Volume 10 - May 29, 2020
Change is NOT a Dirty Word
(Using Rapid Cycle Lean Process In Your Covid-19 Response)
By Andrew Craigie, V2V Management Solutions, Inc.V2V Management Solutions, Inc.
We are hearing a lot of people throw around the proclamation that we need to prepare ourselves for a “new normal”. I must say for me personally, the mandate of a new normal is already as irritating as the phrase “in this together” but again that is a personal opinion. For me and an organization like V2V, change is as natural as breathing. It’s the evolution, that process of improvement, which embraces new opportunities to better our performance, enhance our patient experiences, and respond to the demands of the industry and communities. Its not always easy but the future state it represents is usually worth it.
We are experiencing a monumental shift in how we practice in health care because of the pandemic. There is no denying we will have to examine our business practices carefully and decidedly make changes to address a new reality as we fight to secure our businesses and our economy. We will have to change, and the reality is what we do today will likely change again in the not to distance future.
Process change doesn't have to be difficult or painful and it can successfully happen rapidly. As a leader in this unique time, you can take comfort in the fact that there is a simple way to choose how to do your work, fix broken processes, improve team satisfaction, build stronger systems, and yes, even successfully change.
I have experienced a lot of change initiatives in the course of my professional career, and I have to tell you, without question in my opinion, the most effective approach to lasting change is the process known as rapid-cycle improvement. Rapid-cycle improvement approach is also known as the Plan-Do-Study-Act (PDSA) cycle. The PDSA cycle, a four-stage rapid-cycle quality improvement strategy, is defined below.
- Plan: Identify an opportunity to improve and plan a change or test of how something works.
- Do: Carry out the plan on a small number of patients. The test period may be as short as one day for small PDSA cycles or up to several weeks for more comprehensive change initiatives.
- Study: Examine the results. Gather data on your efforts and determine if you met your goals.
- Act: Use your results to make a decision; either adopt the change or abandon the change and run the cycle again.
Many organizations struggle with implementing Rapid Cycle because they don’t know where to begin. So, we would like to make it a little easier. I am going to share with you a very simple process that any team can utilize to achieve remarkable improvement in short periods of time. The process described within is something that can be followed no matter how big or small the task. It can take a few hours or it can take much longer depending on the problem you are trying to solve. No matter the task or time frame, the method provides consistent results. V2V frequently utilizes this technique when working with our clients. The key is the rapid cycle workshop; an effort that follows a 10 step process to guide the team toward the elimination of waste in any work process and the adoption of solutions that will result in a new “ideal” future state.
In lean process terms, the rapid cycle process starts with the “Gemba Walk” or the Three Actuals Walk. It's all about where the work happens. This process walk involves going to the actual place where the actual work is done and watch the actual people who do the work. It is a very user-friendly approach to Rapid Cycle that includes the following ten steps.
- Select a Priority Process: Identify a process that has frustrating bottlenecks, delays, customer complaints, rework, errors, or any number of forms of waste.
- Identify the Priority Problem: Even if you think you know what is wrong with the process you probably are missing something. Ask the 5 Why’s, work toward getting to the root of the problem.
- Define the Problem: Create a problem statement that clearly articulates the root of the problem, ideally in one sentence and as specific as possible.
- Assemble a Team: Identify the stakeholders who are part of the process to be on the team. These are the people who own the process, lead the process and even customers (internal and even external customers) of the process.
- Conduct a Process Walk: This is also known as a three-actuals walk. Go to the actual place where the actual work is done, observe the actual people who do the work to gather your data on the process.
- Construct a Value Added Time line: Sit down as a team, identify all the non-value added steps in the process and look closely at steps that change the form, fit or function of the product or service, ideally these would be the steps that add value from the “Customers” perspective.
- Identify Ways to Eliminate Waste and Process Variation: Construct a flowchart of the process so all the team members can visualize the workflow and focus on areas of opportunity, constraints in the current system and waste.
- Redesign the Process: After discussing ways to eliminate wasteful steps in the process create a new flow-chart that shows only the new steps in the process.
- Identify Output and Process Measures: Determine what success looks like. What is the key measure of success and how will you evaluate your progress along the way?
- Develop an Action Plan: Prepare to Implement immediately; identify who will do what, by when. Remember Plan – Do – Study – Act. Plan the change, Implement the change, Measure the result to see if it gets you closer to your goal, and then adopt the change…or abandon the change and run the cycle again until you achieve the desired result.
How to change does not have to be intimidating. In fact it can be one of the best ways to bring your team together and strengthen your organization. Don’t let the fear of change keep you from giving the 10 Steps a try.
If you need additional resources during these eventful times call us, we can help.
Disclaimer: V2V Management Solutions is a healthcare consulting firm. We are not licensed attorney’s or certified public accountants. This guide is not intended to replace legal or financial advice from your trusted resources. Before acting on any information provided check with the appropriate legal or financial team. This situation is a constantly evolving landscape be sure to research for most current information.The following content consists of key takeaways on information published in the above referenced articles, facts sheets, and our personal/professional experiences in financial management throughout a crisis.
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