Kaizen Events Hold the Key to Quality Improvement

The quality improvement principles of lean are particularly well-suited to the healthcare industry because of their potential to build efficient care pathways that put patients first. One of the most effective lean techniques is the kaizen event, a multi-day process improvement initiative in which a team focuses on one challenging process and takes action to streamline and improve that aspect of the system.

A kaizen event takes aim at a specific process, such as accounting procedures, materials delivery, warehouse and shipping processes, or other areas where waste has cropped up and slowed down efficiency. Kaizen—Japanese for “change for the better”—involves a team breaking down a process, understanding the root causes of its stumbling blocks, removing any unnecessary elements and brainstorming countermeasures to mitigate the challenges. After such an intense focus, the process should ideally work more smoothly and capitalize on all team members’ skills.

But with so many potential problem areas to improve, how does one choose? “Sometimes staff members point to a problematic process that causes headaches, and other times key performance indicators (KPIs) identify it as an area for immediate improvement,” says Tracy Clarno, PMP, CPHQ, Think Lean Consulting. Clarno recently worked as a facilitator on a kaizen event that shaved 22 minutes off a facility’s ED throughput times.

A Kaizen event can hold the key to unlocking a previously impenetrable problem—bringing about “aha” moments for discouraged staff. “They give staff the opportunity to take a frustrating process and look at it in a new way,” Clarno says. “They empower front-line workers to help implement changes so they’re more permanent. When you figure out the root cause of a challenge and see that light turn on in team members’ eyes, that excitement is contagious and can carry the whole team through hard work of implementation.”

The Phases of a Kaizen Event

Before

Kaizen events—which can last anywhere from a few days, a week or even two weeks—require extensive planning before a chosen problem can be tackled. First, a facilitator or team leader experienced in lean techniques should be chosen to help the team stay on track. “An outside facilitator can come in with an unbiased eye and ask questions that internal staff may not always think to ask,” Clarno says.

The facilitator will help choose between six and 10 members from multiple departments to make up the team. Here are some tips to keep in mind when selecting the team:

      • Ensure that most members currently perform the work that the kaizen event is intended to improve.
      • Choose individuals from a cross-section of departments.
      • Include subject matter experts who have special knowledge about the process.
      • Limit the number of managers on the team.
      • Bring in someone who’s not directly involved in the process to serve as an objective third party. Someone from management could provide this outside voice.

Before starting a kaizen event, it’s
important that everyone knows that the goal is to improve efficiencies and free
people for other work, not eliminate their jobs. “Sometimes when
we talk about lean techniques, people are fearful that we’re just looking to
pinpoint what they’re doing wrong to get them in trouble or that we’re looking
to eliminate positions,” Clarno said. “But it’s completely not true of the lean
process.”

During

After narrowing the size and scope of the
project to be tackled, a team leader or facilitator takes a team through the
following phases:

      • Start up and train. The facilitator explains to all team members the purpose and scope of the kaizen event, as well as key principles of lean manufacturing, such as seven common forms of waste. The facilitator also
        outlines the basic structure and agenda of the event.
      • Map the current state. Team members work together to describe the present process as accurately as possible, both good and bad.
      • Analyze and collect data. Team members identify parts of the process that don’t add value.
      • Brainstorm. Once the current state is mapped, the team generates ideas to design a leaner, more efficient future state.
      • Implement and test. The team gives the new process a test-run to see if the new idea is actually better. “What sounds like a stroke of genius on the whiteboard can turn out to be a bad idea once it’s on the floor,” Clarno says.
      • Launch. After the test phase, the team begins putting the new process into action.

After

The work isn’t finished once the kaizen event is
over. In the post-event phase, team members will:

      • Observe. The team will make sure the new process is being implemented as planned. In this stage, they may find it necessary to make quick, on-the-fly adjustments to hone the process further.
      • Measure. The team will compare before-and-after kaizen event measurements to track the level of improvement.
      • Monitor. The team will keep tabs on the newly changed process to see if it sticks over time. “Sometimes new changes have a way of disappearing as we backtrack to our old, familiar ways of doing things,” Clarno said. But if measurements show that the change did create improvement, it’s vital to keep those benefits going.

To learn more, sign up for the webinar, “Understanding Lean and Using a Kaizen Event to Improve Multi-Department Processes,” on November 21, 2019, 12 p.m. CST. Presenters are Tracy Clarno, PMP, CPHQ, Think Lean Consulting, and Faith M Jones, MSN, RN, NEA-BC, director of care coordination and lean consulting at HealthTechS3.