Event Facilitator Training

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Event Facilitator Training

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Lean request process

• Meet with Leadership
• Why did you call?
• Observe process
• Meet with Leadership
• Recap observations
• Suggest course of action
• Meet with Team
• Discuss proposed plan
• Gauge enthusiasm

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Lean request process (cont.)

• Mapping discussion
• Ask team to describe process
• Magic wand question
• Measures in place?
• Mapping event
• Sometimes combined with above
• Identify weaknesses/opportunities
• With metrics
• Develop improvement plan

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Types of Lean Events
Value Stream
5S
RIE
Project
Do-it
Burst
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Rapid Improvement Event
(a.k.a. Kaizen Event or Rapid Improvement
Workshop)

• 1-5 days
• Scope significant - can be cross-functional
• 6-12 people or more
• Quick impact
• 80 of improvements implemented during event
• 20 of improvements implemented within 30 days
• Implementation per prior management agreement

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Typical RIE Schedule

• Training
• Analyze Current Process
• Define New Process
• Test Finalize New Process
• Report Out Celebrate

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Burst Event

• Short duration (2-4 hours)
• Minimal scope/Single issue
• 4-6 people
• Quick impact
• Intended for relatively simple tasks

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Do-It

• Very short duration (1-2 hours)
• Simple scope/Single task
• 1-3 people
• Immediate impact
• No decisions or management intervention required

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Project

• Long duration (3-12 months)
• Complex scope
• Multiple departments/functions
• Long-term impact

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5S

• Typically a 1-5 day event
• Provides workplace organization
• 6-12 people
• Provides framework for monitoring continuous
  improvement

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How do we know which event type to use?

• Type of activity
• Scope of process/task
• Resources required

Dont worry about fitting the event type into a
specific category
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Agenda for Improvement Events

• Introductions/education review purpose
• Review current state including measures
• Observations
• Review observations/brainstorm
• Identify opportunities
• Suggest changes
• Test changes
• Adjust retest as needed
• Finalize changes
• Estimate impact of changes including measures
• Develop action item list
• Prepare report-out
• Conduct report-out
• Adjourn

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Steps

• Introductions/education
• Have everyone introduce themselves and their
  department/role in the process
• Education as needed enough to get people
  oriented to the task at hand
• Review current state, including measures
• AIM statement
• Mapping
• If map already complete, review map

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Steps (cont.)

• Observations
• Observe process in action without intervention
• Make notes about inefficiencies (use 7 wastes)
• May break up group and observe different parts of
  process, then switch places

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Steps (cont.)

• Review observations/brainstorm
• Bring observations back to the group
• Review and record observations without judgment
• When all are recorded, brainstorm opportunities
  for improvement and record
• Identify opportunities
• From the brainstorm list, identify opportunities
  that may bring improvement

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Steps (cont.)

• Suggest changes
• Select significant changes that can be tested
• Test changes using PDSA
• Prepare tests of change
• Try the new way on a small scale
• Evaluate the results of the test
• Adjust and retest as needed
• All tests will not work
• Learn from the unsuccessful tests, adjust, and
  retest

ESP video
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Steps (cont.)

• Finalize changes
• Develop ways to implement successful tests
• Will take planning, as well as involvement from
  those not in the event
• Estimate impact of changes
• How will changes impact measures?

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Steps (cont.)

• Develop action item list
• List of tasks to be completed after event
• Task, person responsible, due date

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Action Items an example
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Steps (cont.)

• Prepare and conduct report-out
• Report-outs serve two purposes
• Records activity action plan
• Demonstrates results to leadership and others
• Report-outs are short and to the point
• Shouldnt last more than a few minutes
• Report-outs provide team members the opportunity
  to present results to leadership
• Team members should present, not facilitator

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ED Admissions Report-out
An Example

• November 30, 2006

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Scope
Example

• We mapped the steps for admitting a patient from
  the ED to 3C (telemetry) and 5E (medical). The
  review covered the process from the receipt of
  the admission order until the patient is bedded.

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Objectives
Example

• Reduce the amount of time required to admit an ED
  patient
• Comply with JCAHO safety goals
• Standardize handoff information
• Improve communication among caregivers
• Improve patient satisfaction
• Improve staff satisfaction teamwork

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Team Members
Example

• Dr. Ryan Sundermann, ED
• Georgeanne Cassidy-Wescott, Process Mgmt.
• Diane Espenes, Admission Center
• Laura Sagers, ED
• Mary Ann Osborn, Executive Sponsor
• Sandi McIntosh, Champion
• Dean Bliss, Lean

• Melinda Altman, ED
• Anna Finch, ED
• Connie Patterson, Pt Flow
• Tina Rice, House Sup
• Marie Schrock, Housekp
• Norma Roland, Housekp
• Greg Schlueter, 5E
• Sarah Allen, 3C
• Michelle Kiesey, ED

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Process
Example

• Reviewed current process
• Observed current process
• Developed list of potential improvement
  opportunities
• Reviewed opportunities and made decisions
• Performed a trial run of the new process
• Assigned actions
• Measured improvements
• Set time for follow-up

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What we changed
Example

• Adapted admission report form from 5W Frontline
  Leadership project
• Standardizes information
• Tested enabling all nurses on units to receive
  report for admitting patients
• Reduces multiple phone calls
• Tested shifting housekeeping hours
• Makes unit-based housekeeping available during
  peak hours

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Results
Example

• Tested on Wednesday
• Made adjustments to form (handout)
• Staff receptive
• Easy to use
• Helps report to be more complete
• Reduce number of phone calls
• Test cases went smoothly
• Peak hours challenging
• Will validate impact of changes over time

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Measurements
Example

• Sample data reflects the admission process
  averages between 40 and 50 minutes.
• The internal ED goal is 30 minutes.
• By implementing these changes, we expect the 30
  minute internal goal will be met 90 of the time.
• We anticipate the overall time will be reduced by
  10 to 15 minutes.
• Additional planned changes will reduce the time
  even further.

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Action Items
Example
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Keys to Successful Events

• Have the right people in the room
• Empower the team to make immediate changes to the
  process
• Full participation from all team members
• Attack process, not people
• Agree on measures and how they will be collected
• Review action plan frequently for progress

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Group Exercise

• Map a common process
• Clinic visit
• Add data
• Identify improvement opportunities
• What steps are difficult/take a long time?
• Define improvement events
• Areas where improvement would make a significant
  impact on the measures

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Questions?