How to Manage Your Improvement Metrics More Efficiently and

Effectively

@MarkGraban (Presenter)VP of Improvement & Innovation Services

Mark@KaiNexus.com

@Jeff_Roussel (Host)VP of Sales

Jeff.Roussel@KaiNexus.com

Agenda & Logistics

• Presentation(45minutes)• Q&A(10minutes)– UsetheGoToWebinarMeetingPaneltosubmitaquestionatanytime

• Recordinglink&slideswillbesentviaemail– Also– seethe“Handouts”featureandChatbox

About Mark Graban• 20+yearspracticingLean– 10yearsinmanufacturing– 11+yearsinhealthcare

• Books:– LeanHospitals– HealthcareKaizen

(co-authorJoeSwartz)

• www.MarkGraban.comNew3rd Edition!

Why Measure?

Are We Improving?

My Most Favorite Book Ever

http://www.spcpress.com/http://amzn.to/2jJ4fiN

DonaldJ.Wheeler,PhD

Are We Improving?

Daily Lean Management

Source:ThinkingLeanatThedaCare (DVD)

How Are We Doing Compared

to Our Goal?

"Bowling Chart"

Are We Improving?

Can We Tell From This?

A Better Dashboard

Limitedinformationyouneedtomakedecisions

Easier to Tell From This?

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TotalCases

In KaiNexus…

Are We Improving?

Need to Avoid Bad Conclusions

“Theaveragepatientsatisfactionincreasedfrom87.2to89%”

86%

87%

88%

89%

90%

Before After

Need to Avoid Bad Conclusions

“Theaveragepatientsatisfactionincreasedfrom87.2to89%”

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

100%

Before After

Need to Avoid Bad Conclusions

“Theaveragepatientsatisfactionincreasedfrom87.2to89%”

Need to Avoid Bad Conclusions

“TheaveragepatientsatisfactionDECREASEDfrom87.2to85%”??

Are We Improving?

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92PatientSatisfaction(DifferentDataSet)

Linear Trendlines are Easy

Can Linear Trends Be Misleading?

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92PatientSatisfaction

Same Chart Different Timeframe

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92PatientSatisfaction

Are We Improving?

How Can We Tell?

How Should We React?

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Responding to Daily Changes

KB

GOAL

DailyProductionAveragePraiseTeam

PT PT

Arewehelping?Isthisprocessstable?

KBKickButt

Isn’titalwaysthesystem?

It’s(almost)alwaysthesystem.

Signal vs. Noise?

"Whileeverydatasetcontainsnoise,somedatasetsmaycontainsignals.

Therefore,beforeyoucandetectasignalwithinanygivendataset,

youmustfirstfilteroutthenoise.

“X” Control Chart(Chart for Individual Values)

Goal=25minutes

UpperControlLimit

LowerControlLimit

In KaiNexus…

Surgical Cases Table

Surgical Control Chart

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Aug-05 Sep-05 Oct-05 Nov-05 Dec-05 Jan-06 Feb-06 Mar-06 Apr-06 May-06 Jun-06 Jul-06 Aug-06

TotalCases

NOISE

Patient Satisfaction Run Chart“Theaveragepatientsatisfactionincreasedfrom87.2to89%”

Patient Sat. Control Chart

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Nov-08 Dec-08 Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09

PatientSatisfaction

NOISE

Lab Turnaround TimeWhat

Happened?

SIGNAL

Another "Special Cause"

What Happened?SIGNAL

X and MR Chart Combo

Does This Small Business Have Predictable Revenue?

Xchart

MRchart

SIGNAL

Is My BlogTraffic

Increasing?

Evaluate Over Time

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LeanBlog.orgDailyPageLoads

“Western Electric” Rules• Anysinglepointaboveorbelow3-sigmaLCLorUCL

• 8consecutivepointsonsamesideofmean

• 6consecutivepointsmovingsamedirection

• 14alternatingup/downpointsinarowFullrulesà http://bit.ly/WErules

Evaluate Over Time

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LeanBlog.orgDailyPageLoads

Shift the Limits as Indicated

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LeanBlog.org DailyPageLoads

Example of Process Shift

• Ifyoumadeachangethatyouexpectedtoimprovethesystem,useacontrolcharttotestthehypothesis

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ProcessShift

DailyTAT

Example of Process Shift

• IfyoudidNOTmakeachange,youneedtoinvestigatetodeterminethecauseofthissignal

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ProcessShift

DailyTAT

Are We Hitting Our Goals?

Performance vs. Goals

System View vs. Reactive

Control Chart View

Another Example

Goal

Control Chart View

Goal

So We Should Do Nothing?

Improve the System!

NOT Understanding Variation Leads To…

• Pressuringpeopletogetbetterresultsbyworkingharderwithinthesamesystem

• Wastingtimelookingforexplanationsofaperceivedtrendwhennothinghaschanged

• Notfocusingonsystemicimprovementsthatwouldshiftthemean

Our Next Webinar"TheIntersectionofCultureandTechnology:CapturingImprovementWhereitHappens"– MatthewCannistraro– ThursdayFebruary23,1PMET

• KaiNexus.com/webinars

Ask Us Anything!• MarkGraban&Dr.GregJacobson• NextEpisodeFeb14,1pmET• Register&submitquestionsviahttp://kainexus.com/webinars

• PastepisodesavailableonYouTube

Other Resources

www.KaiNexus.com

Podcasts

• www.KaiNexus.com/podcasts

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Thanks!• Web:

– www.kainexus.com– blog.kainexus.com– www.MarkGraban.com

• WebinarsonDemand:– www.kainexus.com/webinars

• SocialMedia:– www.twitter.com/kainexus– www.linkedin.com/company/kainexus– www.facebook.com/kainexus

@MarkGrabanVP of Services

Mark@KaiNexus.com

@Jeff_RousselVP of Sales

Jeff.Roussel@KaiNexus.com

BONUSRECORDINGWILLBESENT:HOWTOCREATECONTROLCHARTS