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Problem Solving and
Daily Management for
Lean Healthcare
What is a Problem in Lean?
“No one has more trouble than the
person who claims to
have no trouble.”
Taiichi Ohno
“Having no problems
is the biggest problem of all.”
Do you have Daily Problem Solving at all Levels?
•Policies
•Annual
Objectives
•Improvement
Plans
•Cross
Organizational
Problem Solving
•Process
Improvement
•Objectives &
Budget
Management
•Management
Directed
Kaizen
•Daily Problem
Solving
•Standardized
Work
•Kaizen
•5S
Supervisors
Staff
Top Management
Manager
Problem Solve
3 Stages of Problem Solving
Goal
Problem Solving that results in
getting to the goal.
New Goal
“Reaching”
“Maintaining”
Problem Solving that focuses on maintaining the
goal.
Problem Solving that focuses on increasing capability beyond the
goal - “Kaizen”.
Maintenance Kaizen Kaizen
“Raising”
PLAN
DO CHECK
ACT
PDCA Cycle
PLAN
DO CHECK
ACT
PDCA Cycle
Traditional Method vs. PDCA
Elements Traditional PDCA
Plan Generally reactive
(put out fire)
Proactive: responsive
to long term goals
Do “Wing it;” figure it
out as you go
Use of “Pilot” activities
before full blown
implementation
Check Hesitancy to
discuss problems
Specific input/output
measures identified for
measuring success
Act Frequent use of
“band aids”
Standardization
Different types of problems
23
Current Situation
Current Ideal
Situation
New Ideal Situation
GAP
GAP “Setting” Type of Problem
Raising the bar to purposely
create a “GAP”
Meeting the Expectation
REACTIVE
PROACTIVE
“Event” Type of Problem
A “GAP” develops between the
ideal and current situation
Snapshot of the 8 steps
P
l
a
n
Step 1
Clarify the Problem
Step 2 Breakdown
the Problem
Step 3
Target Setting
Step 4
Root Cause Analysis
Step 5
Develop
Countermeasures
Step 6
See Countermeasures
Through
Step 7
Monitor Process &
Results
Step 8
Standardize & Share
Best Practices
Do
Check
Act
Step 1: Clarify the Problem
25
Visualizing
Problem
Ultimate Goal/Purpose Purpose of Your Work
Value added’ness
Current Situation
Measurable Comparison
Quantifiable
NOT Quantifiable
GAP
Ideal Situation or
Standard Where you
want to be. Measurable Contribution
So What Factor
Plan
Step 2: Breakdown the Problem
26
Gap from Step 1 (Larger Problem)
Problem
Prioritized
Problem
Problem Problem Problem
Problem Problem Problem Problem
Point of
Occurrence
(POO)
Go through the process
Plan
Separate into division
points using the 4W’s
Step 2a: How to Divide the Problem
Where?
When?
Who?
What?
Continue breakdow
n using Genchi G
enbutsu
4W D
ivision points and prioritizing
1 2
1
Prioritize
2 3
Divide Divide
Problem to
Prioritize
Plan
28
Step 3: Target Setting
Specify:
How much? = # or %
When? = specific date
Target
Always set your Target to address the POO !!
Step 1 POO Step 3
Prioritized
Problem
Point of
Occurrence
Plan
Step 4: Root Cause Analysis
Potential
Cause
Actual
Cause
Point of
Occurrence
Potential
Cause
Potential
Cause
Potential
Cause
Potential
Cause
Actual
Cause
Potential
Cause
Potential
Cause
Actual
Cause
Why?
There
fore
Root
Cause
Plan
Step 5: ID Countermeasures
Countermeasure
Countermeasure
Can We Eliminate?
What are
the risks?
Framework of
Experiences Root
Cause
Countermeasure
Countermeasure
Countermeasure Who will be
impacted?
Framework
of Scope
Plan
31
Step 5a: Develop Countermeasures
△ △ ○
× △ ×
○ ○ ○
Assessment Risk Cost
Choose most practical and effective counter measure using a criteria matrix
Countermeasure #1
Countermeasure #2
Countermeasure #3
Mary
Joe
Who
Action
Action
What When
Build consensus and create a
detailed action plan (Gantt Chart)
Plan
As a
team
32
Step 6: See Countermeasures Through
Never
give up
Timely
Reporting
Proper
Checking
Speedy
action
Informing
(Update)
Consulting
with others
Japanese: Nemawashi Do
33
Good results = luck
Step 7: Monitor Both Processes & Results
In the Eye
Of the
Customer In Your
Company ’s
Viewpoint In Your
Own
Viewpoint
Was the Target in
Step 3 achieved?
Pro
cess
X
Repeatability
Results
Japanese: Hansei
Check
Implementation
Standardization
34
Step 8: Standardize Successful Processes
Japanese:
Yokoten
Standardization
Standardization
Own Work &
Responsibility Overall Company
Success
Ideal Situation or
Standard Where you
want to be.
Act
39
Keys to effective A3:1. Does the A3 tell a problem solving story, using both words and visuals?
2. Is the importance to the business and/or customer evident?
3. Has the current condition been observed directly and understood?
4. Is the A3 being discussed with colleagues, stakeholders, people involved in the process?
5. Has the problem been broken-down and analyzed to root causes using facts and data?
6. Do the countermeasures and actions address the identified root causes?
7. Have success measures been established?
Understanding Agreement Alignment
A3 Thinking and ManagementFostering
effective dialogue
Encouraginginitiative
Developingproblem solvers
Enabling effective execution
Office Products North America
Strategy Objective: Realize new revenue streams via alliances, experiments and exisiting capabilities
Value Stream or Major Process:
Strategy Deployment Leader: Allison Phillips Updated: 12/02/200812/11/2008
V. The target condition - What will the improved state look like?
Problem Statement - What is the gap?: We will have a steady stream of EBIT available to help fund growth initiatives
Marketing, R&D, SFC & GBD project spend has declined at a CAGR of X.X% over the past 5 years - down $X.XMM in last 12 months We will have new partnerships that extend Avery's consumer reach and
Net Sales has declined at a CAGR of -X.X% over the past 5 years - $XX.XMM in last 12 months generate business revenue - ie HP, Visa, IBM
Marketing project spend as % of sales has declined from avg of X.X% during 2005-2008 to a projected X.X% for 2009 AOP We will gather new consumer insights that can be applied to our growth and
Economic environment continues to limit the cash available to fund growth initiatives productivity initiatives - buying patterns, new services, etc
We need to find new ways to fund investments in Marketing, R&D, SFC & GBD to help drive Net Sales growth We will broaden our distribution channels - ie HP, Dell, Google, avery.com, etc
to drive increased business revenue
Business Case - What is the customer or business need?:
We have assets and consumer access that are valuable but have not been monetized to their full potential
Finding ways to derive more direct revenue from these existing assets can help fund growth initiatives quickly
We need to develop a stream of investment income to bring Marketing, R&D, SFC & GBD funding to sufficient levels - X% of sales VI. Action Plan - What must be done to implement the strategy?
Tactics Functions
RequiredWho When Status
A. Monetize consumer reach vehicleseMail Mktg, Legal,
BrandJ.Do, CE Q2
(Ehrenhalt/Do)eMail Mktg, Legal,
BrandJ.Do, CE Q2
Pkging,Legal,
Supply ChainCE, TA Q2
a.com Mktg,
Legal, BrandCE, DM Q2
Metrics with targets: $X.XMM EBITS/W Mktg, Legal,
BrandCE, BD Q2
B. Develop strategic alliances & affiliatesBU's, Sales, S/W,
a.com
JK, DM,
SBQ1-Q4
(Kingsley/Ehrenhalt)Alliance, BU's,
Sales
JK, MC,
SR, KPQ1-Q4
USPS On-line Store, Label UniverseAlliance, BU's
Sales
JK, MC,
RWQ1-Q4
Metrics with targets: $X.XMM Rev. ($1MM in AOP)Alliance, BU's,
Sales, Search
CE, JM,
BAPQ1
** 2009 AOP includes $2.2MM marketing productivity savings C. Drive eCommerce revenue on avery.coma.com Mktg, DR,
SalesBAP, RP Q1
(Maxson)a.com Mktg,
Sales, CIDM, RW Q1
a.com Mktg, BU's,
Sales
MC, SR,
BAPQ2
Metrics with targets: $X.XMM Rev. ($XMM in AOP)a.com Mktg, BU's,
Sales
BAP, RP,
RWQ2
D. Monetize S/W downloads & capabilitiesAvery.com, Bus
Dev, LegalCE, BD Q1
(Dillon)SW Dev, Bus
Dev, LegalBD Q3
Metrics with targets: $X.XMM EBIT ($XXk in AOP)
iStockphoto initiative success opened our eyes to new revenue streams Execution was complex, disruptive to ops, & resource heavy E. Monetize patents and brandsAlliance, Fin,
Brand, LegalCE Q1
Identified new ways to increase direct to consumer sales on the web Limited number pursued due to fear of negative customer reaction (Santhanam/Ehrenhalt)PDev, Fin, Brand,
LegalRS Q2
Avery consumer-facing marketing communications targeted & reach many Difficult to balance competing internal & external demands for space Metrics with targets: $X.XMM EBIT
Identified a range of ways to drive new revenue Two people assigned to find partnerships, develop them & execute
Consumer interactive marketing platforms completely renovated Platform fixed costs a higher % of budget & challenging in soft econ VII. Improvement Metrics - How will we measure the improvement?
Multiple companies are seeking access to our database, techs, & brand Concern over gving away competitive advantages & hurting brand Portfolio Operating Metrics: Target Financial Target Summary: Revenue Re-Invest Status
Portfolio Payback 100% in 12 months/break-even current yr Target Target
Recap key problems and opportunities Benefit/effort ratio Greater than 0.8 A. Monetize consumer reach vehicles 1.5 MM
Selling existing products directly to consumers bears upside & some risk Parameters on what's OK and what's not aren't clear B. Develop strategic alliances & affiliates 2.0MM
Many creative ways to derive revenue identified, but execution is slow Limited human resources, competing business priorities, ops complexity C. Drive eCommerce revenue on avery.com 2.5MM
Avery capabilities and assets have value to consumers & 3rd parties Fear of hurting Avery brand, competitive advantage & consumer experience D. Monetize S/W downloads & capabilities 0.5 MM
There are near term revenue opps, but also longer term opps Solely focusing on quick cash in 2009 could compromise 2010-2011 opps E. Monetize patents and brands 0.5 MM
4.5MM 2.5MM
In 2009, we will find $X.XMM in incremental EBIT to reinvest in our business growth initiatives and an incremental $X.XMM in revenue by 1.5MM 2.4MM
finding new ways to monetize our brand, consumer access, digital and physical assets, and partnerships while laying the foundation
for a 3-5 year pipeline of investment and revenue dollars.
Each initiative will be evaluated on its own merit for return on financial investment and human effort
We will focus on delivering our 2009 objective, but will have a longer term line of sight
We will fund our initiatives from the revenue that we bring in Gain alignment on appropriate level of global versus OPNA support
We assume that the appropriate resources will be made available to execute new revenue model opps Develop parameters/guidelines for acceptable brand and partner affiliations
We will have a bias to longer term partnerships that are compatible with our brand versus short term "opportunistic" partnerships Create clear valuation targets for Avery's media assets
We will be globally opportunistic, but our primary focus will be OPNA
Evaluate linking program from avery.com to
sell branded ink cartridges
Q1 SMB mailing bundle; Q2 CE bundle; Q4
mailing bundle; Q3 Staples program
Action Staples collaboration; 1 at a time label
offering and eCommerce - eval other options
Affiliate Marketing Program
Roll-out on-line postal store test more
broadly; pursue Label Universe business
Launch Q1 test with scrapbooking; roll out to
ASB if successful.
HP eCommerce, Retail, Pdct, sub-logo licensing
Dell.com Bundles & Q3 Staples Ret.
I. Problem statement and business case - Why are we talking about this?
Pursue iStock or similar deal
Benchmark best practices; rates & find
partners
Implementation Activities Implementation Checkpoints
3rd Party eMail Sponsorships, AffiliatesBenchmark best practices; rates & find
partners
Benchmark best practices; rates & find
partners3rd Party Newsletter Sponsorships, Affiliates
II. Current condition reflection and analysis - What have we learned, where are the problems, what are the causes?
3rd Party Packaging In-Packs
3rd Party Advertising on avery.com
Evaluate various options (ask.com, google,
msn), choose partner, implement
Assess current unused IP portfolio and
identify potential licensees; pursue HP in Q1
3rd Party Advertising in softwareBenchmark best practices; rates & find
partners
Free Shipping with minimum order
Toolbar with downloads
Affiliate links/rev share to non-Avery products
Promote "free shipping" more actively on site
Brand & Sub-brand Licensing OppsContract with LMCA in Q1 to bring in potential
opportunities for assessment
Increase visibility of data available from CI
channel partners - esp Staples
Unique Bundles & Active Cross SellIntegrate cross-sell, up-sell and unique
bundles in the shopping area of web site
Channel Intell. Lead Generation
1/31/2009
1/31/2009
IV. Rationale for updated strategy, evaluation of alternatives - Why is this the right strategy and approach?
License DesignPro engineRenew contract with Nova, identify and
pursue other possible licensees.
Causes to address
TOTAL:
Patent Licensing Opps
Incremental to AOP:
VIII. Requests to senior management / Follow-up on unresolved Issues - What other needs or concerns exist?
III. Strategy goal statement and hypothesis - What are we planning to achieve?
Develop parameters/guidelines for selling existing products directly to consumers via the web
Ensure cross-functional resource strategy exists for execution
WHENWHO
1/31/2009
1/31/2009
Action
Robert W. & David M. with Amy
& Todd
Todd, steering team
Todd, steering team
Bruce, steering team
Bruce, steering team
1/31/2009
Allison Phillips
Todd Thompson
Amy Ladwig
Steve Burns
Ramin Heydarpour
Joe Moffa
Brian Daly
Tim Bond
Sign-off's to Ensure Firm Commitment to Resource and Support
Existing assets not fully monetized
33MM software & template downloads
60MM targeted e-mails
30 MM website visits
40MM packages
2MM samples
2.2MM names
Cash flow value potential = ???
Increased project spend funds generated by new revenue stream
15.3
22.119.4
1310.1
0
5
10
15
20
25
2005 2006 2007 2008 2009 AOP
Marketing Project Spend ($MM)825.5 830.8
764.4
689.1 695.8
500
550
600
650
700
750
800
850
2005 2006 2007 2008 2009 AOP
Net Sales ($MM)
1.9%
2.7%2.5%
1.8%1.4%
1.8%
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
3.0%
2005 2006 2007 2008 2009 AOP w/ $2.5MM new EBIT
Marketing Project Spend as % of Sales
A3’s
Roadmap — Start by knowing the
destination
Hoshin Kanri
Everyone knows the
destination!! Manager Annual Plans
Plant Annual Plan
Annual Policy &Objectives
Mid-Range Plan
True North: Ideal
Hoshin Review- PDCA Cycle
・Intervals
・Entire Company
・Individual
Result Check
Grasping the gap between the daily plan and actual performance
Process Check
Group
Individual
Day
Sr. Mgmt Dept Mgmt Subsection
Week 6 12
Mo
nth
s 1
Direction
Management System
1. What do we need to do?
3. How are we doing?
(Results)
2. How should we do it?
(Process)
(Targets)
Problem solving linked to direction
Daily Management System Components
Effective Shop Floor Management
Focuses on building an effective visual
management system to help the group achieve
Hoshin targets.
Member Skill Development
Activities and tools to help develop members capabilities to perform Standardized Work and
achieve daily production goals with
safety and quality.
Team Board-Floor Management Development System
Problem solving linked to direction
Quality Section of Team Board for Floor Management Development System
Fujio Cho, Chairman, Toyota Motor
3 Keys to Lean Leadership
“Senior Management must spend time on the plant floor.”
“Use the ‘Why?’ technique daily.”
“Respect your people.”
Problem solving linked to direction
