The tools to be used are identified in the assessment

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the level of exposure to Lean that the project team has had. The tools to be used are identified in the assessment that is completed as part of planning and pre-work. Training on the tools is provided as needed while the Kaizen is taking place; in other words, it is just-in-time training. Other Training In addition to Lean, there is also training available for staff to become certified in Six Sigma at different levels identified with green, yellow, and black belts. Senior managers must become certified in Six Sigma. The Process Improvement Department managers provide the management engineers and black belts with advanced training on optimizing Lean techniques and combining techniques on a single project. Lean Project Implementation Event Week At LHC, the Kaizen approach is used to implement Lean when focusing on the work systems or processes that need to be improved. The Kaizen event is, in essence, the Lean project kickoff. At the Kaizen event, the management engineer introduces applicable tools and concepts to help achieve a successful project. Sample tools and activities are shown in Exhibit 6.8. The length of a Kaizen at LHC ranges from 1 to 3.5 days, and can be broken into smaller portions, such as 2 hours per day over 5 days. The duration of the event varies depending on the scope of the project and availability of team members. For example, in a small outpatient clinic, the number of staff involved on the project team would require that the clinic shut down. Thus, having 2-hour sessions each day for 5 days ensures that patient care services are not interrupted. One or two management engineers and/or Six Sigma Black Belts lead the Kaizen week. At the end of each day, the team reports to the local hospital leadership (e.g., hospital CEO, operations manager, department chiefs) to share the results of the event, including information on initial outcomes and how the project has affected process. Exhibit 6.8. Kaizen Activities Collect information on the voice of the customer Use tracer methodology to track how a patient moves through the process and aid in the development of value stream mapping Map out the future state of the process Remove non-value-added steps from the future-state process Create spaghetti diagrams to show the pathways staff and patients take to move through the process Prepare a fishbone diagram to examine cause and effect* Use the workout concept to brainstorm problems, and discuss and vote on solutions Implement visual management techniques**
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222 Apply the concept of push versus pull (level loading) Learn data-collection techniques and statistical analysis Visit the units where the process will be implemented Create project-specific tools such as Excel spreadsheets to track bed availability or color-coded systems to indicate patient load Make an action plan for implementing in the department Report the results of the project at 30 days Report the sustainment of the project at 90 days *A visual display of the many potential causes for a problem or effect.
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