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Problem Solving Webinar

Introduction

Virtual College

• 18 years in business

• Based in Ilkley, West Yorkshire

• Over 1.3 million online learners

• Top 30 fastest growing companies

in Yorkshire

• Voted one of the top 6 e-learning

providers in Europe

Introduction

• Work with nearly 5,000 different customers each year, over 500 key

accounts

• Our customers are from a wide variety of sectors, including;

• Every NHS Trust in England

• Over 70 UK councils

• Colleges, Universities and training providers

• Commercial businesses

Introduction

• Learning Management System

• Online Auditing tools

• Bespoke course development

• Mobile app development

• Continuous Improvement /

Lean training & consultancy

Launched in June 2006, Lean Healthcare Academy is an innovative solution, specifically structured for those organisations and individuals within the Health & Social Care sector who want to achieve significant service delivery improvements through the adoption of Lean. The model involves, a blended delivery solution, part e-learning, part face-to-face training/facilitation & programme/ project implementation.

Problem Solving – The traditional way?

Prevents:

• The wrong problem being solved

• “Quick fixes” that don’t work

• Workarounds and band aids

• Wasteful habits that are standardised

• Team losing focus

Problem Solving - Root Cause Analysis

Root Cause Analysis is a rapid and persistent pursuit of the fundamental breakdown or failure that, when resolved,

prevents a recurrence of the problem

Problem Solving – Best Practice

1. Gather the team

2. Ensure you include everyone involved

3. Agree the problem / and or target

4. Ensure everyone can contribute

5. Ensure the group agrees and makes decisions slowly and by consensus

6. As a team “go and see for yourself”

7. Measure the problem

8. Set your targets

A3 Thinking – A practical method for problem solving

Define This is the thinking stage where you develop your Problem & or

Target statements

Outputs = Problem & or Target Statement

Measure

This is the stage where clear & appropriate measurements are

identified in order to inform progress & targets

Outputs = Baseline identified, Baseline process understood, key

measures clearly identified

Analyse This is the stage where analysis is

applied to identify areas for improvement

Outputs = Fishbone , 5 Whys & or Brainstorming

Improve This is the stage where possible solutions are derived based on

the problem identified

Outputs = Use of Lean techniques, 6S, Visual

Management, SOPs, Process Flow etc.

Control

This is the stage where once improvements are made, review

is undertaken to establish it’s sustainability & delivery

Outputs = Action plan and Review schedule

A3 Thinking approach

Problem Solving - Define

“The framing of a problem is often

far more essential than its solution”

Albert Einstein

Define The Problem

Ensure the team agrees on what the perceived

problem is.

Example Problem Statements

“The computer won’t turn on.”

This problem statement is too general. Trying to problem solve and error proof all the ways to turn on a computer would take a long time!

“The power lead is too short.”

This problem statement is too specific and it implies a solution. If this were the problem statement, the solution would be to lengthen the power lead

“The patient is frustrated with our service.”

This is not actionable information. It is emotional data that does not assist in identifying the problem. It only states that there is a problem

“Current capacity of clinic less than patient demand, causing a situation where waiting lists are created.”

Data based problem statement with explicitly stated failure and area of focus

Problem Statements

There are a number of tools to help you measure baseline and show improvement Use any Lean tools at your disposal

If a method of measurement doesn't

exist Invent one!

Audits/Pedometers

Patients perspective

Photo / Visit

Data analysis

Spaghetti diagrams

Process maps

Measure

This matrix can be used to help tease out the potential benefits / measures

Measure - Matrix of KPIs

Analyse

Use: •Blue sky thinking/Brainstorming •5 Why’s •Fishbone charts to understand the problem and develop solutions.

Collect as many ideas as possible from all participants with no criticisms or judgments made

while ideas are being generated. All ideas are welcome no matter how silly or far out they

seem. Be creative. The more ideas the better because at this point you don't know what might work.

Do not criticize or judge. Don't even groan, frown, or laugh. All ideas are equally valid at

this point.

Do build on others' ideas.

Do write all ideas on a flipchart or board so the whole group can easily see them.

Set a time limit (i.e., 30 minutes) for the blue sky thinking

Absolutely no discussion takes place during the activity. Talking about the ideas will take place after

blue sky thinking is complete.

The Rules Of Blue Sky

Thinking

Blue Sky Thinking/Brainstorming

The 5 Whys Questioning Technique

Simply keep asking “why” until you get to the root cause of a problem!

• This could take any number of “whys” to get to the root cause of the problem

• Do not stop until you reach what you believe is a “cause” and not a “symptom”

• If you reach a cause that cannot be controlled, such as weather, go back one level and see if eliminating that cause will help

Example of the 5 Whys?

Event / Problem Nail caused flat tyre in garage

Corrective Action

Why?

Sweep up the nails!

Because there were some nails on the garage floor

Correct Example of the 5 Whys

Event / Problem Car has a flat tyre, in the garage

1. Why? Because there were some nails on the garage floor

2. Why? Because the box split

3. Why? Because the box got wet

4. Why? Because there was rain through a hole in the garage roof

5. Why? Because rain happens!

Example of an Event Tree Diagram

Bread is too difficult to cut!

Exposed to air too long

It was purchased in this condition

Knife not sharp enough

Bread box not closed

Bag broke Bought incorrect bread

Bought stale bread

Using wrong knife

Forgot to close box

Didn’t think it was necessary

Bag melted by toaster

Toaster is too hot

Toaster hasn’t been cleaned

Didn’t know customer

requirements

Didn’t ask for customer

requirements

Bought “bargain” section bread

Don’t have the right knife

Fishbone Diagram

A systematic and structured method for identifying potential root causes of failures:

• Classifies potential causes for a failure into five separate categories

• Very logical and analytical method of determining potential causes for failures

Anatomy of a Fishbone Diagram

Problem Statement /

Effect

People Policy

Procedures Equipment

Environment

Improve

• 6S workplace organisation

• SOPs standard operating procedures

• Process Flow

• Visual Management

• Just Do It

Use the Lean Toolkit

When you create an action plan to start the change process. Focus on:

• costs

• resources

• time, and remember assign actions to people not to departments

Note: If there are several actions use the ease benefit matrix to prioritise them

Improve - Action Planning

Control

Review Performance / results (Check and Reset):

• Regular Reviews are essential to sustain the Improvement • Review the expected benefits against the actual benefits with the team (Frequency dependent on scale and nature of improvement) • Use traffic light approach green/amber/red

http://www.virtual-college.co.uk/products/problem-solving.aspx

info@leanhealthcareacademy.co.uk