Hoshin kanri is the management approach that is usually associated with Lean. In the last few months I’ve worked my way through half a dozen books on hoshin kanri, and I wanted to share my impressions over a series of posts. I reviewed one of the books recently, and I will get round to some of the others soon. For anyone interested, there is an academic bibliography available from the University of East Anglia.
I found the whole topic difficult. At first, some of the books seemed to be describing wildly different things. Eventually, I felt I had recognised the common ground between them, and these posts bring together what I have learned.
Hoshin kanri is a management system by which activities are defined and prioritised, and action then aligns with these priorities. Strategic direction passes from the top of the organisation down, but the means to achieve the objectives comes from operational levels. In this, the first of three posts, I will concentrate on direction setting.
Clarity, according to most authors, is needed on the overall aim of the organisation. This vision is usually supported by a mission statement explaining what makes the organisation distinct from others, and capturing how it expects to go about achieving it. The vision and mission statement may be supported by an explicitly stated set of values.
Looking at some examples, this is Virginia Mason’s:
‘Our vision is to be the Quality Leader and transform health care – To become the Quality Leader, we must first change the way health care is delivered. Our aspiration is not to be the biggest, but to be the best. We will differentiate ourselves on the basis of quality.
Our mission is to improve the health and well being of the patients we serve – Healing illness is our first priority and is what gives our people the energy for our vision. We are also committed to providing a broad range of services that improve one’s sense of well-being.’
Seattle Children’s, another Lean leader, offer this:
We believe all children have unique needs and should grow up without illness or injury. With the support of the community and through our spirit of inquiry, we will prevent, treat and eliminate pediatric disease.
We will be the best children’s hospital.
Our founding promise is to care for every child in our region, regardless of their family’s ability to pay. We aspire to:
- Provide the safest, most effective care possible.
- Control and reduce the cost of providing care.
- Find cures and educate clinicians and researchers.
- Grow responsibly and provide access to every child who needs us.’
Thedacare have this:
To redesign three interdependent components of the healthcare industry which will result in improved value for patients. We will accomplish this by collaborating with patients and leaders in the provider, employer, insurer, and government communities to create transparency of cost, quality, risk and consequences; care delivery redesign with focus on value to patient, and payment models that reward value.
Our vision is to transform the healthcare industry to deliver higher value through experiments, collaboration and education that integrates the three interdependent components and spreads learning and accelerates improvement.’
Whatever terms are used, the intent is to provide a ‘true north’ that then shapes the rest of the organisation’s work.
The next stage, in most descriptions of hoshin kanri, is understanding your current situation. This has three components:
- an ‘environmental scan’ – this encompassed the ‘near environment’ -issues under your direct control, and ‘distant environment’ – things outwith your control, but which may be important, such as economic changes, demographic shift or legilstative changes.
- a review of performance – how are you doing?
- benchmarking against others – how do you do compared to the very best?
This initial diagnosis is then completed at least annually.
The results of this assessment are used to identify what you need to do to move closer to your vision, staying in line with your mission statement, and any described values. Some authors recommend using a process known as an affinity diagram to identify themes, and then using a formal prioritisation metho such as a prioritisation matrix to work out the top priorities.
The catchball phase that follows is described in the next post.