1. Daily Visual Management
Visibility Wall Training
June 18, 2014
Kaizen Promotion Office

2. Presentation/training (35 minutes) Video (10 minutes)
Session Agenda:
Session Agenda
Presentation/training (35 minutes)
Video (10 minutes)
Group work creating your draft walls ( minutes)
Group report-outs (15 – 20 minutes)
Q&A (5 minutes)
Wrap-up and evaluation forms

3. Government of Saskatchewan
Strategic Hierarchy
Government of Saskatchewan
Ministry of Health
Provincial Health System
Regina Qu’Appelle Health Region

4. Reporting and Accountabilities

5. Strategic Framework

6. RQHR Strategic Planning and Reporting Cycle

7. Daily Visual Management
The system used by the organization to perform its daily activities by:
establishing standard operations
identifying and eliminating waste
using data to ensure processes, products and services are continuously improved
Strategy
Deployment/ Hoshin
Kanri
Daily
Visual Management
(DVM)
Cross-Functional
Management
(CFM)

8. Daily Visual Management- Link to Strategy

9. Daily Visual Management Consists of:
A Visual Workplace where abnormalities are seen
An environment where staff test their own ideas
Transparency of objectives and metrics
Managing by measures that change regularly
Connects accountability throughout the organization
What you cannot see, you cannot manage!
- Visual Management

10. “Before cars, make people.” —Eiji Toyoda, former chairman of Toyota
Respect for People
Staff are the problem-solvers:
Staff are a valued source for improvement ideas.
Staff help test and determine whether a new process works.
When errors occur, the process is wrong, not the person.
No blame, no shame!
Quality must be built into every step.
Anyone can, and is expected to, stop the process to prevent a defect from continuing downstream.
“Before cars, make people.”
—Eiji Toyoda, former chairman of Toyota

11. Zero Waits in Emergency
Alignment
Better Care
1-5 Year Outcome Targets
Zero Waits in Emergency
why
why
Corporate Wall
VP/ ED/ Director Wall
why
why
VP / ED / Dir.
Pasqua ED
why
why
Unit / Department Wall
RGH ED
Front Line Managers

12. You Don’t Need to know Lean to get started on Daily Visual Management!
It is critical to understand the current situation first, before applying Lean techniques and tools to make improvements
Use 5 “whys” to get to the root causes and make improvements
Use Plan, Do, Study, Act (PDSA) to do improvements
As you learn Lean, you will make faster progress to achieving your targets

13. Elements of the Daily Visual Management System
Understand your business and daily improvement activities
Create daily actions when issue/challenges occur.
Data is classified into common categories on your unit’s visibility wall – Quality, Cost, Delivery, Safety, Morale (QCDSM)
Data and information is key:
Choice of data
Visual display and charts used
Method and frequency of collection determined
Method and frequency of reporting determined
Only measure something you can action

14. What Should I Do?
1. Go and see – learn from the workplace 2. Make the workplace visual 3. Spend significant time developing people 4. Teach staff to see, create solutions and improve 5. Provide standard work that staff can use as a basis for improvement, and develop your own standard work 6. Never stop improving 7. Be accountable and hold others accountable

15. Setting Up a Daily Visual Management Visibility Wall: Step-By-Step

16. Purpose statement: Core Processes Team communication Improvement
Who are we from the patient perspective?
Core Processes
Team communication
Improvement 
Quality
Example: improve wait time by 50% by September 2013
Cost
Example: Reduce OR supplies by 20% by December 2013
Delivery
Example: Reduce the wait list by 20% by February 2014
Safety
Example: Reduce surgical site infections to 0% by 2014
Morale
Example: Improve attendance by 10% by July 2013
Upcoming This Week
Team Calendar
Improvement ideas
~~~~~~~~
Standard Work
~~~~~~~~ 5S
Corporate Memo’s
Training
Staff Bouquets
Admit
Treat
Discharge
Name Date
Name Date
Name Date
Name Date
Name Date

17. Steps to Creating a Daily Visual Management Visibility Wall
1. Articulate the Purpose Statement of the service area
i.e. Our purpose is to support teams through Lean methodology to create a world-class Saskatchewan Healthcare System, which provides high quality, safe and timely care.
Don’t forget the patient perspective in your Purpose Statement
2. Identify the primary process in your service area and draw a value stream or process map
3. Create your Team Communications
What’s important for your team to know on a weekly basis?
When will you have your weekly huddles, weekly wall walks?
What other information are you going to post on your wall?
Training schedule?
Staff bouquets?
Corporate communication's/memo’s?

18. Steps to Creating a Daily Visual Management Visibility Wall
4. Improvement Ideas
Generate improvement ideas that will directly help improve what you are measuring.
You can use Lean tools like Standard Work and 5S to help.
5. What are one or two measures that best describe how you are meeting the core purpose?
Classify your measures under: Quality, Cost, Delivery, Safety, Morale (QCDSM)
Only measure what you can directly improve
Coming soon: there will be some corporate standard measures

19. Measuring World-Class Quality
Reliability Responsiveness
Consistent
Empathy
Equitable
Quality
Cost Effective
Cost
World-Class Quality
Full Customer* Satisfaction
Assurance of Quality
Right Place
Delivery
Right Time
Right Amount
* Patient
For Patient
Safety
For Provider
Morale
Everyone Cares

20. Purpose statement: Core Processes Team communication Improvement
Who are we from the patient perspective?
Core Processes
Team communication
Improvement 
Quality
Example: improve wait time by 50% by September 2013
Cost
Example: Reduce OR supplies by 20% by December 2013
Delivery
Example: Reduce the wait list by 20% by February 2014
Safety
Example: Reduce surgical site infections to 0% by 2014
Morale
Example: Improve attendance by 10% by July 2013
Upcoming This Week
Team Calendar
Improvement ideas
~~~~~~~~
Standard Work
~~~~~~~~ 5S
Corporate Memo’s
Training
Staff Bouquets
Admit
Treat
Discharge
Name Date
Name Date
Name Date
Name Date
Name Date

21. Photos: Pasqua Cardio Neuro

22. Photos: WRC Children’s Program

23. Photos: WRC Extended Care/Veterans Program

24. Photos: Pasqua Radiology

25. Photos: RGH Surgical 6A

26. Select a consistent time of day for wall walks Start on time
15 Minute Daily Huddle
Select a consistent time of day for wall walks
Start on time
Designate a time keeper so that you can end on time
All staff stand up in front of the visibility wall
Manager leads or designated leader
Consider having other staff be reasonable for some pieces of the data and have them report-out out on the data

27. 15 Minute Daily Huddle: Agenda
Ask 4 questions:
have any patients/residents fallen,
were any employees injured,
is there anyone off sick today,
is there anyone here on overtime today (1 minute)
Review communications/events (2 minutes)
Update on projects (2 minutes)
Review improvement ideas (2 minutes)
Report out on your QCDSM measures- are they green or red (meeting or not meeting your targets) ( 1 minute each)
Update and review actions (3 minutes)

28. Keep In Mind…
The Visibility Wall is not in itself the goal – the discussions, actions and accountability are what is important
PDSA (Plan, Do, Study, Act) – keep pressure on your team to get out and try implementing improvement ideas
The more people informed and trained in changes made, the better chance that changes will be sustained
If the team is stuck, go back to the purpose statement and process steps for direction

29. If you have any questions or want more information, contact:
Sandra Lynn at or
More information can also be found on the Intranet at:
(Departments > Kaizen Promotion Office > Visibility Wall Kits)
Or at