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When Leaders Collaborate: Finding the A-Ha
Moments that Lead to Lean Transformation
Mark Graban
VP of Improvement & Innovation Services
KaiNexus
@MarkGraban
Paul Pejsa
Network Director
Catalysis
@Paul_Pejsa
John Toussaint, MD
CEO
Catalysis
@JohnToussaintMD
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
Catalysis Healthcare Value Network
When Leaders Collaborate: Finding the A-Ha Moments
that Lead to Lean Transformation
John Toussaint
Paul Pejsa
November 29, 2017
When Leaders Collaborate: Finding the A-Ha Moments that Lead to Lean Transformation

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Presented by Jess Orr We will cover topics including: A3 Thinking: A Quick Refresher When to Use an A3 vs. Other Tools How to Engage Others in the Process Change Management 101 The Hardest Part: Sustaining the Gains Hosted by KaiNexus About the Presenter: Jess Orr Jess is a continuous improvement thinker and practitioner with 10+ years experience in a variety of industries, including automotive at Toyota. She holds a bachelor's degree in mechanical engineering from Virginia Tech and two Six Sigma Black Belt certifications. In her current role, Jess applies her passion for people and processes to empower her fellow employees to make impactful and sustainable improvements. You can connect with her on LinkedIn. Her website and blog can be found at www.yokotenlearning.com.

lean manufacturinglean managementkainexus
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Webinar presented by Jeff Hunter, hosted by Mark Graban and KaiNexus Presented by Jeff Hunter, President of Jeff Hunter Strategy Managing vision and purpose with strategic agility has never been more important for health care leaders in a turbulent and transforming industry. We know that our old mental models and systems for strategic planning are insufficient; yet in our early attempts to translate the lean-based system of hoshin planning into strategy deployment, the essence of strategy has been lost in translation. We struggle with creating unique differentiating value from the patient’s perspective, making strategic choices to reduce organizational overburden, aligning strategic intent in the organization, and deploying initiatives in a manner that accelerates learning. In this webinar, Jeff Hunter, the author of Patient-Centered Strategy, will share lessons that can apply to any industry. Learning Objectives: To learn the advantages of this Plan-Do-Study-Adjust strategic management system over the old strategic planning process. To gain new insights for creating value from the patient’s perspective. To understand the steps in the iterative process of developing and deploying strategy through rapid learning cycles. To gain a basic understanding of how the tools in this system work together within the system, so you can practice at home

leanlean managementkainexus
• Founded as the ThedaCare Center for Healthcare
Value in 2008, by John Toussaint, MD, CEO
emeritus of ThedaCare.
• An independent 501(c)3 education institute.
• Headquarters in Appleton, WI with offices in
Traverse City, MI, Akron, OH, Ogden, UT, Phoenix,
AZ, Marco Island, FL, and Boston, MA.
• Rebranded as Catalysis in November 2016.
• We share new knowledge that accelerates change.
• We represent the thinking of hundreds of healthcare
system leaders around North America.
Mission- Transform the Industry
Vision
To transform the healthcare industry to deliver
higher value to patients through experiments,
collaboration and education that spreads learning
and accelerates improvement.

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Becoming the Change: Leadership Behavior Strategies for Continuous Improvemen...
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Presented by John Toussaint, MD, and Kim Barnas from Catalysis In this webinar, you will learn: A method for self-assessment of fundamental behavior How to use A3 format as a personal improvement plan This webinar serves as a bit of a preview of their upcoming book of the same title, due out September 1st -- pre-order now!

lean managementhealthcaremanagement
Our Approach to Transformation
Our Work
• Custom Educational Programs
• Peer to Peer Networks
• CEO Forum
• Products
• Executive Site Visits
• Annual North America Summit and European Summit
• Center for Lean Engagement and Research (CLEAR)
with UC Berkeley
• Resources via createvalue.org
Our Collaborators
• Lean Enterprise Institute (LEI)
• American College of Healthcare Executives
• UC Berkeley School of Public Health
• Institute for Healthcare Improvement
• Shingo Institute
• Consultants - KPMG, Value Capture, IEX
• Faculty - 21and growing
• Network Sponsors
• Toyota
Annual Lean Healthcare Transformation
Summit
Each year Catalysis delivers a high caliber two-day
conference highlighting advancements in lean healthcare.
Attendees from the lean healthcare community worldwide
come to learn, share and connect.
Participants learn from examples of care delivery redesign
supported by results, examples of payment systems that
reward patient value creation, and examples of
transparency of performance supporting business
intelligence.
Save the Date! June 14 – 15, 2018, Chicago, IL

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Catalysis Healthcare Value Network
Network History
• Established in 2009
• Founded by the Lean Enterprise Institute and ThedaCare
Center for Healthcare Value
• 14 Founding Members
• Experiment - Peer to Peer Learning
Network Purpose
• Spread of current best practices
• Accelerate the transformation journey for each
organization
• Drive change in the larger healthcare system
Network Participants
• Engaged healthcare leaders who actively lead change
within their organizations
• Progressive thinkers with a spirit to learn from and share
with others and to spread to others…

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knowledge managementcontinuous improvement
Value of Collaboration
A-Ha Moments that Lead to Lean
Transformation
• Primary benefits of collaborating with peers
• Examples of lean healthcare collaboration results
• Action plan to enhance your collaborating to drive lean
transformation
Three primary benefits of collaborating with
peers
• Accelerates collaborating organizations lean
transformation
• Increases probability of engaging senior leaders through
peer-to-peer connections
• Decreases cost of implementation by avoiding known
pitfalls and overcoming already-learned barriers
• Identifies new improvement areas within an organization
Examples of lean healthcare collaboration
results
• Sponsor members collaboration at HealthEast to design
clinic of the future
• Revenue cycle collaborations with Intermountain Health
and Cleveland Clinic
• Lean Coffee at Indianapolis area CHVN members

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Continuous Improvement Models and Software
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- Proven improvement principles - Characteristics of a culture of continuous improvement - Brief demo of the KaiNexus platform (continuous improvement software)

kainexuscontinuous improvement modelscontinuous improvement
Sponsor members collaboration at HealthEast
to design clinic of the future
• Sponsor members HGA and Herman
Miller along with guests from Epic joined
with HealthEast in learning cycles
focused on future state of ambulatory
care
• Team created mock ups based on best
known design practices, 3P thinking
• Result: reduced floor space 20%, from
15,000 sq. ft. target to 13,102 sq. ft.
Revenue cycle collaborations. Why? How
does collaboration start?
• Revenue cycle is emerging as an important value
stream to improve
• CHVN-facilitated conference calls highlighted best
practices for members to take back for experimentation
• Connections led to next steps…
Revenue cycle collaboration. What does
typical collaboration look like in CHVN?
• Cleveland Clinic invited to visited Intermountain Health for
gemba visit within revenue cycle value stream after first
introductory phone call
• Intermountain Health paid a return visit to Cleveland Clinic to
deepen understanding of revenue cycle value streams
• Spectrum Health saw the collaboration communication on
our CHVN members-only website, joined the Cleveland Clinic
visit to gain knowledge about revenue cycle as they
implement their EHR
Revenue cycle collaboration results
• Cleveland Clinic created a model cell in revenue cycle,
emphasizing the importance of leadership’s role
• Revenue cycle sharing event is in the early planning
stages for the spring of 2018
• Other organizations now ramping up revenue cycle work
based on these initial efforts:
Nemours Children's Hospital
Henry Ford Health System

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leankainnexusa3
How One Community Hospital is Creating a Culture of Continuous Improvement
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The Primary Care Learning Collaborative is an initiative of the Center for Health Market Innovations (healthmarketinnovations.org) This group of primary care provider organizations convened over the course of a year to discuss high-impact innovations that allow them to increase access, affordability, and availability of healthcare for the poor in developing countries. Working in Kenya, India, and Burundi, these organizations share best practices and insights from the evolution of their clinics in the Primary Care Innovator's Handbook. View this presentation for an overview of the Handbook, as presented to the Asia eHealth Information Network on April 15, 2015.

chmiglobal healthhealth
Revenue cycle collaboration – personal
reflections
From participant Tom Smyth, Cleveland Clinic:
• “Confirmed the work that we are each doing. We aren’t
off wondering in the wilderness”
• “Lends credibility to the work. Other respected health
care institutions are on the same journey”
• “Sharing best practices has allowed us to use key ideas
that are working”
• “Leapfrog effect. We are able to spur each other to
improve the systems”
Indianapolis CHVN Members Lean Coffee
• Monthly Lean Coffees hosted by all five Indianapolis
area CHVN members, plus guests
• Topics include barrier-busting, arranging gemba walks,
creating networking opportunities
• Attendance has grown from 4-5 people to 50-60. Chris
Tucker, Acting Chief, System Redesign, Richard L.
Roudebush VA Medical Center: “It’s a great networking
function.”
Action plan to enhance collaboration to
drive lean transformation
• First step: Know thyself. A well developed lean transformation
A3 prepares an organization for collaboration
• Externally: Develop a collaboration rhythm w/in your network:
• CHVN members: Monthly with Catalysis CHVN team member
• Non-CHVN members: Make connections within your geography. Examples: San Francisco
Bay area monthly learning session, Indianapolis area Lean Coffee
• Internally: Create forums for sharing
• Develop a rhythm of improvement event report outs, invite broad audience
• Create sharing intranet / Share Point sites
• Recognize and reward translated improvements: between departments, between sites
Questions?

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By Daniel T Jones of Lean Enterprise Academy shown at the 1st Lean Healthcare Forum 2006 on 25th June 2006 ran by the Lean Enterprise Academy

daniel t jones1st lean healthcare forum 2006lean healthcare
The Low-down on Lean
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If you want to learn more about how and why Saskatchewan is using Lean in health care, join us for this introductory session. During the Quality Summit, you will hear about various Lean tools, concepts and principles, and this session will serve as a quick primer for you, covering some “lean essentials” to enhance your Summit experience!

Announcements
(Then Q&A)
Our Next Webinars
• Register	at	www.KaiNexus.com/webinars
• December	7	:
"4	Components	of	an	Employee-Led	Lean	Initiative"
– Simon	Murray	and	Benny	Ausmus,	Big	Change	Agency
• More	to	come	in	2018!
Other Resources
www.KaiNexus.com/webinars Blog.KaiNexus.com
KaiNexus Podcasts
• www.KaiNexus.com/podcasts
• Subscribe	via:
– iTunes
– Google	Play
– Stitcher

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This document discusses supporting primary care providers through collaboration and new models of care. It provides an overview of programmes and services offered by PCC to facilitate collaboration between general practices. These include facilitating practices to be at the heart of their local healthcare systems, tailored support for practices in developing collaborations, and board development programmes to help leadership. Testimonials from healthcare professionals and organizations highlight how PCC has helped inspire confidence and generate results in establishing collaborative models.

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by Daniel T Jones of Lean Enterprise Academy shown at the 2nd Redesigning Care Summit in Adelaide in March 2006

daniel t joneslean hospitalhealthcare
3 key strategies to boost your lean transformation journey LEI summit 2014 Lo...
3 key strategies to boost your lean transformation journey LEI summit 2014 Lo...3 key strategies to boost your lean transformation journey LEI summit 2014 Lo...
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In this session, Darrell Damron, enterprise lean consultant with the Results Washington team, shared effective strategies for: Establishing a lean expert partnership program. Creating a leadership development program. Fostering communities of practice. Involving employees in improving their work and processes by eliminating waste.

lean governmentleanwashington state
Q&A
• Web:
– www.kainexus.com
– blog.kainexus.com
– www.createvalue.org
• Webinars	on	Demand:
– www.kainexus.com/webinars
• Social	Media:
– www.twitter.com/kainexus
– www.linkedin.com/company/kainexus
– www.facebook.com/kainexus
Mark Graban
VP of Improvement & Innovation Services
Mark@KaiNexus.com
@MarkGraban
Paul Pejsa
Network Director
Catalysis
@Paul_Pejsa
ppejsa@createvalue.org
John Toussaint, MD
CEO
Catalysis
@JohnToussaintMD
jtoussaint@createvalue.org

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When Leaders Collaborate: Finding the A-Ha Moments that Lead to Lean Transformation

  • 1. When Leaders Collaborate: Finding the A-Ha Moments that Lead to Lean Transformation Mark Graban VP of Improvement & Innovation Services KaiNexus @MarkGraban Paul Pejsa Network Director Catalysis @Paul_Pejsa John Toussaint, MD CEO Catalysis @JohnToussaintMD
  • 2. 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
  • 3. Catalysis Healthcare Value Network When Leaders Collaborate: Finding the A-Ha Moments that Lead to Lean Transformation John Toussaint Paul Pejsa November 29, 2017
  • 5. • Founded as the ThedaCare Center for Healthcare Value in 2008, by John Toussaint, MD, CEO emeritus of ThedaCare. • An independent 501(c)3 education institute. • Headquarters in Appleton, WI with offices in Traverse City, MI, Akron, OH, Ogden, UT, Phoenix, AZ, Marco Island, FL, and Boston, MA.
  • 6. • Rebranded as Catalysis in November 2016. • We share new knowledge that accelerates change. • We represent the thinking of hundreds of healthcare system leaders around North America.
  • 8. Vision To transform the healthcare industry to deliver higher value to patients through experiments, collaboration and education that spreads learning and accelerates improvement.
  • 9. Our Approach to Transformation
  • 10. Our Work • Custom Educational Programs • Peer to Peer Networks • CEO Forum • Products • Executive Site Visits • Annual North America Summit and European Summit • Center for Lean Engagement and Research (CLEAR) with UC Berkeley • Resources via createvalue.org
  • 11. Our Collaborators • Lean Enterprise Institute (LEI) • American College of Healthcare Executives • UC Berkeley School of Public Health • Institute for Healthcare Improvement • Shingo Institute • Consultants - KPMG, Value Capture, IEX • Faculty - 21and growing • Network Sponsors • Toyota
  • 12. Annual Lean Healthcare Transformation Summit Each year Catalysis delivers a high caliber two-day conference highlighting advancements in lean healthcare. Attendees from the lean healthcare community worldwide come to learn, share and connect. Participants learn from examples of care delivery redesign supported by results, examples of payment systems that reward patient value creation, and examples of transparency of performance supporting business intelligence. Save the Date! June 14 – 15, 2018, Chicago, IL
  • 14. Network History • Established in 2009 • Founded by the Lean Enterprise Institute and ThedaCare Center for Healthcare Value • 14 Founding Members • Experiment - Peer to Peer Learning
  • 15. Network Purpose • Spread of current best practices • Accelerate the transformation journey for each organization • Drive change in the larger healthcare system
  • 16. Network Participants • Engaged healthcare leaders who actively lead change within their organizations • Progressive thinkers with a spirit to learn from and share with others and to spread to others…
  • 18. A-Ha Moments that Lead to Lean Transformation • Primary benefits of collaborating with peers • Examples of lean healthcare collaboration results • Action plan to enhance your collaborating to drive lean transformation
  • 19. Three primary benefits of collaborating with peers • Accelerates collaborating organizations lean transformation • Increases probability of engaging senior leaders through peer-to-peer connections • Decreases cost of implementation by avoiding known pitfalls and overcoming already-learned barriers • Identifies new improvement areas within an organization
  • 20. Examples of lean healthcare collaboration results • Sponsor members collaboration at HealthEast to design clinic of the future • Revenue cycle collaborations with Intermountain Health and Cleveland Clinic • Lean Coffee at Indianapolis area CHVN members
  • 21. Sponsor members collaboration at HealthEast to design clinic of the future • Sponsor members HGA and Herman Miller along with guests from Epic joined with HealthEast in learning cycles focused on future state of ambulatory care • Team created mock ups based on best known design practices, 3P thinking • Result: reduced floor space 20%, from 15,000 sq. ft. target to 13,102 sq. ft.
  • 22. Revenue cycle collaborations. Why? How does collaboration start? • Revenue cycle is emerging as an important value stream to improve • CHVN-facilitated conference calls highlighted best practices for members to take back for experimentation • Connections led to next steps…
  • 23. Revenue cycle collaboration. What does typical collaboration look like in CHVN? • Cleveland Clinic invited to visited Intermountain Health for gemba visit within revenue cycle value stream after first introductory phone call • Intermountain Health paid a return visit to Cleveland Clinic to deepen understanding of revenue cycle value streams • Spectrum Health saw the collaboration communication on our CHVN members-only website, joined the Cleveland Clinic visit to gain knowledge about revenue cycle as they implement their EHR
  • 24. Revenue cycle collaboration results • Cleveland Clinic created a model cell in revenue cycle, emphasizing the importance of leadership’s role • Revenue cycle sharing event is in the early planning stages for the spring of 2018 • Other organizations now ramping up revenue cycle work based on these initial efforts: Nemours Children's Hospital Henry Ford Health System
  • 25. Revenue cycle collaboration – personal reflections From participant Tom Smyth, Cleveland Clinic: • “Confirmed the work that we are each doing. We aren’t off wondering in the wilderness” • “Lends credibility to the work. Other respected health care institutions are on the same journey” • “Sharing best practices has allowed us to use key ideas that are working” • “Leapfrog effect. We are able to spur each other to improve the systems”
  • 26. Indianapolis CHVN Members Lean Coffee • Monthly Lean Coffees hosted by all five Indianapolis area CHVN members, plus guests • Topics include barrier-busting, arranging gemba walks, creating networking opportunities • Attendance has grown from 4-5 people to 50-60. Chris Tucker, Acting Chief, System Redesign, Richard L. Roudebush VA Medical Center: “It’s a great networking function.”
  • 27. Action plan to enhance collaboration to drive lean transformation • First step: Know thyself. A well developed lean transformation A3 prepares an organization for collaboration • Externally: Develop a collaboration rhythm w/in your network: • CHVN members: Monthly with Catalysis CHVN team member • Non-CHVN members: Make connections within your geography. Examples: San Francisco Bay area monthly learning session, Indianapolis area Lean Coffee • Internally: Create forums for sharing • Develop a rhythm of improvement event report outs, invite broad audience • Create sharing intranet / Share Point sites • Recognize and reward translated improvements: between departments, between sites
  • 30. Our Next Webinars • Register at www.KaiNexus.com/webinars • December 7 : "4 Components of an Employee-Led Lean Initiative" – Simon Murray and Benny Ausmus, Big Change Agency • More to come in 2018!
  • 32. KaiNexus Podcasts • www.KaiNexus.com/podcasts • Subscribe via: – iTunes – Google Play – Stitcher
  • 33. Q&A • Web: – www.kainexus.com – blog.kainexus.com – www.createvalue.org • Webinars on Demand: – www.kainexus.com/webinars • Social Media: – www.twitter.com/kainexus – www.linkedin.com/company/kainexus – www.facebook.com/kainexus Mark Graban VP of Improvement & Innovation Services Mark@KaiNexus.com @MarkGraban Paul Pejsa Network Director Catalysis @Paul_Pejsa ppejsa@createvalue.org John Toussaint, MD CEO Catalysis @JohnToussaintMD jtoussaint@createvalue.org