© Steven J. Spear 2010 The High Velocity Edge: Leadership, Innovation, and World Class Competition Steven J. Spear Senior Lecturer, Massachusetts Institute of Technology Senior Fellow, Institute for Healthcare Improvement

© Steven J. Spear 2010 Competition by innovation. Why look at Toyota? ‘Lean’ learnings… High velocity innovation Other examples Q + A Outline

© Steven J. Spear and 2010…

© Steven J. Spear 2010 Performance -- Efficiency -- Quality -- Variety -- Speed T General Motors Ford Chrysler Toyota GM Ford Chrysler G F C T T Why Toyota?

© Steven J. Spear 2010 Job Shop to Focused Factory Improvisation to Repeatable Standard Chaotic Push to Self Pacing Pull Drill Mill Polish Lathe Drill Mill Polish Lathe Mill Drill Lathe SHIP Drill Mill Lathe Polish Drill Lathe Polish SHIP Drill Production Control Polish Drill Schedule Polish Schedule Learn Learnings: Chaos Out, Stability In a Drill Polish Ship Requests Deliveries Customer

© Steven J. Spear 2010 Steel Coils High Velocity Improvement… Stamp Weld Ship Stamp Weld Ship Stamp Weld Ship 1:System design 2:Problem solving 3:Knowledge sharing 4:Leadership Tool ‘n Die -- Manage systems -- Cascade capability -- Best approach -- See problems -- Stop spread -- Build knowledge -- Apply discoveries systemically.

© Steven J. Spear 2010 Alcoa’s Pursuit of Perfect Workplace Safety 1: Manage work to see problems2: Solve problems as seen 3: Share what is learned4: Develop people for 1-3

© Steven J. Spear 2010 Chance of Successful Outcome Time Surgery Post-Op Potential Actual: Great Actual: Poor Health care: Good News Bad News

© Steven J. Spear : Methods: ACTIVITY PAGES, PROFICIENCY TESTS, TECHNOLOGY ASSESSMENT How to do work ? Pratt&Whitney Engineering Standard Work 1: System Output: DESIGN OBJECTIVES What does the customer need? External Customer 2: Pathway: WORKFLOW MAPS… Who does what work for whom in what order? 3: Connections: DESIGN CRITERIA Expected handoffs Request Response Request Response

© Steven J. Spear 2010 US Navy: Nuclear Propulsion See Problems Solve Problems Share Learnings Lead

© Steven J. Spear 2010 Selected Publications BOOK: Chasing the Rabbit: How Market Leaders Outdistance Their Competition, McGraw Hill, (Fall 2008) “ Who Was Caring for Mary: Revisited, ” with Frederick Southwick, Academic Medicine (December 2009). “ Fixing Healthcare from the Inside: Teaching Residents to Heal Broken Delivery Processes As They Heal Sick Patients, ” Academic Medicine. 81(10) Suppl:S144-S149, (2006). “Better Care for More People at Less Cost,” with Don Berwick Boston Globe op-ed (October 2007) “Learning from the Masters: By learning from Toyota and Alcoa how to manage complex work processes, hospitals can improve performance,” Cerner Quarterly, (2006). “Fixing Healthcare from the Inside: Teaching Residents to Heal Broken Delivery Processes As They Heal Sick Patients,” Academic Medicine. (2006). “Using Real-Time Problem Solving to Eliminate Central Line Infections,” with Richard Shannon and other co-authors. Joint Commission Journal on Quality and Patient Safety, (2006) “Operational Failures and Interruptions in Hospital Nursing Work,” with Anita Tucker, Health Services Research, (2006). “The Health Factory,” New York Times [op ed], (2005). (#) (*) “Fixing Healthcare from the Inside, Today,” Harvard Business Review (2005). “Ambiguity and Workarounds as Contributors to Medical Error,” with Mark Schmidhofer, Annals of Internal Medicine (2005). “Medical Education as a Process Management Problem,” with Elizabeth Armstrong and Marie Mackey, Academic Medicine (2004). (*) “Learning to Lead at Toyota,” Harvard Business Review, (2004) “Driving Improvement in Patient Care,” with Debra Thompson and Gail Wolf, Journal of Nursing Administration (2003). (*) “The Essence of Just in Time,” Productivity, Planning, and Control, (2002). (x) “When Problem Solving Prevents Organizational Learning,” with Anita Tucker and Amy Edmondson, Journal of Organizational Change Management, (2002). (*) “Decoding the DNA of the Toyota Production System,” with H. Kent Bowen, Harvard Business Review, (1999). (#): McKinsey Award, One of top two articles in Harvard Business Review, (*): Shingo Prize winning articles. (x): Best paper proceedings, Academy of Management conference, 2001.

© Steven J. Spear 2010 Speaker Profile Steve Spear, senior lecturer at MIT and senior fellow at the Institute for Healthcare Improvement, is internationally recognized as an expert in innovation, operational excellence, and organizational learning, with deep experience in industry and health care. His reputation stems from award winning articles such as Harvard Business Review’s "Decoding the DNA of the Toyota Production System" and "Fixing Healthcare from the Inside, Today," and his critically acclaimed and prize winning book Chasing the Rabbit: How Market Leaders Outdistance the Competition. Spear focuses on creating organizational capacity for high speed, broad based, improvement and innovation. He has both studied already outstanding organizations and has also helped ordinary organizations become outstanding. Along those lines he helped create the Alcoa Business System and the Perfecting Patient Care System used by hospitals in Pittsburgh, and his work was the foundation for Pratt and Whitney’s Engineering Standard Work for jet engine design. All are credited with marked increases in quality and capacity and reductions in cost. His publications have appeared in Harvard Business Review, Annals of Internal Medicine, Academic Medicine, the New York Times, and the Boston Globe. Awards for his writing include five Shingo Research Prizes, a McKinsey Award from HBR, and a USA Books National Business Book Award. Spear received his doctorate from Harvard Business School, masters of science in Mechanical Engineering and in Management from MIT, and his bachelors degree with a concentration in Economics from Princeton University.