Department of Surgery: 60-Day Report Out
Process Excellence had a busy month of Lean launches and report-outs. We were able to attend the Department of Surgery’s 60-day report-out where we saw their famous viz board that has received quite a lot of attention. They are on track to hitting their goals, and have come to the realization that working as a group has not only been effortless, but also rewarding, as everyone has benefited from these changes for on-boarding. We are excited to see their metrics next month.
Faculty Compensation's Lean Launch
Faculty Comp’s Lean Launch focused on reduction of delays and errors involved in processing changes for faculty who have a Palo Alto VA appointment. These changes include actions for hires, promotions, sabbaticals and other leave types; retirement and 8th’s changes. These actions are all complex due to the need to maintain the parity balance of Stanford salary with often-changing VAPAHCS salary. At the Lean Launch the team mapped out the current process steps for these faculty changes, and then invited colleagues from five departments and the University Benefits team to provide feedback. As a result, several education projects to help department and divisions understand the process, as well as required information have been identified for the team’s 30, 60 and 90 day goals.
SoM Grants and Contracts Group
The SoM Grants and Contracts group were featured in Stanford Connected for applying the Lean Processes to reduce grant-award processing. Click here to read the full story.
Crafting the Goal
The teams in the School of Medicine Operations have been hard at work visualizing their goals. Senior leaders are engaged in a year-long training course, and teams have started putting some of their knowledge into action.
Some of the keys to this are aligning the strategy of the team to the greater organization, managing the work visually, and developing ideas and a way to prioritize ideas. One of the ways that teams have made this more interesting is by not only visualizing their key elements, but by doing it in a creative way.
Marcia Cohen was able to see some of these boards in action when she came to visit the Porter site in early August.
Lean Leadership Training
This year, leaders from throughout the School of Medicine Operations have been taking a year-long course to learn the Lean methodology. Taught by Mike Martyn of SISU Consulting, the course goes in depth on how to run an organization based on Lean principles.
Topics covered so far include the background and history of Lean, organizational maturity, engaging teams, and determining gaps. As we move forward, the team will continue to focus on putting these ideas into practice in their daily work.
Basic Science Financial Reporting Launch
Basic Science DFAs and Analysts and Dean's Office representatives have come together to streamline their financial reporting. They're working to reduce the amount of manual data manipulation so they can spend more time forecasting and analyzing.
They learned about what reports other departments used, and what data was available in various systems, but one of the key takeaways was that a lot of issues are actually very similar across departments. Rather than working in nine different silos, they can leverage the knowledge that people have to create a larger community.
After three days, the team has become just that, a team, and a group that will continue to work together to bring forth ideas and work through issues together.
IRT Provisioning's first 90 days
IRT Provisioning has completed their 90 day journey and had their report out. During that time they accomplished some key goals and have continued to think up new ideas that will take them beyond their first 90 days.
The team has done work to make the ordering process smoother for customers with a new website and a Google form used for ordering. They've tried to make things smoother for their coworkers with a "go-bag" for the most common adaptors and cords that may need to be used when new computers are being deployed by their desktop support colleagues. They've also automated some of the back-end processing by the Finance team. And last, but not least, they've streamlined their own work and improved their accuracy.
BLIMP (Brilliant Lean Inventory Management Process) Rises High
The BLIMP team took flight in early June to help you get your repairs done faster. The team took on the Inventory Management Process, in order to make sure the supplies people need for their repairs are on hand when they need them.
The Launch took place over three days and included customers, people in the field, people who order supplies, and the people who work in the stock room. It was eye opening to see the current process works from start to finish. The team has planned out their next 90 days, and included in that is everything from automating some notifications, to completing a physical audit, to shadowing partners to learn from their process.
They've got a lot going on, but they'll be sure to rise up and deliver on a brilliant new inventory management process.
IRT Data Center Takes Center Stage
The IRT DCS (Data Center) team took three days from their busy schedules to try to tackle the problem of... their busy schedules. As the School of Medicine grows, their need for data also grows. And this team is the backbone of that data. It's a very dynamic environment for this dynamic team.
During their Launch DCS reviewed how they take new projects in, prioritize those projects and get clarity on what they need to be working on.
What they found was there were ten different ways that people contacted them to make requests, everything from a shoulder tap to an email to an Service Now ticket. Everyone also had different ways of keeping track of information, which made it difficult to see what everyone was working on.
They have come together to decide on a few key ways of keeping track of their workload that will give greater visibility into what they do and allow leaders to prioritize.
New Process Excellence website resources
Some changes have been rolled out in the Process Excellence website. We hope you take a moment to take a look at them, we're pretty excited!
We've added a few new areas to the website, including the Principles of Process Excellence, which were created by the Safety, Quality and Value committee. Members of this committee included participants from the School of Medicine, Stanford Health Care, and Lucile Packard Children's Hospital.
The four main principles include:
- We create value for our customers
- People are the most valuable resource
- We strive to be the best at getting better
- Our leaders foster an environment for improvement
We've also added a place for FAQ's about Process Excellence at the School of Medicine Operations. We've taken your feedback and put some answers to the questions that we get asked about the program on our website. Hope you enjoy reading, we've enjoyed putting it together for you.
Provisioning's first 30 days
The Provisioning team has been hard at work for the 30 days since their launch. They've already put into place some quick wins that are making them optimistic that they will hit their goals in time for their 90 day report out.
FAA from the Department of Medicine report out
The FAA team has been hard at work after their launch and were excited to present to a very interested group. The team presented in front of a diverse group of people including people from the Office of Academic Affairs, Faculty Compensation and an extended group from the Department of Medicine. They shared some new standard work that the team developed as a part of their Launch including an adminstrator packet to share with the administrators, a pre-kick-off meeting packet, a calendar among other tools.
IRT Provisioning launches forth
Have you ever wondered what happens when you request a computer? From the initial request to having the computer delivered and ready to install, it’s a complex process that touches multiple teams in IRT (Information Resources and Technology), as well as colleagues in the departments and finance. In late March, a group from across the School of Medicine operations teams came together with some key Stars (key departmental purchasing partners) to try to resolve an issue that had been surfacing from multiple sources: it was taking too long for people to get new computers.
Response times had increased from what had been same day responsiveness to a two to four day wait, not including the time it took to get the computer shipped from the manufacturer. The Provisioning team is new, their scope had grown fast. What last year was 10 -20 requests a week was now clocking in around 70 – 80 requests a week.
Stars from across departments, IRT, Finance and Procurement came together as a team to tackle the questions around how to make their process faster, with more consistency and better visibility for Stars and IRT throughout the provisioning process.
The launch itself lasted two and a half days. During that time they got a brief overview of Lean, mapped their current process, envisioned the future state, identified pain points, brainstormed ideas for improvement, went back over their goals and metrics to reach those goals, identified some key objectives and discussed what was next. They also had a lot of fun while coming together as a group to tackle a complex problem.
Some of their key learnings were that this was a much more complicated process than people realized, with many people involved at various points. It takes around 30 steps, with an additional 16 administrative steps to get a computer out to you. It was also surprising to people that there were multiple rework steps in the process that surfaced from the mapping. People also felt that it was good to get perspectives from around Stanford. Coming out of the launch, the team feels like they are aligned on their goals and how to achieve them. There are some concrete next steps and the team is already hard at work. We are excited to see what they achieve and let us know during their 30, 60 and 90-day report outs.
OFPM reports on their Lean initiatives
At the OFPM (Facilities Planning and Management) all-hands the leaders shared their Lean journeys, including some successful Lean launches, standard work, and how people huddle. Some final thoughts include the fact that, “Lean is cool” and while adopting the Lean approach is not easy, and you need to hang in there and wait for the payoffs, when the team starts to experience the benefits, it’s a really cool thing to watch and be a part of.
Marcia walks the halls
Marcia came to see the continued maturation of the Lean program as she visited the halls of Porter, Page Mill, MSOB (Medical School Office Building) and Li Ka Shing. Her teams were excited to see her and show her their great progress.
HRG is on the right "Track": Human Resources streamlines it's hiring process
Hiring a new employee can be a daunting task for any manager. It takes the time and resources of teams across the organization to find the right candidate to fill a position. In October 2015, a cross-functional team gathered together to launch a Lean initiative to make the hiring process faster and less repetitive for the hiring manager and other School of Medicine staff involved along the way. The “Lean” approach, made famous by Toyota and others, aims to improve processes like these by engaging team members who actually do the work as well as customers who benefit from it to recognize and solve problems. The team began by focusing on the process then used to fill regular staff positions.
A year later the team, comprised of Susan Hoerger, sponsor Cori Bossenberry, and stakeholders within School of Medicine departments and the Dean’s office, took stock to evaluate progress.
An up-to-date re-mapping yielded impressive results, with a much more streamlined process for over half of the hiring requests moving through the system.
How did they do it? In the past, all regular staff requisitions passed through the same hiring funnel. This resulted in all requisitions taking about the same amount of time, regardless of whether the position was a standard entry-level role or a complex, hard-to-fill role.
Done the old way, it would take on average 75 to 150 days from the time a hiring manager first made contact to getting an offer out. The new process has resulted in most straight-forward, open positions having offer letters delivered in 45 to 105 days. Groups have seen a significant decrease in the time for the most straightforward hires. Even the position types that need to go through the most review levels are now being completed in 50 to 144 days.
So, what changed?
The new process breaks hiring requests down into four categories. While this may seem like it’s adding complexity, it helps assign the right level of service to each hiring category, enabling simple requests to move through the pipeline faster.
This was eye opening for many. There were fewer bottlenecks, and the rework that frustrated hiring managers, Directors of Finance and Administration (DFAs) and human resources staffers was identified and reduced. It was great to see a cross-functional team working so well together to determine a way to address process flaws.
The team is now looking at further opportunities to streamline their processes by focusing on a new pain point – quality of applicant pool.
FAA and CISL 60 Day report outs
FAA had their 60 day report out in late February. The team shared their learnings along with some of the work they've done on the Faculty Search Committee Packet.
CISL had a 60 day report out in late February, where they shared some of their successes and roadblocks. The team reported that they've now started thinking about Lean in how they do everything, and they've already started down the path of another avenue of improvement.
2017 Lean Leadership Cohort
We are very excited to announce that we have started our 2017 Lean Leadership Training Program. The first session was on Building Principles-Based Daily Management Systems, and is being led by consultant Mike Martyn. A group of leaders throughout the organization were introduced to the history of lean and the nature of the Toyota Production Systems. The course covered key principles of operational excellence, the relationship between principles, systems and tools, and the industry’s best practices from organizations who have successfully created a culture of continuous improvement build on a foundation of respect, humility, and daily kaizen. This new cohort joins the 13 people who have previously taken the training in Seattle.
Marcia “walks” the Alway halls
Marcia Cohen “walked” over to Alway to visit the OFPM teams for a quarterly Wall Walk. She got a glimpse into some of the key ways the teams have been improving their core services and how they keep track of their progress.
Tech support at medical school gets ‘lean'
Learn about how the IRT Help Desk has adopted and adapted to Lean Process Improvement Prinicples. See how these principles come to life in a group who takes the plunge!
OAA report out:
OAA had their 90 day report out in late January. During that time they discussed how not only were they able to streamline some of their processes, but how they were able to strengthen their customer relationships and build in cross-training within their own organization through the launch process.
CISL 30 Day Report-Out
During their 30 Day Report-Out, CISL revealed the good progress on form design and communications. They continued to review their goals and celebrated their wins! Awesome work CISL team on the collaborative efforts!
January 24: Marcia Cohen returns for Wall Walk
Marcia Cohen returns to 3172 Porter Drive for the quarterly “Wall Walk” with HRG, IRT, Facilities, Fiscal Affairs, and RMG teams.
December 15: Department of Medicine Faculty Affairs 30 Day Report Out
Kudos to the Department of Medicine Faculty Affairs team on their 30-Day Reportout! Since their October Lean Launch, the team has been “huddling” every week to explore and implement ideas like an online form for capturing faculty recruitment requests and new tools to assist faculty search committees. We will unveil the progress of their goal- reducing the time it takes to send a faculty recruitment offer letter at their 60-Day Reportout!
November 28- Nov 30: CISL Launch
The Goodman Immersive Learning Center (ICL) is an exciting hub where state of the simulation medical training takes place inside the Li Ka Shing building. With growth in demand and complexity for ICL resources across Stanford Medicine, the Center for Immersive and Simulation based Learning (CISL) team came together during their November Lean Launch to improve their annual scheduling process for their customers. Check back to see how the team begins to test and implement their ideas at their 30-Day Reportout in January!
October 25- October 27
Department of Medicine Faculty Affairs Launch: Improvement Focus Area- Department of Medicine professoriate recruitment process.
October 24th: Marcia's Quarterly Wall Walk Visit
Excited to have Marcia Cohen, Senior Associate Dean of Finance and Administration, journey through our visual boards. Sending a big thank you to all teams: Facilities, Fiscal Affairs, HRG, IRT, and RMG! We are excited to see all the great improvement work you are doing!
SoM Controller's Group: FY17 Goals
Building the "Viz Board": Newest member of the Controller's Group, Jennifer Chan, Associate Controller, reflects on the useful tool to help familiarize with various projects- past and present.
CT RMG: Lean Conference
Congratulations to the CT RMG team for submitting their poster and representing SoM at the Lean Conference while learning how providers apply Lean in the health care setting.
September 26-27 at Stanford
Stanford School of Medicine is proud to co-sponsor- Lean Healthcare Academic Conference at Stanford.
Key speakers include John Shook, Chairman and CEO of the Lean Enterprise Institute, and Edgar Schein, author of Humble Inquiry.
September 22nd, University of Washington Lean Training and Visit
Visiting University of Washington and learning how leaders connect daily huddles with their team to their monthly leadership huddles that review progress towards their annual goals.