Issue 7 • Nov 2011
Lean Training – Leadership Standard Work
Leadership standard work is the hour by hour activities of management that bring a lean improvement system to life.
Many of you are thinking, "Hour by Hour? Are you nuts? I do not have enough time to get everything done in a day, and now I have ‘more’ work to do every hour?"
If you look at this work as existing outside of your current roles and responsibilities, then you will be time challenged. If I'm spending time each hour working on the things I am held accountable and responsible for, then this is not ‘extra’ time. It is simply how I do my job.
If you are curious, or if you see improvement as an integral part of your day to day responsibilities, then read on.
Leadership standard work is about carving time out of your schedule each hour and focusing on the process, focusing on improvement, or focusing on developing people. Where should you spend your time each hour? That depends on what your area of focus is. Below is a list of topics that may help you decide where to best allocate your time:
Leadership Standard Work Topics:
Address patient/staff/provider safety issues
Review and take action on process control
Observe and coach on standard work
Daily huddle (3 layers)
Audit 5S and take actions
Create missing standards
1 x 1 coaching
Communication updates
Work on improvement
Work on open items / to do lists
Survey customers
Review and take action on results (from performance boards)
Follow up on suggestions
Capture personal and department reflections
Update our own standard work
Lean Safety Initiative Helps Protect Rouge Valley’s Littlest Patients
By Akilah Dressekie, Communications Specialist, Rouge Valley Health System
September 1, 2011
When a code pink — pediatric cardiac arrest — is called at Rouge Valley Health System, a team of nurses, pediatricians and respiratory therapists immediately spring into action to save a baby or child’s life. As the seconds tick away, it is critical to ensure that the right equipment and medication needed are in place.
Sixteen new code pink carts were introduced at RVHS in July, as part of a safety initiative to help improve patient safety for neonatal/pediatric patients, who require an emergency response. The new carts help to standardize the emergency care given to neonatal/pediatric patients ensuring that all staff and physicians are providing the same high standard of care.
Rose Owen is a clinical practice leader (CPL) in the neonatal intensive care unit (NICU) and special care nursery at Rouge Valley’s two hospital campuses. In July she saw first-hand how effective the new carts were. “When a code pink is called, each second is critical. The cart absolutely helped us with our first emergency response. In the old carts, we would have to search through the drawers, looking for the appropriate-sized equipment,” she explains.
“Because the drawers are colour coded, organized and properly stocked, everything needed for a small infant is right there. We aren’t searching for our supplies during these critical moments,” she adds. “This quality initiative ensures that all our neonatal/pediatric patients receive optimum care during times of emergency,” explains Amer Syed, manager and CPL, respiratory therapy.
While code pink carts had already been in place at Rouge Valley’s two hospital campuses, they weren’t as organized for supplies needed immediately during a code pink. Children require equipment of appropriate smaller size, including intravenous or airway supplies. Staff members need to be able to quickly locate those supplies during the rare times when a code pink is called. The new carts are now standardized for a code pink.
Feedback from the nursing staff using the code pink carts has been very positive. “The carts have made a difference by giving us easier access to the equipment we need during an emergency. It also helps our staff to feel more confident that they’ll be able to respond properly when a code is called, because they know that everything they need to help save that baby’s life is going to be there,” adds Rose.
The carts are the culmination of two years of planning by members of the professional practice team. Using Lean methodology, the team worked together to help standardize the carts, so that each is stocked the same way. Every cart also features a map showing a list of supplies in each drawer, making it easy to know what the cart contains, and what to restock. The items stored in them can be used on all pediatric patients 18 and under.
Kamishibai – Living a Lean Culture
Is your organization struggling with staff engagement? How about sustaining standard work? One of the best visual management systems available today is Kamishibai.
What is Kamishibai? Kamishibai is a simple card system that is used for systematically reviewing critical items within the workplace. Said differently, Kamishibai is an audit system that engages each and every staff associate and leader in reviewing safe work practices, adherence to standardized work, maintenance of accurate documentation, and general housekeeping (5S).
The system consists of systematic 2-4 minute spot audits of critical items during the course of daily work. Each audit contains a pass –fail criteria this is easy to interpret and standard for everyone. If the audit is passed, then the success is noted on a visual management board. If the audit fails, then the immediate intervention is taken by the auditor. It is in completing the audit the staff member gets a chance to self reflect on their adherence to standard. This self- reflection, or a reflection related to living a lean culture, is the core of Kamishibai.
The system presents itself in an easy to review board consisting of red and green cards. The green side shows the audit criteria. If the audit is passed, the card is placed into the pocket with the green side showing. If the audit fails, the intervention is immediately taken. The card is then placed into the pocket with the red side showing. (The red side of the card details the audit criteria and the corresponding intervention)
The system assists with adherence to standard work and staff engagement at the same time. Teams that have been improving for about 18 months should be thinking about implementing this system.
Facilitator’s Work Shop
Following the voice of our customers, we are pleased to announce our first workshop in Ontario that targets development of “lean” improvement facilitators. We will be covering all aspects of the facilitator’s role within a quality framework. As a bonus, we have confirmed a panel discussion with 4 senior level executives to cover leadership expectations of the facilitator and respond to the participant’s specific questions regarding the role of leadership in improvement.
This lean facilitation training is integral to generating and sustaining improvement; it is being offered as is a 2-day program on 12-13 December, 2011 in partnership with Holland Bloorview Kids Rehabilitation Hospital. The session will be limited to ~30 participants and will be filled on a first-come first-served basis.
- Eligible individuals: novice or intermediate individuals who want to learn the soft and hard skills needed to lead your organization in quality improvement. This course will apply to clinical, medical, and administrative associates.
- The training will be provided by Ron Bercaw, President, and Heidi Naperala, Master Sensei, with Breakthrough Horizons, Ltd.
- Included in the cost of the training will be training hand-outs, lunch and snacks. Training fees for the curriculum will be $595 CAD per participant. Participants are responsible for travel, and for their own lodging if required.
