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Standard Work for Revenue Cycle"
Michael Axon!September 26, 2013!
Objectives"• Understand why standard work is an
important part of managing and improving an operation.!
• Understand that standard work is needed to establish a foundation for improvement.!
• Understand how to begin developing standard work in a revenue cycle operation.!
• Understand that direct, first-hand observation is the best way to learn how well an operation functions. !
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“Go” and See"
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How long will it take the en0re table to fold the shirt once?
How did we do?"• Did all the folded shirts look the same? !• How do you define “good”?!• Did everyone use the same method to
fold a shirt? !• Was everyone equally proficient at
folding the shirt?!• How many rejects occurred?!• What would you do differently the next
time? !4
Japanese English
Your Office"• Does your team know if they met your
expectations yesterday?!• How do you describe a ‘good’ day
versus a ‘bad’ day?!• How much better is your performance
this year versus last year?!• Do you know what problems your team
encounters each day?!– How are problems resolved?!– Are they resolved correctly?!
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Business Case for Standard Work"
• Labor is (one of) your largest cost(s). !• Customer Service!
– Quality!– Consistency!– Efficiency!
• Training new employees!• Software implementation/upgrades!
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Standardized Work in Lean"
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• Baseline for improvement • ACaining organiza0onal goals at the front-‐line • Engaging people who do the work
• Engagement, involvement, ownership • Each worker as entrepreneur • Trained (TWI, skills matrix, prac0ce) • SW for non-‐standard work • Coaching, ques0oning to make people think • Assign increasing responsibility
• Work standards • Safety, quality, performance • Observa0on and process study • Three basic elements
(takt, sequence, standard WIP) • Standard process for making changes
Purpose
Process People
Standardized Work in Lean"
• Foundation for exposing and solving problems.!
• Supported by kaizen and strong management practices.!– Kaizen prevents turning people into robots.!– Leader’s role is to develop people and
improve the process.!• Learning occurs all the time.!
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Rule 1 – Activities"Guide the design and operation of the
individual, value-adding activity.!
9 Source: Steven Spear and H. Kent Bowen, “Decoding the DNA of the Toyota Production System”, Harvard Business Review, Sept.-Oct. 1999, p. 96
The work of each individual should be highly specified in terms of:
• Content • Sequence • Timing • Outcome • Loca0on
The ac0vity should be designed with built-‐in tests to automa0cally signal if it was not performed as specified or if the expected outcome was not achieved.
Where do I start?Reflect on your leadership skills!
• Role of the manager:!– Set expectations, !– Develop your people, and !– Support problem solving. !
• Are you willing to listen? To experiment? !• Do you know how to embed your
corporate objectives into your standard work? !– If not, they are just words on a page.!– No relationship to how people do work.!
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Where do I start?What is your team doing?!
Go see how work is actually performed"• Person doing the work is the expert!• Deeply understand the work. !
– What completes a task?!– Where is ‘work’ performed on the screen?!
• Show respect!• Be a willing student!
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Where do I start?Analyze what you see!
• Find similarities – not differences.!• Identify the content and sequence
required to complete one unit of work.!• Document the method.!
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