Thursday, November 28, 2013

Focus and Leverage Part 282


In this posting I will continue to write about a great book I am reading, The 4 Disciplines of Execution:  Achieving Your Wildly Important Goals written by Chris McChesney, Sean Covey and Jim Huling.  In my last posting I explained the first Discipline, Focusing on the Wildly Important and I clarified what the authors meant that to mean.  I also told you that in many of my blogs I have told you that if you try and improve everything, you’ll usually end up improving nothing or at least very little.  These authors are saying the same thing.  So let’s now look at the second discipline, Act on the Lead Measures.


But before I present Discipline 2, let’s first talk about the rules that are required to apply Discipline 1 across the organization.  The authors define Rule #1 as follows: No team focuses on more than two WIG’s at the same time.  Personally, I am much more rigid in my belief that there should only be one WIG, but we’ll go with the authors for now.  The authors explain that this rule acts like a governor on an engine.  Although there may be dozens of goals across the organization, focus on the one WIG that is most important.


Rule # 2:  The battles you choose must win the war.  For this rule the authors tell us that there’s a relationship between battles and wars, meaning that the only reason you fight a battle is to win the war.  In other words, the sole purpose of WIG’s at lower levels in the organization is to help achieve the WIG’s at higher level.  That is, the lower-level WIG’s must ensure the success of the higher level WIG’s.  This concept is very much in line with how Goal Trees are aligned.  In a Goal Tree we start with a single goal, but immediately beneath the goal are 3-5 Critical Success Factors (CSF’s) which must be achieved if the organizations goal is to be achieved.  This is where the first integration of Goal Trees and the wildly important goals (WIG’s) occurs.  What I am saying here is that in addition to the CSF’s articulated in the Goal Tree, I am proposing the inclusion of WIG’s within the Goal Tree.  Later on in my postings I will demonstrate this visually.


Rule # 3:  Senior leaders can veto, but not dictate.  The authors tell us that “the highest levels of execution are never reached when the strategy is devised solely by the top leaders of the organization and simply handed down to the leaders and teams below.”  The point is, “without involvement, you cannot create high levels of commitment that execution requires.”  “While the senior leaders will undoubtedly determine the top-level WIG, they must allow the leaders at each level below to define the WIG’s for their teams.”  The authors explain that this not only leverages the knowledge of these leaders, but also creates a sense of ownership and involvement which are both critical to the success of any improvement initiative.


Rule # 4:  All WIG’s must have a finish line in the form of X and Y by when.  For me, this is one of the keys to success in that every WIG at every level must contain a clearly measurable result.  In fact, when the WIG is articulated, it should contain a measurable target and a finish line.  For example, suppose you state your WIG as something like, improve patient satisfaction.  Written in this manner doesn’t provide enough direction on either the target or by when.  But suppose you wrote your goal as something like, Improve patient satisfaction from 81 percent to 93% by January 30th.  Stating the WIG in this manner tells the team where you are now, where you want to go and the deadline for achieving the goal.  Written this way, the team now has the needed clarity.


But what about lower level goals, or in the case of the Goal Tree, the Critical Success Factors (CSF’s)?  How should they be written?  Quite simply, they should also be written in the form of X and Y by when.  The purpose of the WIG is to inform the team of what winning the game looks like.  The authors provide an analogy to explain why clarity is so important.  Suppose you were playing a game of basketball, but you weren’t keeping score.  Are you playing to win?  No, it’s only when you are keeping score that winning becomes important.


Another very important point here is the difference between lagging and leading metrics.  The WIG will always be a lagging indicator simply because it is the result of actions taken to reach it….so it lags….it’s a future indicator.  A leading indicator is measurable in real time and tells you if you are likely to achieve your goal.


Now let’s return to discussing Discipline 2:  Act on the Lead Measures.  The authors tell us that “lead measures must be both predictive of achieving the WIG and influenceable by the team.”  Some comparative examples of the difference between Lead and Lag Measures provided by the authors are as follows:

Team
Lag Measure
Lead Measure
Hospital Quality Improvement
Decrease in mortality rate in the hospital from 4% to 2% this year.
Evaluate susceptible patients twice a day against pneumonia prevention protocols.
Restaurant
Increase average check amount by 10% by year end.
Suggest the specialty cocktail of the day to 90% of all tables.

Both of these lead measures are both predictive and influenceable by the improvement team.  If the team acts on the lead measure, they will move the lag measure.  The authors explain that “acting on the lead measures is essential to superb performance, but it is also the single most difficult aspect of installing 4DX in your team.”  They further explain that there are three reasons for this.

-  “Lead measures can be counterintuitive.  Most leaders focus on the lag measures because the bottom line results are what ultimately matter to them.  But in reality, lag measures can’t be acted upon because they are the result of past actions taken.

Lead measures are hard to keep track of.  The authors explain that lead measures are measures of new and different behaviors and tracking behaviors is much harder than tracking results.

-  Lead measures often look too simple.  They demand a precise focus on a certain behavior that might look insignificant, particularly to those outside the team.”


The authors tell us that there are two different types of lead measures.  Small outcomes are lead measures that focus the team on achieving a weekly result, but give each member of the team latitude to choose their own method for achieving it.  The other type is leveraged behaviors that track the specific behaviors you want the team to perform throughout the week.  As such, they provide a clear measurement of how well the team is performing.  In other words, a leveraged behavior lead measure holds the team accountable for performing the behavior, rather than producing the result.”  The authors provide the following example.

What the authors are attempting to do is to help you understand that it’s not a question of which is a better lead measure, but rather it’s a question of which is a better lead measure for your team.


In the final section of this posting, the authors present the steps for arriving at high-level lead measures.


Step 1:  Consider the possibilities.  Begin by brainstorming possible lead measures, but resist the temptation to choose quickly.  They recommend asking questions like, “What could we do that we’ve never done before that might make all the difference to the WIG.”


Step 2:  Rank by impact.  When you’re satisfied with your list of candidate lead measures, you’re ready to identify the ideas that promise the greatest potential impact on the Team WIG.


Step 3:  Test top ideas.  Once you’ve identified some high-leverage lead measures, test them against these 6 criteria:

-  Is it predictive?  This is the most important test of all, so if it fails this one, reject it.

-  Is it influenceable?  Does the team have at least 80% control over the measure?

-  Is it an on-going process of a “once and done”?  Will it result in something habitual and not a one-time deal?

-  Is it a leader’s game or a team game?  The behavior of the team must drive the lead measure.

-  Can it be measured?  Success on lag measures absolutely requires successfully tracking the lead measure.

-  Is it worth measuring?  If it takes more effort than its impact is worth, it fails this test.


Step 4:  Define the lead measures.  Ask these questions.

-  Are you tracking the team or individual’s performance?

-  Are we tracking the lead measure daily or weekly.  This should be at least weekly.

-  What is the quantitative standard?  How much/how often/how consistently are you supposed to perform?

-  What is the qualitative standard?  How well are you supposed to perform?

-  Does it start with a verb?  Simple verbs focus the mind immediately on action.

-  Is it simple?  State your lead measure in as few words as possible.

The deliverable for discipline 2 is a small set of lead measures that will move the lag measure on the WIG.


In my next posting we’ll delve into Discipline 3:  Keep a compelling scorecard.  I encourage all of my readers to go get this book because it is full of great ideas and case studies.  I am so thankful that I found it!!

Bob Sproull

Wednesday, November 27, 2013

Happy Thanksgiving...........

I want to thank everyone for their support of my blog and wish everyone a very Happy Thanksgiving.  We all have much to be thankful for in this country and around the world.  As we pause on this day, let's all remember the less fortunate around the world and hope that this year will be the best year of their lives.

Bob Sproull

Monday, November 25, 2013

Focus and Leverage Part 281


In my last posting I told you about a wonderful book I’m reading, The 4 Disciplines of Execution:  Achieving Your Wildly Important Goals, authored by Chris McChesney, Sean Covey and Jim Huling.  I explained that the 4 Disciplines of Execution  that the authors refer to this as 4DX, is a simple, repeatable and proven formula for executing your most important strategic priorities in the midst of the whirlwind of all the other competing priorities.  I told you that the 4 Disciplines were:

 -  Focusing on the Wildly Important

-  Acting on Lead Measures

-  Keeping a Compelling Scorecard

-  Creating a Cadence of Accountability


I also told you that  4DX is not a theory, but rather a proven set of practices that have been tested and refined by hundreds of organizations and thousands of teams over many years.  In addition I explained that I have written about a technique first introduced as the Intermediate Objectives Map by H. William Dettmer who most recently has elected to change the name of this logical tool to the Goal Tree.  In this posting I want to further discuss each of these 4 disciplines that, if used correctly, can propel your organization to exciting levels of improvement.  I also want to explain how I intend to integrate these disciplines into the framework of the Goal Tree.


The authors of this book explain that there are two principle things a leader can influence when it comes to producing results: Your strategy (or plan) and your ability to execute that strategy.  If you are a leader, my bet is that you struggle more with the execution piece.  The authors are saying the same thing and when they have asked clients what they were taught more of, they received a clear answer….it was strategy.  So when I saw the review of this book on Amazon, I knew I had to buy it.


The authors point out correctly that if you are leading people, you’re probably trying to get them to do something different because no significant result is achievable unless people change their behavior and this is not easy.  The simple fact is, when you execute a strategy that requires a lasting change in behavior of other people, you are clearly facing one of the greatest challenges you will ever face as a leader.  There are two distinctively different strategies for improvement.  One, the authors refer to as stroke-of-the-pen, are those that you execute just by ordering them to be done.  The second strategy is referred to as a behavioral change strategy.  With this type, you can’t order them to happen….they require as the name implies, a change in behavior and not by just a few, but many people.  Organizational change requires that the entire organization must do something it has never done before, so no wonder it is so difficult.  It is not unusual to see this type of strategy fail at the execution stage.


The authors tell us that one of the prime suspects behind execution breakdown is clarity of the objectives.  In other words, people don’t understand the goal they were supposed to execute.  Another problem the authors point out that the people who did understand the goal, had problems committing to achieving it.  Accountability was also an issue, meaning that most people will tell you that there was no accountability for regular progress on the organization’s goal.  So it’s no wonder that execution is so difficult.  If the people weren’t sure of the goal, weren’t committed to it, didn’t know what to do about it specifically, and weren’t being held accountable for it, then how could they possibly execute it.


The authors rightfully point out that the real enemy of execution is your day job, which they referred to as the whirlwind.  The whirlwind is the massive amount of energy that’s necessary just to keep your operation going on a day-to-day basis; and ironically, it’s also the thing that makes it so hard to execute anything new.  In other words, “the whirlwind robs from you the focus required to move your team forward.  And as the name of my blog indicates (i.e. Focus and Leverage), without the proper focus, then any path will do.  In everyone’s defense, the whirlwind is urgent and acts on you every minute of the day.  Yes the goals are important, but as the authors point out, “when urgency and importance clash, urgency will win every time.  An important point is made here, “Executing in spite of the whirlwind means overcoming not only its powerful distraction, but also the inertia of “the way it’s always been done.”  The key takeaway here is that if you ignore the urgent (the whirlwind), it can kill you today, but if you ignore the important it will kill you tomorrow.


What I have just articulated is why I believe this book is a must read.  The 4 Disciplines of Execution are not designed for managing in your whirlwind.  The 4 Disciplines are rules for executing your most critical strategy in the midst of your whirlwind.  So just what are the 4 Disciplines?  Let’s look at each one in more detail.  Remember, ultimately I want to demonstrate how I intend to integrate the teaching within this book with the Goal Tree, so keep this in mind as we move forward.


The first Discipline is Focusing on the Wildly Important, so what does this mean?  In many of my blogs I have told you that if you try and improve everything, you’ll usually end up improving nothing or at least very little.  The authors echo this when they say, “basically, the more you try to do, the less you actually accomplish.”  And because ambitious leaders want to do more, this is a very important thing to remember.  Focus is a natural principle, so it’s important to learn how to do this.  You may remember from previous posts on the Goal Tree that the first step is deciding on the Goal of the organization.  The first discipline requires you to go against the natural tendency to attempt to improve many things and focus on that one truly important goal.  The authors refer to this one (or maybe two) important goal as a Wildly Important Goal (WIG) to make it clear that this is the one that matters most.  The authors tell us that, “failure to achieve it will make every other accomplishment seem secondary, or possibly even inconsequential.”


In my next posting, we’ll continue discussing the Four Disciplines for Execution and then begin to discuss how I believe they fit so naturally with the Goal Tree.


Bob Sproull

 

 

 

 

Sunday, November 24, 2013

Focus and Leverage Part 280


From time to time on my blog I take the time to recommend books that I think are drivers of excellence and today’s blog is one of those times.  The book I am referring to is, The 4 Disciplines of Execution:  Achieving Your Wildly Important Goals, authored by Chris McChesney, Sean Covey and Jim Huling.  The primary reason is because I (and the authors of this book) have seen many improvement initiatives “die either with a loud crash or slowly and quietly suffocated by other competing priorities.”  And as the authors point out, “By the time it finally disappeared, it’s likely no one even noticed.”  What happened?  The authors of this book answer this question in an in-depth manner.  The 4 Disciplines of Execution can change this forever.


The 4 Disciplines of Execution (they refer to this as 4DX) is a simple, repeatable and proven formula for executing your most important strategic priorities in the midst of the whirlwind of all the other competing priorities.  In this wonderful book, the authors teach us that by applying their 4 Disciplines:  - Focusing on the Wildly Important, -  Acting on Lead Measures, -  Keeping a Compelling Scorecard and -  Creating a Cadence of Accountability, leaders can produce breakthrough results, even when executing the strategy requires a significant change in behavior from their teams.  4DX is not a theory, but rather a proven set of practices that have been tested and refined by hundreds of organizations and thousands of teams over many years.  4DX represents a new way of thinking and working that is essential to thriving in today’s competitive climate.  Simply put, this is one book that no business leader can afford to miss.


Throughout the years I have written about a technique first introduced as the Intermediate Objectives Map by H. William Dettmer who most recently has elected to change the name of this logical tool to the Goal Tree.  For those of you who follow my blog regularly, I have modified Dettmer's use of the Goal Tree to a tool that I use to quickly assess an organization and from this assessment, I use it to develop an improvement plan.  The time has come to evolve this tool once again.  This book has not only inspired me, but I truly believe that by combining the principles and practices contained in this book with the Goal Tree, the end product will be a new and much more effective tool for not only assessing the current practices within an organization, but also how to develop and execute a formidable improvement plan.


I am still in the process of developing the details of this new tool, so please stay tuned.  At my age, I don’t get excited as much as I used to when I was much younger, but this book has managed to do so.

Bob Sproull

Wednesday, November 20, 2013

Focus and Leverage Part 279


This is the final posting on our clinic case study on how to use a hybrid version of the Thinking Process' Future Reality Tree (FRT).  As I say in this posting, I don't recommend this method, but when time is a factor, this hybrid version can work effectively to create an improvement action plan.  Traditionally, after creating a Current Reality Tree, one would then perform a full Thinking Process (TP) analysis using all of the TP trees, but because time was a factor, I developed what I am referring to as a "hybrid" Future Reality Tree (FRT).  The FRT essentially transforms all of the Undesirable Effects (UDE’s) from the CRT into Desirable Effects (DE’s).  In other words, we simply state the opposite condition expressed in the UDE’s to create the DE’s. 


 

The figure above is the FRT that was created.  In order to convert the UDE’s to DE’s in the FRT, it is necessary to insert injections or improvement ideas that will transform the UDE’s to DE’s.  The injections for this hybrid FRT are color-coded in green.  Please note that the “bow-tie-like symbols” used in the FRT are intended to demonstrate the magnitudinal effects of the injections. Theoretically, if we were to implement the injections, as stated in the FRT, most of the UDE’s would disappear and patient wait times could be significantly reduced. 

I would like to be able to tell you that all of the injections were implemented, but such was not the case.  And to be honest, I’m not certain that they will ever be.  One of the problems this team faced was the lack of involvement of the Attending Physicians and the clinic leadership which are critical factors for the success of this or any improvement initiative.  My intention in this posting was to simply demonstrate how the CRT and hybrid FRT could be used to develop an effective improvement plan.


The Constraints Management Thinking Process (TP) tools truly are an effective way to demonstrate and highlight the changes that must be made in order to achieve the desired end-state.  The important point here is that it is not always necessary to follow the rigors of a full TP analysis.  I don’t recommend the methodology I used, but when time is a factor, I recommend using some kind of shortened version.  I have always believed that as improvement agents we should learn tools and make them our own as long as the end product is useful.


There is no doubt that the world of healthcare is very complicated and full of uncertainty.  In addition, conflicts permeate throughout each and every healthcare facility I have worked with.  However, just because healthcare organizations are complicated and complex, does not translate that there are not simple solutions.  In fact, in the example I presented in this posting, the proposed solutions do not require expensive equipment or hiring an army of new people.  The fact is, complex problems usually always require simple solutions.


Three key points to consider when attempting to improve a seemingly difficult problem such as excessive patient wait times are:

 
1.  Identify and focus on the core problem or problems.  Healthcare organizations (or any organization for that matter) will always have a multitude of problems or undesirable effects (UDE’s).  I have seen many organizations attempting to solve all of these UDE’s one-by-one, when in reality they were simply working on the symptoms of a larger core problem.  If the true core problem(s) is/are correctly identified and the effort to correct them is done so in a focused way, then many or most of the symptoms will disappear simply because these UDE’s are usually always connected through sufficiency type logic (“if-then” relationships).

2.  By identifying the relatively few constraints that exist within any organization will always result in significantly less effort for the resources charged with improving the organization’s flow.  It matters not whether we’re working on the flow patients, products or services, the fact of the matter is that the constraint controls the output rate of any process or system.

3.  Many of the problems we observe within an organization such as a healthcare facility are the direct result of policies that were probably put in place as a result of a previous corrective action.  Many of these policies are probably outdated now and should be eliminated.


Bob Sproull

Monday, November 18, 2013

Focus and Leverage Part 278


In this posting I want to demonstrate how to create and use one of the Thinking Process (TP) tools to identify the reasons why patient wait times are excessively long in this clinic.
 
One of the primary tools in our arsenal was the Current Reality Tree (CRT) and it is this tool that I will focus on for the remainder of this blog posting.  I do so because the CRT clearly articulated the problems within this clinic, especially as it relates to overbooking.  This CRT was actually created as a result of a conference call with the Process Owner and Champion prior to a Rapid Process Improvement Workshop (RPIW), but was later updated based upon new facts and assumptions discovered during the actual RPIW.  In reality, I don’t recommend using a phone call to develop CRT’s, but in this case, since I was a thousand miles away and pressed for time, I elected to do so.


If you are new to my blog, let me briefly explain a bit about CRT’s, how they are developed and how they are used.  CRT’s are part of a larger body of knowledge in TOC known as the Thinking Process (TP) tools.  CRT’s are used to identify, visualize and link the Undesirable Effects (UDE’s) that exist within any organization. UDE’s are all of the “things” you don’t like about the way the organization is currently operating. The method I used to create a CRT was to first, list all of the negative or “undesirable effects (UDE’s)” that I heard during our conference call.  I then proceeded to connect the UDE’s using sufficiency based logic (i.e. a series of “if-then” causal relationships).  That is, if “x” exists, then “y” will be observed.  In reality, there is a logical order that connects these UDE’s to each other and when the CRT is completed, the lower level UDE’s usually become the root cause or core problem(s) causing many of the others.


In the case of this clinic, there were initially 10 UDE’s that I picked up by listening to the various conference call participants.  In the CRT below I have highlighted the original list of UDE’s in orange.  I then began the “effect-cause-effect” linkage process which is done by arranging the UDE’s in a logical order to arrive at the final order that you see in the figure below.  I construct the CRT from top to bottom and then read it from bottom to top using the sufficiency logic I referred to earlier (i.e. “if A, then B”).  In constructing the CRT I added additional UDE’s (shaded in white) to complete the cause and effect connections.  These add-on UDE’s were ones that I learned about during our actual RPIW.


It is clear that all of the UDE’s listed in this CRT are contributing to the most important UDE of all, “Patient wait times are excessively long.”  In the CRT that was created, there were three primary causes for this most important UDE as follows:

1.  The clinic is over-booked most of the time.

2.  Attending physicians do not have time to see patients in a timely manner

3.  There is no synchronized patient flow in the clinic

 

Upon completion of the CRT I discovered something very compelling.  That is, there were five different causes for the clinic being over-booked.  If we could come up with the right injection(s) to eliminate most of these UDE’s, then much of our problem could be resolved.  The ellipse beneath the UDE, “The clinic is over-booked most of the time” is the logical “and” statement used when developing the CRT.  This “and” statement simply means that all five of these UDE’s contribute to the problem of over-booking.  In reality, I probably shouldn’t have used this symbol since each of these UDE’s by themselves could have created an over-booked state, but I elected to use it to demonstrate the conditions that are working together to create the over-booked state.

In my next posting I will demonstrate how to turn the CRT into a Future Reality Tree (FRT) and discuss how this will help create improvement actions to reduce  the excessive patient waiting times,

Bob Sproull

Saturday, November 16, 2013

Focus and Leverage Part 277


One of the joys I receive from consulting is the chance to be able to assess new companies and new industry types and then help them improve.  For the past year or so, most of my clients have been in the healthcare field and in the foreseeable future I don’t see that changing much.  And with all of the recent focus on healthcare, I’m very happy to be a part of potentially changing and improving upon the way hospitals operate.  One thing that jumps out at me is the dedication of the healthcare workers in wanting to improve their patient experience.  In the next few postings I want to discuss how one can use a hybrid version of TOC’s Thinking Processes (TP’s) to define potential focus areas for improvement.  Specifically, for those of you familiar with the TP’s, I will presnt how I developed a Current Reality Tree and what I refer to as a hybrid Future Reality Tree.  For obvious reasons, I will never divulge the name of the organizations I am helping to improve.


I have been working for two different healthcare groups in the past two months and although each is drastically different, both are very, very similar in terms of the problems facing them.  In one organization I have been working with is a general surgical unit while the other one is much more specialized in that it is a clinic which treats different types of healthcare problems.  It is the latter one, the clinic, that I want to discuss in a more detail.  I will say however, that in both organizations, patient waiting times for various procedures are considered to be excessively high, so both have essentially the same objective of reducing patient wait times to a more acceptable level.


The actual clinic improvement initiative began 3-4 weeks ago when I facilitated a team through a value stream analysis.  We first we developed a Current State process map and then evaluated each of the individual steps in terms of its value-added content.  We then created an Ideal State map, constructing it as though no waste existed and finally a Future State map removing as much waste as possible, being limited only by the non-value-added but necessary category.  We then identified the system constraint as being the availability of Attending Physicians.  After much discussion, we elected to pursue two areas of this process in order to reduce waiting times.  The first area involved the time from patient check-in until the patient was able to be examined by a Resident Physician.  Because this is a teaching hospital, the first, second and third year Residents can only examine patients and not actually sign them out.


The second focal point was defined as the elapsed time between being seen by a Resident Physician and the final examination by the Attending Physician.  As mentioned earlier, the Attending Physician is the only Physician who can sign-off and sign-out patients from the clinic.  We discussed the potential risk of “speeding up” the front end of the process without being able to significantly reduce the Attending Physician’s time. Because the Attending Physician’s availability was the constraint within this clinic, we were worried that patients might zip through the first part only to stack-up waiting to see the Attending Physician.  But in the end, it was decided that we would pursue wait time reductions in both parts of the process.
 

One area that was of major concern to us was the scheduling process that was in place.  It was very clear to all concerned that the clinic had a chronic problem of “over-booking” of patients.  In other words, there were simply too many patients entering the clinic (both scheduled and unscheduled) based upon the capacity of the clinic to test and treat the patients.  This clinic did schedule patients, but there were unanticipated add-ons that were not on the original schedule which contributed significantly to the over-booked status.
 
In my next posting, I'll demonstrate how we were able to identify and link all of the Undesirable Effects (UDE's) or negative symptoms we found within this  clinic.
 
Bob Sproull

Friday, November 15, 2013

An article on integrating Lean and TOC.........

For the past couple of posts, I have been sharing links on integrating TOC with Lean and Six Sigma.  Here is a link to an article written about integrating only Lean with TOC.  I will be back to writing my own posts soon as I have been very busy and unable to devote enough time to writing.

http://fr.slideshare.net/amcsb/lean-toc-presentation

Bob Sproull

Thursday, November 14, 2013

Manufacturing in America....

Here's an article that might be of interest to anyone interested in the state of Manufacturing in America.  I found it very eye-opening!!  I hope the link works.

http://www.census.gov/how/infographics/manufacturing_in_america.html

Bob Sproull

Tuesday, November 12, 2013

An interview with Joe Dager of Business 901

There seems to be a lot of interest in integrating TOC with Lean and Six Sigma.  Here is a link to an interview I did with Joe Dager of Business 901 where he was asking me questions about my then new book, The Ultimate Improvement Cycle.  I hope this link works.

http://fr.slideshare.net/business901/integration-of-the-theory-of-constraints-w-lean-six-sigma

Bob Sproull

TLS a la Phillip Marris..........

I wanted to share a set of slides produced by my good friend Phillip Marris.  These slides are Phillip's version of the integration of Theory of Constraints, Lean and Six Sigma (a.k.a. TLS).  I think you will find them most helpful.  I hope this link works for you.

http://fr.slideshare.net/Philip_Marris/pov-tls-v12-uk-20130903-pdf#!

Bob Sproull

Monday, November 11, 2013

A video on how TPS helped Super Storm Sandy victims.....

Here's a video on how the Toyota Production System (i.e. Lean) helped distribute food to the victims of Super Storm Sandy.  I think it's good and wanted to share it with everyone.  I hope this link works, but if it doesn't, just Google Meals per hour on YouTube.

http://www.youtube.com/watch?v=EedMmMedj3M



Bob Sproull

Sunday, November 10, 2013

Focus and Leverage Part 276



One of the measures I use to determine whether or not my readers are happy with what I post here on my blog is the number of page views that occurred in a month.  In October, this metric rose to over 12,000 and I want to thank everyone for their interest in what I write.  I also track which posting was viewed the most and for October, it was posting Focus and Leverage part 227 which was a series of overheads on how I present constraints management (TOC) to individuals and improvement teams who are not familiar with this approach to improvement.


The top 5 most viewed postings along with the posting number, the subject of the posting, along with a link to each posting for those who want to check them out:

                                                          Posts

             Entry                                                       
Subject  
Teaching TOC
Conflict Resolution Diagrams 
Cost Acct. vs. TP Acct. 
Focus and Leverage Part 192 Categories of Leg. Reservation
Integrating L SS & TOC

I have really enjoyed writing this blog and as long as there is interest in it, I will continue to do so.  I might add that if there is a subject of interest that you would like me to write about, either post a comment on my blog or send me a direct email at ras8202@live.com and I will do my best to do so.  I would only ask that the request stay within the intent of my blog.  That is, the request is directly related to TOC, Lean, Six Sigma or the integration of these 3 improvement methodologies.


Again, thanks to all of my readers for supporting my blog and I hope the links take you to the correct postings.

Bob Sproull

Sunday, November 3, 2013

Focus and Leverage Part 276


As I mentioned in my last posting, I have received requests to post an index of all of the writings I have posted.  This posting is that index.  In creating this Index I discovered that I have, in the past, actually duplicated past postings, so going forward I will try to avoid this to avoid redundancy.
 

Each of the following postings can be reached by searching for the number designation below.  For example:  1 is Focus and Leverage (My very first posting in 2010).  2 is Focus and Leverage Part 2, 3. Is Focus and Leverage Part 3 and so forth.  The link to the first blog posting is:  http://www.blogger.com/blogger.g?blogID=4654571158555106378#editor/target=post;postID=4464386559619829406


I did not include and postings that did not have a Focus and Leverage Part # assigned to it, so postings that contained things like Epiphanized book reviews, apologies for making mistakes, etc. are not included on this list.  I would have liked to make each one of these a direct link, but the memory requirements would not permit this.  I will make every effort to keep this index updated going forward and will post it periodically.  This will be a long posting since there are 276 individual Focus and Leverage Postings.


Focus and Leverage Post #        Subject Discussed

 

1. Introduction to TOC – Lean – Six Sigma

2. Why Improvement Initiatives Fail

3. The Basic Concepts of TOC

4. Throughput Accounting

5. The Process of On-Going Improvement (POOGI)

6. The 3 Cycles of Improvement

7. Combining TOC, Lean and Six Sigma Graphically

8. Step 1a Performance Metrics

9. Planning Steps 1b and 1c Reducing Waste and Variation

10. Developing a Constraint’s Improvement Plan

11. This number was skipped

12. Steps 1b and 1c Reducing Waste and Variation plus an intro to DBR

13. Drum-Buffer-Rope

14. The Final Steps of UIC

15. How do I start the UIC?

16. The 10 Prerequisite Beliefs

17. Comparing Lean, Six Sigma and TOC

18. Types of Constraints

19. The Logical Thinking Processes

20. Undesirable Effects (UDE’s)

21. Categories of Legitimate Reservation

22. Current Reality Trees

23. Constructing Current Reality Trees

24. Conflict Diagrams Basic Principles

25. Constructing Conflict Diagrams

26. Intro to Future Reality Trees

27. Constructing Future Reality Trees

28. Prerequisite Trees

29. Constructing Prerequisite Trees

30. Transition Trees

31. Constructing Transition Trees

32. Book Announcement

33. Project Management Failures

34. Project Management Negative Behaviors

35. Critical Path Management (CPM)

36. Critical Chain Project Management (CCPM)

37. Tracking Projects In CCPM

38. Final Posting on CCPM

39. Intro to the TOC Parts Replenishment Model versus the Min/Max System

40. The TOC Parts Replenishment Model

41. Interview with Joe Dager from Business901

42. Deming, Ohno and Goldratt Commonality

43. Dedication to Dr. Eliyahu Goldratt

44. How processing time, cycle time, throughput and WIP are interrelated

45. Little’s Law

46. Batch and queue production system and the fallacy of a balanced line

47. Why an unbalanced line is better.

48. What prevents me from making more money now and more money in the future?

49. More on the 10 Prerequisite Beliefs

50. Motivating a work force to actively participate in improvement initiatives

51. Re-Introducing the Intermediate Objectives Map

52. Introducing Be Fast or Be Gone: Racing the Clock with CCPM

53. Parkinson’s Law, The Student Syndrome, Cherry Picking and Multi-Tasking

54. Overcoming the four negative behaviors in Project Management

55. Intro to combining the Interference Diagram (ID) and the IO Map

56. The Simplified Strategy

57. The Interference Diagram

58. Interference Diagram for Strategy

59. The ID/IO Simplified Strategy

60. Preface Part 1 for Epiphanized©

61. Preface Part 2 for Epiphanized©

62. CHAPTER 1 Part 1 for Epiphanized©

63. CHAPTER 1 Parts 2 and 3 for Epiphanized©

64. CHAPTER 1 Part 4 for Epiphanized©

65. CHAPTER 1 Part 5 for Epiphanized©

66. Focused Operations Management For Health Service Organizations by Boaz Ronen, Joseph Pliskin and Shimeon Pass

67. Marketplace Constraints

68. A Discussion on Variability

69. More Discussion on Variability

70. Still More Discussion on Variability

71. Paper from the International Journal of Integrated Care

72. Value Stream Mapping

73. Paths of Variation

74. Step 3, Subordination

75. The Key to Profitability: Making Money Versus Saving Money

76. My First Experience With TOC

77. TOC in Non-Manufacturing Environments

78. Deborah Smith’s Excellent Chapter in the TOC Handbook (i.e. Chapter 14)

79. More on Performance Metrics

80. Efficiency, Productivity, and Utilization (EPU) ©

81. Productivity as a Performance Metric

82. Utilization as a Performance Metric

83. What the Dog Saw –Malcolm Gladwell

84. Speaking at the CPI Symposium – Cal State, Northridge

85. NOVACES– A Great Young Company

86. NOVACES’SystemCPI©

87. Problems With My Publisher

88. The Why? – Why? Diagram

89. Experience With the Integrated Methodology

90. A New Piping Diagram

91. The Healthcare Industry

92. More Bad News From the Publisher

93. A Message from the CPI Symposium

94. Multiple Drum-Buffer-Rope

95. Problem Solving Roadmap

96. Problem Prevention Roadmap

97. Improving Profitability

98. More on Throughput Accounting

99. More on Parts Replenishment

100. TLS

101. Engaging the "Money Makers" in Your Company

102. A Conversation on the Theory of Constraints

103. The Key to Successful Consulting Engagements

104. The Three Basic Questions to Answer

105. A Problem With the Airlines

106. A Better Way to Improve Processes and Systems

107. The Problem With Project Management

108. Critical Path Project Management Revisited

109. Critical Chain Project Management Revisited

110. The Fever Chart

111. Comparing CPM and CCPM

112. Performance Improvement for Healthcare – Leading Change with Lean, Six Sigma and Constraints Management

113. More on Performance Improvement for Healthcare

114. Even more on Performance Improvement for Healthcare

115. Still One More on Performance Improvement for Healthcare

116. The Final One on Performance Improvement for Healthcare

117. The Real Final One on Performance Improvement for Healthcare

118. Focused Operation's Management for Health Services Organizations.

119. Focused Management Methodology

120. The Clogged Drain

121. The “Soft” Tools of Improvement

122. More on TOC’s Distribution/Replenishment solution

123. Still More on TOC’s Distribution/Replenishment solution

124. Amir Schragenheim’s Chapter 11 entry in the TOC Handbook

125. Comparison of Lean, Six Sigma and TOC

126. A Simple Lesson on Applying TLS to Your Processes

127. A Historical Index of Blog Postings

128. Mafia Offer Part 1

129. Mafia Offer Part 2

130. Mafia Offer Part 3

131. Airline Problems

132. A YouTube Interview with Bob Sproull and Mike Hannan

133. Active Listening

134. Viable Vision

135. Throughput Accounting

136.  Performance Metrics

137.  On-the-Line Charting

138.  Comment on Epiphanized from a reader in the US Marines

139.  Active Listening

140.  Healthcare Case Study

141.  Change

142.  Getting buy-in for Change

143.  Aviation Maintenance, Repair and Overhaul Client Part 1

144.  Aviation Maintenance, Repair and Overhaul Client Part 2

145.  Continuous Improvement in Healthcare

146.  Using Your Senses in Continuous Improvement

147.  A Video by Phillip Marris on CI

148.  An article about a Construction Company Using the TOC Thinking Processes

149.  Using TOC in Healthcare Part 1

150.  Using TOC in Healthcare Part 2

151.  Using TOC in Healthcare Part 3 Supply Replenishment

152.  Using TOC in Healthcare Part 4 Supply Replenishment (con’t)

153.  Using TOC in Healthcare Part 5 Supply Replenishment (final)

154.  The Sock Maker

155.  The Negative Effects of Using Efficiency

156.  Cost Accounting Part 1

157.  A Political Voting Story

158.  Cost Accounting Part 2

159.  Cost Accounting Part 3

160.  Using TLS for the Affordable Care Act

161.  The System Constraint in Hospitals Part 1

162.  Wait Times in Hospitals

163.  The Oncology Clinic Case Study Part 1

164.  The Oncology Clinic Case Study Part 2

165.  Article: Emergency Department Throughput, Crowding, and Financial Outcomes for Hospitals

166.  Goldratt’s 5 Focusing Steps in Healthcare

167.  My First Experience With TOC Part 1

168.  My First Experience With TOC Part 2

169.  My First Experience With TOC Part 3

170.  My First Experience With TOC Part 4

171.  My First Experience With TOC Part 5

172.  My First Experience With TOC Part 6

173.  Healthcare Case Study Part 1

174.  Healthcare Case Study Part 2

175.  Healthcare Case Study Part 3

176.  TOC in Healthcare

177.  Healthcare Case Study Part 4

178.  My Transition From Aviation Maintenance to Healthcare

179.  Door to Doc Time Case Study Part 1

180.  Door to Doc Time Case Study Part 2

181.  Door to Doc Time Case Study Part 3

182.  Door to Doc Time Case Study Part 4

183.  My White Paper in Quality Forum Part 1

184.  My White Paper in Quality Forum Part 2

185.  My White Paper in Quality Forum Part 3

186.  A Meeting on Epiphanized at the Pittsburgh Airport

187.  Billing for Immunizations Case Study Part 1

188.  Some Thoughts on Performance Improvement Part 1

189.  Some Thoughts on Performance Improvement Part 2

190.  Case Study on Using TOC in Healthcare

191.  IO Map

192.  TOC Thinking Process Tools Part 1

192B.  TOC Thinking Process Tools Part 2

193.  Case Study on How to Use TOC’s Thinking Processes Part 1

194.  Case Study on How to Use TOC’s Thinking Processes Part 2

195.  Case Study on How to Use TOC’s Thinking Processes Part 3

196.  Synchronized and Non-synchronized Production

197.  Competitive Edge Factors

198.  Case Study on How to Use TOC’s Thinking Processes Part 4

199.  Case Study on How to Use TOC’s Thinking Processes Part 5

200.  Case Study on How to Use TOC’s Thinking Processes Part 6

201.  Case Study on How to Use TOC’s Thinking Processes Part 7

202.  Case Study on How to Use TOC’s Thinking Processes Part 8

203.  Case Study on How to Use TOC’s Thinking Processes Part 9

204.  Case Study on How to Use TOC’s Thinking Processes Part 10

205.  Case Study on How to Use TOC’s Thinking Processes Part 11

206.  Case Study on How to Use TOC’s Thinking Processes Part 12

207.  Case Study on How to Use TOC’s Thinking Processes Part 13

208.  Case Study on How to Use TOC’s Thinking Processes Part 14

209.  Case Study on How to Use TOC’s Thinking Processes Part 15

210.  Case Study on How to Use TOC’s Thinking Processes Part 16

211.  The IO Map Revisited Part 1

212.  The IO Map Revisited Part 2

213.  The IO Map Revisited Part 3

214.  The IO Map Revisited Part 4

215.  An Interview About The Ultimate Improvement Cycle by Joe Dager

216.  Healthcare Case Study:  Door to Balloon Time Part 1

217.  More On My First Experience With TOC Part 1

218.  More On My First Experience With TOC Part 2

219.  More On My First Experience With TOC Part 3

220.  More On My First Experience With TOC Part 3

221.  More On My First Experience With TOC Part 4

222.  A Discussion on Constraints Management Part 1

223.  A Discussion on Constraints Management Part 2

224.  A Discussion on Constraints Management Part 3

225.  A Discussion on Constraints Management Part 4

226.  A Discussion on Constraints Management Part 6

227.  How I Present TOC Basics to Students & Teams Part 1 (Most viewed of all posts)

228.  How I Present TOC Basics to Students & Teams Part 2

229.  YouTube Video on Improving Flow Through a Bottleneck

230.  YouTube Video on Throughput Accounting

231.  YouTube Video on What to Change

232.  YouTube Video on What to Change To

233.  YouTube Video on How to Cause the Change to Happen

234.  A Meeting With an Executive of a Larger Corporation

235.  The Missing Link

236.  You Tube Video by Goldratt on Henry Ford and Taichi Ohno

237.  Prevention Versus Detection – The Bug Guy

238.  An Article by Anna Gorman of the LA Times

239.  TOC’s Solution to Supply Chain Problems

240.  The Nun and the Bureaucrat Part 1

241.  The Nun and the Bureaucrat Part 2

242.  The Nun and the Bureaucrat Part 3

243.  The Nun and the Bureaucrat Part 4

244.  The Nun and the Bureaucrat Part 5

245.  The Nun and the Bureaucrat Part 6

246.  A Healthcare Clinic Case Study Part 1

246B.  An Update to Focus and Leverage Part 246

247,  Drum Buffer Rope in Manufacturing

248.  The Sock Maker Revisited Part 1

249.  The Sock Maker Revisited Part 2

250.  Throughput Accounting Part 1

251.  Throughput Accounting Part 2

252.  Throughput Accounting Part 3

253.  How to Use and Integrated TOC, Lean & Six Sigma Methodology Part 1

254.  How to Use and Integrated TOC, Lean & Six Sigma Methodology Part 2

255.  How to Use and Integrated TOC, Lean & Six Sigma Methodology Part 3

256.  How to Use and Integrated TOC, Lean & Six Sigma Methodology Part 4

257.  How to Use and Integrated TOC, Lean & Six Sigma Methodology Part 5

258.  Critical Path Project Management Versus Critical Chain PM Part 1

259.  Critical Path Project Management Versus Critical Chain PM Part 2

260.  Critical Path Project Management Versus Critical Chain PM Part 3

261.  Critical Path Project Management Versus Critical Chain PM Part 4

262.  Critical Path Project Management Versus Critical Chain PM Part 5

263.  Critical Path Project Management Versus Critical Chain PM Part 6

264.  The Cabinet Maker – A TOC Case Study Part 1

265.  The Cabinet Maker – A TOC Case Study Part 2

266.  The Cabinet Maker – A TOC Case Study Part 3

267.  The Cabinet Maker – A TOC Case Study Part 4

268.  How I Run Improvement Events

269.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 1

270.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 2

271.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 3

272.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 4

273.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 5

274.  Using The Goal Tree vs. the Full Thinking Process Analysis Part 6

275.  An Analysis of Focus and Leverage’s Top Page View Postings

276.  An Index of All Focus and Leverage Blog Posts

 

Bob Sproull