Healthcare Plan

Healthcare System Improvement Build Process

2 Year, High-Level Plan (Microsoft Project Validated)


  1. Phase 1: *** Management Engagement, Staffing, and Set-up ***,
  2. Educate the Management Team on the System Improvement Process,
  3. Management Commitment. Benefit: Executive Buy-In and Commitment,
  4. Start an Office of Toyota Operational Excellence,
  5. Staff up with 3 Black and 2 Green Belts. Start this early because this will take time and is a Critical Success Factor,
  6. Start the build of your Healthcare System “Guiding Principles”. This includes goals, and responsibilities designed to create an agile and robust company, if not currently existing. Start with Toyota as a guide.
  7. Phase 2: *** Value Stream Mapping ***,
  8. Agree on Success Metrics,
  9. Select Improvement Projects: (Your System is comprised of Value Streams). Map Value Streams on critical healthcare systems as well as poor-performing systems. Benefits include:
    1. Profound Knowledge of each process in the Value Stream and then your system,
    2. Built-in performance metrics
      1. Increase Value Stream and Process velocity,
      2. Decrease costs, and
      3. Increase quality.
  10. Educate employees on Waste, or activities a customer would not willingly pay for. Use the Lean Six Sigma acronym DOWNTIMES.
  11. Phase 3: *** Initiate Value Stream Improvement Efforts ***,
  12. Select the target Value Streams to map
  13. Start the Project Charter Build for each targeted Value Stream. This provides much-needed direction and project management guidance,
  14. Initiate the Mapping of Value Streams,
  15. Document and Promote the successes of targeting Value delivered and building project inertia,
  16. Initiate an Education and Instruction Program to increase improvement velocity,
  17. Select the mapped Value Streams to improve
  18. Investigate the usefulness of crucial Lean Six Sigma tools,
  19. Phase 4: *** Consider building an Operational Excellence Website *** containing:
    1. Toyota Production System (TPS) overview,
    2. TPS’s competitive advantages,
    3. Lean Six Sigma tools,
    4. Current Projects,
    5. The checkbox of Future Projects planned.
  20. Phase 5: *** Major Strategic Phase ***,
  21. Phase 6: *** SDD – Standardize, Document, and Display ***. Standardize on Best Practices,
  22. Establish success metrics,
  23. Initiate a system-wide standardization effort,
  24. Phase 7: *** Investigate Production Leveling Options ***. This may or may not work for you,
  25. Determine areas of Flow potential. Start the process of rearranging activities.,
  26. Establish success metrics,
  27. Investigate Value Stream Maps for Flow Potential
  28. Create Flow Where Possible
  29. Publicise Success
  30. Phase 8 *** Initiate efforts to implement Kanban Pull around areas of Flow ***.
  31. Phase 9: *** Investigate andon solutions ***. andon means that you stop to fix a defect in a process, product, or service when detected. Toyota still averages 800 a year. This helps create a Learning Organization,
  32. Above all, Establish the Metrics that demonstrate System Success,
  33. Phase 10: *** Initiate the Strategic Kata Continuous Improvement Effort ***, Educate Employees, & Select Value Stream Managers,
  34. Educate management on the process,
  35. Build the Kata structure for your system.
  36. Initiate build of Continuous Improvement Program by SelectingYour Improvement bogey, Toyota uses 6ms,
  37. Select a Business VP who benefits and cares about improving a Value Stream,
  38. Select Value Stream Managers. It’s essential for future improvement that Value Streams have ownership. A Value Stream Manager would have additional time to perform other job functions such as managing other Value Streams or operational responsibilities,
  39. Select starting target Value Streams,
  40. Publish success results,
  41. Phase 11: *** Validate Milestones, Improve Supply Chain Relationships ***,
  42. Therefore an Estimated Progress Milestone: At the end of the first quarter, you will have put in place all the parts needed to optimize the implementation of your Production System. Value Streams are Mapped and Improved. The next steps accelerate your march forward,
  43. Supply Chain. Benefit: Bring them closer to meeting your requirements whether lower prices or Just-in-Time
  44. Align your Supply Chain into 6 tiers of partners,
    1. Tier 1: Critical and Just-in-Time,
    2. Tier 2: Critical and Just-in-Time possible,
    3. Tier 3: Critical but no Just-in-Time,
    4. Tier 4: Other suppliers that deliver Just-in-Time,
    5. Tier 5: Other suppliers Just-in-Time possible, and
    6. Tier 6: Other non-critical suppliers.
  45. Explore enhanced relationships with Tier 1,
  46. Include in contracts a constant demand for increased Sigma performance,
  47. Determine which Tier 2 Suppliers could move to Just-in-Time,
  48. Toyota uses 2 hours of inventory as their Just-in-Time requirement. Determine your optimal Just-in-Time requirements,
  49. Phase 12*** Future Actions ***
  50. Apply for a Baldrige Performance Excellence Award for Process Excellence,
  51. Phase n: *** Continue the path toward Greatness ***,
  52. (Optional, based on aggressiveness) Hire more Black and Green Belts. This will ramp up the improvement effort through your company, and
  53. Select additional critical and less critical Value Streams to map

Estimated Progress Milestones:

At the rate of 5 Values Streams Mapped and Improved every 4 weeks you will have:

  • First Quarter: 9 Value Streams
  • Second Quarter: 24 Value Streams
  • Third Quarter: 39 Value Streams
  • Fourth Quarter: 54 Value Streams
  • Second Year: 114 Value Streams (or more if you continue to staff up)

Benefits of your new Healthcare System:

  • Profound Knowledge of your Production System
  • Operational Excellence (a competitive advantage)
  • Increased Value Stream velocity
  • Decreased costs
  • Increased product/service quality
  • Above all, Continued Improvement with a quest for Perfection

In Conclusion

This is a big effort but unlike other projects, measurable benefits start within the second month. This effort will move your healthcare system to constantly change, create an improvement culture, and comes with Performance Metrics. Your Healthcare System is now on its way to excellence.