By November 13, 2013 2 Comments Read More →

Recording and Q&A Follow Up from Shingo Institute Webinar on “Healthcare Kaizen”

shingo institute

Last month, Joe Swartz and I presented a webinar for the newly renamed Shingo Institute about our  Healthcare Kaizen books. The Shingo Institute’s new logo is at left and you can watch a video about their new name and expanded focus.

Here is a recording of the webinar, via their site and YouTube  (and PDF slides can be found here).

There were many great questions, but we ran out of time to cover them all. Here, we present Q&A from the additional questions…

Shingo Webinar Follow Up Q&A

Do you recommend having the CEO (or other executive) submit a Kaizen to show that they are committed to continuous improvement?

Joe: Yes, at Franciscan we do recommend having our executives do Kaizen and submit their completed Kaizen Reports. They really need to do Kaizens themselves before they fully understand how to do Kaizen.

We ask them to be conscious of the impact of their requests on our organization.   For example, our C-suite got together on a Kaizen earlier this year and reduced the times our environmental services staff clean their offices from daily to once a week.   It was a good faith gesture that they are doing their part.   They also reduced the number of regularly generated reports for board meetings.   Asking them to do Kaizen also gives them an appreciation for the amount of effort and work that goes into making simple changes in their area.

Are savings shared with the idea originator and countermeasure implementation team?   If so, how is this established? What support staff is needed to accomplish this?

Joe: Yes, information about cost savings is shared with the originator.   Our Kaizen Coordinator, who we hired from our finance department, gets with each Kaizeneer who documents an estimated savings of over $1,000.  The Kaizen savings is reviewed and adjustments are made, if appropriate.   Any that save over $10,000 are more thoroughly analyzed and reviewed by our Kaizen Coordinator who has finance sign off on it.

If suggestion boxes don’t work, how do you collect suggestions for improvement?

Mark: One method we talk about in the book is a “visual idea board” (as shown here). The cards on the board are structured to list a problem and an idea, not just a “suggestion.” A board like this is much more transparent and collaborative, to allow ideas to be seen and worked on quickly.

Do you have a Kaizen Department or how is this supported organizationally?

Joe: Yes, Franciscan has a department called “Business Transformation” which takes on the role of a Kaizen Promotion Office (KPO).   It includes a Kaizen Coordinator who spends half their time supporting Kaizen organizationally.   It also includes a director and manager who spend about 20% of their time each supporting Kaizen organizationally.   The rest of their time is spent leading Lean Six Sigma projects.   So, amongst our team we have almost one FTE directly facilitating the practice of Kaizen across the organization.

How do you ensure Kaizen is not done to optimize locally at the expense of other parts of the system or value stream?

Mark: This is a big part of the role of leaders in a Kaizen approach. Before Kaizen, the leader might be the only one who comes up with ideas or they might be the only one who implements things. In a Kaizen approach, leaders are still involved (one reason why, as Joe presented, that employees discuss ideas with their manager). A Kaizen leader’s job is to look out for things that are sub-optimizing or to check with higher levels and other departments to make sure that an idea isn’t at the expense of other parts of the system.

Is there a session to present Kaizens to employees in the organization?

  • Joe: We do a short ovThe erview in new employee orientation. There are also open sessions they can attend throughout the year.   This year we did a number of one hour classes on “Introduction to Kaizen” and several called “585” which stands for 5S, 8 wastes and 5 whys, which introduces them to those basic Lean practices.

Mark: In organizations I have coached, as they start making progress toward that culture of continuous improvement, they start including the Kaizen process into staff orientation discussions and presentations. As a result, I’ve seen people bring up a Kaizen idea that was implemented in their very first day on the job!

Do the employees have a chance to present their improvements?

Joe: Every employee gets the chance to present their Kaizen to their supervisor.   The supervisor then acts as a coach helping them plan a successful Kaizen implementation. That practice helps supervisors become more aware of, and to recognize, their staff’s improvement contributions.

Small Kaizens that only impact one person may or may not be presented beyond the supervisor.   Larger Kaizens that impact more employees will likely be escalated and presented by the Kaizeneer more widely to more people.

Also, employees can post their improvements on the departmental Kaizen board. Some departments have a 7-day rule where the Kaizen is posted on the Kaizen board for 7-days to give staff in the department time to review those that are proposed.   Some managers ask employees to present them in their regular departmental meetings.

Additionally, Notable Kaizens are sent to the COO who sends them out via email to all 4,000 employees on a regular basis.   Employees are also recognized at an annual Kaizen recognition ceremony.   We recognize the top departments on total number of Kaizens, and Kaizens per employee.   We recognize the top 25 Kaizeneers.   We also recognize the ten top cost-saving Kaizens.

How do you handle Kaizens when the topic is related to an FDA issue?

Joe: Supervisors act as Kaizen coaches and it is their responsibility to identify regulatory (FDA) and patient safety issues and work with the employee to explain it and think through other ways of handling the Kaizen idea.   That is why we require Kaizens to be approved by the Kaizeneer’s supervisor.

How does a Kaizen event relate to a {Lean] Rapid Improvement Event?   Cousins?   Parent/Child?

Mark: “Rapid Improvement Event” (or “Rapid Process Improvement Workshop”) is really just another name for “Kaizen Event.”   The terms RIE and RPIW have been used in healthcare more than “Kaizen Event,” for some reason. But, they’re all basically the same thing.

You can, of course, read more in our two books:


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Now Available – The updated, expanded, and revised 3rd Edition of Mark Graban’s Shingo Research Award-Winning Book Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement. You can buy the book today, including signed copies from the author.

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Mark Graban's passion is creating a better, safer, more cost effective healthcare system for patients and better workplaces for all. Mark is a consultant, author, and speaker in the "Lean healthcare" methodology. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. His most recent project is an eBook titled Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also the VP of Improvement & Innovation Services for the technology company KaiNexus.

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2 Comments on "Recording and Q&A Follow Up from Shingo Institute Webinar on “Healthcare Kaizen”"

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  1. Koos Faber says:

    Hi Mark,

    Looking forward to the recording of the webinar, which in the end I could not attend.

  2. Koos Faber says:

    Just received the link to the recording :-)

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