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Value Stream Transformation:

Achieving Excellence through Leadership Alignment


and Holistic Design

CONNECT
January 8, 2014

Why Value Stream Mapping?


Why Now?

2014 The Karen Martin Group, Inc.

To order from Amazon: www.bitly.com/VSMbk


For more information: www.ksmartin.com/VSM

Value Stream Mappings Roots

Value
Value Stream
Flow
Pull
Perfection
1996

2014 The Karen Martin Group, Inc.

Value Stream Defined


Value Stream: All of the activities required to
transform a customer request into a good or service.

Process

Customer
Request

Process

Process

Customer
Receipt
First defined in The Machine That Changed the World,
James Womack, Daniel Jones, & Daniel Roos, 1990.

2014 The Karen Martin Group, Inc.

Silo-Centric vs. Value Stream Thinking


Function

Function

Function

Function

Support Value Stream


Value stream
segment

Core Value Stream

Value stream
segment

Support Value Stream

2014 The Karen Martin Group, Inc.

Value Stream Mappings Roots

Mike Rother & John Shook


1999

Beau Keyte & Drew Locher


2004

Whenever there is a product for a customer,


there is a value stream.
The challenge lies in seeing it.
2014 The Karen Martin Group, Inc.

Mike Rother & John Shook, Learning to See

Value Stream Mapping: Common Failings

Using the mapping process solely as a work design exercise


Using the map to make tactical improvements
Creating maps but taking no action
Mapping with an inappropriate teamor no team at all
Creating value stream maps during a kaizen event
Creating maps with no metrics
Mapping without a team charter or not socializing it

2014 The Karen Martin Group, Inc.

Value Stream Thinking: Strategy Before Tactics


Where am I?
Where do I want
to go?
Which route
should I take?
I-80 option

2014 The Karen Martin Group, Inc.

?
?
I-40 option

I-70 option

Value Stream Mapping Benefit:


Reaching Leadership Consensus

2014 The Karen Martin Group, Inc.

Value Stream Mapping enables a


mapping team to get ABOVE the work
2014 The Karen Martin Group, Inc.

10

VSM Promotes Systems Thinking

Individual Efficiency = Sub-optimization

System Efficiency = Optimal Value Stream Performance


2014 The Karen Martin Group, Inc.

11

Work: Degrees of Granularity


Macro
Perspective

Value
Stream

Define strategic
direction (what)
Heavy leadership
involvement
Value Stream
Mapping

Process

Process

Micro
Perspective

Process

Step

2014 The Karen Martin Group, Inc.

Step

Step

Identify the
tactical how
Heavy frontline
involvement
Metrics-Based
Process Mapping

12

Work: Degrees of Granularity


Order Fulfillment Value Stream
Order
Fulfillment

Strategic
Value-stream
Perspective
Quote

Tactical
Process-level
Perspective

2014 The Karen Martin Group, Inc.

Design

Produce

Fabricate

Assemble

Ship

13

Value Stream Mapping:


Visualize your Entire Operation on a Single Sheet of Paper

2014 The Karen Martin Group, Inc.

14

Basic Value Stream Map:


3 Sections
ABC Technology, Inc.
Current State Value Stream Map
Name of Value Stream Being Mapped
Demand Rate = XX / Year
Name of Value Stream Champion
Mapping Date

Customer

1
Information
Flow

IT-1

2
Work
Flow
1 items

3
Timeline

IT-2

Process 1

Process 2

Process 3

Process 4

Process 5

Function A

Function B

Function C

Function D

Function E

11

LT = 1 days
PT = 10 mins.
%C&A = 50%

LT = 0.5 days
PT = 5 mins.
%C&A = 75%

480mins.

240mins.

10mins.

5mins.

45 items

3
LT = 5 days
PT = 120 mins.
%C&A = 85%

10 items

LT = 2 days
PT = 30 mins.
%C&A = 99%

LT = 1 days
PT = 15 mins.
%C&A = 95%

5days

2days

480mins.

120mins.

30mins.

15mins.

Total LT = 9.5 days


Total PT = 180 mins.
Activ ity Ratio = 3.9%
Rolled %C&A = 30.0%

2014 The Karen Martin Group, Inc.

15

Basic Value Stream Map:


Future State
ABC Technology, Inc.
Future State Value Stream Map
Name of Value Stream Being Mapped
Demand Rate = XX / Year
Name of Value Stream Champion
Mapping Date

Customer

IT interface
Standard
work

Error
proof

IT-1

Crosstrain

Process 2

Function A
5

Standard
work

Process 3

Function C
5 items

LT = 1 days
PT = 10 mins.
%C&A = 99%

2014 The Karen Martin Group, Inc.

Crosstrain

Modified
approvals
Process 1

1 items

IT-2

Function E
10 items

3
LT = 2 days
PT = 120 mins.
%C&A = 95%

4
LT = 0.5 days
PT = 30 mins.
%C&A = 95%

1days

2days

0.5days

Total LT = 3.5 days

10mins.

120mins.

30mins.

Total PT = 160 mins.


Activity Ratio = 9.5%
Rolled %C&A = 89.3%

16

Basic Value Stream


Future State Performance Metrics
Current State

Projected
Future State

Projected
% Improvement

9.5 days

3.5 days

63.2%

180 minutes

160 minutes

11.1%

Activity Ratio

3.9%

9.5%

143.6%

Rolled % Complete &


Accurate

30.0%

89.3%

197.7%

Metric
Total Lead Time
Total Process Time

User defined
User defined
2014 The Karen Martin Group, Inc.

17

Value Stream
Mapping
Executing
Transformation
Plan

2014 The Karen Martin Group, Inc.

Making
Specific
Improvements

18

Value Stream Mapping Activity


Phases and Timing
Repeat
Prepare

4 Weeks Prior
to Mapping

2014 The Karen Martin Group, Inc.

Understand
Current State

Design
Future State

Develop
Transformation
Plan

Three Consecutive Days

Execute
Transformation
Plan

Following
Mapping

19

Charter: Critical planning, communication, and consensus-building tool


Value Stream Mapping Charter
Scope

Accountable Parties

Logistics

Executive
Allen Ward
Sponsor

Value Stream Capital equipment


Specific Engineer to order, requires both hardware &
Conditions software customization

Event Dates July 24-26, 2013


& Times 8:00 am - 5:00 pm

Value Stream
Nancy Little
Champion

Demand Rate 1,000 per year

Base-camp
Surf's Up - Room A
Location

Facilitator Dave Parks

Trigger Customer submits RFQ


First Step Sales reviews the RFQ

Logistics
Dave Parks
Coordinator

Last Step Production ships product


Boundaries & No new software; only minor changes to existing IT
Limitations systems; no additional staff; no budget changes

Briefing
Attendees
** required
*optional

Improvement Time Future state design is fully realized by


Frame December 31, 2013.

Meals
Continential breakfast & lunch
Provided

** Allen W (COO), Joe M (CIO),


Sal T (VP Sales)
* Bruce R (VP Ops), Carlos P
(HR), Su T (CFO), Bill M (VP CS)

Current State Problems & Business Needs

Mapping Team

1 Desire to stay ahead of the competition & deepen customer loyalty.

Function / Title

Name

2 Forecasted growth of 15% for next fiscal year.

1 Sales, Director

Sean Michaels

3 Unclear & incorrect information flowing through value stream.

2 IT, Director

Diana Marie

4 Lead time for RFQ turnaround = 2 weeks; PO to software dev = 5 weeks

3 Finance, Controller

Dave Gerald

5 (Competition's RFQ LT is 1 wk and PO to delivery is 4 wks)

4 Scrum Master

Ryan Austin

5 Engineering, Vice President

Nancy Little

1 Reduce RFQ lead time by a minimum of 50%.

6 Manufacturing, Director

Ambreen Motiwala

2 Reduce PO to software development lead time by a minimum of 50%.

7 Customer Service, Manager

Danny Tran

3 Improve quality of information flowing throughout value stream.

8 Customer (contract manufacturer)

JR Hunt

Goals & Measurable Target Conditions

Briefing
July 24, 25, & 26
Dates &
4:00-5:00 pm
Times

Contact Information

10

Benefits to Customers & Business

On-Call Support

1 Faster delivery; less hassle; less cost.

Function

Name

2 Better working relationships between sales, estimating & engineering.

1 Planning / Purchasing, Planner Lourdes Dwyer

3 Freed capacity to absorb additional business w/o increasing staff.

2 Production Supervisor

Contact Information

Tom St. James

Relevant Data

Agreement

1 Sales effectiveness: RFQ conversion rate.

Executive Sponsor

Value Stream Champion

Facilitator

2 Financial: Estimate-to-actual cost comparison.


3 Operational: LT in segments (RFQ to quote; PO to development).

Signature:

Signature:

Signature:

Date:

Date:

Date:

2014 The Karen Martin Group, Inc.

20

Charter: Critical planning, communication, and consensus-building tool


Value Stream Mapping Charter
Scope

Accountable Parties

Logistics

Executive
Allen Ward
Sponsor

Value Stream Capital equipment


Specific Engineer to order, requires both hardware &
Conditions software customization

Event Dates July 24-26, 2013


& Times 8:00 am - 5:00 pm

Value Stream
Nancy Little
Champion

Demand Rate 1,000 per year

Base-camp
Surf's Up - Room A
Location

Facilitator Dave Parks

Trigger Customer submits RFQ


First Step Sales reviews the RFQ

Logistics
Dave Parks
Coordinator

Last Step Production ships product


Boundaries & No new software; only minor changes to existing IT
Limitations systems; no additional staff; no budget changes

Briefing
Attendees
** required
*optional

Improvement Time Future state design is fully realized by


Frame December 31, 2013.

Meals
Continential breakfast & lunch
Provided

** Allen W (COO), Joe M (CIO),


Sal T (VP Sales)
* Bruce R (VP Ops), Carlos P
(HR), Su T (CFO), Bill M (VP CS)

Current State Problems & Business Needs

Mapping Team

1 Desire to stay ahead of the competition & deepen customer loyalty.

Function / Title

Name

2 Forecasted growth of 15% for next fiscal year.

1 Sales, Director

Sean Michaels

3 Unclear & incorrect information flowing through value stream.

2 IT, Director

Diana Marie

4 Lead time for RFQ turnaround = 2 weeks; PO to software dev = 5 weeks

3 Finance, Controller

Dave Gerald

5 (Competition's RFQ LT is 1 wk and PO to delivery is 4 wks)

4 Scrum Master

Ryan Austin

5 Engineering, Vice President

Nancy Little

1 Reduce RFQ lead time by a minimum of 50%.

6 Manufacturing, Director

Ambreen Motiwala

2 Reduce PO to software development lead time by a minimum of 50%.

7 Customer Service, Manager

Danny Tran

3 Improve quality of information flowing throughout value stream.

8 Customer (contract manufacturer)

JR Hunt

Goals & Measurable Target Conditions

Briefing
July 24, 25, & 26
Dates &
4:00-5:00 pm
Times

Contact Information

10

Benefits to Customers & Business

On-Call Support

1 Faster delivery; less hassle; less cost.

Function

Name

2 Better working relationships between sales, estimating & engineering.

1 Planning / Purchasing, Planner Lourdes Dwyer

3 Freed capacity to absorb additional business w/o increasing staff.

2 Production Supervisor

Contact Information

Tom St. James

Relevant Data

Agreement

1 Sales effectiveness: RFQ conversion rate.

Executive Sponsor

Value Stream Champion

Facilitator

2 Financial: Estimate-to-actual cost comparison.


3 Operational: LT in segments (RFQ to quote; PO to development).

Signature:

Signature:

Signature:

Date:

Date:

Date:

2014 The Karen Martin Group, Inc.

21

Charter: Critical planning, communication, and consensus-building tool


Value Stream Mapping Charter
Scope

Accountable Parties

Logistics

Executive
Allen Ward
Sponsor

Value Stream Capital equipment


Specific Engineer to order, requires both hardware &
Conditions software customization

Event Dates July 24-26, 2013


& Times 8:00 am - 5:00 pm

Value Stream
Nancy Little
Champion

Demand Rate 1,000 per year

Base-camp
Surf's Up - Room A
Location

Facilitator Dave Parks

Trigger Customer submits RFQ


First Step Sales reviews the RFQ

Logistics
Dave Parks
Coordinator

Last Step Production ships product


Boundaries & No new software; only minor changes to existing IT
Limitations systems; no additional staff; no budget changes

Briefing
Attendees
** required
*optional

Improvement Time Future state design is fully realized by


Frame December 31, 2013.

Meals
Continential breakfast & lunch
Provided

** Allen W (COO), Joe M (CIO),


Sal T (VP Sales)
* Bruce R (VP Ops), Carlos P
(HR), Su T (CFO), Bill M (VP CS)

Current State Problems & Business Needs

Mapping Team

1 Desire to stay ahead of the competition & deepen customer loyalty.

Function / Title

Name

2 Forecasted growth of 15% for next fiscal year.

1 Sales, Director

Sean Michaels

3 Unclear & incorrect information flowing through value stream.

2 IT, Director

Diana Marie

4 Lead time for RFQ turnaround = 2 weeks; PO to software dev = 5 weeks

3 Finance, Controller

Dave Gerald

5 (Competition's RFQ LT is 1 wk and PO to delivery is 4 wks)

4 Scrum Master

Ryan Austin

5 Engineering, Vice President

Nancy Little

1 Reduce RFQ lead time by a minimum of 50%.

6 Manufacturing, Director

Ambreen Motiwala

2 Reduce PO to software development lead time by a minimum of 50%.

7 Customer Service, Manager

Danny Tran

3 Improve quality of information flowing throughout value stream.

8 Customer (contract manufacturer)

JR Hunt

Goals & Measurable Target Conditions

Briefing
July 24, 25, & 26
Dates &
4:00-5:00 pm
Times

Contact Information

10

Benefits to Customers & Business

On-Call Support

1 Faster delivery; less hassle; less cost.

Function

Name

2 Better working relationships between sales, estimating & engineering.

1 Planning / Purchasing, Planner Lourdes Dwyer

3 Freed capacity to absorb additional business w/o increasing staff.

2 Production Supervisor

Contact Information

Tom St. James

Relevant Data

Agreement

1 Sales effectiveness: RFQ conversion rate.

Executive Sponsor

Value Stream Champion

Facilitator

2 Financial: Estimate-to-actual cost comparison.


3 Operational: LT in segments (RFQ to quote; PO to development).

Signature:

Signature:

Signature:

Date:

Date:

Date:

2014 The Karen Martin Group, Inc.

22

Charter: Critical planning, communication, and consensus-building tool


Value Stream Mapping Charter
Scope

Accountable Parties

Logistics

Executive
Allen Ward
Sponsor

Value Stream Capital equipment


Specific Engineer to order, requires both hardware &
Conditions software customization

Event Dates July 24-26, 2013


& Times 8:00 am - 5:00 pm

Value Stream
Nancy Little
Champion

Demand Rate 1,000 per year

Base-camp
Surf's Up - Room A
Location

Facilitator Dave Parks

Trigger Customer submits RFQ


First Step Sales reviews the RFQ

Logistics
Dave Parks
Coordinator

Last Step Production ships product


Boundaries & No new software; only minor changes to existing IT
Limitations systems; no additional staff; no budget changes

Briefing
Attendees
** required
*optional

Improvement Time Future state design is fully realized by


Frame December 31, 2013.

Meals
Continential breakfast & lunch
Provided

** Allen W (COO), Joe M (CIO),


Sal T (VP Sales)
* Bruce R (VP Ops), Carlos P
(HR), Su T (CFO), Bill M (VP CS)

Current State Problems & Business Needs

Mapping Team

1 Desire to stay ahead of the competition & deepen customer loyalty.

Function / Title

Name

2 Forecasted growth of 15% for next fiscal year.

1 Sales, Director

Sean Michaels

3 Unclear & incorrect information flowing through value stream.

2 IT, Director

Diana Marie

4 Lead time for RFQ turnaround = 2 weeks; PO to software dev = 5 weeks

3 Finance, Controller

Dave Gerald

5 (Competition's RFQ LT is 1 wk and PO to delivery is 4 wks)

4 Scrum Master

Ryan Austin

5 Engineering, Vice President

Nancy Little

1 Reduce RFQ lead time by a minimum of 50%.

6 Manufacturing, Director

Ambreen Motiwala

2 Reduce PO to software development lead time by a minimum of 50%.

7 Customer Service, Manager

Danny Tran

3 Improve quality of information flowing throughout value stream.

8 Customer (contract manufacturer)

JR Hunt

Goals & Measurable Target Conditions

Briefing
July 24, 25, & 26
Dates &
4:00-5:00 pm
Times

Contact Information

10

Benefits to Customers & Business

On-Call Support

1 Faster delivery; less hassle; less cost.

Function

Name

2 Better working relationships between sales, estimating & engineering.

1 Planning / Purchasing, Planner Lourdes Dwyer

3 Freed capacity to absorb additional business w/o increasing staff.

2 Production Supervisor

Contact Information

Tom St. James

Relevant Data

Agreement

1 Sales effectiveness: RFQ conversion rate.

Executive Sponsor

Value Stream Champion

Facilitator

2 Financial: Estimate-to-actual cost comparison.


3 Operational: LT in segments (RFQ to quote; PO to development).

Signature:

Signature:

Signature:

Date:

Date:

Date:

2014 The Karen Martin Group, Inc.

23

Value Stream Scoping Diagram


Defining Specific Conditions
Catalog

Configure
to order

Custom
hardware

Engineer
to order

Custom
software

New Product
Development

Both

Capital
Equipment

Golden State
Equipment, Inc.

Catalog
Spares &
subassemblies
Engineer to
order
2014 The Karen Martin Group, Inc.

24

Where should the fenceposts be?


Function

2014 The Karen Martin Group, Inc.

Activity

Marketing

Generates sales leads

Sales

Calls on and qualifies customers

Customer

Submits RFQ to sales

Sales

Reviews RFQ

Estimating

Generates quote

Sales

Approve quote

Customer

Accepts quote; submits a PO

Sales

Approves PO

Customer service

Creates SO; compiles spec package

EE/ME design

Designs product; generates BOM

Customer

Approves design

EE/ME design

Forwards design to SW dev

Software Dev

Writes code

Purchasing/Planning

Releases WO; schedules production

Supplier (external)

Delivers materials

Production

Manufactures & ships product

Customer

Installs equipment

Field service

Conducts 90-day follow-up


25

Who should be on the team, serve on-call,


and attend daily briefings?

2014 The Karen Martin Group, Inc.

26

Charter: Critical planning, communication, and consensus-building tool


Value Stream Mapping Charter
Scope

Accountable Parties

Logistics

Executive
Allen Ward
Sponsor

Value Stream Capital equipment


Specific Engineer to order, requires both hardware &
Conditions software customization

Event Dates July 24-26, 2013


& Times 8:00 am - 5:00 pm

Value Stream
Nancy Little
Champion

Demand Rate 1,000 per year

Base-camp
Surf's Up - Room A
Location

Facilitator Dave Parks

Trigger Customer submits RFQ


First Step Sales reviews the RFQ

Logistics
Dave Parks
Coordinator

Last Step Production ships product


Boundaries & No new software; only minor changes to existing IT
Limitations systems; no additional staff; no budget changes

Briefing
Attendees
** required
*optional

Improvement Time Future state design is fully realized by


Frame December 31, 2013.

Meals
Continential breakfast & lunch
Provided

** Allen W (COO), Joe M (CIO),


Sal T (VP Sales)
* Bruce R (VP Ops), Carlos P
(HR), Su T (CFO), Bill M (VP CS)

Current State Problems & Business Needs

Mapping Team

1 Desire to stay ahead of the competition & deepen customer loyalty.

Function / Title

Name

2 Forecasted growth of 15% for next fiscal year.

1 Sales, Director

Sean Michaels

3 Unclear & incorrect information flowing through value stream.

2 IT, Director

Diana Marie

4 Lead time for RFQ turnaround = 2 weeks; PO to software dev = 5 weeks

3 Finance, Controller

Dave Gerald

5 (Competition's RFQ LT is 1 wk and PO to delivery is 4 wks)

4 Scrum Master

Ryan Austin

5 Engineering, Vice President

Nancy Little

1 Reduce RFQ lead time by a minimum of 50%.

6 Manufacturing, Director

Ambreen Motiwala

2 Reduce PO to software development lead time by a minimum of 50%.

7 Customer Service, Manager

Danny Tran

3 Improve quality of information flowing throughout value stream.

8 Customer (contract manufacturer)

JR Hunt

Goals & Measurable Target Conditions

Briefing
July 24, 25, & 26
Dates &
4:00-5:00 pm
Times

Contact Information

10

Benefits to Customers & Business

On-Call Support

1 Faster delivery; less hassle; less cost.

Function

Name

2 Better working relationships between sales, estimating & engineering.

1 Planning / Purchasing, Planner Lourdes Dwyer

3 Freed capacity to absorb additional business w/o increasing staff.

2 Production Supervisor

Contact Information

Tom St. James

Relevant Data

Agreement

1 Sales effectiveness: RFQ conversion rate.

Executive Sponsor

Value Stream Champion

Facilitator

2 Financial: Estimate-to-actual cost comparison.


3 Operational: LT in segments (RFQ to quote; PO to development).

Signature:

Signature:

Signature:

Date:

Date:

Date:

2014 The Karen Martin Group, Inc.

27

Create the Current State Map


Prepare

1.
2.
3.
4.
5.

Understand
Current State

Design
Future State

Develop
Transformation
Plan

Execute
Transformation
Plan

Value stream walk #1


Layout the map
Value stream walk #2
Add map details
Add timeline; calculate
summary metrics
28

Effective Way to Visualize Relationships between


IT Systems and the Operation

2014 The Karen Martin Group, Inc.

29

Create the Future State Map


Prepare

Understand
Current State

Design
Future State

Develop
Transformation
Plan

Execute
Transformation
Plan

1. Define the right work


2. Make the right work flow
3. Manage the right work

30

How will you realize the future state?


Prepare

Understand
Current State

Develop
Transformation
Plan

Design
Future State

Execute
Transformation
Plan

Value Stream Transformation Plan


Value Stream
Executive Sponsor
Value Stream Champion
Value Stream Mapping Facilitator
Date Created
FS VSM
Block #
2

Measurable Target

Scheduled Review Dates

Outpatient Imaging
Allen Ward

1-Nov-12

Paul Scanner

21-Nov-12

Dave Parks

13-Dec-12

10/18/2012

10-Jan-13

Proposed Countermeasure

Exec.
Method*

Owner

Planned Timeline for Execution


1

10 11 12

Status

Improve quality of referral to 85%

Implement standard work for referral


process

KE

Sean
Michaels

100%

Reduce lead time between scheduling


and preregistration step to 45 minutes

Cross-train and co-locate work teams

Proj

Dianne
Marie

75%

Only one check in per patient

Collect copays in Imaging

KE

Ryan
Austin

50%

Reduce wait time in waiting area by 50% Balance work / level demand

KE

Dianne
Marie

50%

Eliminate 6 hour lead time associated


with transcription step

Implement voice recognition technology

Proj

Dave
Gerald

50%

Eliminate redundant data entry

Auto populate between PACS and


Meditech

Proj

Dave
Gerald

25%

Visually managed inventory; no outages


or expired items

5S CT supplies area; implement kanban

KE

Michael
O'Shea

100%

Reduce imaging LT to one hour

Value-stream specific radiologists

Proj

Martha
Allen

25%

Reduce report delivery LT to 30 minutes

Increase % of physicians receiving


electronic delivery

Proj

Martha
Allen

0%

Reduce LT at image review to 1 day

Visual metrics and indicators

JDI

Dave
Gerald

100%

3,4

Agreement
Executive Sponsor

Value Stream Champion

Value Stream Mapping Facilitator

Signature:

Signature:

Signature:

Date:

Date:

Date:

* Execution Method = JDI (Just-do-it), KE (Kaizen Event), or Proj (Project)

31

Where the rubber meets the road


Prepare

Understand
Current State

Design
Future State

Develop
Transformation
Plan

Execute
Transformation
Plan

Accountability rests with executive sponsor


Monthly status meetings
Adjust plan as new discoveries are made

32

And then repeat

33

Current State Value Stream Map


Outpatient Imaging Services
Pre-register
Patient

Customer Demand:
15 patients perDay
(Takt Time 1920seconds)
8 hours per day

Schedule
Appointment

Referring
Physician

Hospital

Lead Time = 24 days

Lead Time = 990 mins.

Cycle Time = 30 mins.


Lead Time = 990 mins.
% C&A = 100 %

Demand = 15 per day

Lead Time = 12 mins.

Cycle Time = 11 mins.


Lead Time = 12 mins.
% C&A = 98 %

% C&A = 65 %

CT=Cycle Time
LT=Lead Time
%C&A=% Complete & Accurate

Symposium

E Pay

Excel

ADS

Internet

Meditech

Fax Order
Solutions

Waiting Room
Management
System

PACS

Auto Fax 50%


Us Mail 25%
MD Mailbox 25%
Rework Loop
via Fax 25% of
the time

Check-in
Patient
(Admitting)

Prep
Patient
(Tech)

Check-in
Patient
(Imaging)

Complete
Exam
(Tech)

Transmit
Images
(Tech)

Read/Dictate
Exam
(Radiologist)

Transcribe
Report
(MDI)

Review
Draft/Sign
(Radiologist)

Print
Reports
(Imaging)

Send
Reports
(Imaging)

5 mins.
5

5 mins.

Cycle Time = 2 mins.


% C&A = 90 %
0.0833 hrs.

0.0833 hrs.
2 mins.

Cycle Time = 1 mins.


% C&A = 98 %

45 mins.

0.75 hrs.
1 mins.

30 mins.

Cycle Time = 10 mins.


% C&A = 100 %

0.5 hrs.
10 mins.

5 mins.

Cycle Time = 15 mins.


% C&A = 90 %

0.0833 hrs.
15 mins.

248 mins.

Cycle Time = 3 mins.


% C&A = 100 %

10

4.13 hrs.
3 mins.

365 mins.

Cycle Time = 15 mins.


% C&A = 95 %

11

6.08 hrs.
15 mins.

960 mins.

Cycle Time = 5 mins.


% C&A = 75 %

12

16 hrs.
5 mins.

110 mins.

Cycle Time = 1 mins.


% C&A = 95 %

1.83 hrs.
1 mins.

13

120 mins.

Cycle Time = 1 mins.


% C&A = 99 %

2 hrs.
1 mins.

14

Cycle Time = 3 mins.


% C&A = 90 %

LT = 32.5 hrs.
3 mins.

CT = 56 mins.
CT/LT Ratio = 2.87%
Rolled First Pass
yield = 29%

Future State Value Stream Map


Outpatient Imaging Services
Standard
Work

Work
Balance

Customer Demand:
15 patients perDay
(Takt Time1920 seconds)
8 hours per day

Co-locate
Schedule appt
Pre-register

Referring
Physician

Hospital

3
Lead Time = 15 days

Demand = 15 per day

Lead Time = 45 mins.

Cycle Time = 11 mins.


Lead Time = 45 mins.
% C&A = 98 %

% C&A = 85 %

Risk
Reduction
(Joint
Commision)

Symposium

E Pay

Excel

Internet

Waiting Room
Management
System

Work
Balancing

Standard
Work

35 mins.

Cycle Time = 1 mins.


% C&A = 98 %
0.0833 hrs.

Complete
Exam
(Tech)

20 mins.

Cycle Time = 10 mins.


% C&A = 100 %

0.583 hrs.
1 mins.

Transmit
Images
(Tech)

5 mins.

Cycle Time = 10 mins.


% C&A = 90 %

0.333 hrs.
10 mins.

Visual
Workplace

Set-up
Reduction

Prep
Patient
(Tech)

Check-in
Patient
(Imaging)

Fax Order
Solutions

PACS

Auto Fax 80%


Us Mail 15%
MD Mailbox 5%
5S

Value Stream
Alignment

Pull System
(Supplies
Kanban)

Remove
Check in
and Reduce
System Access

5 mins.

Meditech

CT=Cycle Time
LT=Lead Time
%C&A=% Complete & Accurate

120 mins.

Review
Draft/Sign
(Radiologist)
420 mins.

Cycle Time = 15 mins.


% C&A = 95 %

2 hrs.
2 mins.

Batch
Reductions

Voice
Recognition

Read/Dictate
Exam
(Radiologist)

Cycle Time = 2 mins.


% C&A = 100 %

0.0833 hrs.
10 mins.

Continuous
Flow

Print
Reports
(Imaging)

2 mins.

Cycle Time = 1 mins.


% C&A = 95 %

7 hrs.
15 mins.

Rework Loop
via Fax 10% of
the time

30 mins.

Cycle Time = 1 mins.


% C&A = 99 %

0.0333 hrs.
1 mins.

10

Send
Reports
(Imaging)

0.5 hrs.
1 mins.

11

Cycle Time = 3 mins.


% C&A = 90 %

LT = 11.3 hrs.
3 mins.

CT = 43 mins.
CT/LT Ratio = 6.32%
Rolled First Pass
yield = 40%

Outpatient Imaging
Value Stream Improvement Results
Current
State

Improved
State

%
Improvement

LT

32.5 hrs

11.3 hrs

65%

PT
AR
RFPY
# Steps

56 mins
2.9%
29%
14

43 mins*
6.3%
40%
11

23%
117%
38%
21%

100%

25%

75%

Metric

Tech turnover
(annual)

* This reduction (freed capacity) enabled the client to collect $500K more in annual
revenue without incurring additional labor or equipment expenses.

Current State Value Stream Map


Purchasing Non-repetitive purchases less than $5,000
Supplies Purchasing - Current State VSM

Inititate Req.

Originator
31
PT = 10 mins.
C&A = 10%
Supplies
Hard Copy

Form File

File Maker

Quicken

Vendor
Website

Excel

ERP

Data Entry

Review
Budget

Review Req.

Finance
PT = 5 mins.
C&A = 60%

0.25 days

4 hrs.

PT = 5 mins.
C&A = 95%

0.5 days
5 mins.

20 Reqs

Review
Requisition

Review
5
Requisition

PT = 5 mins.
C&A = 90%

8 hrs.

PT = 5 mins.
C&A = 100%

1 days
5 mins.

10 Reqs

PT = 10 mins.
C&A = 95%

4 hrs.

PT = 15 mins.
C&A = 98%

0.5 days
10 mins.

Approve in
ERP

24 hrs.

PT = 5 mins.
C&A = 90%

3 days
15 mins.

Submit PO
to Supplier

8
63 Reqs

10
External
Supplier

Corp Purchasing
Manager
1

Admin Asst

Financial Mgr
1
8 hrs.

1 days
5 mins.

Enter
Requisition

Review
6
Requisition

IS Manager
1

1
40 hrs.

5 days
5 mins.

Sys Engineer

Supervisor
2

6
2 hrs.

Corp Purchasing
6
56 hrs.

PT = 15 mins.
C&A = 98%

7 days
5 mins.

80 hrs.

PT = 20 mins.

10 days
15 mins.

LT = 28.4 days
PT = 65 mins.
AR = 0.477%
RFPY = 4.2%

Customer Demand:
615 requisitions per y ear

PT = Process Time
LT = Lead Time
C&A = % Complete & Accurate
AR = Activ ity Ratio (PT/LT x 100)
RFPY = Rolled First Pass Y ield

Future State Value Stream Map


Purchasing Non-repetitive purchases less than $5,000
Supplies Purchasing - Future State VSM

Additional
IT access
Enter Req.
in ERP
Integrate Form
File with File
Maker

Originator
31
PT=30 mins.
C&A = 85%
Supplies
Requisition
Checklist
Vendor
Websites

File Maker

Cross
Training

Approval

Additional
IT access

6 hrs.

0.75 days
5 mins.

Place
Order

5
External
Supplier

PT=20 mins.

80 hrs.

PT=20 mins.
C&A = 98%

1 days
5 mins.

Dedicated
Buyers

Corp Purchasing
8 hrs.

PT=5 mins.
C&A = 90%

PT=5 mins.
C&A = 95%

0.5 days

Approve
in ERP
Dept.
Manager
1

Supervisor
4 hrs.

Use budget in place


of Quicken

Auto Notify

Standard
Work for
review

Review
Req.

ERP

10 days
20 mins.

LT = 12.3 days
PT = 30 mins.
AR = 0.508%

Customer Demand:
615 requistions per year

PT = Process T ime
LT = Lead T ime
C&A = % Complete & Accurate
AR = Activity Ratio (PT /LT x 100)
RFPY = Rolled First Pass Yield

RFPY = 71%

Purchasing Process
Projected Results
Current
State

Projected
Future State

%
Improvement

28.4 days

12.3 days

56.7%

65 mins

30 mins

53.8%

Activity Ratio

0.48%

0.51%

6.3%

Rolled %C&A

4.2%

71.0%

1,590%

# Handoffs

10

50%

# IT Systems

50%

Metric

Total Lead Time


Total Process Time

%C&A = Correct & accurate (Quality)

Value Stream Mapping:


As Much Art as Science

2014 The Karen Martin Group, Inc.

40

Available Now!

To order from Amazon: www.bitly.com/VSMbk


For more information: www.ksmartin.com/VSM
2014 The Karen Martin Group, Inc.

41

For Further Questions


Karen Martin, President
7770 Regents Road #635
San Diego, CA 92122
858.677.6799
ksm@ksmartin.com
Blog & newsletter: www.ksmartin.com/subscribe

2014 The Karen Martin Group, Inc.

42

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