Case Study DMS- Daily Management System

The Challenge:

This 500 bed, two hospital system decided to introduce the Lean Synergy & Solution's Daily Management System (DMS) in two different areas to monitor results. At one hospital the diagnostic imaging department with 12 modalities was selected & at the other, the nursing units. Within 2 months it was clear that DMS was producing results in areas that had previously had been difficult to impact.

The Approach:

The goal was to have the 3 basic elements* in place within 2 months. The dashboards in each area had the following headers; Patient Experience, Quality, Financial Stewardship, Delivery, Safety & People (Engagement). Diagnostic Imaging Department The supervisor for each modality worked with their manager to develop dashboard metrics specific to their area. Using a tool for cascading strategic deployment measures they were assured that their measures were linked to the top organization goals. With their dashboards in place they began having 5 minute daily huddles at the start of each shift. They then selected a representative from each modality to be on the ACT Team, a selfmanaging team whose purpose is to implement ideas from front line team members that fall within their guidelines. The results achieved within their first 3 months prompted leadership to want LSS DMS in all areas by the end of the year.

Nursing Units  -  The nursing units followed the same process to identify & create their dashboards. Each unit (average 30 beds each) conducted a huddle during each shift. Their ACT Teams took on a different structure in that each unit had 3-5 members & the captains would meet monthly to review & share ideas.

Implementing across the organization -  By using the LSS DMS “in a kit” approach, the 3 basic elements in Level 1 (see figure 1) were implemented in 67 of the 90 hospital departments within 9 months. Of those 67, 18 departments implemented Levels 1 & 2 DMS; allowing the divisional vice president to have a daily huddle to review current performance of all areas.

The Result

The organization has estimated the economic benefit at $864,365 during the first 9 months using the LSS DMS. A large portion of the benefit is attributed to the daily focus & staff engagement to monitor hours per patient day (HPPD) & hours per unit of service. The workgroups began taking action to right size the staffing without help from their supervisors. A few of the results across the organization include:

• 1,111 ACT Ideas Submitted
• 745 ACT Ideas Implemented
• 100% Med Rec forms completed
• Improvement in CMS measures
• Over 50 Days without a fall
• Lead time reduction in test results
• HPPD at or below budget

Outcomes

The Leaders at this hospital system have experienced first-hand the benefits of using LSS DMS at every level and the opportunity it creates for learning. They quickly saw how this structure allowed team members to make a difference on a daily basis. They were able to accelerate their progress by using lean as a management system versus just a set of tools. The Lean Synergy & Solutions Daily Management System is just one component in truly operationalizing lean, but perhaps one of the most powerful because of its frequency and deep engagement. It gets leaders involved in what is strategically important, and what is happening hour by hour, shift by shift, day by day, week by week, and month by month. Sharing and modeling their thinking and principles every day allows leaders to bring lean principles to life – building the habits that fuel a learning organization

• Co-workers actively engaged in financial responsibility and cost savings
• Co-workers taking initiative to problem solve and find solutions
• Using data in decision making
• Escalating problems quickly for immediate attention & follow-up
• Creating discipline, accountability and ownership at all levels

The Daily Management System from Lean Synergy & Solutions

The Lean Synergy & Solutions Daily Management System (LSS DMS) is a management approach and a set of tools to help work groups improve their processes. A work group is a group of people who perform tasks on similar or connected processes, and work in close proximity. Each work group customizes LSS DMS to meet its own unique needs. LSS DMS helps:

• Simplify communication
• Involve employees and promote team work
• Identify and solve problems instead of working around them
• Measure progress
• Establish goals for improvement
• Align work group activities with organization goals and priorities

The Three Basic Elements of the Daily Management System

1. Visual Dashboard: An information center for each work group. The display includes all the information discussed during the huddle, including the metrics used to measure the work group’s progress in critical areas. It is updated daily.

2. Daily huddles: routine 5 – 10 minute huddles of each work group in front of the dashboard. The huddle brings the works group together and gives every person the same picture of team priorities. It speeds the sharing of information about what happened the day before and what is planned for the day. The huddle focuses a team on the performance measurements critical to employees and their managers; it generates a sense of ownership among the team about its work and environment.

3. ACT Team - ACT Teams are designed to engage everyone in continuous improvement activity. The ACT Team is composed of selected department team members who will be responsible for encouraging staff members to identify problems and to make suggestions for improvement. A staff member sees a problem or waste; obtains the ACT Form (STP format) and drafts the Situation, Target & Proposal statements. He or she places the ACT Idea Form in the submitted slot on the Improvement Idea Board. The ACT Team reviews, approves & assigns ACT Improvement Ideas for implementation.

Contact Teresa Deason to learn more about how we can implement the Lean Synergy & Solutions Daily Management System into your organization.