KaiNexus webinar by Mark Graban In this Webinar you will learn: Some of the common mistakes people make when looking at performance metrics and the resulting problems Simple, but statistically valid and effective methods for creating, maintaining, and reviewing charts over time When to react and ask “what happened?” when reviewing new data points metrics... and when to stop overreacting to each data point How to integrate this into your use of KaiNexus or for charts you create in Excel

1. How to Manage Your Improvement
Metrics More Efficiently and
Effectively
@MarkGraban (Presenter)
VP of Improvement & Innovation Services
Mark@KaiNexus.com
@Jeff_Roussel (Host)
VP of Sales
Jeff.Roussel@KaiNexus.com

2. Agenda & Logistics
• Presentation (45 minutes)
• Q&A (10 minutes)
– Use the GoToWebinar
Meeting Panel to
submit a question at
any time
• Recording link & slides will be sent via email
– Also – see the “Handouts” feature and Chat box

3. About Mark Graban
• 20+ years practicing Lean
– 10 years in manufacturing
– 11+ years in healthcare
• Books:
– Lean Hospitals
– Healthcare Kaizen
(co-author Joe Swartz)
• www.MarkGraban.com
New 3rd Edition!

4. Why
Measure?

5. Are We
Improving?

6. My Most Favorite Book Ever
http://www.spcpress.com/
http://amzn.to/2jJ4fiN
Donald J. Wheeler, PhD

7. Are We
Improving?

8. Daily Lean Management

9. Source: Thinking Lean at ThedaCare (DVD)

10. How Are We
Doing Compared
to Our Goal?

11. "Bowling Chart"

12. Are We
Improving?

13. Can We Tell From This?

14. A Better Dashboard
Limited information you need to make decisions

15. Easier to Tell From This?
400
450
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550
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650
Aug-05
Sep-05
Oct-05
Nov-05
Dec-05
Jan-06
Feb-06
Mar-06
Apr-06
May-06
Jun-06
Jul-06
Aug-06
Total Cases

17. In KaiNexus…

18. Are We
Improving?

19. Need to Avoid Bad Conclusions
“The average patient satisfaction
increased from 87.2 to 89%”
86%
87%
88%
89%
90%
Before After

20. Need to Avoid Bad Conclusions
“The average patient satisfaction
increased from 87.2 to 89%”
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Before After

21. Need to Avoid Bad Conclusions
“The average patient satisfaction
increased from 87.2 to 89%”

22. Need to Avoid Bad Conclusions
“The average patient satisfaction
DECREASED from 87.2 to 85%”??

23. Are We Improving?
76
78
80
82
84
86
88
90
92
Patient Satisfaction (Different Data Set)

24. Linear Trendlines are Easy

25. Can Linear Trends Be Misleading?
76
78
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84
86
88
90
92
Patient Satisfaction

26. Same Chart Different Timeframe
78
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90
92
Patient Satisfaction

27. Are We
Improving?

28. How Can
We Tell?

29. How Should
We React?

30. 0
10
20
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40
50
60
3/1/07
3/2/07
3/3/07
3/4/07
3/5/07
3/6/07
3/7/07
3/8/07
3/9/07
3/10/07
3/11/07
3/12/07
Responding to Daily Changes
KB
GOAL
Daily Production Average
Praise
Team
PT PT
Are we helping? Is this process stable?
KB
Kick
Butt

31. Isn’t it always the system?
It’s (almost) always the system.

32. Signal vs. Noise?
"While every data set contains noise,
some data sets may contain signals.
Therefore, before you can detect a signal
within any given data set,
you must first filter out the noise.

33. “X” Control Chart
(Chart for Individual Values)
Goal = 25 minutes
Upper Control Limit
Lower Control Limit

34. In KaiNexus…

35. Surgical Cases Table

36. Surgical Control Chart
0
100
200
300
400
500
600
700
800
Aug-05 Sep-05 Oct-05 Nov-05 Dec-05 Jan-06 Feb-06 Mar-06 Apr-06 May-06 Jun-06 Jul-06 Aug-06
Total Cases
NOISE

37. Patient Satisfaction Run Chart
“The average patient satisfaction
increased from 87.2 to 89%”

38. Patient Sat. Control Chart
78
80
82
84
86
88
90
92
Nov-08 Dec-08 Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09
Patient Satisfaction
NOISE

39. Lab Turnaround Time
What
Happened?
SIGNAL

40. Another "Special Cause"
What
Happened?
SIGNAL

41. X and MR Chart Combo

42. Does This Small Business Have
Predictable Revenue?
X chart
MR chart
SIGNAL

43. Is My Blog
Traffic
Increasing?

44. Evaluate Over Time
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LeanBlog.org Daily Page Loads

45. “Western Electric” Rules
• Any single point above or below 3-sigma LCL or UCL
• 8 consecutive points on same side of mean
• 6 consecutive points moving same direction
• 14 alternating up/down points in a row
Full rules à http://bit.ly/WErules

46. Evaluate Over Time
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3000
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LeanBlog.org Daily Page Loads

47. Shift the Limits as Indicated
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LeanBlog.org Daily Page Loads

48. Example of Process Shift
• If you made a change that you expected to improve the system,
use a control chart to test the hypothesis
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Process Shift
Daily TAT

49. Example of Process Shift
• If you did NOT make a change, you need to investigate to
determine the cause of this signal
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Process Shift
Daily TAT

50. Are We Hitting
Our Goals?

51. Performance vs. Goals

52. System View vs. Reactive

53. Control Chart View

54. Another Example
Goal

55. Control Chart View
Goal

56. So We Should
Do Nothing?

57. Improve the
System!

58. NOT Understanding Variation Leads To…
• Pressuring people to get better results
by working harder within the same
system
• Wasting time looking for explanations
of a perceived trend when nothing has
changed
• Not focusing on systemic improvements
that would shift the mean

59. Our Next Webinar
"The Intersection of Culture and
Technology: Capturing Improvement
Where it Happens"
– Matthew Cannistraro
– Thursday February 23, 1 PM ET
• KaiNexus.com/webinars

60. Ask Us Anything!
• Mark Graban & Dr. Greg Jacobson
• Next Episode Feb 14, 1 pm ET
• Register & submit questions via
http://kainexus.com/webinars
• Past episodes available
on YouTube

61. Other Resources
www.KaiNexus.com

62. Podcasts
• www.KaiNexus.com/podcasts
• Subscribe via:
– iTunes
– Google Play
– Stitcher

63. Thanks!
• Web:
– www.kainexus.com
– blog.kainexus.com
– www.MarkGraban.com
• Webinars on Demand:
– www.kainexus.com/webinars
• Social Media:
– www.twitter.com/kainexus
– www.linkedin.com/company/kainexus
– www.facebook.com/kainexus
@MarkGraban
VP of Services
Mark@KaiNexus.com
@Jeff_Roussel
VP of Sales
Jeff.Roussel@KaiNexus.com
BONUS RECORDING WILL BE SENT:
HOW TO CREATE CONTROL CHARTS