Results Washington of the Washington State Government seems to have taken a great interest in Lean techniques. They have sponsored a series of conferences and, as befits a public agency, a lot of the presentations are available on-line, either as pdf files or, in some cases, as YouTube videos of the presentations themselves. The video quality is not always great, but it is certainly good enough to follow the gist of the presentations – and it’s a lot cheaper than going to Washington State for the conference.
There is a general introduction to Lean at this link. Understandably, it focuses on Lean as applied to public agencies. This video covers the basics of value, waste and flow, paying a lot of attention to office processes. It has a good discussion of wastes in processes and of discussion of batching versus continuous flow in offices, with some discussion of pull systems, and a useful review of the role of leaders in a Lean system.
There is a large collection of previous presentations available at this link. This is well worth exploring. I’d pick out a presentation on Daily Management from Julie Fry, of the Virgina Mason Medical Center. Julie’s presentation is available as a pdf.
The presentation discussed the idea of World Class Management (closely associated with hoshin kanri, discussed in a previous post) and linked to ideas of strategy (or policy) deployment, catchball, and daily management. I’ve discussed Daily Management in a previous post, and this presentation captures the ideas well, and shows its practical use in a health care setting.
Seattle Children’s Hospital weighs in with a presentation on reducing re-admission, ‘From 10kft to Sea Level‘. This is a great illustrative example of incremental improvement. The presenters, Andrew Hanson and Kathy Mullin, show the process of understanding the problem, listening to the customer, involving the care team, and working through seven versions of a discharge checklist with regular feedback from the customer. Interestingly, the team went through four paper versions before electronic versions began to appear. Well worth a look.
As well as the usual Lean health and social care suspects, the back catalogue of the conference contains some off the wall gems – at least off the wall from a health and social care perspective.
I particularly admired a presentation on shellfish stock management. What does that have to do with health and social care? Well, nothing much, but the problem was:
- crossed multiple agencies
- required use of data and structured problem solving
Oddly, it can sometimes be easier to see techniques in use in areas in which you have no direct investment. This may be because it’s easier to stand back and see their use, rather than get caught up in the technical details of the problem.
The method for improvement in this example proved to be agreement on the nature of the problem, real time use of data, partnership working, rapid improvement work with fast turnarounds, and clarity on accountability and responsibility. All of these techniques are relevant to the type of poorly structured – or at least poorly understood – problems that crop up in health and social care.
If you want to spend five minutes on something a bit different, the shell fish presentation is available at this link.
I’d like to extend my personal thanks to Results Washington for making this material available on the internet.
Clipart coutesy of jumpordie at freeclipart.com