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The Power of Alignment and
Intrinsic Motivation in
Continuous Improvement
Host: Clint Corley
Clint.Corley@KaiNexus.com
Presenter: Mark Graban
Mark@KaiNexus.com
Webinar Logistics
• Presentation (45 minutes)
• Q&A (10 minutes)
– Use the GoToWebinar
Meeting Panel to
submit a question at
any time
• Recording link & slides will be sent via email
– Also – see the “Handouts” feature and Chat box
Our Presenter: Mark Graban
• Senior Advisor, KaiNexus
• President, Constancy, Inc.
• Author of:
– Lean Hospitals
– Healthcare Kaizen
– Practicing Lean (editor)
– Measures of Success
A Very
Common
Question
“Should we give
incentives or rewards
for participation in
Kaizen?”
Rewards &
Recognition
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
https://www.leanblog.org/2014/11/our-toyota-tour-guides-kaizen/
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
“Kaizen is
voluntary.”
What’s their
motivation?
• “the reason or reasons one has for acting or
behaving in a particular way”
• “the general desire or willingness of someone
to do something”
• “provide (someone) with a motive
for doing something”
• “stimulate (someone's) interest in or
enthusiasm for doing something”
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
What problem are we trying to solve?
Not enough
improvement
Why?
• People aren't speaking up?
• People aren't improving?
• People aren’t documenting?
Blame
Why?
•Lack of participation?
•Lack of motivation?
•Lack of confidence?
“Most companies have
it all wrong.
They don’t have to
motivate their
employees.
They have to stop
demotivating them.”
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
“One is born with
intrinsic motivation,
self-esteem, dignity,
cooperation, curiosity,
joy in learning.
These attributes are high at
the beginning of life, but are
gradually crushed by the forces of destruction.”
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
“These forces… crush out joy in learning,
joy on the job, innovation.
Extrinsic motivation gradually replaces
intrinsic motivation, self-esteem, dignity.”
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
“In 85% of companies, employees' morale
sharply declines after their first six months
— and continues to deteriorate for years
afterward.”
– Based on surveys of about 1.2 million employees at 52 primarily Fortune 1000 companies
from 2001 through 2004, conducted by Sirota Survey Intelligence
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
It's the behaviors,
stupid!
Rewards and Recognition
“Substitute
Leadership.”
Leader Behaviors for
Strategy Deployment
• Define purpose clearly
• Identify the biggest obstacles
• Create an atmosphere conducive
to initiative and creativity
• Reduce hassle
Rewards and Recognition
(A countermeasure to what problem?)
Rewards and Recognition
• Incentives
• Bonuses
• Raises
• Targets
• Quotas
Rewards Sound Great But…
Paying for Ideas?
Advantages
• Seems motivating
• Gets attention and
participation from some
• Seems fair to share savings
Disadvantages
• Can discourage teamwork
• Seems unfair if value of idea
isn’t agreed on
• Takes focus off improvement
• Requires a bureaucracy
to manage
• Harms creativity
Recognition and Rewards
• Thanks
• Smiles
• Handshakes
• Public recognition
• Sharing improvements
• Annual awards
• Points
• Cash payments
• Time off
• Shared savings
• Drawings for prizes
• Performance appraisals
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
Paying for Ideas? What Works
• Small payments
• Based on implementation
• Includes all who participated
Setting Goals? What Works
• A goal, not a quota, not a limit
• Express belief in people
• If not hitting goals, ask "why?”
– Or “How might we?”
• Focus on the process, not just numbers
“Substitute
Leadership.”
The right behaviors lead to
employee participation…
"Clients, on average, implement
more than 80 percent of ideas
submitted via KaiNexus…"
If you don't get participation,
there's no hope for
alignment
If you get participation,
you can then aim for
some alignment
Alignment’s
too heavy
Participation’s
too light
AlignmentParticipation
Alignment in…
Measures Activities
Six
Sigma
Projects
Large
Kaizen
Medium
Kaizen
Small
Kaizen
Lean
Events
Circle size is meant to roughly represent relative size of effort; Blue = tracked top initiatives ("Baby A3s")
Complexity
Daily Kaizen
Women
& Children’s
3P
Electronic
Medical
Record
Implementation
New
Bed Tower
3 Types of Kaizen
Safety Quality Cost Morale
Safety
Inpatient
Labor &
Delivery
Med/Surg
Outpatient
Clinics
Clinic A
Physician A Physician B
Clinic B
Surgery
Emergency
Dept
Sprains &
Strains
Patient Falls
Patient Falls
X
Must Prioritize the Large Things
What are the
“must do, can’t fail”
initiatives for
our organization?
John Toussaint, MD
A Lack of Focus & Alignment
Photo: John Toussaint, M.D.
“Deselecting”
Source: ThedaCare
The Power of Alignment and Intrinsic Motivation in Continuous Improvement
“Should we give
incentives or rewards
for participation in
Kaizen?”
“DO WE HAVE TO
give incentives or
rewards for
participation in Kaizen?”
“Moderation
in all things.”
#KaiNexusUC16
Ralph Waldo Emerson
#KaiNexusUC16
“In all things
balance is
better.”
Homer’s The Odyssey
Announcements
(Then Q&A)
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Q&A
• Web:
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– blog.kainexus.com
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Presenter: Mark Graban
Mark@KaiNexus.com
Host: Clint Corley
Clint.Corley@KaiNexus.com

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The Power of Alignment and Intrinsic Motivation in Continuous Improvement