Learning Program


RAPID START: LEAN FOR PUBLIC SERVICE
1. ½ day elearning 3. ½ day individual project
1. Introduction to Lean Office Principles coaching
2. Eight Wastes
3. Value Stream Mapping
4. 5S
5. Visual Workplace
6. Kaizen Registration Fee:
2. 2 days in class $1995 + applicable taxes
1. Kaizen project identification and scoping
2. Process variation & Input and Output
Variables
3. Process mapping & visualization
4. Brainstorming & Innovation Techniques
5. Root Cause Analysis
6. Observation & Data Collection
7. Process Rationalization
8. Selection of Solution(s)
9. Solution Implementation Planning
10. Process Control Planning


E-ZSIGMA SERVICES
PUBLIC SECTOR SPECIFIC TRAINING PROGRAMS
E-Zsigma has designed an 5-day Blended Lean Six Sigma for Public
Sector program tailored specifically for the Canadian Public Service
industry. This program is the first of its kind in Canada.
CUSTOMIZED SOLUTIONS
Our training programs can be customized to suit your needs and be
delivered at your location.
PROJECT MANAGEMENT & LEADERSHIP
Allowing our senior Master Black Belts to help you lead rapid and
highly successful lean six sigma improvement projects
E-LEARNING SOLUTIONS
We understand the hectic schedule of the healthcare professional.
Therefore we offer a comprehensive eLearning program designed to
meet your needs on your schedule.


QUALITY CAMPUS


CONTACT INFORMATION

E-Zsigma (Canada) Inc.
One Dundas St W, suite 2500
Toronto, ON
www.e-zsigma.com
Bill Clarke
D: 613.830.0322
O: 416.593.8026
F: 416.204.1939

Thank you for joining us today!

Lean For The Public Sector

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