1 00:00:00,000 --> 00:00:19,960 Hi, and welcome to Be The Flagship with our podcast host, Jeff Parsons. 2 00:00:19,960 --> 00:00:24,240 This is where we tackle the day-to-day talent management challenges you face, particularly 3 00:00:24,240 --> 00:00:26,900 in hospice and small healthcare organizations. 4 00:00:26,900 --> 00:00:28,640 And now over to our host. 5 00:00:28,640 --> 00:00:29,640 Take it away, Jeff. 6 00:00:29,640 --> 00:00:34,160 Hey there, and welcome to this week's podcast, Be The Flagship. 7 00:00:34,160 --> 00:00:43,160 I'm your host, the one and only Jeff Parsons, and my wife says, thank God for that. 8 00:00:43,160 --> 00:00:50,440 We have another outstanding episode for you today with our guest speaker, Terry Norris. 9 00:00:50,440 --> 00:00:58,820 And Terry has joined us for the month of January to speak about process improvement in healthcare. 10 00:00:58,820 --> 00:01:01,720 So we're just absolutely thrilled to have Terry with us. 11 00:01:01,720 --> 00:01:04,280 He's a lean consultant. 12 00:01:04,280 --> 00:01:06,480 He's a lean healthcare expert. 13 00:01:06,480 --> 00:01:14,240 He's the author of the book, How to Make Lean Work in Your Hospital or in Your Department. 14 00:01:14,240 --> 00:01:20,720 And he has vast experience in developing healthcare leaders at all levels. 15 00:01:20,720 --> 00:01:22,400 So Terry, welcome back. 16 00:01:22,400 --> 00:01:25,760 We're so glad you were able to join us again today. 17 00:01:25,760 --> 00:01:26,760 For sure. 18 00:01:26,760 --> 00:01:27,880 Thanks for the opportunity. 19 00:01:27,880 --> 00:01:32,440 So today, Terry, we're going to further our discussion on value stream mapping. 20 00:01:32,440 --> 00:01:39,080 We're going to talk about root cause analysis and other tools we can use and other things 21 00:01:39,080 --> 00:01:43,120 to think about in improving our healthcare processes. 22 00:01:43,120 --> 00:01:47,200 Before we get into the detail and pick up from last week's discussion, let's take a 23 00:01:47,200 --> 00:01:48,200 quick break. 24 00:01:48,200 --> 00:01:49,600 We'll be right back. 25 00:01:49,600 --> 00:01:54,520 At Flagship Talent, we work with our clients to find and place the right talent. 26 00:01:54,520 --> 00:01:56,380 What do we mean by the right talent? 27 00:01:56,380 --> 00:02:01,000 We mean we find talent who will commit to your organizational goals and align with your 28 00:02:01,000 --> 00:02:03,700 values and behavior expectations. 29 00:02:03,700 --> 00:02:06,240 Talent who will perform to your expectations. 30 00:02:06,240 --> 00:02:09,780 Talent who will stay and grow with your organization. 31 00:02:09,780 --> 00:02:11,760 How are we different from our competitors? 32 00:02:11,760 --> 00:02:14,600 We offer the lowest fee structure in the industry. 33 00:02:14,600 --> 00:02:17,440 We offer the best talent guarantee in the industry. 34 00:02:17,440 --> 00:02:22,280 We provide selection and interviewing support to our clients at no additional fee. 35 00:02:22,280 --> 00:02:27,680 We want to save you money, deliver high quality talent, become an extension of your organization, 36 00:02:27,680 --> 00:02:31,240 and be your preferred provider of talent acquisition solutions. 37 00:02:31,240 --> 00:02:37,000 To learn more, contact Jeff Parsons by email at jeff at flagshiptalent.com or by phone 38 00:02:37,000 --> 00:02:42,200 at 1-800-530-4189, extension 101. 39 00:02:42,200 --> 00:02:44,880 Okay, we're back. 40 00:02:44,880 --> 00:02:49,560 So Terry, value stream mapping and root cause analysis. 41 00:02:49,560 --> 00:02:55,360 So let's shift just a little bit and talk about root cause analysis because again, I'm 42 00:02:55,360 --> 00:03:01,780 a novice obviously, but going back to the value stream map, is it one of the things 43 00:03:01,780 --> 00:03:08,440 you want to do when you identify the barriers and all that is get to the root cause of why 44 00:03:08,440 --> 00:03:09,600 you have the barrier? 45 00:03:09,600 --> 00:03:14,460 But just talk to us a bit about root cause analysis, Terry, and give us your thoughts 46 00:03:14,460 --> 00:03:18,480 on that and how to really get to the root cause of a problem. 47 00:03:18,480 --> 00:03:22,400 Those are your assumptions oftentimes. 48 00:03:22,400 --> 00:03:28,880 Okay, well if you will allow me to go back to the current state mapping and build to 49 00:03:28,880 --> 00:03:33,640 that point because during that process, you're getting ready for that. 50 00:03:33,640 --> 00:03:38,400 And I'd like to throw in just one more suggestion on the current state map too. 51 00:03:38,400 --> 00:03:40,800 Let's use an example again of the OR. 52 00:03:40,800 --> 00:03:44,840 Let's say you want to map out the turnover time. 53 00:03:44,840 --> 00:03:47,560 How long does it take to change your room over? 54 00:03:47,560 --> 00:03:48,560 It would depend, right? 55 00:03:48,560 --> 00:03:51,920 Whether you're doing a big ortho case or whether you're doing an IK case or whether you're 56 00:03:51,920 --> 00:03:54,680 doing, it would make a huge difference. 57 00:03:54,680 --> 00:04:01,200 So when you pick something to map out, you want to pick something that's done frequently, 58 00:04:01,200 --> 00:04:05,120 that's done frequently and it's sort of an average thing, something that you do all the 59 00:04:05,120 --> 00:04:10,040 time and then you can extrapolate from that for the bigger cases, for the smaller, but 60 00:04:10,040 --> 00:04:12,080 you do want to pick something specific. 61 00:04:12,080 --> 00:04:15,140 Otherwise, when you start mapping, everybody will say, well, it depends. 62 00:04:15,140 --> 00:04:19,800 It depends if we're doing this or we're doing this and that depends can just really waste 63 00:04:19,800 --> 00:04:22,080 a lot of time and create a lot of confusion. 64 00:04:22,080 --> 00:04:24,640 So be specific on what you're mapping out. 65 00:04:24,640 --> 00:04:30,140 Map out one thing with one patient, one person from beginning to end and the improvements 66 00:04:30,140 --> 00:04:31,140 you make. 67 00:04:31,140 --> 00:04:35,760 You can bleed over into the other types of things that you do. 68 00:04:35,760 --> 00:04:39,600 So when you're doing your current state map, you've got your process steps up. 69 00:04:39,600 --> 00:04:43,740 We talked about you can add your communication flow, how the supplies get in this. 70 00:04:43,740 --> 00:04:45,960 You can have different data points on there. 71 00:04:45,960 --> 00:04:48,480 What's your manual touch time for each step? 72 00:04:48,480 --> 00:04:50,120 What is your flow time for each step? 73 00:04:50,120 --> 00:04:52,440 How long does it actually take? 74 00:04:52,440 --> 00:04:55,240 And then you can also, you'll have identify your barriers. 75 00:04:55,240 --> 00:04:58,480 You'll go through and say, well, here's a place where we spend a lot of time. 76 00:04:58,480 --> 00:05:00,840 Here's a place where we do a lot of rework. 77 00:05:00,840 --> 00:05:06,120 Here's a place where there's a lot of waiting, but you identify those all through the map 78 00:05:06,120 --> 00:05:11,000 and that's really the beginning of your root cause analysis because you're identifying 79 00:05:11,000 --> 00:05:16,360 what are the issues that slows down our current process as it is now. 80 00:05:16,360 --> 00:05:21,240 Once you identify all those, and let's just use a scenario where we have, let's say 85 81 00:05:21,240 --> 00:05:25,920 steps in a process and we have 25 barriers. 82 00:05:25,920 --> 00:05:29,600 So you go through the team and you say, okay, well, let's look at those 25 barriers and 83 00:05:29,600 --> 00:05:36,680 let's sort of, you know, basically take those off or rewrite them, which is rework, but 84 00:05:36,680 --> 00:05:40,200 that's the one time I say, okay, I want to be able to see my actual current state map 85 00:05:40,200 --> 00:05:42,160 and I want to be able to do this work over here. 86 00:05:42,160 --> 00:05:45,340 But you take those 25 barriers and you start working on them. 87 00:05:45,340 --> 00:05:46,340 You put them together. 88 00:05:46,340 --> 00:05:49,600 If they have something to do, let's say with training or if they have to do with personnel 89 00:05:49,600 --> 00:05:53,840 or whatever the case is, you sort of affinitize them and put them in groups. 90 00:05:53,840 --> 00:05:56,520 And then you have the team come up and vote on them. 91 00:05:56,520 --> 00:06:02,560 Of all these 25, and let's say we broke it into maybe seven categories now, which of 92 00:06:02,560 --> 00:06:06,480 these do you think is the absolute biggest problem? 93 00:06:06,480 --> 00:06:09,440 What's the number one problem that slows us down? 94 00:06:09,440 --> 00:06:10,440 What's the number two? 95 00:06:10,440 --> 00:06:11,440 What's the number three? 96 00:06:11,440 --> 00:06:15,000 And you may do three to five of your biggest issues. 97 00:06:15,000 --> 00:06:19,800 And that's important because you want to solve the big issues because generally if you solve 98 00:06:19,800 --> 00:06:24,320 the big issues, most of the other, sometimes every one of the other, but most of the others 99 00:06:24,320 --> 00:06:28,000 will be solved as well of those other issues. 100 00:06:28,000 --> 00:06:32,800 So let's say you have the three top issues from a process that had 25 barriers and 85 101 00:06:32,800 --> 00:06:33,800 steps. 102 00:06:33,800 --> 00:06:36,840 You do root cause analysis on those barriers. 103 00:06:36,840 --> 00:06:42,000 You put them on a board one at a time and you ask the question. 104 00:06:42,000 --> 00:06:45,940 You turn the barrier into a question basically, and then you ask the question, well, why does 105 00:06:45,940 --> 00:06:47,440 this happen? 106 00:06:47,440 --> 00:06:51,000 And that's when you get into your root cause analysis really when you start doing the five 107 00:06:51,000 --> 00:06:57,360 whys and the five whys, which I know I'm just introducing, but it's a technique where you 108 00:06:57,360 --> 00:07:01,360 ask the question ideally five times to get to the root cause. 109 00:07:01,360 --> 00:07:03,760 And it could be three and it could be seven. 110 00:07:03,760 --> 00:07:07,960 And people that's actually ever done this exercise realize that almost never works like 111 00:07:07,960 --> 00:07:11,320 it does in textbook, which is so perfectly so why does this happen? 112 00:07:11,320 --> 00:07:14,400 And it works its way to the root cause. 113 00:07:14,400 --> 00:07:19,400 So how to do that literally, actually, if I was teaching and I have taught many folks 114 00:07:19,400 --> 00:07:21,240 how to do it is to brainstorm. 115 00:07:21,240 --> 00:07:25,320 You know, if you have, you know, ask the question, why does this thing not work like it's supposed 116 00:07:25,320 --> 00:07:26,320 to? 117 00:07:26,320 --> 00:07:27,320 Why? 118 00:07:27,320 --> 00:07:29,720 And then write down your brainstorm, everything that you hear. 119 00:07:29,720 --> 00:07:33,160 And then you start putting in some sort of order that makes sense that would work your 120 00:07:33,160 --> 00:07:35,960 way to the actual root cause. 121 00:07:35,960 --> 00:07:36,960 And it works. 122 00:07:36,960 --> 00:07:42,320 And it's in my opinion of all of the different tools that I use in root and in lean root 123 00:07:42,320 --> 00:07:45,400 cause analysis is the most challenging. 124 00:07:45,400 --> 00:07:50,880 And I tell people just get a good night's sleep, be ready to think on your feet and, 125 00:07:50,880 --> 00:07:55,580 you know, to be able to lead the group and to find out what the actual root cause is. 126 00:07:55,580 --> 00:07:57,380 So you have your issue. 127 00:07:57,380 --> 00:08:00,960 You've identified what your root cause is through the five whys. 128 00:08:00,960 --> 00:08:06,840 And then the next step is to come up with some sort of a countermeasure or solution. 129 00:08:06,840 --> 00:08:13,120 And if you identify the correct root cause, it's almost obvious, obviously, usually what 130 00:08:13,120 --> 00:08:14,840 you need to do. 131 00:08:14,840 --> 00:08:20,320 So if you're successful in identifying the root cause, you're getting closer to what 132 00:08:20,320 --> 00:08:23,760 you've called in earlier episodes, standard to work. 133 00:08:23,760 --> 00:08:24,760 Is that right? 134 00:08:24,760 --> 00:08:25,760 Yes. 135 00:08:25,760 --> 00:08:32,760 And almost always, if not always, when you're trying to improve a process, you're almost 136 00:08:32,760 --> 00:08:38,000 always one of your countermeasures is going to be to develop standard work. 137 00:08:38,000 --> 00:08:40,880 You know, there's exceptions to everything in the world. 138 00:08:40,880 --> 00:08:42,000 That's why I say almost always. 139 00:08:42,000 --> 00:08:46,880 But on this one, I'm going to go ahead and say, I can't remember a time that it's ever 140 00:08:46,880 --> 00:08:50,680 happened that we'd made something there and we didn't develop standard work. 141 00:08:50,680 --> 00:08:56,400 So it's most likely most places, even if they have standard work, it's going to have to 142 00:08:56,400 --> 00:08:57,880 be redone. 143 00:08:57,880 --> 00:08:59,840 It's generally going to have to be redone. 144 00:08:59,840 --> 00:09:01,640 It's going to have to be enforced or something. 145 00:09:01,640 --> 00:09:06,040 But that component is a very, very large component to make things better. 146 00:09:06,040 --> 00:09:14,880 So when you identify and document standard work, then there's obviously some training 147 00:09:14,880 --> 00:09:23,560 that's required to train the organization or to retrain the organization on one of the 148 00:09:23,560 --> 00:09:25,320 standard work practices. 149 00:09:25,320 --> 00:09:27,800 This is the way we're going to do it from this point forward. 150 00:09:27,800 --> 00:09:29,280 Is that right? 151 00:09:29,280 --> 00:09:31,420 Generally, yes. 152 00:09:31,420 --> 00:09:36,680 It's generally the steps in a process, along with maybe some notes about how to do that 153 00:09:36,680 --> 00:09:40,280 step along with how long it takes to do that step. 154 00:09:40,280 --> 00:09:45,280 And it can get more complicated than that with tact time and things that's very standard, 155 00:09:45,280 --> 00:09:47,320 I'd say manufacturing. 156 00:09:47,320 --> 00:09:52,040 But in healthcare, I tend to treat standard work a little bit differently. 157 00:09:52,040 --> 00:09:56,440 I mean, the general idea is that we all do the same job the same way every time and we 158 00:09:56,440 --> 00:09:59,320 continuously make it better over time. 159 00:09:59,320 --> 00:10:02,960 That's kind of a broad definition of standard work. 160 00:10:02,960 --> 00:10:04,240 Question for you, Terry. 161 00:10:04,240 --> 00:10:10,060 In your experience, have you witnessed people, although you had standard work, they reverted 162 00:10:10,060 --> 00:10:13,640 back to their old habits or their old ways? 163 00:10:13,640 --> 00:10:18,480 Well, not getting into the improvement piece of it, but yes, you have to have that in-service 164 00:10:18,480 --> 00:10:23,800 training and even a bigger piece of that because almost everybody that I've worked with does 165 00:10:23,800 --> 00:10:29,640 the training, but then people don't follow it. 166 00:10:29,640 --> 00:10:34,280 So if you don't have some sort of audit and accountability in that, in general, I'm talking 167 00:10:34,280 --> 00:10:35,720 about quality people too. 168 00:10:35,720 --> 00:10:38,160 You really assume you're best people. 169 00:10:38,160 --> 00:10:42,220 It's just human nature just to sort of fall back into what you're doing. 170 00:10:42,220 --> 00:10:47,320 So you do have to take time to train and you have to take time to also audit and to encourage 171 00:10:47,320 --> 00:10:52,360 and to lead and all that to get people to follow the standard work, to get used to following 172 00:10:52,360 --> 00:10:53,360 that. 173 00:10:53,360 --> 00:10:57,760 And that is a big piece in changing your culture too because we're not used to doing that. 174 00:10:57,760 --> 00:11:00,480 What about reinforcing improvement? 175 00:11:00,480 --> 00:11:04,900 And I will say through observations, many observations, I don't recall ever, ever in 176 00:11:04,900 --> 00:11:10,680 any industry seeing two people do the same job the same way without some variation in 177 00:11:10,680 --> 00:11:11,800 that. 178 00:11:11,800 --> 00:11:15,840 So you want people to do things the same way each time, no matter, you know, so if you 179 00:11:15,840 --> 00:11:19,380 show up for an appointment of any sort, it doesn't matter who's working, you're going 180 00:11:19,380 --> 00:11:23,640 to get the same level of care because people are doing things the same way. 181 00:11:23,640 --> 00:11:28,260 It'll be safer, higher quality, training will be much, much easier if you have standard 182 00:11:28,260 --> 00:11:29,480 work. 183 00:11:29,480 --> 00:11:32,800 So yes, standard work is a very, very important component. 184 00:11:32,800 --> 00:11:39,840 You can't really, in my opinion, it's hard to be consistently better and consistently 185 00:11:39,840 --> 00:11:44,880 improve things over time without giving attention to standard work. 186 00:11:44,880 --> 00:11:51,520 Yes, and that's, you know, what tends to happen, which is, you know, part of the rapid improvement 187 00:11:51,520 --> 00:11:56,280 and part of the training, the understanding is generally there's a dip in performance 188 00:11:56,280 --> 00:12:00,560 a little bit just in the beginning because people are having what they're used to doing 189 00:12:00,560 --> 00:12:06,160 and to just doing it for 20 years or more, 30 and everybody has their different time 190 00:12:06,160 --> 00:12:09,720 span, but they've done some a certain way for a long time. 191 00:12:09,720 --> 00:12:14,200 So now they have to consciously think about it and follow the steps. 192 00:12:14,200 --> 00:12:18,040 And the idea is not that you sit with a piece of paper every single time you do, you know, 193 00:12:18,040 --> 00:12:21,760 some basic functions and you have, but you do understand, you learn what's on that standard 194 00:12:21,760 --> 00:12:24,000 work and then you learn to follow it as it is. 195 00:12:24,000 --> 00:12:27,800 And you don't have to look at it every time because you memorize it after you've done 196 00:12:27,800 --> 00:12:30,920 it multiple times a day, day after day. 197 00:12:30,920 --> 00:12:38,160 Well that's right, you know, and it's all about effectively, you know, managing the 198 00:12:38,160 --> 00:12:45,760 change and I do an exercise when I'm facilitating change management training and it's really 199 00:12:45,760 --> 00:12:50,640 funny as you take them through the steps, really you're taking them through the steps 200 00:12:50,640 --> 00:12:53,180 of change, they just don't know it yet. 201 00:12:53,180 --> 00:12:59,160 And at the very end of it, they almost always revert back to what they were doing, even 202 00:12:59,160 --> 00:13:04,720 if the change is better, even if the change is more comfortable for them, people just 203 00:13:04,720 --> 00:13:05,880 tend to revert back. 204 00:13:05,880 --> 00:13:11,040 They'll pull out that old form out of a locker or out of a desk drawer and you never know 205 00:13:11,040 --> 00:13:12,400 when I might need it again. 206 00:13:12,400 --> 00:13:13,520 So you're right. 207 00:13:13,520 --> 00:13:21,520 It takes, you know, it takes leadership's commitment to holding the organization accountable. 208 00:13:21,520 --> 00:13:28,640 Absolutely, and even to add to what you just said because it's the team, a team says, you 209 00:13:28,640 --> 00:13:31,760 know, they're excited about the change. 210 00:13:31,760 --> 00:13:34,520 Leadership comes in and says, oh my goodness, this is great. 211 00:13:34,520 --> 00:13:36,720 Now this will say this is a Friday. 212 00:13:36,720 --> 00:13:39,120 Everybody's all excited about the change. 213 00:13:39,120 --> 00:13:41,920 I mean, I'm proud of it, it's celebration. 214 00:13:41,920 --> 00:13:46,200 And then they go right back, fall right back into what they were doing before. 215 00:13:46,200 --> 00:13:48,560 And I thought that was fascinating in the beginning. 216 00:13:48,560 --> 00:13:50,480 I'm like, you wanted to do it. 217 00:13:50,480 --> 00:13:51,800 It was your idea. 218 00:13:51,800 --> 00:13:52,800 Everybody agreed on it. 219 00:13:52,800 --> 00:13:57,560 Your leadership thought you were a genius, you know, and then, oh, at least we understand 220 00:13:57,560 --> 00:13:58,560 that. 221 00:13:58,560 --> 00:14:03,040 So we know on Monday we have to be ready because it's going to be a tendency for people just 222 00:14:03,040 --> 00:14:05,440 to go back and do what they were doing. 223 00:14:05,440 --> 00:14:06,440 Okay. 224 00:14:06,440 --> 00:14:09,520 So talk to us about future state mapping. 225 00:14:09,520 --> 00:14:11,000 Okay. 226 00:14:11,000 --> 00:14:12,600 Future state mapping. 227 00:14:12,600 --> 00:14:16,640 So you've done your current states, you understand it, you know your barriers, you've done your 228 00:14:16,640 --> 00:14:21,320 root cause analysis, so we know that we're going to take our solutions that we came up 229 00:14:21,320 --> 00:14:25,960 with during our root cause analysis and we're going to incorporate that into the future 230 00:14:25,960 --> 00:14:26,960 state. 231 00:14:26,960 --> 00:14:30,080 So the future state generally, as long as you didn't change your first and your last 232 00:14:30,080 --> 00:14:32,500 step, your scope stays the same. 233 00:14:32,500 --> 00:14:36,960 You put that on the board, your first step, your last step, you incorporate your ideas 234 00:14:36,960 --> 00:14:39,200 where you know that you've made changes. 235 00:14:39,200 --> 00:14:44,440 We assume now our standard work is in place and we assume that we've moved this machinery 236 00:14:44,440 --> 00:14:48,640 around and we've organized, we've done things that's going to save a lot of time. 237 00:14:48,640 --> 00:14:51,720 And we build that map based on that assumption. 238 00:14:51,720 --> 00:14:56,120 And then we ask for everybody's ideas, you know, like what else could we do? 239 00:14:56,120 --> 00:14:57,480 Now this isn't just everybody. 240 00:14:57,480 --> 00:14:58,480 These are the experts. 241 00:14:58,480 --> 00:15:02,160 These are the people who do the work day after day after day that are directly involved in 242 00:15:02,160 --> 00:15:04,040 that process. 243 00:15:04,040 --> 00:15:08,880 And generally, a lot of those people have had great ideas for years and this is the 244 00:15:08,880 --> 00:15:12,660 first opportunity they really had to say anything about it. 245 00:15:12,660 --> 00:15:16,720 So we take our root cause analysis, we do some other training about, you know, standard 246 00:15:16,720 --> 00:15:18,920 work and we do training about mistake proofing. 247 00:15:18,920 --> 00:15:23,040 But we get people in the idea of understanding like some of the things that would go into 248 00:15:23,040 --> 00:15:25,000 a future state map. 249 00:15:25,000 --> 00:15:27,600 So then we map it out and then we challenge it. 250 00:15:27,600 --> 00:15:29,240 We talk through it, we challenge it. 251 00:15:29,240 --> 00:15:30,560 We're like, well, could we do this? 252 00:15:30,560 --> 00:15:31,800 Couldn't we do this? 253 00:15:31,800 --> 00:15:36,000 I mean, the way we've got this thing built, we've, you know, our goal was to reduce something, 254 00:15:36,000 --> 00:15:37,000 let's say 30 percent. 255 00:15:37,000 --> 00:15:42,600 But if we follow through just as it is, we're not going to meet that goal with, by the way, 256 00:15:42,600 --> 00:15:45,160 it's usually far exceeds whatever the goal normally. 257 00:15:45,160 --> 00:15:49,320 But if that happened, we would go back, we would keep working and trying to find places 258 00:15:49,320 --> 00:15:53,500 where we could make a real change, change that we can do, not something that's crazy 259 00:15:53,500 --> 00:15:56,560 or costs, you know, an exorbitant amount of money. 260 00:15:56,560 --> 00:16:01,480 They would keep working with a future state map until it meets our goal, until whatever 261 00:16:01,480 --> 00:16:06,820 targets we set in the beginning, we're confident if we do that, we can make it. 262 00:16:06,820 --> 00:16:08,680 And then we map it out. 263 00:16:08,680 --> 00:16:12,640 And then, of course, we're not to get ahead, but, you know, to map it out, to get it, to 264 00:16:12,640 --> 00:16:14,920 make it work, you got to have an action plan, right? 265 00:16:14,920 --> 00:16:20,320 So we build an action plan based on the things we need to do to make that future state reality. 266 00:16:20,320 --> 00:16:21,320 Okay. 267 00:16:21,320 --> 00:16:30,260 Now, earlier, you mentioned future state mapping and you mentioned ideal state mapping. 268 00:16:30,260 --> 00:16:33,960 So what's the difference between future state and ideal state? 269 00:16:33,960 --> 00:16:36,600 Wouldn't your future state be the ideal? 270 00:16:36,600 --> 00:16:38,960 Oh, that's a great question. 271 00:16:38,960 --> 00:16:42,920 And it does create confusion, especially just throwing it out and talking about it like 272 00:16:42,920 --> 00:16:47,560 I did without it being a part of a, you know, train, even during the wrap and improvement 273 00:16:47,560 --> 00:16:48,560 event. 274 00:16:48,560 --> 00:16:50,680 We do a little bit of training, then we do a little training, then we do. 275 00:16:50,680 --> 00:16:52,800 But an ideal state map is different. 276 00:16:52,800 --> 00:16:57,320 So it's, you do that before the future state, you do that between recourse analysis and 277 00:16:57,320 --> 00:16:59,480 the future state map. 278 00:16:59,480 --> 00:17:02,800 Because at that point you said, okay, let's pretend like there's no boundaries, there's 279 00:17:02,800 --> 00:17:03,860 no rules. 280 00:17:03,860 --> 00:17:04,860 You can do whatever you want. 281 00:17:04,860 --> 00:17:11,160 And we want to make a future, we want to make an ideal state, something that would be perfect. 282 00:17:11,160 --> 00:17:15,440 So you separate people into small groups and you have them generally draw and there's different 283 00:17:15,440 --> 00:17:16,440 ways of doing it. 284 00:17:16,440 --> 00:17:19,480 But I generally have them just draw pictures, very few words. 285 00:17:19,480 --> 00:17:21,440 What would it look like in the future? 286 00:17:21,440 --> 00:17:23,980 With an ideal state, what would it look like? 287 00:17:23,980 --> 00:17:26,280 And they're usually impossible. 288 00:17:26,280 --> 00:17:32,240 You know, they're things that are not reasonable because, you know, you tell people that there 289 00:17:32,240 --> 00:17:36,480 are no barriers, which is funny too, another whole conversation, but it's hard for people 290 00:17:36,480 --> 00:17:38,320 to imagine no barriers. 291 00:17:38,320 --> 00:17:39,800 That's an exercise, that's a fun exercise. 292 00:17:39,800 --> 00:17:43,760 So people even for 10 minutes can't put out of their mind barriers. 293 00:17:43,760 --> 00:17:45,520 We just, it's something else. 294 00:17:45,520 --> 00:17:50,480 But anyway, so people build these things and we take a look at them and we have them explain, 295 00:17:50,480 --> 00:17:51,480 we put them up. 296 00:17:51,480 --> 00:17:53,000 Okay, everybody does a little back brief. 297 00:17:53,000 --> 00:17:56,440 This whole exercise, if you do it right, it shouldn't take that long. 298 00:17:56,440 --> 00:17:59,520 You spend 10 minutes building it, you know, a few minutes presenting it. 299 00:17:59,520 --> 00:18:03,960 But as you're presenting it, as the teams are, they'll say, well, in this future state, 300 00:18:03,960 --> 00:18:08,680 let's say from the emergency room, for example, the patient walks in one big room and in that 301 00:18:08,680 --> 00:18:14,000 room is the doctors, the lab, the cardiologist, everybody, the radiologist, everybody that 302 00:18:14,000 --> 00:18:15,200 you need is already there. 303 00:18:15,200 --> 00:18:18,820 They're just waiting on you, you know, in an ideal state, there's no waiting. 304 00:18:18,820 --> 00:18:23,440 You just get helped with whatever you need right then as an example. 305 00:18:23,440 --> 00:18:27,240 So as a leader, a facilitator, you'd ask the question, well, what makes that better? 306 00:18:27,240 --> 00:18:28,840 And you'd say, oh, there's less waiting. 307 00:18:28,840 --> 00:18:31,320 So you write down a theme. 308 00:18:31,320 --> 00:18:33,560 In this ideal state, there's less waiting. 309 00:18:33,560 --> 00:18:34,560 What else? 310 00:18:34,560 --> 00:18:35,560 Well, there's standard work. 311 00:18:35,560 --> 00:18:40,760 There's, you know, the time it takes, it goes from four hours to 30 minutes, whatever. 312 00:18:40,760 --> 00:18:45,720 When you jot down all those things for each of those ideal states and what that does, 313 00:18:45,720 --> 00:18:50,680 you say, okay, well, let's take these themes, you know, standard work, doing things faster, 314 00:18:50,680 --> 00:18:54,680 one touch, and let's help build that into the future state. 315 00:18:54,680 --> 00:18:59,600 So it does that, but bigger than that, it really gives you the team a mental, you know, 316 00:18:59,600 --> 00:19:02,120 it opens up their mind a little bit. 317 00:19:02,120 --> 00:19:05,560 So they're not looking at work the same way they've looked at it for the last 15, 20, 318 00:19:05,560 --> 00:19:08,820 30 years, like, okay, what could we do? 319 00:19:08,820 --> 00:19:14,120 The idea is to sort of motivate people, give them that touch of creativity just before 320 00:19:14,120 --> 00:19:17,300 you build a future state map to open up their thinking a little bit. 321 00:19:17,300 --> 00:19:19,840 It's a wonderful tool, widely underused. 322 00:19:19,840 --> 00:19:24,360 You know, most places that I've introduced it, I'm the one that introduced it because 323 00:19:24,360 --> 00:19:27,920 it wasn't used before, so, but it's a great tool. 324 00:19:27,920 --> 00:19:28,960 Yeah. 325 00:19:28,960 --> 00:19:30,240 Thanks for that discussion. 326 00:19:30,240 --> 00:19:32,960 Thanks for that explanation, Terry. 327 00:19:32,960 --> 00:19:38,480 I know this is not a tool, but I know you have referenced it multiple times in previous 328 00:19:38,480 --> 00:19:44,040 episodes and you mentioned it earlier in this episode, but talk to us about, it's another 329 00:19:44,040 --> 00:19:49,120 one of those Japanese words, I'm afraid, but the gimbal walk. 330 00:19:49,120 --> 00:19:51,760 What exactly is that? 331 00:19:51,760 --> 00:19:52,760 Okay. 332 00:19:52,760 --> 00:19:59,840 So gimbal walks or, gimbal is a Japanese term, another Japanese term, and a way to describe 333 00:19:59,840 --> 00:20:02,840 it I think is it's the place where the work is being done. 334 00:20:02,840 --> 00:20:06,120 The gimbal is where the truth is told. 335 00:20:06,120 --> 00:20:08,280 It's where the facts are discovered. 336 00:20:08,280 --> 00:20:11,280 It's just, you think of it literally, it's where the people are out doing the work. 337 00:20:11,280 --> 00:20:16,160 So if you're doing work in the lab, the gimbal would be where the person's in the room taking 338 00:20:16,160 --> 00:20:20,520 blood, you know, the part, it would be the person that's doing the work from interacting 339 00:20:20,520 --> 00:20:23,440 with the patient or they'd be doing the work in the lab. 340 00:20:23,440 --> 00:20:26,780 That's where the work is being done versus a conference room. 341 00:20:26,780 --> 00:20:28,680 You're actually going out to where things are happening. 342 00:20:28,680 --> 00:20:31,960 So that's what the gimbal is. 343 00:20:31,960 --> 00:20:35,760 And so that happens how often? 344 00:20:35,760 --> 00:20:36,760 It depends. 345 00:20:36,760 --> 00:20:39,800 So if it happens, if you're a frontline supervisor, it happens every day. 346 00:20:39,800 --> 00:20:42,380 It happens multiple times throughout the day. 347 00:20:42,380 --> 00:20:45,260 If you're a director, it should happen every day. 348 00:20:45,260 --> 00:20:50,500 If you're in the C-suite, you're a CEO, CFO, it should happen at least weekly. 349 00:20:50,500 --> 00:20:53,260 You should be on the gimbal interacting. 350 00:20:53,260 --> 00:20:57,320 So it depends on what level you're at in the organization. 351 00:20:57,320 --> 00:21:02,600 And you know, I've heard the concept before, learning to see, right? 352 00:21:02,600 --> 00:21:07,040 And learning to see what's really happening in your process. 353 00:21:07,040 --> 00:21:09,040 And I'll give you an example. 354 00:21:09,040 --> 00:21:16,920 I had a job candidate I was interviewing for a VP of operations role and she was a lean 355 00:21:16,920 --> 00:21:19,180 champion. 356 00:21:19,180 --> 00:21:21,920 She was very strong and lean. 357 00:21:21,920 --> 00:21:24,000 It was manufacturing. 358 00:21:24,000 --> 00:21:29,720 And she mentioned that an employee from a different department walked up to her one 359 00:21:29,720 --> 00:21:35,040 day and said, hey, I have this problem over here and I have a leak. 360 00:21:35,040 --> 00:21:38,440 I have a water line or a hydraulic line or something like that. 361 00:21:38,440 --> 00:21:42,280 It was leaking and I need to have something done about it. 362 00:21:42,280 --> 00:21:45,480 And she said, well, why are you coming to me? 363 00:21:45,480 --> 00:21:50,360 And the employee said, because I know that you get things done. 364 00:21:50,360 --> 00:21:55,920 And so the person walked, the leader walked over to the process with the employee and 365 00:21:55,920 --> 00:21:57,520 saw the leak. 366 00:21:57,520 --> 00:22:03,960 And the fascinating thing was they had the organization, the company had invested tons 367 00:22:03,960 --> 00:22:07,000 of money in upgrading her process. 368 00:22:07,000 --> 00:22:13,040 I mean, they had some new work areas and workflows. 369 00:22:13,040 --> 00:22:19,200 I had invested a lot of money in that process, but they left a leak, right? 370 00:22:19,200 --> 00:22:25,640 And it was like, how did you invest that type, that sum of money, but you overlooked this 371 00:22:25,640 --> 00:22:28,800 one little thing that was that employee's worst nightmare. 372 00:22:28,800 --> 00:22:32,600 It was really a pain for her. 373 00:22:32,600 --> 00:22:38,000 And can you talk to us a little bit about how Aline? 374 00:22:38,000 --> 00:22:39,000 Yes. 375 00:22:39,000 --> 00:22:42,800 And I'm assuming tying it into gimbal walks as well. 376 00:22:42,800 --> 00:22:44,760 But yes. 377 00:22:44,760 --> 00:22:50,160 So that example you gave was a wonderful example, really, because when people just generally, 378 00:22:50,160 --> 00:22:53,920 and this is across industry as well, I've had the opportunity to work in different types 379 00:22:53,920 --> 00:22:58,240 and that helps me see that some things are very common across industry. 380 00:22:58,240 --> 00:23:04,760 But we, I say leadership, generally tends to make decisions in the conference room, 381 00:23:04,760 --> 00:23:07,440 in meetings and things like that, now teams. 382 00:23:07,440 --> 00:23:11,640 But they're gathered with their folks, they ask questions, they get information, they 383 00:23:11,640 --> 00:23:12,640 make decisions. 384 00:23:12,640 --> 00:23:16,280 Well, what a difference it is when you get up from your desk and you go out to where 385 00:23:16,280 --> 00:23:18,360 the work is actually happening. 386 00:23:18,360 --> 00:23:20,720 I mean, it's shockingly different. 387 00:23:20,720 --> 00:23:26,520 I mean, it's like your whole perspective of what you thought changes almost every time. 388 00:23:26,520 --> 00:23:31,160 So developing a culture where your people, leadership actually do that is, you know, 389 00:23:31,160 --> 00:23:33,680 it's a challenge like everything else. 390 00:23:33,680 --> 00:23:37,800 I'll give one example and if I'm not answering your question exactly, please come back to 391 00:23:37,800 --> 00:23:38,800 me on that. 392 00:23:38,800 --> 00:23:44,560 But I just worked relatively recently in a very, very large system and they were very 393 00:23:44,560 --> 00:23:49,840 much on board with doing the work, having the departments do the work, value stream 394 00:23:49,840 --> 00:23:54,320 map and root cost analysis, you know, making changes that are important. 395 00:23:54,320 --> 00:23:58,780 But the one thing that the senior leadership was not willing to do was gimbal walks. 396 00:23:58,780 --> 00:24:04,640 They thought this whole idea of lean was fine for the people that worked for them. 397 00:24:04,640 --> 00:24:07,840 And they had some engagement, so I don't want to make it sound so negative, but the one 398 00:24:07,840 --> 00:24:09,620 thing they would not do is gimbal walks. 399 00:24:09,620 --> 00:24:15,320 They would not go out, they would not commit to going out into the areas that they owned, 400 00:24:15,320 --> 00:24:18,960 you know, that they led once a week. 401 00:24:18,960 --> 00:24:22,880 And you know, some people believe that if you don't do the gimbal walks, nothing, you 402 00:24:22,880 --> 00:24:23,880 will never. 403 00:24:23,880 --> 00:24:25,600 That's the key. 404 00:24:25,600 --> 00:24:27,240 That's the glue that holds everything together. 405 00:24:27,240 --> 00:24:30,440 Some people believe that strongly in the gimbal walks. 406 00:24:30,440 --> 00:24:33,840 You have to go out there to where the people are. 407 00:24:33,840 --> 00:24:38,560 So to change a culture, to get people to do that, it takes the CEO back to the CEO from 408 00:24:38,560 --> 00:24:42,760 a previous conversation, you know, we had, but the CEO has to say, okay, we're going 409 00:24:42,760 --> 00:24:43,760 to do this. 410 00:24:43,760 --> 00:24:47,760 We're going to set time aside every Friday from nine to one. 411 00:24:47,760 --> 00:24:52,240 I want all C-suite folks doing gimbal walks in your areas. 412 00:24:52,240 --> 00:24:53,740 No meetings during that time. 413 00:24:53,740 --> 00:24:54,740 There's nothing else. 414 00:24:54,740 --> 00:24:59,480 Don't put anything else on your schedule from nine to one on Fridays or whatever, you know, 415 00:24:59,480 --> 00:25:00,480 something like that. 416 00:25:00,480 --> 00:25:02,000 But they're dogmatic about it. 417 00:25:02,000 --> 00:25:03,000 They make people do it. 418 00:25:03,000 --> 00:25:07,920 They, you know, whenever you say it that way, it sounds so negative, but it's mandatory. 419 00:25:07,920 --> 00:25:08,920 You have to do it. 420 00:25:08,920 --> 00:25:12,320 It's part of how we're going to change our culture, you know, and you don't necessarily 421 00:25:12,320 --> 00:25:16,320 present it that way, but you have to, it has to, you know, people have to do it. 422 00:25:16,320 --> 00:25:20,320 So the gimbal walk is a very big part of changing the culture and without it, you're going to 423 00:25:20,320 --> 00:25:25,800 have it, it'll be, you'll be hard pressed to really make any lasting changes, much less 424 00:25:25,800 --> 00:25:29,480 continuously make things better over time. 425 00:25:29,480 --> 00:25:31,020 You have to go out there. 426 00:25:31,020 --> 00:25:38,760 So Terry, when, when you're putting together the rapid improvement event team, how do you 427 00:25:38,760 --> 00:25:40,720 determine who should lead that team? 428 00:25:40,720 --> 00:25:47,000 You know, let's just assume that the improvement is in a department, which it almost always 429 00:25:47,000 --> 00:25:49,440 is in a department of some sort. 430 00:25:49,440 --> 00:25:55,360 I believe the department leader should be the team leader because otherwise, you know, 431 00:25:55,360 --> 00:25:58,340 again, it's, they, they're responsible for that department. 432 00:25:58,340 --> 00:26:02,280 So if they're not the team leader and they delegate that or something, then they're not 433 00:26:02,280 --> 00:26:04,240 engaged, they're not involved. 434 00:26:04,240 --> 00:26:05,840 And if it's my department, I should want it. 435 00:26:05,840 --> 00:26:11,600 I don't want people doing things, making, you know, making, I want input, you know, 436 00:26:11,600 --> 00:26:15,560 and some people, some people may say, and they, and that there is a point sometimes, 437 00:26:15,560 --> 00:26:20,180 like if the leader's in there, the leader will, you know, can influence everyone else's 438 00:26:20,180 --> 00:26:24,480 comments and decisions, especially if they're a really strong leader that has, you know, 439 00:26:24,480 --> 00:26:25,480 a strong opinion. 440 00:26:25,480 --> 00:26:30,360 And, but as a facilitator, we know that we watch for that and we try to, you know, take 441 00:26:30,360 --> 00:26:32,800 measures, mitigate to mitigate that altogether. 442 00:26:32,800 --> 00:26:33,800 So that doesn't happen. 443 00:26:33,800 --> 00:26:36,600 But to me, it's the department leader. 444 00:26:36,600 --> 00:26:37,600 Okay. 445 00:26:37,600 --> 00:26:43,760 And that's a great point about the value that a facilitator brings to the process because 446 00:26:43,760 --> 00:26:49,560 you know, leaders are different and then, and the team dynamics are different. 447 00:26:49,560 --> 00:26:50,560 Right. 448 00:26:50,560 --> 00:26:57,480 And so if you have a very strong leader with very strong opinions, it could negatively 449 00:26:57,480 --> 00:27:01,080 impact the success of that team. 450 00:27:01,080 --> 00:27:06,360 And so having a facilitator who knows how to facilitate and guide the team through the 451 00:27:06,360 --> 00:27:09,320 process adds, brings so much value. 452 00:27:09,320 --> 00:27:14,520 And I just, in my experience, I know that oftentimes, you know, people are reluctant 453 00:27:14,520 --> 00:27:19,800 to bring a facilitator in, but it just adds so much value to the process and making sure 454 00:27:19,800 --> 00:27:25,640 that the deliverables are met. 455 00:27:25,640 --> 00:27:29,000 So what about the team members? 456 00:27:29,000 --> 00:27:34,280 The other thing that I see is that oftentimes the team leader will say, okay, I need to 457 00:27:34,280 --> 00:27:39,740 involve everybody because if I don't involve everybody, then someone's going to get their 458 00:27:39,740 --> 00:27:41,400 feelings hurt. 459 00:27:41,400 --> 00:27:46,240 And then you bring the team together and some of the members of the team don't know enough 460 00:27:46,240 --> 00:27:52,080 about the process to be able to contribute effectively. 461 00:27:52,080 --> 00:27:58,240 So what has been your experience and how do you determine who the right team members are? 462 00:27:58,240 --> 00:28:02,920 Well, we determine the right team members by using that side path that I mentioned earlier. 463 00:28:02,920 --> 00:28:08,480 We hit all the major processes, the major steps in the process, and then we say, well, 464 00:28:08,480 --> 00:28:09,480 who does that? 465 00:28:09,480 --> 00:28:10,480 Who does that? 466 00:28:10,480 --> 00:28:11,480 You know, who does triage? 467 00:28:11,480 --> 00:28:13,520 Oh, it's triage nurse, you know. 468 00:28:13,520 --> 00:28:16,200 Who does the initial exam and the medical, you know, the physician? 469 00:28:16,200 --> 00:28:19,160 We work our way through and we're like, okay, we need a triage nurse. 470 00:28:19,160 --> 00:28:23,400 We need an emergency room tech. 471 00:28:23,400 --> 00:28:26,500 We need a physician, et cetera. 472 00:28:26,500 --> 00:28:29,640 We need someone from the lab, someone from radiology, because those were all steps in 473 00:28:29,640 --> 00:28:31,860 the process that we came up with. 474 00:28:31,860 --> 00:28:34,920 That's how we determine the positions. 475 00:28:34,920 --> 00:28:40,160 And then we ask leadership, you know, pick people that you think that will more likely 476 00:28:40,160 --> 00:28:45,440 be engaged or pick people that are engaged, that would be engaged in, and influential 477 00:28:45,440 --> 00:28:48,460 back when they go back out on the floor. 478 00:28:48,460 --> 00:28:52,800 And we take other steps to try and involve everyone in the entire department, but not 479 00:28:52,800 --> 00:28:54,520 during the rapid improvement event. 480 00:28:54,520 --> 00:28:58,520 Example, two weeks before rapid improvement event, we'll put up a board and we'll say, 481 00:28:58,520 --> 00:29:00,480 okay, well, we're trying to do this. 482 00:29:00,480 --> 00:29:01,600 This is what we're trying to do. 483 00:29:01,600 --> 00:29:03,840 Do you have any suggestions or ideas? 484 00:29:03,840 --> 00:29:05,560 Or what do you think the major issues are? 485 00:29:05,560 --> 00:29:08,720 And we, for two weeks, we ask people to add their comments. 486 00:29:08,720 --> 00:29:10,200 That way everybody at least has a hand. 487 00:29:10,200 --> 00:29:12,580 They have something to say, they have some input. 488 00:29:12,580 --> 00:29:14,680 And we bring that with us to the rapid improvement event. 489 00:29:14,680 --> 00:29:17,280 And that helps involve everyone without everyone being there. 490 00:29:17,280 --> 00:29:19,920 And most of the time you can't shut down operations. 491 00:29:19,920 --> 00:29:23,980 So if you have a department of 15, usually a couple of people will come and everybody 492 00:29:23,980 --> 00:29:26,160 else has to stay and do the work. 493 00:29:26,160 --> 00:29:29,520 Now if you have a small, like we're talking small healthcare sometimes, and occasionally 494 00:29:29,520 --> 00:29:30,520 you could. 495 00:29:30,520 --> 00:29:36,080 But if you have a small team, your whole entire department's eight people, you could do something 496 00:29:36,080 --> 00:29:39,320 on a weekend or you could do something like that and you could include everyone. 497 00:29:39,320 --> 00:29:41,640 But generally that's not how it works. 498 00:29:41,640 --> 00:29:42,920 Got it. 499 00:29:42,920 --> 00:29:44,160 That's a great approach by the way. 500 00:29:44,160 --> 00:29:47,440 I mean, that's great. 501 00:29:47,440 --> 00:29:54,880 So when you bring the team together and you're exposing them to these tools, the value stream 502 00:29:54,880 --> 00:30:02,800 mapping and the five whys and root cause analysis, all these things, do you provide the training 503 00:30:02,800 --> 00:30:08,280 upfront before the team gets started, before the rapid improvement event begins? 504 00:30:08,280 --> 00:30:14,760 Or do you provide as a facilitator yourself or do you provide training on the go? 505 00:30:14,760 --> 00:30:17,540 You know, basically just in time training. 506 00:30:17,540 --> 00:30:21,880 How do you approach that and teach people how to use these tools? 507 00:30:21,880 --> 00:30:28,200 So I'll start it with a story, so when I first got into Lean, very first, the organization 508 00:30:28,200 --> 00:30:31,560 that we brought in, basically we did the training in advance. 509 00:30:31,560 --> 00:30:37,260 We did it and what we realized right away is that not everybody showed up. 510 00:30:37,260 --> 00:30:39,840 So after doing that one or two times, it was obvious. 511 00:30:39,840 --> 00:30:41,600 I'm like, you know, I was a leader. 512 00:30:41,600 --> 00:30:42,960 I was the director of the department. 513 00:30:42,960 --> 00:30:43,960 Like we're not doing this. 514 00:30:43,960 --> 00:30:45,300 Yeah, we're good. 515 00:30:45,300 --> 00:30:46,960 We're not going to do this. 516 00:30:46,960 --> 00:30:50,680 So now since that's 2006 or seven maybe. 517 00:30:50,680 --> 00:30:54,200 So since that time, we always do just in time training. 518 00:30:54,200 --> 00:30:56,780 You know, it's like we're getting ready to do a current state map. 519 00:30:56,780 --> 00:30:57,780 We do a little bit of training. 520 00:30:57,780 --> 00:30:58,780 We do a current state map. 521 00:30:58,780 --> 00:30:59,780 We do root cause analysis. 522 00:30:59,780 --> 00:31:01,120 We do a little bit of training. 523 00:31:01,120 --> 00:31:06,080 We do root cause analysis and most of the tools lend themselves to just that. 524 00:31:06,080 --> 00:31:10,640 You can do a little just in time training and people can successfully maneuver through 525 00:31:10,640 --> 00:31:11,640 them. 526 00:31:11,640 --> 00:31:12,700 That makes sense. 527 00:31:12,700 --> 00:31:14,480 So let's take a quick break. 528 00:31:14,480 --> 00:31:16,760 We'll come back and wrap things up. 529 00:31:16,760 --> 00:31:20,560 Did you know that most employees quit their boss before they quit their company? 530 00:31:20,560 --> 00:31:25,520 At Flagship Talent, we take your bosses and create organizational leaders. 531 00:31:25,520 --> 00:31:30,720 We bring over 30 years of leadership development and coaching expertise to your organization 532 00:31:30,720 --> 00:31:35,240 and have developed leaders in most parts of Europe, mainland China, Thailand, and the 533 00:31:35,240 --> 00:31:36,240 Americas. 534 00:31:36,240 --> 00:31:41,760 We have also developed leaders in most industries, including hospice and other small healthcare. 535 00:31:41,760 --> 00:31:46,180 Our approach is always customized to your specific organizational needs. 536 00:31:46,180 --> 00:31:50,420 We utilize a leadership coaching approach for individual managers, identifying their 537 00:31:50,420 --> 00:31:54,700 skills gaps and providing just in time training to address the gaps. 538 00:31:54,700 --> 00:31:59,340 We then coach the manager in a way that facilitates the application of new learning and skills 539 00:31:59,340 --> 00:32:04,640 in their unique work environment and helps them overcome their specific challenges. 540 00:32:04,640 --> 00:32:09,240 We also offer customized leadership training on your site to develop your entire leadership 541 00:32:09,240 --> 00:32:10,240 team. 542 00:32:10,240 --> 00:32:14,560 We are committed to meeting your scheduling challenges and within your budget. 543 00:32:14,560 --> 00:32:15,840 Need a virtual option? 544 00:32:15,840 --> 00:32:17,000 We have that too. 545 00:32:17,000 --> 00:32:21,820 We offer online development for your managers and make it available on their schedule. 546 00:32:21,820 --> 00:32:27,820 To learn more, contact Jeff Parsons by email at jeff at FlagshipTalent.com or by phone 547 00:32:27,820 --> 00:32:32,880 at 1-800-530-4189, extension 101. 548 00:32:32,880 --> 00:32:37,840 Your managers have the greatest impact on employee engagement, performance, and retention. 549 00:32:37,840 --> 00:32:39,200 What are you waiting for? 550 00:32:39,200 --> 00:32:42,280 Let's take your managers and create leaders. 551 00:32:42,280 --> 00:32:50,800 Okay, we're back and I'd like to wrap this episode up with a few things. 552 00:32:50,800 --> 00:32:56,760 First when we talk about process improvement and we've over the month of January we've 553 00:32:56,760 --> 00:33:03,560 emphasized lean in healthcare, but lean has other applications other than in clinical 554 00:33:03,560 --> 00:33:06,320 care or operations, right? 555 00:33:06,320 --> 00:33:12,720 We like to think that it's sort of narrowly focused on operations, but it's also very 556 00:33:12,720 --> 00:33:21,200 applicable in administrative functions such as HR and finance and other administrative 557 00:33:21,200 --> 00:33:22,200 functions. 558 00:33:22,200 --> 00:33:26,260 In other words, if you have a process you can use the same tools we've been talking 559 00:33:26,260 --> 00:33:32,720 about this month to improve your processes, to improve your effectiveness and your efficiency. 560 00:33:32,720 --> 00:33:34,800 Give you a couple of examples in finance. 561 00:33:34,800 --> 00:33:39,840 How many days does it take to close your monthly books? 562 00:33:39,840 --> 00:33:41,160 What's the process for it? 563 00:33:41,160 --> 00:33:43,220 It is a process. 564 00:33:43,220 --> 00:33:44,960 Can you improve upon it? 565 00:33:44,960 --> 00:33:48,020 HR, what's your time to hire? 566 00:33:48,020 --> 00:33:52,960 How long does it take you from the time of an employee requisition to the time that that 567 00:33:52,960 --> 00:33:54,880 person starts on the job? 568 00:33:54,880 --> 00:33:55,920 That's a process. 569 00:33:55,920 --> 00:33:59,480 Can you improve upon it with the tools we've talked about this month? 570 00:33:59,480 --> 00:34:00,920 Yes, you can. 571 00:34:00,920 --> 00:34:05,880 And so think of it in the broader terms of how can I take these tools, even if I'm not 572 00:34:05,880 --> 00:34:12,560 in clinical care or any other type of operations support, how can I take these tools and use 573 00:34:12,560 --> 00:34:21,120 these tools to improve my processes and improve my performance and the performance of my team? 574 00:34:21,120 --> 00:34:27,280 Those are the important things to get out of this month's episodes. 575 00:34:27,280 --> 00:34:31,880 And also I'd like to leave you with one more process improvement quote for the month of 576 00:34:31,880 --> 00:34:35,560 January where we have focused on process improvement. 577 00:34:35,560 --> 00:34:41,080 And although this is an improvement quote, it's not necessarily process driven, it's 578 00:34:41,080 --> 00:34:42,200 people driven. 579 00:34:42,200 --> 00:34:49,000 And remember, be the flagship is about talent and process improvement is about talent. 580 00:34:49,000 --> 00:34:52,220 It's about managing talent, managing change. 581 00:34:52,220 --> 00:35:00,320 So here's the quote, it's by a person named Melcher Lim. 582 00:35:00,320 --> 00:35:09,400 And his quote is, there is no exercise better for the improvement of our world than reaching 583 00:35:09,400 --> 00:35:14,960 down on a daily basis to lift someone up. 584 00:35:14,960 --> 00:35:17,420 No truer words have been spoken. 585 00:35:17,420 --> 00:35:22,120 So there's no exercise better for the improvement of our world than reaching down on a daily 586 00:35:22,120 --> 00:35:25,640 basis to lift someone up. 587 00:35:25,640 --> 00:35:33,040 With that, Terry again, thank you so much for your contributions in the month of January 588 00:35:33,040 --> 00:35:35,520 on process improvement and healthcare. 589 00:35:35,520 --> 00:35:38,600 I truly appreciate you. 590 00:35:38,600 --> 00:35:45,280 For our listeners, remember you can find his book on lean healthcare. 591 00:35:45,280 --> 00:35:50,920 The book is titled, how to make lean work in your hospital or in your department. 592 00:35:50,920 --> 00:35:58,000 Doesn't matter if you're a hospice, home health, other small healthcare, those tools apply 593 00:35:58,000 --> 00:35:59,600 to your organization. 594 00:35:59,600 --> 00:36:01,320 So it's a great book. 595 00:36:01,320 --> 00:36:04,640 You can find it on Amazon again, by Terry Norris. 596 00:36:04,640 --> 00:36:11,560 Terry, thank you so much for your contribution and you have an open invitation to join this 597 00:36:11,560 --> 00:36:12,560 podcast. 598 00:36:12,560 --> 00:36:13,560 Thank you so much. 599 00:36:13,560 --> 00:36:14,560 Thank you too. 600 00:36:14,560 --> 00:36:15,560 Bye bye. 601 00:36:15,560 --> 00:36:20,540 Thank you for listening to this episode of Be the Flagship with Jeff Parsons. 602 00:36:20,540 --> 00:36:21,780 We hope you enjoyed it. 603 00:36:21,780 --> 00:36:24,860 If you did like it, please subscribe and share with others. 604 00:36:24,860 --> 00:36:51,580 Until next time, take the step to become the flagship in your marketplace.