Slides from the speech given by Daniel T Jones at the Lean Forum Norway on 11th November 2015

1. What have we learnt
about Lean?
Daniel T Jones

2. Lean is everywhere
But there is still much confusion Are we really doing Lean?

3. New ways of seeing the Work
From batches to Flow – model cells & lines
From MRP to Pull – to real not created Demand
Stabilise steps & Standardise work
Quality at source – never pass on defects
Make deviations &
problems visible
See the whole value stream
Learnt through using the Lean tools

4. Software followed a parallel path
Agile – frustration with Waterfall & autonomy
Continuous Programming/DevOps – from batch to Flow
Scrum/Kanban – review cadence & pull the work
Extreme Programming/XP – standard & testable code
SOA/Amazon – modular architecture & daily releases
Lean Startup – frequent experiments & user feedback
Agile & Lean need to work together

5. Getting management involved
“Do it for me” does not work
Runs up against MBO & financial targets
Need to show that “better processes lead to better results”
Better quality & responsiveness grows Sales
Creating Flow releases Cash
Increased throughput lowers Cost
Simpler assets/systems saves Capital
What is your business problem?

6. Sustaining the gains
“Do it to others” – works for a while
Experts & Programmes – come & go!
How to help the front-line to learn
to do it themselves?
And really get it by practicing it every day!
This has to be the responsibility of line management

7. Supporting learning
Making work transparent and visual
Regular reviews of P/A & responses
Coaching problem solving using A3 & PDCA
Capturing “ah ha” insights for the future
Later linking improvements
along the value stream
Deselecting & aligning activities
to close key performance gaps
A M J J A S O N D J F M
X X X X X X Visual Hospital X X X X X X X X X X X X X
X X X X X X X X X X X X X X X X X X X X X X X X
X X X X Integrated 7 day working at back door X X X X X X X X X X X
X X X X X X X X X X X X X X X X X
X X X X X X X X X X X X X X X X X X X X X X
X X X X X X X Pathway redesign X X X X X X X X X X X X X X X X X X X
X X X X X Theatre utilisation X X X X X X X X X X X X X X X
X X X X Endoscopy utilisation X X X X X X X X X X X X X X
X X X X X X X X X X X X X X
On Target
Not on Target or Missed
X X X X X X X X X X
X X X X X X X X X X X
X X X X X X X X X X X X
X X X X X
X X X X X X X
X X X X X X X X X
X X X X X X X X X X
X X X X X X X 061011 version 9
Release 9438 bed days in surgery
Release 24627 bed days in medicine
Release of 735 OPD clinics
Reduction of 1993 readmissions
Integrated Urgent Care Centres to release 2393 bed days
Increase of 96 day cases
ImplementationofUrgentCareStandards
OPD new/ F/U ratio
ImplementationofPlannedCareStandards
FinancialBalance
ImprovedTheatres/EndoscopyUtilisation
Redesignoffrontdoor
LengthofStayReduction
Improvedaccesstoplannedcare-OPD&diagnostics
15%reductioninsurgicallengthofstay
Reducebedoccupancyto95%
Transformation Deployment Matrix - Work Streams - Trust Level 2011/12
Integrated Urgent Care Centre
Plan for Every Patient
Senior daily review
Increase of 86 lists in endoscopy
Potential efficiency equal to 4221 cases in theatres
15%reductioninemergencymedicallengthofstay
PlannedCareAccess-HeatherCarter
Theatres&Endoscopy-HeatherCarter
UrgentCareAccessAnneSymon
50%reductioninonthedaycancellations
LengthofStay-DavidFurley
Readmissionswithin30days-25%reduction
25%reductiontowards08/09admissionslevelsinED
Increasedaycaserateby25%forselectconditions
Increasetheatreutilisationto85%
Increasedischargeratetomeettakt7days
Increaseendoscopyutilisationto92%
Achieve25%reductioninOutpatientfollowups
15%reductioninLoSfor5ambulatorypathways
TRANSFORMATIONPRIORITIES
TIMELINE
TTT
TARGETSTARGETS
PROJECTS
TTT
PROJECT DELIVERABLES
TOPLEVELMETRICS

8. Leading and Learning
Thousands of problem solvers
learning to stabilise & practice PDCA
Lead by questioning
challenging
& enabling
Leaders learn to
face find & frame problems
by coaching the front line

9. The true power of Lean
5% a year plus 30% every product generation
Through cumulative incremental improvements
40% less capital & operating costs
Capability to meet
green challenges
Supply chain 97 weeks to 24 days

10. Digital connectivity
Is transforming every sector
media, retail, mobility, money, health etc.
Technical capabilities + social organisation + user acceptance
Two way dialogue with communities of
expert users agreed on sharing & privacy
Learn to think back from users
Based on frequent experiments,
validated learning & continuous improvement

11. Meaningful work
Squads Teams Kaizen
Chapters Knowledge Mastery
Tribes Streams Purpose
Actions to support Teams = Leadership
How to avoid “Big Company”
disease as you scale?
How to mobilise your “Smart creatives”

12. Conclusions
Making things better
the ability to do more with less waste
Meaningful work
developing capabilities with others
Managing by science
whether hardware or software
knowledge or physical work

13. What have we learnt
about Lean?
Daniel T Jones
dan@leanuk.org
@DanielJonesLean