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Management Seminar Around the world it is well known , that those organisations who are the greatest performers are those , who have well developed learning systems and understand how to make production flow fast and efficiently. Management.
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Management Seminar Around the world it is wellknown, thatthose organisations whoare the greatest performers arethose, who have welldevelopedlearning systems and understand how to makeproduction flow fast and efficiently
Management • Leading a group of people(who, education, expirience etc.) • Basedonacceptedvalues(ethics, moral) • Respecting the Raison d’être • Within the defined ressource limits (budget, financing) • To achieve/reach/obtain(how) • A commonobjective/goal/result (welldefined) • Makingcustomers/clients/patientssatisfied(how to know)
The UMSB Raison d’être Weexistbecause The BhutanesePeoplewants to helpthosewhoaresuffering from disease and disability ----to do so, the people has expresseditswill to: Provide Bhutan withhighlyqualifieddoctors, nurses and…. Support the developement of evidence based medicine in all parts of Bhutanese healthcare a. research b. education c. anyotherknowledge transfer d. medicaltechnologyassessment e. innovation
Plan Deming’s PDCA-cycle Act Do Check
Today I will speak about a management philosophy withfocusonlearning and flow basedonrespect for people LEAN
2 GOAL The LEAN-house Continual improvements Flow Make your flows flow by tacting and conecting elements of the flow Respect forpeople Quality Directly on-time intervention. Remove causes of failures Tact / reduction of variations Agreements / Standards/SOP’s
Stop production so that productionnever has to stop
The LEAN-Philosophy Is basedon Respectfor people. The moment of truth is the meeting with the student Ourstudents areequalcitizens All employeesareimportant Werespect principles of democracy Wekeepourpromises Werespectourcollegues time Respect forpeople
Continued improvements Continued Improvements Respect forpeople llll
The LEAN-house– How to think and actin case of failures anddeviations from our agreements??? Directly on-time intervention. Remove causes of failures Continued Improvements Respekt förmänniskan Quality Directly on-time intervention. Remove causes of failures Tact / reduction of variations Agreements / Standards
ANDON table Productionrunning but with problems thatneedurgent Intervention Production stop problems need urgent intervention
The LEAN-house– To agreeonwhat is actually the best (procedure, technology, pedagogicprinciple, organisation etc....) Continued Improvements Agreement We .... Standard Respekt förmänniskan Agreements / Standards
The LEAN-house– How to think and actin case of failures anddeviations from our agreements??? Three simple tools to support us in dailylearning Satisfactometer 5 whys Fishboneanalysis Directly on-time intervention. Remove causes of failures Continued Improvements Respekt förmänniskan Quality Directly on-time intervention. Remove causes of failures Tact / reduction of variations Agreements / Standards
Results Satisfiedbecause Dissatisfiedbecause w1 w2 w3 w4 w5 w6 Dr. Bent’sSatisfactometer
5 WHYS The 5 Whys is a simple but powerful problem-solving technique that allows you to dip below the surface level of a problem
Why did your car stop? - Because it ran out of gas. • 2. Why did it run out of gas? - Because I didn’t buy any gas on my way to work. • 3. Why didn’t you buy any gas this morning? -Because I didn’t have any money. • 4. Why didn’t you have any money? - Because I lost it all last night in a poker game. • 5. Why did you lose your money in last night’s poker game? - Because I’m not very good at “bluffing” when I don’t have a good hand.
Fishbone Diagram Equipment Process People factors Problem Primary cause Secundary cause Material Environment Management
Affinity Diagram Staff Providers Management Technology WorkingEnvironment
Affinity Diagram Staff Providers Management Technology WorkingEnvironment
Affinity Diagram Staff Providers Management Technology WorkingEnvironment
Affinity Diagram Staff Providers Management Technology WorkingEnvironment
Affinity Diagram Staff Providers Management Technology WorkingEnvironment
Affinity Diagram Staff Providers Management Technology WorkingEnvironment
Affinity Diagram Staff Providers Management Technology WorkingEnvironment Own 5-why
Fishbone Diagram Ledelse Medarbejdere Sekundær årsag faktorer Primær årsag Problem Arbejdsmiljø Teknologi Underleverandører LEAN land
Now -letusfocus on production flow. How do wemakeour flows flow ??? Learnhow to use a flow-chart
Makeyour flows flow by tacting and connecting elements of the flow Continued Improvements Flow Makeyour flows flow by tacting and connecting elements of the flow Respekt förmänniskan Quality Directly on-time intervention. Remove causes of failures Tact / reduction of variations Agreements / Standards
The LEAN-house– Tact / reduction of variations Continued Improvements Respekt förmänniskan Tact / reduction of variations Agreements / Standards
Just writetheseheadlines With a whiteboard pen or alike Brain storm prior to the flow-chartdrawing Put a bigpiece of plastic on the wall Divide it into intervals as appropriate Everybodyinvolved in the proces describetheiractivity on a yellow post-it label and place it in relevant interval. One activityonly per label 3. In the same waywritedownyour problems (red) and questions (green) and placethem on the plastic 4. If posiblegroup all related actions and problems. It makes it mucheasierwhenyou start drawingyour flow-chart During the operation Prior to admission In-hospital prior to operation After the operation Big piece of plastic on the wall Post-it glued paper-labels
Group Brain Storm prior to commencing the flow-chartdrawing at Skåne University Hospital, Lund, Sweden
On the whiteboard or a piece of paper Step 2: All Groups together arrange activities and decisions Nurse Doctor Lab technician Adm. staff Whenyou have finishedyourflow-chart: For eachelement/activity ask whetheror not thisparticularactivity addsvalue to the patient (customer) - if not: take it away
A3 – new process design Department X - JDWNRH Theme & background Target Condition A short and precisedescription of the problem -no conclusions Current Condition Implementation Plan Step Responsible Deadline first step second step 3. third step KP Dr Sonam ICN Surg 15.11.2012 01.01.2013 31.01.2013 Follow-up Plan A clinical audit shall be performed 5. February 2013 Responsible: Dr. Bent Root Cause analysis Follow-up Result
Yourfirst LEAN-Board (Production & Improvement Board Mystery Ltd. Production Quality and Improvement Improvement Projects www xxxxxxzzqqqq Mnmnloloøøø ………. … A3 A 3 Ressource Consumption Cumulative New improvement Ideas from Staff Members Jan Dec
Leadership Hoshin - Kanri Systematiscbreak-down of goalsdown through all levels in the organisation and systematicreporting of results up through all levels of the organisation LEAN-tavle Quality Deliverance WorkingEnvironment Productivity LEAN land