1. Introduction to Kaizen
Last Revised: 8/9/2017

2. Kaizen Objectives Understand and be able to articulate what Kaizen is
Explain how Kaizen fits into Riverside culture
Demonstrate how to implement Kaizen and the Idea Board in your department
Last Revised: 8/9/2017

3. It is also sometimes referred to as continuous improvement.
Note – I do not expect you to learn Japanese to use Kaizen. 
Kaizen is a philosophy of continuous improvement – trying to find small ways to improve every day.
It is also sometimes referred to as continuous improvement.
Last Revised: 8/9/2017

4. Kaizen is one of the tools used by those who practice Lean.
Kaizen and Lean
Kaizen is one of the tools used by those who practice Lean.
Last Revised: 8/9/2017

5. Lean and Kaizen
Lean is a set of practices, a management system, and an organizational culture based on Lean manufacturing or the Toyota Production System.
Lean Healthcare works to provide ideal patient care, improving quality, reducing waiting times, and minimizing costs.
See the Introduction to Lean lesson for more information on Lean.
Last Revised: 8/9/2017

6. Lean Thinking Specify value in the eyes of the customer.
Identify the value stream and eliminate waste.
Make value flow at the pull of the customer.
Involve and Empower employees.
Continuously improve in pursuit of perfection.
Other important points we must consider:
focus on what the customer wants, and the align all our processes to deliver
collect best practices and develop standard processes
use teams to execute
use all of the brains in the company
establish flow; eliminate the barriers to flow (causes of waste)
rework is not value-added, need quality built into products/processes
understand customer demand
reward Lean thinking and Lean behavior
reward problem solving rather than work-arounds
make every process visual
multi-skill everyone
Last Revised: 8/9/2017
Source: Lean Thinking, Womack and Jones 1996

7. What is Waste?
Once you identify waste in your workflows, use the Kaizen boards to gather and implement ideas to eliminate/minimize it.
Last Revised: 8/9/2017

8. So what is Kaizen?
Our people are the only real differentiator or competitive advantage for our organization.
Last Revised: 8/9/2017

9. Kaizen is not a suggestion system
So what is Kaizen?
Kaizen is not a suggestion system
More
Transparent
Faster
Not the locked suggestion box that no one looks in
More
Collaborative
Last Revised: 8/9/2017

10. Kaizen is managed using an Idea board.
Last Revised: 8/9/2017

11. Idea Card
The employee fills out the front and posts in the 1st section of the board
Once we have something we want to implement, we fill out the back side of the card
Last Revised: 8/9/2017

12. Idea Board
The employee fills out the front of the idea card and posts it in the Ideas section
The board manager (often a peer), moves viable ideas to the To Do section
Once we have an implementation plan, it moves to Doing, where we use PDCA to try out an idea
After completion, the idea is moved to Done
Last Revised: 8/9/2017

13. Idea Board
Here’s another example of a board with and additional “Needed More Information” section
This works as long as ideas are addressed. You don’t want this to be the place ideas go to die.
Last Revised: 8/9/2017

14. Use PDCA to Test an Idea
PDCA (or the Deming Cycle) is a way to test out your idea.
Document your implementation plan
Set a time frame for the test
Check to see if you got the expected results
Act by making the new workflow your standard or designing another round of PDCA if you weren’t happy with the results
Last Revised: 8/9/2017

15. Kaizen Implementation
Share
Post it
Review it
Discuss it
Give recognition
Last Revised: 8/9/2017

16. What is Kaizen? Meaningful improvements Made by those who do the work
Small, low cost, and easily implemented
Synonymous with PDCA, PDSA, continuous improvement, or Process Excellence
We devote project teams to larger issues, Kaizen is for day-to-day improvements
Last Revised: 8/9/2017

17. Why Kaizen? Improve quality Prevent errors and improve patient safety
Increase employee engagement, encouraging staff to fix problems
Reduce waste (also often the root cause of dissatisfaction)
On the 2016 Pulse Survey, only 59% of employees said they felt like management involves people in decisions that affect their jobs or work environment
You often hear staff dealing with waste when they say things like – I felt like I spent all day fixing problems instead of doing my real work.
Last Revised: 8/9/2017

18. Why Kaizen? Save staff time
Improve satisfaction – patient, employee, physician
Cost Reduction and/or cost avoidance– hard and soft
Higher revenue, improve throughput
Last Revised: 8/9/2017

19. Kaizen Implementation
Find
Opportunity for improvement
Search for ideas that make their work easier, safer, more interesting
Start small
Discuss
Thank them for their suggestion
Say yes
If you can’t say yes, say why
75% of ideas implemented is a good metric
How do we want to vet new ideas?
What criteria will result in a no?
We’re working on the processes, not the people
Last Revised: 8/9/2017

20. Kaizen Implementation
Implement the change as part of the PDCA cycle
Ideally the person that initiated the idea should be the one to test it
Address in a timely manner
Document
Critical step
Give it a catchy title, use pictures if possible of the before and after
Quantify benefits
What is a timely manner for us?
Last Revised: 8/9/2017

21. Recording a Kaizen Event
Title: [Insert a brief title here]
Before
After
[A sentence or two about the “before” condition and problem statement. Right click on the box below and then select paste to add a picture there.]
[A sentence or two about what was done and about the improved condition. Type benefits into the “Effect” box , below]
Effect
[Describe the effects and benefits of the Kaizen. Describe categories of improvement, such as patient experience or staff time savings. Quantify the benefits, including any cost savings, when you can.]
Name(s)
Department
Supervisor
Date
Include everybody who participated.
Recording a Kaizen Event
This PowerPoint template is available from the Lean Educator.
Last Revised: 8/9/2017

22. Equipment Not Easily Accessible Or Hard To Find
Before
After
Equipment was cluttered into one room and it was not easy to obtain from the back of the room. Staff was having to empty out the room just to find something.
Equipment was organized, and unnecessary equipment was removed from the room. Staff was educated on where equipment would be placed.
Effect
Organizing the room resulted in less time spent looking for and accessing equipment. This lead to happier staff and more time for patient care!
Name(s)
Department
Supervisor
Date
Valerie Hatley, Heather Davis, Whitney Behrens
2med/peds
Diane McGrath
11/15/2013
Examples of completed Riverside Kaizen ideas.
Last Revised: 8/9/2017

23. Title: Isolation Equipment
Before
After
PPE boxes that used to hang on the doors didn’t have room for extra isolation supplies to be stored and we would run out frequently.
New isolation carts were ordered hospital wide with drawers big enough to hold extra supplies and are used for multiple patient use.
Effect
Having enough PPE equipment stocked in the hallways resulted in staff members saving time looking for equipment elsewhere. This also resulted in increased compliance with isolation protocols and patient safety.
Name(s)
Department
Supervisor
Date
Meghan Davilo
2med/peds
Diane McGrath
11/16/13
Examples of completed Riverside Kaizen ideas.
Last Revised: 8/9/2017

24. What processes or workflows can we look for improvements on at our location?
Last Revised: 8/9/2017

25. Last Revised: 8/9/2017

26. Barriers to Kaizen Lack of time “I get rewarded for firefighting”
Might get in trouble for admitting we have problems
It’s the other people who need to change
Fear of losing jobs
-Usually outcomes prove that the time spent on an improvement is less than the time being spent on work-arounds
-about an hour a week to manage the board, time spent on PDCAs can vary
-No one wants to be a fire marshal when they grow up
-”Can I move it to another department’s board?” Reach out and work with that department
-We have never reduced a position because of Lean in the 10 years we have been using it
Last Revised: 8/9/2017

27. Barriers to Kaizen Perceived loss of control
Forget to follow up on ideas
People give up when not getting responses
Lack of trust in the organization
Getting in trouble with coworkers
Last Revised: 8/9/2017

28. If problems are not visible, then we have no way to address them
We have to create a culture where problems are embraced
If an employee is afraid to bring up a problem, then it may never get fixed.
Last Revised: 8/9/2017

29. Role of Leaders Managers can’t do it all
Determine who is going to “manage” the board
Leaders sort, coach and coordinate, receive, approve, and track
Use department meetings, huddles to discuss ideas
In the 2016 Pulse Survey, on 53% of employees felt that management was approachable/easy to talk with
Last Revised: 8/9/2017

30. Role of Leaders
Encourage Staff to Participate by Asking for Their Ideas
Ask if anything has changed lately
Carry blank idea cards
Create a Department Recognition System
Tie to Performance Evaluations
Have a kick-off event? Bring an idea and get free lunch, etc.
Last Revised: 8/9/2017

31. Discuss With Your Team
How are we going to encourage people to bring ideas?
What sort of recognition system do we want for people who submit ideas?
What should be our goal for how many ideas we want submitted per month?
Should we limit how many ideas we work on at a given time?
What do we consider timely response?
Last Revised: 8/9/2017

32. Kaizen Idea tracking metrics
Jan
Feb
Mar
Apr
Number of Ideas Submitted
Number of Ideas Completed (goal 75%)
% of Total Ideas Completed
Number of Ideas per month divided by number of employees
(goal avg. X per employee)
These spreadsheets for tracking Kaizen board usage are available from the Lean Educator.
Last Revised: 8/9/2017

33. Kaizen Tracking Form x X
Department
Date Completed
Completed Project Link
Problem Title
Before Condition
After Condition
Safety
Quality
Efficiency
Patient/
Physician/ Employee Satisfaction
Cost (Quantify if possible)
2nd Med/Peds
11/13/2013
2 Med-Peds\ Crash Cart.ppt
Cash Cart not accessible for Emergencies
Equipment blocking crash cart
Equipment rearranged for easy access of crash cart. x
11/15/2013
Clutter in Equipment Room
Equipment hard to find
Equipment room 5Sed
2 Med-Peds\ Treatment Room.ppt
Treatment Room Poor Lighting and Lack of supplies
Staff frequently and concerns about leaving to get supplies and difficulty seeing during a procedure.
Unnecessary equipment removed, supplies stocked and improved lighting. X
2 Med-Peds\ Nuses station signs.pptx
Nurses station signs in hallway
Family and staff members unable to locate different nurses stations on unit
Signs installed in hallways on unit
11/16/2013
2 Med-Peds\ communication manager.ppt
Communication with staff and patients difficult
Time spent searching for staff , unable to hear call bells and emergency lights
More Ascom phones purchased and call bells and lights sent to phones
2 Med-Peds\ Isolation Equipment.ppt
Isolation Equipment
Running out of PPE and isolation supplies
New isolation carts were
These spreadsheets for tracking Kaizen board usage are available from the Lean Educator.
Last Revised: 8/9/2017

34. What Kaizen feels like Work and patient care flow like clockwork
The workplace is clean, orderly and safe
Everyone works together
Everything gets questioned
Last Revised: 8/9/2017

35. What Kaizen feels like Everyone is engaged
Everyone is searching for opportunities to improve
You have control over your workplace
Patients and families are happy
Staff and physicians are happy
Last Revised: 8/9/2017

36. Everyone is Happy
Last Revised: 8/9/2017

37. Where can we start?
Last Revised: 8/9/2017

38. If you have any questions or would like to learn more about Lean at Riverside, feel free to contact me:
Sara Meyer
Lean Educator
(815) x6392
Any questions?
Last Revised: 8/9/2017