Enterprise Strategic Analysis for Transformation Primer Dr. Jayakanth Srinivasan ( jksrini@mit.edu ) LAI ANNUAL CONFERENCE Dana Point CA http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 1 Outline • Understanding g the ESAT Context • From Lean Now! → EVSMA → ESAT • Key elements of ESAT • Executing an ESAT • Discussion Panel http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 2 Enterprise Definition “A systematic purposeful activity” - Merriam-Webster.com One or more persons or organizations that have related "One activities, unified operation or common control, and a common business purpose" -Blacks Law Dictionary, y, 1999 “A lean enterprise is an integrated entity which effectively and efficiently creates value for its multiple stakeholders by employing lean enterprise principles and practices.” - Lean Advancement Initiative, MIT, 2008 http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 3 Understanding Transformation or Source: http://www.innovationsinnewspapers.com/index.php/category/news-corporation/ Source: Terry Bryan Second-order change is a multi-dimensional, multi-level, qualitative, discontinuous, radical, organization change involving a paradigmatic shift - Levy and Merry* *Levy, A. and U. Merry (1986). Organizational Transformation: Approaches, Strategies, Theories, Greenwood Publishing Group http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 4 Strategic Analysis • Support pp Decision Making g • Strategic • Tactical • Operational “We define a strategic decision as one which is important, important in terms of the actions taken, the resources committed, or the precedents set… that is,, we focus f on those infrequent f q decisions made by the top leaders of an organization that critically affect organizational health and survival” – Eisenhardt and Zbaracki Source: Eisenhardt K. M. And Zbaracki M.J., “Strategic Decision Making”, Strategic Management Journal, 13, 17-37, 1992 http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 5 What are we trying to transform? “A minimal defining characteristic of a formal organization is the distinction between members and non-members, with an organization existing to the extent that some persons are admitted, while others are excluded, thus allowing an observer to draw a boundary around the organizations organizations” - Thompson Source: Thompson, J. "Organizations and Output Transactions," American Journal of Sociology, Vol. 68 (1962), 309- 325. SPO SPO DCMA DCMA 9 6 1 2 9 5 10 8 1 7 The “Current State” C-17 Enterprise 7 6 10 2 Boeing 5 8 The “New” C-17 Enterprise 4 (Notional Process Flow) (Notional Process Flow) 3 3 AMC Boeing 4 AMC Process 1 AMC AMC Weaap Syss Rqm mt Boeing Boeing Prod Process 2 Boeing Prod Process 3 Boeing Prod Process 4 Boeing Prod Process 5 Boeing Prod Process 6 Boeing Prod Process 7 Boeing Prod Process 8 Boeing Prod Process 9 Prod Boeing SPO Process 10 Process 1 SPO Prod Process 2 Boeing Prod Process 3 Boeing Prod Process 4 DCMA Prod Process 5 DCMA / Boeing DCMA Prod Process 6 Prod Process 7 SPO / Boeing Prod Process 8 DCMA / SPO / Boeing DCMA / SPO Prod Process 9 Prod Process 10 Source: Wolfenbarger and Bowman (2004), C-17 Journey towards a Lean Enterprise, LAI Executive Board Presentation, http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 6 Who is the enterprise creating value for? In strategic decisions, many of the most important assumptions deal with the behaviour of groups or individuals who are important to the success of the strategy and who have a stake in the outcome of the strategy - Schwenk Source: Schwenk, Charles R. 1988. THE COGNITIVE PERSPECTIVE ON STRATEGIC DECISION MAKING. Journal of Management Studies 25 (1):41-55. Shareholders Customers End-user Society Suppliers/ Partners http://lean.mit.edu Leadership Enterprise Employees © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 7 Understanding Value “How various stakeholders find particular worth, utility, benefit, or reward in exchange for their respective p contributions to the enterprise.”* Develop and Agree to the Find Approach Stakeholder Value Value Identification * Source: Murman et al., al Lean Enterprise Value, Value Palgrave 2002 http://lean.mit.edu Value Proposition Execute on the Promise Value Delivery Dynamic and Iterative © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 8 How does the enterprise create and deliver value? Enterprise Leadership Processes Strategic, high level, cross-functional activities decisions activities, decisions, and interfaces involved in creating and delivering value to one or more enterprise stakeholders http://lean.mit.edu Conduct Strategic Planning Define Business Models Manage Growth Foster Strategic Partnering Define and Integrate Organizational Structure Manage Transformation Life Cycle Processes Manage Acquisition and Programs Define Requirements Develop Product/Processes Manage Supply Chain Provide Products and Services Distribution and Support Products Enabling Infrastructure Processes Program and Budget Enterprise Activities Provide and Maintain Information Technology Manage and Support Human Resources g Quality Q y Assurance Manage Provide Facilities and Services Ensure Health, Safety, and Environmental Protection © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 9 How does the enterprise manage performance? “You are what you measure” - Hauser & Katz http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 10 ESAT Strategic g Objectives j Enterprise Boundaries Performance Management Systems Enterprise Definition Process Architecture Enterprise Analysis Stakeholder Analysis Process Interaction Analysis Enterprise Alignment Analysis Future State Analysis Future State Vision Deployment Development Actionable Transformation Plan http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 11 Enterprise Transformation Roadmap STRATEGIC CYCLE Determine • Strategic • Imperative • Articulate the Case for Transformation Focus on Stakeholder Value Leverage Transformation Gains Pursue & Sustain Enterprise Transformation Transformation Council Strategic Implications of Transformation • Monitor & Measure the Outcomes • Nurture Process & Embed Nurture Process & Embed Enterprise Culture • Capture & Diffuse Lessons Enterprise Learned Thinking • Synchronize Strategic Planning & Execution Cycles • Convey Urgency Engage • Cultivate Enterprise Thinking Leadership in • Obtain Executive Buy-In Transformation • Establish Executive Long-Term Corrective Action PLANNING CYCLE A Committed Leadership Team Understand Current State • Perform Stakeholders Analysis • Analyze Processes & Interactions • Perform P f Enterprise E t i Maturity M t it Assessment • Assess Current Performance Measurement System Implementation Results Implement & Coordinate Transformation Plan • Develop Detailed Project I l Implementation i Pl Plans • Synchronize Detailed Plans • Commit Resources • Provide Education & Training • Implement Projects and Track Progress Capabilities & Deficiencies Identified Short-Term Corrective Action Envision & Design Future Enterprise • Create Vision of Future State • Architect “To-Be” Enterprise Value Stream • Perform Gap Analysis Between Current and Future States EXECUTION CYCLE Enterprise Vision Create Transformation Plan • • • • Identify Improvement for Focus Areas Determine Impact On Enterprise Performance Prioritize, Select and Sequence Project Areas Publish Communication Plan http://lean.mit.edu http://lean.mit.edu Alignment Requirements Identified Align g Enterprise Structure and Behaviors • Rationalize Systems & Policies • Align Performance Measurement System • Align Incentives • Empower Change Agents © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 12 Source: Nightingale, Srinivasan and Mize – Updated 3/05/10 – Version 005 © 2010 Massachusetts Institute of Technology 12 EVOLUTION TO ESAT http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 13 http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 14 Lean Now! Source: lean.mit.edu [publications – lean now] http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 15 Enterprise Value Stream Mapping and Analysis (alpha) Outcomes • • • Current and Future State Value Stream Maps Enterprise vision 2 2-5 5 years out Implementation Plan "EVSMA provided our management team with several insights about how our enterprise actually functions. It also provided a way to identify improvement activities that support our total enterprise strategic objectives and optimize functional i t integration ti in i the th value l stream.” t ” - Site Director http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 16 Enterprise Value Stream Mapping and Analysis – V1 Define and Characterize the Current State Create the Future State Enterprise Boundaries Enterprise E t i Interactions LESAT Strategic Objectives Stakeholder Values Enterprise Wastes http://lean.mit.edu Enterprise Processes Close the Gap Prioritized Improvement Plan Lean Enterprise Vision 5-10 years in the future • Enterprise goals • Vivid description • Focus areas • Revised system of metrics © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 17 1 • Enterprise Commitment • ESAT Team • Facilitators • Enterprise Lean Training • Current Enterprise Goals 2 • Prioritized Stakeholder Values • LESAT Scores • Enterprise Resource Allocation Based on Processes ocesses • Current Metric Values • Team Charter • Enterprise Description: Boundaries, Stakeholders, Processes Define the Enterprise Collect Data 3 4 • Stakeholder Values Analysis • Current State Process Map • Process Interactions Leadership Processes Material Value Stream - ŅShop FloorÓ Product(s) & Service(s) Life Cycle Processes High Information Value Stream - ŅOffice FloorÓ Product / Service Quality Current Performance Enabling Processes Cost of Ownership • Alignment of Goals, Values, Processes, Metrics • List of Wastes • List of Opportunities Cycle Time Relationship with Corp. Low Relative Importance to Stakeholder High Construct Current State Perspectives Identify Enterprise Opportunities 5 6 • 5 - 10-yr Goal • Focus Areas • Mid-point Mid point Goals Leadership Project A People Project B Processes Project E Information Flow Project C Project K Project J Project D Customers http://lean.mit.edu Describe Future State Vision Suppliers Project H Project F Project I Project G • Strategic Transformation Plan • Governance G Model M d l • Revised System of Metrics • Communication Plan © 2010 Jayakanth Massachusetts Institute of Technology March 25, 2010 - 18 CreateSrinivasan/ Transformation Plans Source: www.dilbert.com www dilbert com http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 19 1 Enterprise Strategic • • Analysis for • Transformation 2 Enterprise Commitment ESAT Team Current Enterprise Goals • Team Charter • Enterprise Description: Boundaries, Stakeholders, Processes Collect Data Define the Enterprise 4 3 • Prioritized Stakeholder Values • LESAT Scores • Enterprise Resource Allocation • Processes Data • Current Metric Values 5 Leadership Processes • Stakeholder Value Analysis • Current State Process Map • Process Interactions Material Value Stream - ŅShop Floor Ó Product(s) & Service(s) Life Cycle Processes High Information Value Stream - ŅOffice Floor Ó Product / Service Quality Current Performance Enabling Processes Cost of Ownership Cycle Time Relationship with Corp. Low Relative Importance to Stakeholder Construct Current State Perspectives High Identify Enterprise Opportunities 6 Project A People Project B Processes Information Flow Project C Project K Project E Project J Project D Project F Customers Suppliers Project H Project G Project I Create Transformation Plans http://lean.mit.edu • Strategic Transformation Plan • Governance Model • Revised System of Metrics • Communication Plan • 3 - 5-yr Goal • Transformation Focus Areas • Waypoint Goals Describe Future State Vision 8 7 9-block Initial Planning Template Project Name • Integrated Project Portfolios Transformation • Detailed Plan Descriptions • Recommended Metrics Create Deployment • Resources Create Actionable Plans Required Project Descriptions by Project Project Srinivasan/ Benefits Massachusetts Institute of Technology March 25, 2010 - 20 © 2010 •Jayakanth JDI X Kaizen Impact Leadership • Alignment of Goals, Values, Processes, Metrics • List of Wastes • List of Opportunities X Estimated Event Date(s): XXX Recommended Process Owner: XXX Project Difficulty Event Description: Describe the task in sufficient detail. (one or two sentences) Reason for Event: Describe the problem the team is addressing and answers the Òwhy nowÓ question. Recommended Team Leaders & Members: XXX Estimated Implementation Costs: None Estimated Savings: XXX ESAT Differentiators • Enterprise Perspective • Enables a clear definition of the enterprise as a whole • Fosters enterprise thinking and system-wide improvement • Stakeholder Centricity • Process focuses on maximizing value delivery to all key enterprise stakeholders • Data Driven • Qualitative data through stakeholder interviews • Quantitative data from performance against key processes and d strategic t t i goals l http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 21 KEY ELEMENTS http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 22 Inputs Process Outputs 1 • Enterprise Commitment • ESAT Team • Facilitators • Enterprise Lean Training • Current Enterprise Goals • Team Charter • Enterprise Description: Boundaries, Stakeholders, Processes Define the Enterprise Identify enterprise goals/strategic objectives and motivate change Identify and empower ESAT participants Create team charter Describe enterprise Identify key stakeholders Identify major enterprise processes Identify high-level metrics related to strategic objectives Create communications plan and initiate communication about ESAT effort and its purpose (internal/external) Summarize insights and document progress http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 23 Stakeholder Analysis • Identification & Grouping • Prioritization • Value Elicitation • A l i Analysis http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 24 Stakeholder Identification Source: Stoyanov and Srinivasan 2010 MyOrg Customer Level of Analysis Networks MyOrg Customer Cust_Facing Team Supplier pp _Facingg Team Supplier_Facing CCA_Team http://lean.mit.edu © 2008 Massachusetts Institute of Technology Presenter MM/DD/YY 25 Supplier Value Exchange Value Expected from the Enterprise • • • • • • Stable Drawings On-Time Payment Clear requirements q Ordering Effectiveness Communications Collaboration http://lean.mit.edu Stakeholders Suppliers • Murray Engineering • Lammingg Composites p • Romance Specialty Materials Value Contributed to the Enterprise • • • • Quality Product On-Time Delivery R&D support pp Sustainability © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 26 Stakeholder Values Stakeholder Group: Stakeholder Name: Ask the stakeholder what they value. What do they expect to get from their involvement with your enterprise? What are the things that would make your enterprise highly thought of by them? http://lean.mit.edu On a scale of 1 to 5 how important is this value to the stakeholder? On a scale of 1 to 5 how well is the enterprise delivering this value? © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 27 Understanding Value Exchange Person to Project Dev1 Dev2 Software engineering skills 5 Problem solving skills 3 Build u de effective ect e work o e environment o e ta and d tea team 5 Timely decisions 4 Timely deliveries 4 Policy enforcement 5 Communication 4 Task p planning g 4 Working process best practices 4 Customer satisfaction 5 Creativity 0 Project planning 0 Process and resource management 0 Dev3 PM 4 3 4 2 3 0 4 2 0 3 3 3 3 4 0 0 0 0 0 0 3 0 0 0 0 0 Source: Stoyanov and Srinivasan 2010 Dev4 Dev5 Expected 5 3 4 5 4 0 4 4 3 3 5 4 5 0 0 5 2 0 2 4 0 0 3 4 4 0 2 4 0 0 0 5 0 0 0 4 4 0 0 5 4 0 0 4 3 0 2 4 4 0 0 5 Dev1 Application of best practices(process) Application of best practices(engineering) Learning opportunities Multiplatform portable development Flexible working time Research and Analysis Technology trends Communication opportunities Gain experience in real project F il Failure ttolerance l OOAD Innovation opportunities Estimation & planning improvement http://lean.mit.edu Dev2 4 4 3 5 5 4 4 0 0 0 0 0 4 Project to Person Dev3 2 2 5 4 0 4 0 3 3 0 4 0 0 PM 2 5 5 5 3 0 0 0 0 0 0 3 0 Dev4 3 4 5 5 2 4 0 3 0 3 0 3 3 Dev5 4 4 0 3 5 0 3 3 5 0 3 0 4 4 4 4 4 5 0 5 4 5 4 5 0 4 Expected 4 5 5 5 4 4 4 3 5 3 5 3 4 © 2008 Massachusetts Institute of Technology Presenter MM/DD/YY 28 Stakeholder: Employee High g Currentt Perform mance Fair Wages Benefits Job Satisfaction Security Rewards Career C Growth Training Facilities Low Low http://lean.mit.edu Relative Importance Tools to Do Job High i © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 29 Inputs Process Outputs 2 • Team Charter • Enterprise Description: Boundaries, Stakeholders, Processes Collect Data • Prioritized Stakeholder Values • LESAT Scores • Enterprise Resource Allocation Based on Processes • Current Metric Values Identify enterprise costs Define value exchange between each stakeholder and enterprise Conduct LESAT Collect enterprise process headcount data Collect enterprise performance data, based on enterprise metrics http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 30 Inputs Process Outputs 3 Leadership Processes • Stakeholder Value Analysis • Current State Process Map • Process I Interactions i Material Value Stream - ŅShop Floor Ó Life Cycle Processes Product(s) & Service(s) High Product / Service Quality Information Value Stream - ŅOffice FloorÓ Enabling Processes Current Performance C • Prioritized Stakeholder Values • LESAT Scores • Enterprise R Resource Allocation Based on Processes • Current Metric Values Cost of Ownership Cycle Time Relationship with Corp. Low Relative Importance to Stakeholder High Construct Current State Perspectives Analyze stakeholder value delivery Analyze LESAT results Review enterprise process data Assess process interactions Review R i current enterprise i performance, f based b d on high-level metrics Summarize insights and document progress http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 31 Inputs Process Outputs 4 • Stakeholder Value Analysis y • Current State Process Map • Process Interactions • Alignment of Goals, Values, Processes, Metrics • List of Wastes • List of Opportunities Identify Enterprise Opportunities Assess alignment of enterprise goals, metrics, processes, and stakeholder t k h ld values l Identify enterprise-level waste Summarize opportunities for improvement http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 32 X-Matrix Assessment Process • http://lean.mit.edu The grids in each corner of the matrix represent potential interaction between the row and column they y connect: • Strategic objectives • Enterprise metrics • Enterprise processes • Stakeholders values © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 33 X-MATRIX Template 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 0 0 0 M ti Metrics Stakeholder Values Key Processes 0 0 0 Enterprise Process 0 0 0 Enterprise Process 0 0 0 http://lean.mit.edu Stakeholder Value e Strategic Objectives Enterprise Process © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 34 X-Matrix Completion Process Move around the matrix in a counter-clockwise direction The following questions will help fill in the matrix with either, strong, weak, or no interaction. http://lean.mit.edu 1. Is this strategic objective measured by this metric? 2. Does this metric measure performance of this process? 3. Does this process contribute to delivering this stakeholder value? 4. Is this stakeholder value represented by this strategic objective? © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 35 Example: Filling in the X-MATRIX 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Strategic Objective Is this strategic objective measured by this metric? Strategic Objective Strategic Objective Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective 0 0 0 Strategic Objective M ti Metrics Stakeholder Values Key Processes 0 0 0 Enterprise Process 0 0 0 Enterprise Process 0 0 0 http://lean.mit.edu Stakeholder Value e Mettric Mettric Mettric Mettric Mettric Mettric Mettric Mettric Mettric Mettric Strategic Objectives Enterprise Process © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 36 processes – Transfers to inpatient – Program referrals s s ss s s s s w w w w w ww w w w 11 011w w w w w ww w w s s s w w w w Quality Improvement Complience -VA Code of Patient Concern & JCAHO Evidence Based Care (inc (inc. Through Educational Residencies) Become World Class Research Hospital Accessible Care s Residential Program (REACH) s s s s Tobacco Measure Mental Health Access Waiting Times - Clinic Mental Health Measure Enterprise Metrics Strong alignment with areas in service, care, & research Mental Health Outpatient Impatient Service 0 5 6 0 0 0 0 0 0 values such as: – Operating within budget – Well‐documented monetary transactions 1 0 1 w 0 0 0 0 1 1 0 1 1 s s 0 0 0 0 0 3 0 0 0 1 1 0 0 811s 0 0 0 0 1 1 s s s w ws s w s s s s 0 0 0 Processes vs. Values 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 w w s s w s s s s s w w s s w w Stakeholder Values Key Processes w w s 1 0 4 0 1 1 1 0 0 0 0 1 1 0 1 0 1 0 0 0 w s 13 5 8 ws s w 12 8 4 w w 8 4 4 ww s w w s s 5 1 4 w s w s s s s w s s w ws ss w s ws ss s w sw w w Stakeholder Values 15 6 9 s w 4 2 2 s w 4 2 2 s w 4 2 2 w 6 3 3 4 2 2 s w w s w s w Residential Treatment s Transfer from Residential to Inpatient w s s w Discharge from Residential s Transfer to Outside Facility s s Outpatient Treatment s w Referral to Inpatient s w R f Referral l tto R Residential id ti l s w s s w w 5 2 3 6 3 3 s w 4 2 2 w s w w s w s w s w Patient Data Management s w Research w w s s w s s s s s s w w s w s s w w w w s w w s w w s sw s s 4 4 6 4 4 4 w w s s 13 8 5 w w w w w w s Walk-in to Outpatient Purchasing (Supplies & Services) w s s Discharge from Inpatient w s w Human Resources 1 1 1 1 0 0 w w Payroll 1 4 1 1 1 1 w s s Quality Assurance 1 s s s w Inpatient Treatment Transfer from Inpatient to Residential Facilities and Maintance 1 1 1 1 1 1 w 13 9 4 Transfer from VA ER to Inpatient Transfer from Urgent Care to Inpatient Transfer from Outside ER to Inpatient 0 0 0 s s w Strategic Objectives Metrics s s Upstanding member of local community s s s Efficient Resource Management Accurate and well-documented monetary transactions s s s 12 2 3 1 5 23 1 1 0 1 35 3 4 1 6 Reasonable expectations and respectful treatment of employees Research Advancement Knowledge Transfer Communication and Implementation of VA C culture and values 01313s s Operating within budget s s 1 3 4 Fair Wages for services Sufficient Inpatient and Outpatient Capacity S s Clean, High Quality Facility s s s Accurate Patient Records Availability of medications, supplies, and equipment s s s ss Safety/Security of premises s s ss s Timely and accurate information flow ss s s Timeliness of diagnosis and treatment Quality of patient experience (minimal discomfort respectful etc ) s s s MH: SMI - MHICM Capacity Values vs. Goals Strong alignment with outpatient treatment and clinic wait times Missing metrics for key s s s 2 1 1 1 4 4 2 2 2 1 3 5 6 4 3 0 1 5 3 0 2 1 7 7 5 4 4 5 7 5 2 3 4 Serve Boston Healthcare System s Team Oriented - Integrated Care s 12 012 Gap lies in aligning goals to Metrics vs. Processes s s 01313s MHICM Program - Day Program Methadone Clinic documented Research is a goal but not measured locally s 01212s Vocational Industry Program Goals are not formal or 2 1 2 0 2 2 5 5 4 4 5 4 7 6 6 4 7 7 Correctness of diagnosis and treatment Very strong alignment with most metrics on target 2 5 7 01313s Substance Abuse Outpatient Program Substance Abuse Intensive Outpaitent Program 2 2 2 2 2 2 4 4 4 4 4 4 6 6 6 6 6 6 Keey Processes Metrics vs. Objectives Strrategic Goals G VA X-Matrix Analysis s s ss s w w w s w w w w s s 1 9 16 15 7 1 3 3 2 9 2 3 1 7 9 5 5 1 1 3 2 5 1 0 2 7 10 2 0 2 0 0 4 1 3 2 2 3 3 3 2 4 3 1 s ss s w 2 2 3 1 1 2 s s w 3 3 21 2 3 1 1 4 2 1 2 2 17 0 2 9 10 10 9 5 7 6 5 7 5 2 5 3 5 3 4 3 2 Strong alignment in areas of service, research, & quality Processes addressing the least stakeholder values are primarily patient movement Strong Alignment Source: ESD.61J / 16.852J: Integrating the Lean Enterprise Class Project, http://lean.mit.edu Czaika, Tomlinson, Kopp, Verdugo-2008 Weak Alignment © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 37 Enterprise Level Wastes Waiting Delays Idle time due to late decisions, cumbersome and excessive approvals, and unsynchronized enterprise processes E Excessive i Transportation T t ti Unnecessary movementt (i U (including l di electronically) l t i ll ) off administrative d i i t ti information and people; multiple approvals and handoffs Inappropriate Processing / Ineffectual Effort Effort expended that does not increase value to any of the enterprise’s stakeholders; can occur within the workforce, within management ranks, or across the th entire ti enterprise t i Inventory Unnecessary levels of any enterprise resource: capacity, space, workforce, suppliers, information/data Excessive Motion Any y human effort that does not increase stakeholder value. Defects/Rework Erroneous results from defective enterprise processes and decisions Over Production Any creation of enterprise outputs that does not increase stakeholder value Structural Inefficiencies Waste resulting from inappropriate organizational structure, policies, business model structure, alignment, or strategies Opportunity Costs Wastes resulting from lost opportunities, e.g., untapped talent in the workforce http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 38 Enterprise Opportunities • • Begins the transition to the future state • Dependent on… and a summary of all previous work This will capture the insights…the “ah-has”, issues and opportunities • • Will d documentt the th currentt insights i i ht and d opportunities What opportunities do we want to address in our future state vision? http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 39 Inputs Process Outputs 5 • Alignment of Goals, Values, Processes, Metrics • List of Wastes • List of Opportunities • 5-10 year Goal • Focus Areas • Mid-point Goals Describe Future State Vision Develop lean enterprise vision, including 5-10 year goal and future enterprise description Develop future state metrics that are aligned with “BHAG” Identify focus areas to move towards vision Collect and analyze data on gaps between current state and future vision to make recommendations for prioritized improvements http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 40 Inputs Process Outputs 6 • 5-10 year Goal • Focus Areas • Mid-point Goals Leadership Project A People Project B Processes Project j E Information Flow Project C Project K Project j J Project D Project F Customers Suppliers Project H Project G Project I Create Transformation Plans • Strategic Transformation Plan • Governance Model • Revised System of Metrics • Communications Plan Develop strategic transformation plan Prepare hand-off packages for subsequent b t improvement i t teams t Develop an on-going governance model Update enterprise metrics Provide input to communication plan http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 41 Inputs Process 7 Individual Project portfolios 9-block Initial Planning Template Project Name JDI X Kaizen Impact • Strategic Transformation Plan • Governance Model • Revised System of Metrics • Communications Plan X Estimated Event Date(s): XXX Recommended Process Owner: XXX Project Difficulty Event Description: Describe the task in sufficient detail. (one or two sentences) Outputs Recommended Team Leaders & Members: XXX • Actionable project detail descriptions • Recommended Project Metrics • Resource draw by project • Pre-event data requirements Reason for Event: Describe the problem the team is addressing and answers the Òwhy nowÓ question. Estimated Implementation Costs: None Estimated Savings: XXX Create Actionable Project Descriptions • Projects Benefits • Recommended project teams and Project duration Develop individual actionable projects Prepare project portfolios Develop resource and project duration descriptions by project Develop project metrics Develop pre event data collection matrix by project Develop expected benefits matrix Develop inputs to initial transformation communications Plan Develop exit strategy for each project proposed http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 42 Inputs Process Outputs 8 Individual Project portfolios • Actionable project detail descriptions • Recommended Project Metrics • Resource draw by project • Pre-event data requirements • Projects Benefits Create Deployment Plan • Prioritized list of actionable projects • Project timelines established • Resource commitments received • Tracking metrics in place • Project tracking schedules Prioritize projects Develop timelines for each prioritized project Establish resource commitment for top 3-5 projects Develop metrics for tracking projects to completion Develop top level governance for project j t mentoring t i and d tracking t ki http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 43 EXECUTING ESAT http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 44 Goals and Expected Outcomes • Create a vision of the enterprise five to ten years in the future which optimizes enterprise value creation and delivery • Provide enterprise executives with a balanced decision aid to: • • • • Identify barriers to the creation/delivery of value to each stakeholder Specify p y a vision of their future enterprise p Determine significant gaps between current and future states Prioritize opportunities for eliminating waste and increasing value delivery for the maximum benefit of the total enterprise http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 45 Estimated Resources Required • Small execution team including: g • Enterprise leader as champion or sponsor • Team lead, one of the enterprise leaders direct reports • Facilitator, Facilitator with background in lean and ESAT method • Enterprise process owners on an ad hoc basis as needed to provide information • Following the ESAT methodology can take up to two to three months total time • Down from six months http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 46 Enterprise Strategic Analysis for Transformation (ESAT) Process Flow Source: Dr. Eric Rebentisch Workshop 1 Collect Data Workshop 2a 15-16 January 23-25 February Team Charter Conduct LESAT Identify Id tif Enterprise Boundaries Analyze LESAT Results Identify Stakeholders Collect Stakeholder D Data Stakeholder Value Analysis Identify Processes Collect Process Data Current State Process Map & Interactions Collect Enterprise Metrics Data Review Enterprise Metrics & Performance Identify Enterprise Metrics Workshop 2b Workshop 3a Workshop 3b 10-12 March 14-15 April 28 April-1 May Enterprise Goals Enterprise Alignment (X-Matrix) Enterprise Wastes Enterprise Opportunities Project Hand HandOff Packages Vivid Description of Future State Identify Enterprise Architecture Gaps & Opportunities Actionable Project Descriptions Enterprise Metrics Governance Framework Integrated Deployment Roadmap Communication Strategy Identify & Prioritize Enterprise P j t Projects ESAT Steps Individual project portfolios • Actionable project detail descriptions • Recommended project metrics • Resource draw by project • Pre-event data requirements • Projects benefits • Recommended project Create Actionable teams and project duration Project Descriptions 7 Impact 9-block Initial Planning Template Project Name JDI X Kaizen Estimated Event Date(s): XXX X Recommended Process Owner: XXX Project Difficulty Event Description: Describe the taskin sufficient detail. (one or two sentences) Reason for Event: Describe the problem the team is addressing and answers theÒwhy nowÓ question. 1 Define the Enterprise • Team charter • Enterprise description: Boundaries, Stakeholders, Processes • Homework assignments understood and accepted http://lean.mit.edu © 2009 Massachusetts Institute of Technology 2 Collect Data • Prioritized stakeholder values • LESAT scores • Enterprise resource allocation based on processes • Current metric values 3 Material Value Stream - ŅShop FloorÓ Life Cycle Processes Product(s) & Service(s) High Product / Service Quality Information Value Stream - ŅOffice FloorÓ Enabling Processes Cost of Ownership Cycle Time Relationship with Corp. Low Relative Importance to Stakeholder High Construct Current State Perspectives Identify Enterprise Opportunities 6 5 4 • Stakeholder value analysis • Current state process map • Process interactions Leadership Processes Current Performance • Enterprise commitment • ESAT team • Facilitators • Enterprise lean training • Current enterprise goals • Alignment of Goals, Values, Processes, Metrics • List of wastes • List of opportunities Describe Future State • 3- to 5-year Goal • Focus areas • Waypoint goals Leadership Project A People Project B Processes Project E Information Flow Project C Project K Project J Project D Customers Project H Project F Project G Create Transformation Roadmap Suppliers Project I • Strategic transformation roadmap • Governance framework • Revised system of metrics • Communications strategy Recommended Team Leaders & Members: XXX Estimated Implementation Costs: None Estimated Savings: XXX 8 47 • Prioritized list of actionable projects • Project timelines established • Resource commitments received • Tracking metrics in place • Project tracking schedules © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 47 Create Deployment Roadmap Enterprise Transformation Principles 1. 2. 3. Adopt a holistic approach t enterprise to t i transformation. Secure leadership commitment to drive and d iinstitutionalize tit ti li enterprise behaviors . Identify relevant stakeholders and dd determine t i th their i value propositions. 4. 5. 6. 7. Focus on enterprise effectiveness before efficiency. Address internal and external enterprise interdependencies Ensure stability and flow within and across the enterprise Emphasize organizational learning. http://lean.mit.edu Source: D. Nightingale and J. Srinivasan, MIT 2009 © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 48 Contact Dr. Jayakanth Srinivasan (jksrini@mit.edu) P f Debbie Prof. D bbi Nightingale Ni hti l (dnight@mit.edu) (d i ht@ it d ) http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 49 TEMPLATES http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 50 Stakeholder Values Stakeholder Group: Stakeholder Name: Ask the stakeholder what they value. What do they expect to get from their involvement with your enterprise? What are the things that would make your enterprise highly thought of by them? http://lean.mit.edu On a scale of 1 to 5 how important is this value to the stakeholder? On a scale of 1 to 5 how well is the enterprise delivering this value? © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 51 Value Exchange Template Value Expected from the Enterprise Stakeholders • List the data collected about value expected here NAME • List the enterprise Stakeholders here http://lean.mit.edu Value Contributed to the Enterprise This list is a starting place, tailor it as appropriate. © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 52 Stakeholder: ____________ Currentt Perform mance High g Low Low http://lean.mit.edu Relative Importance High i © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 53 FOUNDATIONS http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 54 “Classical” Lean Thinking Specify value from the standpoint of the end customer by product family Identify all the steps in the value stream for each product family, eliminating whenever possible those steps that do not create value As flow is introduced, let customers pull value from the next upstream activity. http://lean.mit.edu Make the value-creating steps occur in tight sequence so the product will flow smoothly toward the customer. As value is specified, value streams are identified, wasted steps are removed, and flow and pull are introduced, begin the process again and continue it until a state of perfection is reached in which perfect value is created with no waste. © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 55 Lean Enterprise Principles Create lean value by doing the job right and by doing the right job Deliver value only after identifying stakeholder value and constructing robust value propositions Address the interdependencies across enterprise levels to increase lean value http://lean.mit.edu Fully realize lean value only by adopting an enterprise perspective People, not just processes, effectuate lean value © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 56 Toyota Way Problem Solving People and Partners Process Philosophy http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 57 Theory of Constraints “Every real system, such as a business, must have within it at least one constraint. If this were not the case then the system could produce unlimited amounts of whatever it was striving for, profit in the case of a business...” - Eli Goldratt Step 1: Identify the system’s constraints. Defined System Step 2: Decide how to exploit the system’s constraints. System Goa Goals Syste s Defined e ed by Owners Step 3: Subordinate everything else to the decisions of Step 2. Step 4: Elevate the system’s constraints. Step 5: If a constraint is broken go back to Step 1 http://lean.mit.edu in Step 4, Constraints on the System Defined Measurements in line with the Goal and Constraints © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 58 Benefits of ESAT • • • • • • Focuses at total enterprise level Provides a cohesive method for diagnosing an enterprise in order to expose sources of waste and to identify y barriers to value delivery y Gives consideration to the needs/values of all stakeholders Focuses on enterprise-wide processes Identifies process interfaces, disconnects and delays Id tifi iimprovementt opportunities Identifies t iti that th t will ill benefit the entire enterprise http://lean.mit.edu © 2010 Jayakanth Srinivasan/ Massachusetts Institute of Technology March 25, 2010 - 59