by Lee Fried, on 15 May 2007 06:16 am
The Journey
Today’s Work Today
In the Model Line area we are currently in the process of planning and executing multiple Rapid Process Improvement Events (RPIW) to transform the environment from batch and queue to continuous flow. One of our major focuses is working down backlogs and getting to the point where we can complete today’s work today. Other departments are focusing on the same goal and I believe this will be a huge win for our members and patients as cycle times come down and problems become more visible.
Each of the teams I have been working with tend to run between a five and ten day backlogof work. When you study the data over time these backlogs tend to stay consistent in size. In other words, on average they get about as much done as comes in. So why the backlog? There are many reasons, but the root cause is a result of our tendency to set up a specialist model of staffing where staff become highly skilled in doing a small number of complex tasks very productively. Having specialists leads to two major problems: first, it is very difficult to be flexible to changes in demand or staffing leading to bottlenecks. Second, with a specialist model we tend to focus on individual productivity which leads us to establish systems where we try to always have work available for staff to work on (backlog).
In order to reduce backlogs and get teams to a point where they are doing today’s work today we are applying many of the Lean tools. We are building workcells, implementing hejunika, putting in place standard work, simplifying work and cross-training like crazy. All of these efforts are begining to show drastic reductions in cycle time which will lead to increased member satisfaction. In addition, we are beginning to see improvements in quality as well as reductions in work. Quality has improved because we are breaking down our focus on individual specialists and implementing highly trained work teams. Reduction in work, because when there is no longer a back log problems become much visible and since most of our processes are exception based we are able to determining root cause and prevent the work from coming in, in the first place.
on 15 May 2007 at 11:27 am 1.Marlan Crosier said …
Great to read about the excellent progress Lee – and look forward to seeing some of the results of these changes!
What I’m wondering is how often backlogs are due to the assumptions of people in the system that the cause is due to insufficient resources to meet the demand. I have certainly found that assumption to be almost universal with managers and providers I have worked with to eliminate appointment backlog in behavioral health outpatient clinics.
To the extent this is true in a particular situation, then backlogs may exist more by default rather than by design. Thoughts? Was/is this a factor in your situation?
Marlan