Process Excellence

James Ramos, Director of Process Excellence

Process Excellence: Empowering innovation in every person, every day  

Stanford Medicine Process Excellence advances the School of Medicine’s transition to a continuous improvement organization by working with teams to discover how to improve the quality and value of our administrative operations.

Our mission is to empower innovation in every person, every day. 

Virtual vs Physical Vizboards

It seems only natural that Stanford employees, nestled in the heart of Silicon Valley, in a time colloquially referred to as the digital or information age, would have an immediate affinity towards a cloud-based solution to vizboards.  Solutions such as Miro and Trello come with an astonishing set of features and increasingly compelling visual aesthetics.  However, those who have used these products extensively, know  More from hard-fought experience that they are not the panacea they are often made out to be.  At the School of Medicine no discussion around vizboards is more frequently pursued than the one that pits physical boards versus virtual boards.

It is our contention—particularly for teams new to Lean—that physical boards are hands-down a more pragmatic initial approach.  To summarize, physical boards are simpler to use, easier to customize, visible to the team and to the organization, and are highly conducive to building strong working relationships through in-person communication. 

Building Strong Team Dynamics

Vizboards are meant to help teams explore, organize, and prioritize work—that is, they’re designed to create an environment for structured discussion.  Since human communication is generally laden with non-verbal cues, discussions will always be more information-rich and, therefore, more meaningful and more relevant, if they are done face to face.  Physical boards require teams to physically interact while virtual boards facilitate virtual interaction.  The academic literature on organizational behavior has shown repeatedly that teams that regularly engage in structured physical interactions—e.g., huddles at their physical board—are more likely to build strong collaborative interpersonal dynamics than their virtual counterparts.

Customizability and Ease-of-Use

When it comes to customizability, virtual boards have come a long way in the last few years, but they still cannot beat the ease-of-use and the almost limitless potential of dry-erase markers and chalk.  In addition to the endless ways you can configure physical boards, many teams see significant engagement benefits by having fun with their boards and centering on a given theme (e.g. Star wars, Seinfeld, The Wizard of Oz, etc.)  This type of creativity is impossible with most, if not all, of the cloud-based tools.

Work that is Visible

Physical boards have the great advantage of always being “on”, where virtual boards are seen only when a user logs in—out of sight, out of mind, as the old dictum states.  Part of our journey in creating a culture of improvement is sharing our work, our process, our problems, and our successes with the broader community.  That’s easy to do with physical boards—hard to do with virtual boards.      

Where virtual boards have a clear advantage is when it comes to features.  There are things you can do in the digital domain that are impossible in the physical.  Though even this advantage is not clear-cut.  Consider the endless size of one’s virtual canvas.  It’s relatively easy to build a board that sprawls uncontrollably and becomes unmanageable.  In fact, this is the most frequent pitfall teams fall into when using virtual boards.  If the point of the vizboard is to facilitate structured discussions, the friction that arises when teams can’t find a note or idea, or if they simply get lost in the maze of stickies that have built up over time, is deadly to conversations that are meant to be short and to the point.  The tangible limitations of a physical board turn out to be a blessing in disguise as they force teams to learn to prioritize.        

While we understand their appeal, virtual boards only make sense for teams with considerable lean experience.  Even teams with highly distributed workforces or employees with remote workdays would derive benefit from starting with a physical board, learning what works for them and what doesn’t, and only then transitioning to a virtual board.  For these teams, there are plenty of options you can use to involve all your team members in a huddle around a physical board.  If you are part of a team and would like help setting up your physical board or, even, help in understanding the different virtual board platforms that are out there, please reach out to the Process Excellence team to help provide you with a framework on how to get started.



Upcoming Workshops

Stay tuned.  Workshops coming soon!

share with us

Do you have an improvement story or an idea that you or your team implemented? What are some of the big wins? Who did this impact? We want to feature your story here- email us

coming up

  • October 8, 2019
    9-10:30am: EPS: Biosciences Admissions 90-day report out (MSOB X140) 
  • October 13, 2019
    9-9:30am: Ortho-research 60-day report out (Zoom) 
  • October 18, 2019
    11-11:30am: cFTE Calculation Standardization 90- day report out (Zoom) 
  • October 18, 2019 
    TBD: SNP workload mgmt 30-day report out (2490 Hospital Dr Ste. 205) 
  • October 22, 2019 
    TBD: DoS onboarding 90-day report out (Alway M121) 

Interested in a Launch?

I’m interested in using the launch process to help my team solve a problem.

Step 1: Are you a member of the Stanford School of Medicine?

Step 2: Start with a problem facing your team. Typically, this would be an area in where there is a gap between expectations and results.

Step 3: Discuss with your manager or leader, and contact us to determine if this would be a fit for a launch—usually a three-day event that focuses your team and customers on targeted improvements.

Step 4: We will work with your Team Leads/Managers to produce a scope document that sets goals aimed at significantly reducing your gap. The launch would then be scheduled, team members would be named, and facilitators and resources would be secured.

Step 5: The launch itself is attended by your team and a team leader; all participants collaboratively map the current and desired/future processes, along with issues and ideas for improvement. The final day includes a report out to your sponsors.

Step 6: After the launch, there are 30, 60, and 90-day report outs.