January 2016

Save the Date:
Special Thank you to Spectrum Health for Sponsoring the 2016 MLC HealthCare Symposium!

2016 MLC HealthCare Symposium: Lean and High Reliability, will be held on May 20, 2016 at Spectrum Health, Grand Rapids. Also, a reminder that January 15 is our deadline for speaker submissions! 

Quality and Lean in Process Interactions Part 3 & 4
By: Dennis Sergent, MLC Chair

Read the first two parts here.

The aim and purpose of the organization as defined by its vision, mission, and values is the first guiding component of this framework.  The method for this thoughtfully engages the people who manage, direct, guide and lead the organization with the people who do the work to fulfill the aim and purpose of the organization.  We focus our attention first on the questions 'what are we trying to achieve?' and 'how can we support each other?'
The framework of the system begins with this articulation of aim, vision, mission and values. Leaders of the organization usually define the first version of this at the beginning of organizing the enterprise and will adapt it as time and conditions change. While the aim and purpose are long term views of where the organization wants to be at a distant point in time, the means to get there through vision, mission and values should be constantly reviewed by the organization from top to bottom and side to side. Everyone in the organization should be engaged in the pursuit of the future of the system as the needs of their environment change.      Russ Ackoff 
said "A non-adaptive organization in a changing environment ...will ultimately, through non­ adaptation destroy itself.”
At this first, most fundamental level, we define "why" the organization exists.  We enter the details at the top of the systems map to guide the organization, then document who is responsible for leading and directing the overall system and proceed.

With engagement of the leadership team, the process demonstrates to the SMEs at this level how to improve their leadership processes with a method, supplemented by targeted classroom training in general philosophy, principles and practices of quality and Lean. With respect to strategic direction from leadership and the proper management processes, we "learn as we go" in the philosophy, practices, methods and tools, so that at every level, the organization learns "how" to focus problem-solving, improve results and then sustain this progress through continual improvement.
The system map shows how major processes link together in the system. The primary benefit of the systems map is to help the group define the relationships between processes and develop a new understanding of "how we get things done here."
This creates a picture of the organization as a system, a view of how the components of the organization flow and work together to accomplish the aim and purpose of the system. Viewing the system at this level allows anyone in the organization to see the overarching system that the processes and work fit into and it
reminds everyone of the context in which they must operate.
At this fundamental level, "what" the organization does to exist and develop is documented. We enter the details for three categories of processes in the general areas of top middle and bottom of the systems flow chart:
  • Leading, directing & guiding processes
  • Core processes
  • Support processes
We also incorporate feedback loops and processes with knowledge into the aim, purpose, vision, mission and values to provide the organization with the real outcomes and allows the organization to manage and adapt their plans to the reality of results obtained from the effort. 
To manage a system effectively, you must focus on the interactions of the parts rather than the behavior taken separately. Systems are more than the sum of their parts. Each system is an indivisible whole, that loses its essential properties when it is taken apart. The elements of a system may themselves be systems, and every system may be part of a larger, overarching system. 
The system map accomplishes four major purposes:
  1. Links the aim and purpose of the system through the processes that people work in at all levels of the organization.
  2. Helps managers and members to view the organization as a system, and allows them to use this method to focus management efforts on the systems inside and outside of it.
  3. Helps those working in the system to see their interdependence with others and thus encourages recognition of the relationships in the organization.
  4. Helps the focus of problem solving and quality improvement to be on the processes in the organization, not just on the individual departments or people.
A focus on system and processes requires the help of the people who work in the processes and depends on their trust.   It means we must set aside fears, preconceptions and judgments to define the system as it is experienced by the customer and the people who work closest to the customer.  Leaders and facilitators of this process must focus the initial dialogue on a few basic rules of respect and openness.  This helps people uncover what may remain otherwise hidden. 
We start with the end in mind, by describing our aim and common purpose of improvement and learning.  We continue by asking open-ended questions about the enterprise, the system and the processes.  We ask the subject matter experts who work in the system and processes to tell us how it works, not how someone else says it should work, but how it actually works. 
And then we must listen to them, document what they say, let them talk and let the silence guide them into self-discovery.  With thoughtful help, whether they are the CEOs or the front-line team members, they will describe the system as it is.  This requires that we engage them to share their knowledge of their system and their “business”.
This concept of a system of production is directly attributed to the work of Deming and we’ll say more about linking value streams to system mapping in a future article.

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