Boost productivity LEAN How lean is ï¬پxing the NHS Boost productivity How your staff ... has...
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The experts talk Your management questions answered
On the mend How lean is fixing the NHS
Boost productivity How your staff could hold the key
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Moving forward: How lean could fix your business today
No. 1 / September. ’09
PHOTO: ALEXANDER HAFEMANN
FOR AN EFFICIENT BUSINESS
Moving forward: How lean could fix your business today
MAKE YOUR BUSINESS HEALTHIER
Sinking fast Could lean save the soft- ware industry?
Bridge that gap Why middle management could be the answer to your problems
Trade secrets Lean pioneers reveal their best tips for better efficiency
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Create a winning formula for your organisation through lean
Pioneered in the car industry, adopted across manufacturing industry and now becoming de rigeur in the service sector. Lean is the way to not just survive, but thrive in today’s economic climate.
L ean is a customer focused ap- proach to the delivery of out- standing products and serv ices with the use of a mini-
mum of resources. It uses a range of diagnostic and implementation tools such as Value Stream Map- ping, 5S, TPM, and Kanban. But real- ly it is a way of thinking and organ- ising yourself to become both effi- cient and effective. The key to lean is in leadership, alignment & moti- vation of people and getting every- one to think how tomorrow could be better than today.
Which industries are using it?
1 Lean started as an integration of the Just-In-Time principles with the Total Quality Control ap- proach pioneered by many Japa- nese manufacturers after the war. The term has since become synony- mous with the approach used by Toyota in their phenomenal recent rise to become today’s #1 selling car maker.
When we launched our Lean En-
terprise Research Centre in 1994, Lean was only really used in the car industry. However, one of our goals has been to see lean spread. Work- ing with Tesco from the mid 90s we found the approach, if not exactly the same tools, was readily applica- ble to supermarkets and their sup- ply chains. Since then they have grown by a factor of three and seen profits rise six fold. Not bad for a firm in a mature and highly com- petitive industry.
Since the turn of the century the use of lean has really exploded. It is now widespread, indeed almost mandatory for success in manufac- turing and is rapidly being taken up by service industries. It is increas-
ingly being applied as Lean & Green with also an environmental bent.
Where can you lose lean?
2 Lean is best used right across an organisation. However, many fail to do this and apply lean in narrow pockets, such as the shop floor in manufacturing or the back office in service organisations. The result is that they tend to only scratch the surface of what is possi- ble. Where we see the best results, as in the steel-processor Cogent Power described in our recent Stay- ing Lean book, it is applied right across the business. It affects the strategy, leadership approach, alignment & engagement of people, all business processes and the tools they use. However, most of all, it leads to a different mindset. In such firms you notice a shift from run- ning today’s business to one of cre- ating tomorrow’s business. Such firms will no doubt thrive whilst other may well struggle to survive.
Professor Peter Hines Chairman Lean Enterprises Research Centre, Cardiff University and Co-author of the Shingo Prize winning Staying Lean book
“A lot of ideas are bottom-up so managers may well think ‘hang on, I manage that.’”
Catherine McDermott Director of distribution at Argos on how lean worked for them
LEAN MANAGEMENT, 1ST EDITION, SEPTEMBER 2009
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There is no getting away from it. The next few years are going to be tough for public services. Whoever is in power after next Spring’s election will have to take tough decisions on where public spending can be reduced. Although the NHS may be shielded against the toughest cuts, it will almost certainly be called up- on to prove it is delivering value for money and achieving more with the same input.
Hence Daniel Jones, Chairman of the Lean Enterprise Academy, ex- plains that he has been helping sev- eral hospitals get to grips with lean management. In fact, the interest among hospitals in the past four to five years has been so great that he has also authored Making Hospitals Work to introduce NHS managers to the principles of lean management.
“Hospitals waste so much time through the need for so many things that are not managed to come together before a patient can leave,” he says.
“You need the pharmacy to pro- vide the right drugs, for test results to get back to the ward, for a bunch of forms to be filled in and for all this to coincide with whenever the doctors do their rounds. Nobody has an overview of the process and so It means people spend so much more time in hospital than they need to and beds don’t get freed up.”
Better flow Jones sums up hospitals as having a ‘back door’ problem where the big- gest room for improvement is get- ting people out of hospital in a time- ly fashion so they make way for more people to enter the system.
The key to investigating lean management techniques is for management and healthcare pro- fessionals to map out processes so they can be designed to cut down on predictable time delays and, cru- cially, be synced around the patient and the ward they are staying on.
“You’ve got to focus on the cus- tomer and all too often this can ap- pear to be the consultant and not the patient,” Jones adds.
“It can be hard to get everyone working together. However, if you show to doctors and consultants
that by freeing up beds there is more scope for them to do their elective work and then you show the man- agers they can do more operations and cut down on waiting lists with the same resources. Then you show nurses they can actually do their job instead of running round looking for test results and drugs. The result is everyone can see the sense in bet- ter processes.”
In fact the upshot can be, Jones predicts, a welcome end to people being resentful for being blamed for time delays built in to process- es they have no overall view of and which they did not design but in- herited.
Question: With tough choices on public spending ahead, what can the principles of lean management bring to the NHS? Answer: Building streamlined services around the customer should allow hospitals to achieve more with the same or a lower budget.
MAKE YOUR BUSINESS HEALTHIER- GET LEAN
Daniel Jones Lean Enterprise Academy Chairman.
START FROM THE BOTTOM UP
STSTTSTAAAAATTTT RTRTRTTRTRTRT RT FRFFROFROFROFROFROROMMMM M THE BOTTOTTOMOM UP
Lean Finance experts
When you decide the time is right to cut needless work and ineffi- ciencies in your Finance processes, who should you get to help?
The Big Consulting firms all say that they can do it. But the reality is that Lean 6 Sigma experience in Finance processes is thin on the ground.
If you are prepared to use a boutique consultancy, you should talk to us – JSK Solutions.
Our clients include a FTSE 100 retail company, a FTSE 100 In- surance company and the European Shared Services Centre of a Fortune 500 FMCG company.
JSK Solutions is often used by the big firms to provide the required skilled resource to enable them to deliver.
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IN THE RIGHT DIRECTION Lean management is helping the NHS to not on- ly cost cuts but reduce waiting-time for patients PHOTO: DR. HEINZ LINKE
DANIEL JONES’ BEST TIPS FOR A LEAN NHS
3 Start at the back door
1 If test results, ward rounds and take-home medications are not synchronised and nurses are busy with other things then pa- tients end up staying much longer than they need to, blocking other patients.
Typically 25% of medical patients are ready to go home but can’t. Re- ducing length of stay means that hospitals can slash their overtime budgets, existing staff can see more patients and they no longer need to cancel elective procedures.
Follow the patient
2 No one sees the whole jour-ney experienced by patients, particularly the multiple visits and the lengthy waits. Give someone the responsibility to get agreement from everyone to enable patients to flow.
Look in the cupboards
3 Reveal thousands of pounds worth of stock hoarded in eve- ry ward and theatre because re- plenishment is