2015-09 ibms
TRANSCRIPT
Can
Lean improve your laboratory?
Immunology
The Management of Change
"Lean is about continuously developing people and improving processes to create and flow value to customers using the least possible resources required."
“Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back of his head, behind Christopher Robin. It is, as far as he knows, the only way of coming down-stairs, but sometimes he feels that there really is another way, if only he could stop bumping for a moment and think of it.”
Unconscious incompetenceConscious incompetenceConscious competenceUnconscious competence
• Lean tools
• Developing people
“When a company engages its people in problem solving as part of their daily work, they feel more motivated, they do their jobs better, the organization’s performance improves, and a virtuous cycle starts to turn”.
A lean transformation must keep an even balance…..
‘Tools’
TECHNICAL
‘People’
CULTURAL
Too much emphasis on tools and methods….
Extensive use of “tools”Use of Japanese terms and conceptsSome processes made more efficientLean belongs to a few enthusiasts
TECHNICAL
Failure to embed or spreadResistance to changeResults not sustainedNo overall transformation
CULTURAL
If Cultural concerns predominate….
Failure to establish flowLack of rigour in use of toolsLean “speak” without true understandingFull potential not realised
TECHNICAL Temporary feel good factor createdBetter teamworkIncreased levels of involvementBut hard to sustain without results
CULTURAL
Continuous Improvement Toolbox
Value Stream Mapping
Pull Systems
5S System Layout
Setup Reduction
Teams
Visual Controls
POUSStandardized Work
Quality at the Source Continuous Flow
Work Cells Performance MeasurementTPM
Batch Size Reduction
Lean
Too
ls
Batch logic v Flow Logic
SPF
Ba
tch 1
2
3
3
2
1
Assumptions:• 3 Operators• 3 processes• 1 min per process• 0 min Move Time• 10 specimens
10m 20m 30m
Batch21”30”
SPF 3”12”First
resultLast result
Band 6 microtomy
Trust objectivesManagement reviewObjectivesAnnual AppraisalDaily huddlesSuggestions
Alig
nmen
tA
lignment
Directorate of Laboratory Medicine Cellular Pathology Page 1 of 1 Cell-Path-Appraisal-003 Revision Version: 3
Professional and Leadership Behaviours
Appraisal self-assessment form Name: ................................................ Date of IPR: ............................................ Return form to: ................................................ By: ............................................ VALUES BASED PERFORMANCE MANAGEMENT POINTS FOR DISCUSSION Please complete the following statements reflecting on your overall performance throughout the period under review. Use 1 for Always Use 2 for Most of the time Use 3 for Rarely Use 4 for Never
Our Values
Quality
Motto
Employee Promise
Declaration
Doing the RIGHT thing
the
RIGHT way
at the
RIGHT time
Quality is doing it right when no one is looking
Continually striving for
ZERO DEFECTS
to be the
BEST in CLASS
LABORATORY
in the world
Together we will strive
for
PERFECTION
by applying principles of mutual respect,
integrity, understanding, cooperation and
effective communication
I am
EMPOWERED
to work with my
colleagues to make changes, based on Lean principles, to
make things right for ourselves, our
clinician customers and our patients
• Involve operators in improving their workplace
• ‘We make people before we make reports’• Every lab is different but all human beings
share the same capabilities and potentials• Develop problem solving in every person –
not apply lean tools to every process
• Zero quality control• Zero defects• Enable employees to do quality work and
ensure perfection every time
Never accept, make or pass on a defect
• Need FACTS to make decisions
• ‘If you can’t measure it, you can’t improve it’
• ‘100 audit’
Service Improvement Team• Reps from each section and grade 2/52• Sub groups – small and focussed
• use PDCA, DMAIC, A3• report to main group to…
– show progress – seek authorisation– share the gain
4.14.4 Staff suggestions
Patient Safety
Briefing
1. Avoid reliance on memory2. Make things visible3. Review and simplify processes4. Standardise common processes
and procedures5. Routinely use checklists6. Decrease the reliance on vigilance
Apply human factors thinking to your work environment
“Problems”Or is it… “Issues” or “Opportunities”?
• Engagement; what’s in it for me?• Not lean from my perspective• Right first time. Better slower and correct
than have to solve error, correct and rework. ? = license to under perform.
• “When everyone’s super – no one will be.” - Team not individual
Can Lean improve your laboratory?
LeadershipAwareness of toolsEmployee involvementSet cultureAMRObjectivesAnnual AppraisalSuggestionsDaily huddles
Go see, ask why?
respect people
Go see, ask why?
respect people
Oct-0
2
Oct-0
3
Oct-0
4
Oct-0
5
Oct-0
6
Oct-0
7
Oct-0
8
Oct-0
9
Oct-1
0
Oct-1
1
2000
2500
3000
3500
4000
4500
5000
3
5
7
9
11
13
15
17
19
Histopathology TAT 10-2002 to 05-2012R
eque
sts
TAT
May-1
2Aug
-12
Nov-1
2Fe
b-13
May-1
3Aug
-13
Nov-1
3Fe
b-14
May-1
4Aug
-14
Nov-1
4Fe
b-15
May-1
5Aug
-15
2000
2500
3000
3500
4000
4500
5000
5500
3.00
3.50
4.00
4.50
5.00
5.50
6.00
6.50
Histopathology TAT 05-2012 to 08-2015R
eque
sts
TAT
Average of TAT Collection to
Receipt
Average of TAT Receipt to stain
Issue
Average of TAT Stain Issue to
AuthAverage of Total
Tat
2010-05 13:17:08 61:51:31 150:34:15 225:42:542011-05 15:36:30 51:23:08 145:12:50 212:12:282012-05 13:31:56 48:57:02 117:20:27 179:48:192013-05 9:07:54 51:26:46 171:28:50 232:03:302014-05 10:23:39 52:32:24 148:42:33 211:38:362015-05 11:19:56 55:28:57 158:57:13 225:46:05