What change can we make that will lead to improvement? Change Concept: General notion or approach to change that has been found to be useful in developing specific ideas for changes that lead to improvement. Go over what is a change concept Reference: The Improvement Guide, 2nd Ed. Langley, Nolan, Nolan, Norman Provost, Appendix A; pgs. 357-408 29

A Resource Guide to Change Concepts Grouping: A. Eliminate Waste B. Improve Work Flow C. Optimize Inventory D. Change the Work Environment E. Enhance the Producer/Customer Relationship F. Manage Time G. Manage Variation H. Design Systems to Avoid Mistakes I. Focus on a Product/Service # of Concepts 11 4 8 5 Reference: The Improvement Guide, 2nd Ed. Langley, Nolan, Nolan, Norman Provost, Appendix A; pgs. 357-408

Complete List of Change Concepts Manage Variation Standardization (Create a Formal Process) Stop tampering Develop operation definitions Improve predictions Develop contingency plans Sort product into grades Desensitize Exploit variation Design Systems to avoid mistakes Use reminders Use differentiation Use constraints Use affordances Focus on the product or service Mass customize Offer product/service anytime Offer product/service anyplace Emphasize intangibles Influence or take advantage of fashion trends Reduce the number of components Disguise defects or problems Differentiate product using quality dimensions Added for 2nd Edition 71. Change the order of process steps 72. Manage Uncertainty, Not Tasks Eliminate Waste Eliminate things that are not used Eliminate multiple entry Reduce or eliminate overkill Reduce controls on the system Recycle or reuse Use substitution Reduce classifications Remove intermediaries Match the amount to the need Use Sampling Change targets or set points Improve Work Flow Synchronize Schedule into multiple processes Minimize handoffs Move steps in the process close together Find and remove bottlenecks Us automation Smooth workflow Do tasks in parallel Consider people as in the same system Use multiple processing units Adjust to peak demand Optimize Inventory Match inventory to predicted demand Use pull systems Reduce choice of features Reduce multiple brands of the same item Change the Work Environment Give people access to information Use Proper Measurements Take Care of basics Reduce de-motivating aspects of pay system Conduct training Implement cross-training Invest more resources in improvement Focus on core process and purpose Share risks Emphasize natural and logical consequences Develop alliances/cooperative relationships Enhance the Producer/customer relationship Listen to customers Coach customer to use product/service Focus on the outcome to a customer Use a coordinator Reach agreement on expectations Outsource for “Free” Optimize level of inspection Work with suppliers Manage Time Reduce setup or startup time Set up timing to use discounts Optimize maintenance Extend specialist’s time Reduce wait time Instructions (continued) Fill in these fields: Questions Predictions Change or Test Data Collection Use additional paper if needed. Guidelines  How frequently does each cause occur? How seriously does each cause affect the process?  Discussion  As time permits, discuss what you might do in the Do, Study, and Act phases of this PSDA cycle. Reference: The Improvement Guide, 2nd Ed. Langley, Nolan, Nolan, Norman Provost, Appendix A; pgs. 357-408

Using Change Concepts Vague, strategic, Improve process to reduce anxiety creative Give patients and families access to information #27 Use beepers for family and friends waiting Specific, actionable, Make beepers available to Results families of all surgery patients next week. Reference: The Improvement Guide, 2nd Ed. Langley, Nolan, Nolan, Norman Provost, Appendix A; pgs. 357-408