‘You are a virus!’

When our Master of Business Operational Excellence health-care students spent some with Kathryn Correia, chief of Minnesota’s HealthEast Care System, she brought up a great point about the things that slow us down. Most of the interruptions that impede the flow of care, she said, aren’t surprises. If a machine breaks down, we know that somewhere we missed out on the preventive maintenance. If patients, providers or staffs are waiting for too long, we know that we have not really designed our processes to meet the demand. Defects occur because we have long been fixing symptoms but not the root causes.

This was one interesting insight in a busy week for the students, who heard from a number of instructors.

art byrne
Lean expert Art Byrne, speaking to our MBOE cohort.

Bill Boyd, director plan development at Wisconsin’s ThedaCare, spent some time with students explaining how the company has adopted the value stream approach to enhance the patient experience and quality and efficiency of care. He emphasized how important it is to stop working in silos and come together as a team to address the care needs of patients.

Post-lunch, the health-care and industry cohorts spent three hours with Gary Butler and yours truly in an emergency department simulation. They applied their learnings in understanding the wastes in the process and improving the efficiency and quality of care the patients received. The simulation is designed to help understand how lean principles apply to a non-manufacturing process.

The day came to an end with a visit from Art Byrne, an expert in lean strategy, and Tom Mooney, manager of Lean Transformations at Goodyear. Byrne has been implementing lean from the position of a President, CEO or Chairman of the organizations he worked with since the last 20 years. He shared his perspective on the role the leaders have to play to successfully implement lean and sustain the gains. He left the students with a thought his sensei Chihiro Nakao once said to him: “Byrne San, if you don’t try something, no knowledge will visit you.” Lean is all about trying out ideas. If you don’t try, how will you know about the process you are improving?

Mooney gave a different twist to the challenges of a lean practitioner. He said to the students, “You are a virus!” He emphasized that the change agents always get resistance from almost everyone. The resistors are like the antibodies who are trying to dissuade and destroy the change agents. He urged the students to keep going, coach others and multiply the lean knowledge rapidly to bring change in the organization.

Fisher students explore paths to speedier outpatient wait time in year-long project

A group of undergraduate Fisher College of Business students has undertaken the most ambitious project yet for the college’s Buckeye Operations Management Society – and one not far from home.

Students recently presented results of a year-long project within the gastrointestinal oncology unit of the James Cancer Hospital and Solove Research Institute at Ohio State University’s Wexner Medical Center. The goal was to make improvements in an area that has long dogged health care as a customer service concern: Patient wait time.

BOMS student Wexner Medical Center project
From left to right: Nick Caminiti, Ruizhi Wang, Spencer Shewbridge, Tanner Congleton, Tyler Kukurza, Molly Vlahakis

Out of the 70 students in BOMS, which the Center for Operational Excellence supports annually, seven took on the effort. Pictured, from left to right, are Nick Caminiti, Ruizhi Wang, Spencer Shewbridge, Tanner Congleton, project lead Tyler Kururza, and Molly Vlahakis. Not pictured is Junyi Xiong.

As in many hospitals and health-care providers’ offices, patients at the James were spending too long in the system from arrival to departure. Students not only targeted a decrease in total wait time but an increase in time spent with health-care providers. To accomplish this, they spent months gathering data at the James, feeding this information into simulations of the process, helped along the way by Dave Schilling, a professor of management sciences at Fisher.

In a hospital, even a manufacturing line, the solution is a lot more complex than “Faster!” The BOMS students in the process calculated the takt, or cycle, time of a patient through the system and pinpointed its true capacity, even determining when capacity levels would require new hires. These measures and the simulation were used to devise an alternative in patient routing.

The result: Students were able to create a new path that could boost the level of patients seen by as much as 25 percent, while increasing the amount of time a patient spent with a doctor or nurse practitioner by up to an impressive 75 percent. These recommendations were passed on to the James.

BOMS adviser Andrea Prud’homme, an assistant clinical professor of management sciences and an associate director of the Center for Operational Excellence, said the project marks a milestone for the student organization. BOMS students previously have tackled projects at Royal Building Products, Avon, the MidOhio Foodbank, and others – but none of this scale and with this level of research.

“These students took on this project for no class credit or compensation and learned new simulation software, which has never been done before in a BOMS project,” Prud’homme said. “This is very impressive work and I’m extremely proud of them.”

MBOE recap: Lean in the grocery aisle

Some processes in our daily lives we easily take for granted – grocery shopping, for example. Our Master of Business Operational Excellence students in a recent visit to the Dublin, Ohio, Giant Eagle location saw firsthand that the grocery business is serious business.

Giant Eagle
Giant Eagle has adjusted its inventory strategy to allow for a closer link between back-room supply and customer demand.

Pittsburgh-based Giant Eagle, a member of the Center for Operational Excellence, has implemented lean principles in its stores to improve cost, efficiency, and customer experience. They call this system the Giant Eagle Business System, or GEBS. The MBOE program is designed to provide students all possible perspectives and experiences for a holistic learning experience, thus we brought them to Giant Eagle to give them yet another example of how a non-manufacturing process has successfully adopted lean principles to its advantage. So what did Giant Eagle implement and what were their gains? Well, first of all, the chain looked at the eight wastes in its processes. They differentiated what is value-added and non-value-added from the customer standpoint. Then they attacked the wastes.

Giant Eagle also addressed the variation in how inventory is stocked and developed a standardized process for that. They looked at the amount of inventory they carry in their back room. Giant Eagle used to operate as a wholesaler who just so happened to sell groceries.  Being wholesalers, their tendency was to buy as much in bulk, so warehouses and back rooms were filled with too many products. To pick the right item, material handlers would need to move or lift a lot of products before they could get down to the one they needed to stock the shelf.

To become lean, Giant Eagle looked closely at the demand, and started ordering only how much was being used. They were also able to convince some of their suppliers to change their packaging to allow only enough quantities of products that can fit their shelves. They increased the frequency of deliveries from their warehouse and, as a result, drastically reduced how much inventory they hold in stores. One glance at the back room and it’s evident that inventory is minimal.

The students got a preview of how lean can be applied in a grocery store to ensure that customers can easily see and get the products they need as they walk around in the aisles.

COE’s Prud’homme honored with OSU Career Services Award

Part of the work we do at the Center for Operational Excellence is collaborating with our member companies to ensure they’re connecting with our students for internships and full-time jobs. Dozens, occasionally more than 100, students each year head to our member companies for temporary or permanent employment.

Andrea Prud'homme
Prof. Andrea Prud’homme

We’re exceedingly proud that one of our own, COE Associate Director Andrea Prud’homme, has been recognized by Ohio State University’s Career Services office for her efforts in supporting student career development. Prud’homme was nominated for the Career Services Award by Fisher’s Office of Career Management.  Read more about the honor in a Fisher news article.

The many hats Prud’homme wears around Fisher contribute to the impact she makes in the career paths of her students. In addition to her COE role, she’s an assistant clinical professor in the Department of Management Sciences, and she also serves as the faculty adviser to the Buckeye Operations Management Society.

One student from BOMS said Prud’homme has “a unique talent for getting us back to the present, and helping us stay on track. Her advice and support are invaluable.”

Congrats, Andrea!

MBOE recap: Lean in the back office

Last week, we hosted our industry and health-care MBOE cohorts on campus, bringing together dozens of professionals in a range of different fields. The principles and leadership skills we teach in each program carry many similarities, but there remain some key differences between health care and the rest of the pack. Shingo prize-winning author Jean Cunningham highlighted one of those when she visited our health-care cohort last week.

jean cunningham consulting lean accounting
Jean Cunningham (courtesy jeancunninghamconsulting.com)

Health care might be the only industry, Cunningham said, where you put a charge on a bill but only end up collecting a partial amount. That amount is based on the contracts and agreements organizations make with public and private insurance companies. Cunningham, author of the book Real Numbers, said traditional cost accounting systems are designed for all the resources to be used fully all the time. You create capability to create demand, and gather all resources such as people, materials and equipment and then produce what the customer needs. Taiichi Ohno, father of the Toyota Production System, once said that costs don’t exist to be calculated – they exist to be reduced. Lean accounting, Cunningham’s area of expertise, helps do exactly that by identifying and eliminating non-value add waste in the accounting process and helping managers understand the numbers to make meaningful decisions.

When organizations bring in lean, the first place they apply it is the “shop floor,” where patient care is actually provided. As the changes are being implemented, Cunningham said, it’s important to indicate them on financial statements. How do you do that? Well, the most important thing to do is to get the financial folks to plunge into operations and lean activities. Make them a part of the improvement teams so they can understand the changes that are being implemented and how they impact the financials. Lean accounting is about applying lean tools to streamline accounting and finance processes and also accounting for lean transformations.

Explaining lean accounting isn’t possible in the space of a single blog, but the key takeaway here is knowing that people outside of accounting need fewer, and easier-to-understand transactions. When they make transformations the key is to provide information that takes the right calculations into accounting and reflect gains and losses.

Interested to hear more about lean accounting from Cunningham? Click here