Wednesday, February 17, 2016

Visual Management

5S is just one example of a Lean concept called “visual management.” We can also think of visual management as a form of “standardized work” for everyone in the practice.

As explained in the book Lean Hospitals (3rd edition), the goal of visual management is to make waste, problems and abnormal conditions readily apparent to employees and managers. As Fujio Cho, honorary chairman of Toyota says, “One of the worst situations… is not being able to tell whether things are standard or out of standard (normal or abnormal).” Our aim should be to expose problems so they can be fixed, as opposed to the old approach of hiding problems to make things look good. Jamie Bonini of the Toyota Production System Support Center organization says, "The ideal is to be notified of any abnormality immediately and to solve problems as they occur, while the situation is still fresh."

Visual management has two main tenets: first, make problems or status visible; and, second, manage those situations, reacting as needed in the short term and solving root causes of those problems over the longer term. Even before Lean, healthcare organizations might put multi-colored plastic “flags” up in the hallway outside each exam room. These flags, if used consistently by staff, can provide a clear visual indicator that answer questions such as, “Is there a client in that room yet?” or “Where does Dr. Y need to go next?”

While visual management is ideally used for real-time decision making and problem solving, Lean organizations tend to also post performance measures (or metrics) on the wall for everybody to see. Understanding the performance of a practice (in areas such as safety, quality, patient satisfaction, or financials) can help everybody focus their kaizen improvement efforts (as described later). Posting metrics cannot become an exercise in blaming or just pressuring people to perform better. Everybody must work together to improve the systems and processes that lead to those results.

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