1. Therefore improvements are required to ensure a sustainable healthcare system able cope with an increasing demand that: a. NHSG has knowledgeable and confident staff prepared to lead and engage in CSI activities. b. Pan-NHSG service delivery is led, managed, prioritised and improved using lean techniques. c. NHSG agree and establishes it’s use of lean improvement tools and techniques. d. NHSG approach realises significant benefits. a. Lean trained staff b. CSI Spread c. Tools & Techniquesd. Delivery against True North a. Trained staff b. CSI Spread c. Tools & techniquesd. Expected Benefit = £ ____ Seek to show the tools and logic used to determine direct causes of problems and true root cause. Recommended approach; show fish bone or affinity diagram with: - Problem Statement from box 1 in head. - a, b, c & d improvement requirements as “rib” titles. - Primary Root Causes (the 5th Why) on the branches. - Prioritise Root Causes by numbering them; where 1 = highest impact, etc. The top 6 carried down in order to the Solution box 5 below… - If VSA then add Current State Summary box.. Max 3 Actions WIP/person 30-90d break through focus. Last Column is Status - use RAG (Red, Amber Green) Good events have no to do list! a. People/culture b. Quality c. Time/Deliveryd. Actual Benefit = £ _____ This box is “GO” when Box 8 = Box 3 Monitor ACTUAL results against the metrics defined in initial and target state Actions What went well? Consider; Process Team Leader Sensei Culture & Behaviour What helped? What hindered? What did not go well? What are the fundamental lessons of the event and the improvement cycle? 2. Initial State5. Solution Approach8. Confirmed State 1. Reason for Action4. Gap Analysis7. Completion Plan 3. Target State6. Rapid Experiments9. Insights & Lessons Reflections: Root Causes: If true root cause not clear then review above. Reflections: No Go GoNo Go GoNo Go GoNo Go GoNo Go GoNo Go GoNo Go GoNo Go GoNo Go Go ExperimentAnticipated Effect Actual Effect Follow up Action 2345 6789 1 Team Members: Start Date: 25 June 09 Current Date: 9 Sep 09 End Date: Title: Process Owner: Dave Jones-Lofting/Lynn Marsland Facilitator: Eileen Buchan If actual effect = anticipate then proceed to box 7 if not then return to box 4: Cause /Priority SolutionAffectingCurrent StateFSEC A B C d1dOO ActionTTOwnerDue RAGRAG What did you learn and what are you going to do as a result? AND SO WHAT? Explanation of last 5 columns: - Affecting - If major affect on deliverable then use CAPITAL, if minor then lower case. - Current State = data point that describes current performance in terms used in boxes 2 & 3. - FS = Future state prediction (e.g. 1 day) - EASE O = Easy ∆ = Medium Ease X = Difficult. - COST O = Low Cost ∆ = Medium Cost X = High Cost Executive Sponsor: Mark Sinclair ?? What did you learn and what are you going to do as a result? AND SO WHAT? Pauline Strachan, Alan Gall, Stuart Scott, Alison Hawkins, David Sullivan, Ewan Robertson, Anne Ross Strategic implementation of Continuous Service Improvement in NHSG Event Date: 8 Sep 09 TEAM PHOTO # Projects with Exec Sponsors # trained Project Leads # Lean Practitioners # People Act Plan Study DoDo ? June 09 Confusing array of improvement tools; very few lean tools £M # People Jul 09 Jan 10 Jul 10 Jan 11 £M NHSG The NHSG Directory ? What will be our ROI 09/10 10/11 11/12 ? We want improve the health of population by providing high quality services for our patients and to help them to look after their. The circumstances we currently face (economic, clinical progress & demographics) require a dramatic change in our approach to service provision While there is a good deal of constructive and innovative change taking place, we need to make these activities even more effective, widespread and sustainable. This will be achieved only if this change is understood, owned and delivered by all NHSG staff. Therefore all staff need to be supported and encouraged to be involved APPENDIX 1