Kaizen

Kaizen an integral part of the Lean Healthcare philosophy, is a Japanese word that means to make peoples jobs easier by taking them apart, studying them and making improvements. The intent is to make people more productive by improving their working environment and the focus is immediate action rather than longer-term alternatives to change. Kaizen is also known as the Deliberate Application of Common Sense.

Improvement begins with the admission that every organization has problems and these problems provide opportunities for change and improvement. The traditional conventional wisdom holds that “If it ain’t broke, don’t fix it.” The Kaizen philosophy takes the view that every process can be improved and therefore even if you think “It ain’t broke, fix it anyway.”

The best knowledge resides with the people who actually perform the work. They know the problems and often the solutions. During a Kaizen event, they make the recommendations on how to improve the process and they make the physical changes to the processes. They will also support and continue the process after the event is over.

Because the people who have to live with the processes on a daily basis are the people who study the current process, design the improved process and then physically make the changes to convert to the new process, there is tremendous involvement, buy-in and ownership of the improvements. The changes created through the Kaizen event are very sustainable. The processes do not revert back to the less efficient way of doing things.

One of the Key Concepts of Kaizen is that If there is No Action there can be No Success.” The goal is not a 100% solution that solves all the problems at one time. But rather a 60% solution that can be accomplished in a one-week time frame with the intent to hold another event in several months that further improves the processes. The process does’t have to be perfect the first time. Strive for “base hits” not “home runs” and no idea is a bad idea. Just do it!

Quick and simple is better than slow and fancy. Be creative – get the new process in place and working. Utilize what exists to implement the new process quickly. A Kaizen event is not a license to spend and should be accomplished with very little expenditure. The essence of Kaizen is making improvements with what you have (or less) using existing people, machines, computers, space, etc. Overall emphasis is placed on creating solutions and improvements with existing assets. As a result, they are a very cost-effective method to create dramatic improvements in processes.

A typical Kaizen event is one week long. A team is usually a cross-functional team that is composed of from 8 to 10 people. The team is composed of people who are in the process to be reviewed, such as the nurses, lead people, and supervisors. Additional resources from other departments are assigned to support the event. Even personnel from suppliers or Physicians can be included.

Training is done the first and second morning in the classroom. In the afternoon, the tools that were taught are applied by gathering data on the floor. Metrics for the current as-is process are established during the first afternoon. A report is made each afternoon to the group and other teams to exchange ideas. On the third afternoon, the team should have a proposal put together as to what changes are proposed. The proposal includes the new metrics, proposed process flow, process map, process flow analysis and spaghetti diagrams. Once the proposal is approved, the team can then start implementing the changes. The scope of the plan is to be able to complete the changes and have the new improved process be up and running by Monday. So when the employees come in on Monday the new processes are in place.

Typical Five Day Kaizen Event Plan

Day 1 Day 2 Day 3 Day 4 Day 5
Training
  • Lean Healthcare
  • Introduction
  • 5S, Visual Factory, Kaizen Key Concepts
  • Kaizen Process
  • Process Flow Analysis, Current State & Future State Value Streams
  • Spaghetti Diagrams
Floor Work
  • Process Observations
  • Takt-Cycle Time
  • Proposed Layout
  • Team Reports
Floor Work
  • Develop Future State Value Stream Map
  • Develop Implementation Plan
Floor Work
  • A3 Completed
  • Implement Improvements
  • 5S Activity
Floor Work
  • Complete Improvements
  • Prepare Presentation to Management
  • Communication PLan
  • A-3 posted
Floor Work
  • Current State Value Stream Map
  • Process Mapping
  • Process Flow
  • Analysis
  • Spaghetti Diagrams
  • Begin Current State Development
Floor Work
  • Baseline Data
  • Current state development
  • Team Reports Current State to Stakeholders
Floor Work
  • Start to Implement Improvements
  • Team Reports to stakeholder
  • Approve Plan
Floor Work
  • Implement Improvements
Floor Work
  • Team Presentation to Management