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Pacing by Demand Continuous Flow Pull Systems

MQS. Michigan Quality System Quality – Safety – Efficiency – Appropriateness – Service . Built-in Quality. Just-in-Time. Error Proof Surface Problems Stop and Respond to Abnormalities Solve Problems at Root Cause. Pacing by Demand Continuous Flow Pull Systems.

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Pacing by Demand Continuous Flow Pull Systems

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  1. MQS Michigan Quality System Quality – Safety – Efficiency – Appropriateness – Service Built-in Quality Just-in-Time • Error Proof • Surface Problems • Stop and Respond to Abnormalities • Solve Problems at Root Cause • Pacing by Demand • Continuous Flow • Pull Systems Customer DefinesValue LeveledWorkload Continuous Improvement (P-D-C-A) and Learning Standardized Work Make Value Flow by Eliminating Errors and Waste MQS House – Master version (All Missions) Sources: J. Shook, J. Billi, J. Liker, S. Hoeft, J. Womack, Park-Nicollet /jmk 06.23.07

  2. Align & Balance Efforts • System level • Flow (Value Streams) • Point improvements • Learning organization • Area transformation (Ambulatory Care, C&W) • Work group learning (Mott ORs, “LIT” pilots) • Individual learning Process Improvement People Development

  3. Most Frequent Adult High Level Patient Journeys Acute Medical (unscheduled) Ambulatory MOU ED Home or ECF Primary Care Medical Inpatient Medical Clinics Surgical Inpatient ORs Surgical Clinics Home or ECF Major Proce- dure Rooms Surgical (scheduled)

  4. Patient Care Major Patient Journeys (Value streams across areas/units) Clinical Stream Chief Engineer: Ambulatory Care Medical Stream - Adult Surgical Stream - Adult Unscheduled Inpt - Child Scheduled Inpt - Child Dept. Leader: ED/MOU Med. Surg. Anes. Nursing Modified from John Shook

  5. Unquestioned Assumptions Driving:Complexity • Blanket solutions • Use of CI specialists to solve organizational problems • Not building capability of others • Missing opportunities for learning Focused on the final result, not on the problem solving process • Fragmented actions • Lack of organization wide strategy • Silos • Failure is not allowed • Employees feel the need to justify their actions • Someone else caused the problem • Rationalization of data • Metrics and status reports are the primary management tool • Deferring to the person of highest rank Source: J. Luckman/LEI

  6. Unquestioned Assumptions Driving:Continuous Improvement Focused on the means to achieve great results Let’s identify the problem and solve it together Processes and people are aligned to achieve organizational goals Create an environment where it’s OK to fail • Go See • Mentor people to develop problem solvers Source: J. Luckman/LEI

  7. Practice the Change Source: J. Luckman/LEI

  8. Shift Mental Models

  9. PEOPLE PHILOSOPHY PROBLEMSOLVING PROCESS Adapted from J. Liker: The Toyota Way

  10. ADJUST PLAN CHECK DO PROBLEM!! Standard Actual What parts are missing in our work areas and leadership??? Modified from Dave LaHote, with permission

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