Whole Systems Redesign

The following is an article that appeared in Amnis’s monthly newsletter. To receive a similar article every month as well as opportunities to download guides and books join our newsletter today by visiting www.amnis.uk.com.

Taking an End-to-End view of improvement activities is the key to transformation. Looking at pathways, value streams and processes only within a department or across a single organisation normally leads to minor improvements that are difficult to sustain, and the reason they are difficult to sustain is because such things as the quality of information and peaks/troughs of activity coming into the department or organisation has not been tackled.

Focusing internally can also lead to costs and risks being transferred elsewhere within the overall system. For example, a change of policy on checking for errors in one area can lead to increased errors occurring further downstream.

Having said this, even taking an End-to-End (E2E) focus is not fool proof and sometimes you need to consider the impact of other pathways and processes within a ‘Whole System’. This is where you start considering the overall organisation and reviewing where you really should be applying resources, as well as assessing the risks of ‘knock on’ effects of transformation activities in one pathway affecting others.

To find out more about Whole Systems Analysis contact us on info(a)amnis.uk.com.

Transformation Mapping

The following is an article that appeared in Amnis’s monthly newsletter. To receive a similar article every month as well as opportunities to download guides and books join our newsletter today by visiting www.amnis.uk.com.

Can you really make a difference without senior sponsorship? Trying to get senior sponsorship for improvement programmes can be difficult, especially if the senior team can’t see how your idea helps them to deliver the strategic objectives within the organisation but trying to implement any form of change where you don’t have senior sponsorship can be just as difficult and will probably prove fruitless.

If the need for change has been identified by the senior team then sponsorship will be much easier to find but if it is not initiated by the senior team or the board then it will be down to individual leaders at varying levels within an organisation to try to make the improvements happen. Trying to implement the changes in isolation within a single department, area or even division though can create an ‘island of excellence’ often with inefficient processes upstream or downstream of the island that eventually wash away all of the good things that have been achieved especially if the managers of those other departments are being given conflicting messages and targets by their own senior managers.

To avoid this it is vital that you obtain (and maintain) senior team support and this is best achieved by demonstrating how the improvements will help the organisation to deliver its strategic objectives. For example, if there is an organisational objective to reduce costs then a clear demonstration of how your project or idea for improvement links to this objective will get significantly more attention from potential senior sponsors than just outlining the operational benefits to your department in isolation.

 This process works in reverse too for senior teams where they can take high level strategic objectives and identify the specific actions that have to be taken to deliver each objective in a process called Transformation Mapping and by ensuring that every improvement activity or event can clearly be traced back to a strategic objective is the best way of coordinating effort across an organisation and of ensuring long term senior team engagement.

To find out more about how to engage senior teams or Transformation Mapping call Amnis on 0870-446-1002 or email info(a)amnis.uk.com.

6 Questions to give your service improvement strategy some pace

Recognising that different groups of people within your organisation will need differing skills and will also need to have differing responsibilities for making your improvement programme work and that the actual service improvement journey for a typical healthcare organisation is 3 years (and more) then the following six questions will help you give your programme the pace it needs;

1. At the end of 3 years how many people do you want to be ‘aware’ of the overall service improvement strategy?

2. At the end of 3 years how many people do you want to have participated in an improvement activity?

3. At the end of 3 years how many people do you want to capable of initiating projects?

4. At the end of 3 years how many people do you want to be leading your service improvement programme?

5. How many senior improvement sponsors (and clinical champions) will you want in 3 years time?

6. How many managers will need to understand their role in delivering your improvement objectives?

Now obviously you will have your own objectives but normal answers to these questions will give results that represent the following percentages of your total staffing;

1. 100% – everyone needs to understand the basic skills and objectives of your strategy.

2. 30-40% – maybe more, maybe less (but not much less).

3. 10-15% – these are people with a ‘day job’ who also have a role in service improvement.

4. Around 0.5% – these people lead your improvement activities, train everyone else and facilitate events and activities – they are not project managers!!

5. At least 2 senior management sponsors and 2 (or more) clinical champions.

6. 100% of your managers need to understand their role and the objectives of the strategy.

What this means for an organisation with a total workforce of 3,000 people is that;

• All 3,000 will need to be made aware of the basic skills and the details of the service improvement strategy. Assuming each awareness session lasts 2-3 hours and has 25-30 attendees will mean around 120 training sessions over the 3 years.
• Around 1,000 people will have been involved in an improvement activity. Assuming that each event (such as a Rapid Improvement Event) has an average headcount of around 10 people (some will be smaller and some larger) means 100 improvement activities over the 3 years.
• Around 300 people will have the skills to initiate projects and to lead small and localised improvement activities. These people will need to be practitioners, having skills such as those offered by our ‘Accelerated Lean Skills Programme’ (http://www.downloads.amnis.uk.com/ALSP.pdf). Assuming each training programme has 15 attendees means 20 need to be run over the 3 years.
• 0.5% of your team (15 people) will be Service Improvement Leads with skills such as those provided by our Lean Leaders Programme (http://www.downloads.amnis.uk.com/LLP.pdf).
• You will also need to undertake training for your Process Owners of around a day and for your senior team and clinical champions of around 1/2 day. There should also be regular reviews of progress with your senior team and ‘top up’ training for your Process Owners and Practitioners.

Does this seem excessive? Well, maybe – but the returns it will bring to your organisation in terms of improved safety, quality, productivity, efficiency and capacity, not to mention patient and staff satisfaction, is worth the effort isn’t it?

We call this approach to building an improvement strategy ‘EQIP’ (Enabling Quality Improvement Programmes) and to find out more contact us via info(a)amnis.uk.com or visit our website at http://www.amnis.uk.com.

New Masterclass Programme for 2010 Announced

Amnis (www.amnis.uk.com) and the Institute of Healthcare Management are delighted to announce their programme of next series of activities for 2010. These masterclasses build on the successful first series of 5 that Amnis and the IHM have run together.

Titles and dates include;

Lean Fundamentals for Managers & Executives	24th May 2010
Problem Solving Tools for Service Improvement	7th June 2010
Developing a Culture of Continuous Improvement	13th September 2010
Thinking Strategically	28th September 2010
Value Stream Mapping	12th October 2010
Managing a Lean/Service Improvement Programme	22nd November 2010
The Lean Toolkit for Service Improvement	7th February 2010

For more information contact Ruth Bodman (ruthbodman@amnis.uk.com) or ring +44(0) 870 446 1002.

Thinking Strategically Masterclass

Amnis (www.amnis.uk.com) in partnership with the Institute of Healthcare Management are running a masterclass on the 26th Feb in Birmingham entitled ‘Thinking Strategically’.

The masterclass will focus on the core tools and concepts that underpin strategic thinking and particularly strategic thinking in a healthcare environment.

To find out more or to book a place visit http://www.ihm.org.uk/events/view/527 or email info@amnis.uk.com.

Accelerated Lean Skills Programme

Amnis (www.amnis.uk.com), in partnership with Training Bulletin, will be running one of their popular Accelerated Lean Skills Programme’s from the 13th-15th April 2010. Details of the programme can be found from this link: http://www.trainingbulletin.co.uk/course_details.php?course_id=292.

Alternatively, if you are interested in running a programme on-site, download our training brochure for the Accelerated Lean Skills Programme from here; (http://www.downloads.amnis.uk.com/ALSP.pdf) or ring +44(0) 870 446 1002 or email Ruth Bodman (ruthbodman@amnis.uk.com).

Amnis in the Press

Over the last few months Amnis has been reported in a wide range of publications, both online and in print.
 
Some of the links to recent references to Amnis online are shown below.
 
Real transformation needs more than one skill set
 
http://www.trainingpressreleases.com/newsstory.asp?NewsID=4848
 
http://www.makemenews.com/38475,real-transformation-needs-more-than-one-skillset.html
 
http://www.live-pr.com/en/real-transformation-needs-more-than-one-r1048347350.htm
 
http://www.techexpoworld.com/manage.cgi?action=readnews&id=4750
 
Accelerating Performance & Service Improvement
 
http://www.pr-inside.com/accelerating-performance-service-improvement-r1574306.htm
  
http://www.pressreleasepoint.com/accelerating-performance-amp-service-improvement 
 
http://www.1888pressrelease.com/accelerating-performance-service-improvement-pr-163528.html
  
http://www.przoom.com/news/60366/
 
http://www.trainingdirectoryuk.com/index.php?page=news_369
 
Using Lean to drive the Patient Safety Agenda
 
http://www.free-press-release.com/news-using-lean-to-drive-the-patient-safety-agenda-1259169097.html
 
http://www.prlog.org/10427988-using-lean-to-drive-the-patient-safety-agenda.html 
 
http://www.fastpitchnetworking.com/pressrelease.cfm?PRID=35347
 
http://www.newswiretoday.com/news/61249/
 
http://www.press-releases-news.com/2009/11/25/using-lean-to-drive-the-patient-safety-agenda/
 
http://www.ukprwire.com/Detailed/Health_Wellbeing/Using_Lean_to_drive_the_Patient_Safety_Agenda_59072.shtml
 
http://www.clickpress.com/releases/Detailed/173548005cp.shtml
 
http://web2.sys-con.com/node/1201140
  
Amnis and IHM reveal the secrets of problem solving to improve service in the healthcare sector
 
http://www.ukprwire.com/Detailed/Health_Wellbeing/Amnis_and_IHM_reveal_the_secrets_of_problem_solving_to_improve_service_in_the_healthcare_sector_59858.shtml
 
http://www.pressbox.co.uk/detailed/Health/Amnis_and_IHM_reveal_the_secrets_of_problem_solving_to_improve_service_in_the_healthcare_sector_409919.html
 
http://www.fastpitchnetworking.com/pressrelease.cfm?PRID=35580
 
http://www.1888pressrelease.com/amnis-and-ihm-reveal-the-secrets-of-problem-solving-to-impro-pr-169384.html
 
http://www.your-story.org/amnis-and-ihm-reveal-the-secrets-of-problem-solving-to-improve-service-in-the-healthcare-sector-64050/
 
http://www.pressreleasepoint.com/node/415181
 
Amnis and IHM share radical tips on how to sustain Lean
 
http://www.pressmethod.com/releasestorage/142008.htm
 
http://www.free-press-release.com/news-amnis-and-ihm-share-radical-tips-on-how-to-sustain-lean-1260357940.html
 
http://www.prlog.org/10444892-amnis-and-ihm-share-radical-tips-on-how-to-sustain-lean.pdf
 
http://www.techexpoworld.com/manage.cgi?action=readnews&id=5109
 
http://www.press-releases-news.com/2009/12/09/amnis-and-ihm-share-radical-tips-on-how-to-sustain-lean/
 
http://www.pubarticles.com/article-amnis-and-ihm-share-radical-tips-on-how-to-sustain-lean-1260361433.html
 
Amnis provides an accelerated introduction to Lean principles and practice
 
http://www.personneltoday.com/articles/2009/12/16/53452/amnis-provides-an-accelerated-introduction-to-lean-principles-and-practice.html
 
http://www.pressbox.co.uk/detailed/Education/Amnis_provides_an_accelerated_introduction_to_Lean_principles_and_practice_414432.html
 
http://www.trainingpressreleases.com/newsstory.asp?NewsID=4952
 
http://www.pubarticles.com/article-amnis-provides-an-accelerated-introduction-to-lean-principles-and-practice-1260800234.html
 
http://www.pr-inside.com/amnis-provides-an-accelerated-introduction-to-r1629771.htm
 
http://www.pressmethod.com/releasestorage/142996.htm
 
Amnis offers help to those criticised by The Foster Report
 
http://www.pressreleasepoint.com/amnis-offers-help-those-criticised-foster-report
 
http://www.pr-inside.com/amnis-offers-help-to-those-criticised-r1644422.htm
 
http://www.prlog.org/10463237-amnis-offers-help-to-those-criticised-by-the-foster-report.html
 
http://www.ukprwire.com/Detailed/Health_Wellbeing/Amnis_offers_help_to_those_criticised_by_The_Foster_Report_61767.shtml
 
http://www.1888pressrelease.com/amnis-offers-help-to-those-criticised-by-the-foster-report-pr-173769.html
 
http://www.pubarticles.com/article-amnis-offers-help-to-those-criticised-by-the-foster-report-1261568919.html
 
Amnis helps improve clients’ return on investment in project management

http://blog.taragana.com/pr/amnis-helps-improve-clients%E2%80%99-return-on-investment-in-project-management-11652/
 
http://www.trainingpressreleases.com/newsstory.asp?NewsID=5016
 
http://newsreleaser.com/0000010858.html
 
http://www.information-online.com/node/31908
 
http://www.seenation.com/view_full_news_details.php?newsid=155830
 
http://www.your-story.org/amnis-helps-improve-clients%E2%80%99-return-on-investment-in-project-management-83273/
 
http://www.bignews.biz/?id=834335&keys=project-productivity-management-healthcare
 
http://www.prfocus.com/article.html?page=Amnis_helps_improve_clients%92_return_on_investment_in_project_management_32245.html
 
http://www.24-7pressrelease.com/press-release/amnis-helps-improve-clients-return-on-investment-in-project-management-132648.php

For more information about Amnis visit our website at www.amnis.uk.com.

NHS Employees

Whilst the suggestion by the Liberal Democrats last week that every NHS Employee should also be a form of shareholder of the organisation they work within maybe difficult to implement from scratch the concepts that the careers and livlihoods of employees are directly linked to the success of their organisation are not so hard to imagine, mostly because this concept already exists.

The problem is that whilst conceptually employees should feel a tremendous sense of loyalty to the organisation they work within the reality is that many feel disconnected, disempowered, undervalued and sometimes simply ignored. The NHS of the future will be delivered by helping the majority of staff feel that they are a key part of the organisation, involving them in the process of change and giving them the leaders they deserve.

To find out more about creating the organisation of the future contact Amnis via info@amnis.uk.com or visit our website www.amnis.uk.com.

Toxic Environments

The way a team performs and behaves is directly related to the organisational environment that is created by the management style, measures and systems within the organisation. Why is it that like for like healthcare organisations dealing with the same types of patients with staff with the same skills and competences can have such widely differing outcomes, including mortality rates? The reason is generally related to the organisational environment – how well people work together, how they deal with problems, how issues are raised and discussed and other such issues.

Toxic Environments are ones where the organisation creates an environment that generates ‘bad’ results. This could be an organisation where managers and clinicians don’t work well together, where individuals don’t feel empowered to speak out when they encounter problems and where the way measures are used by the organisation drive the wrong behaviours.

A focus on 4 hour waits in A&E that does not take into account outcomes and experience will result in driving behaviours that could be unsafe.

The reasons why organisations structure to create the right environment and the actions to be taken to ensure success are the subject of a researched article recently written by Amnis and that will shortly be available to those who receive the Amnis Newsletter. To find out more and to sign up for our newsletter (and download a free copy of Uncovering Lean) from this link: http://www.amnis.uk.com/download-uncovering-lean-for-free.

For general information visit www.amnis.uk.com or phone 0870-446-1002.

Transforming Services Is Not Just About Patients

Many services that don’t work well for patients also don’t work well for staff. Whilst it is vital to have an effective health service that is focused on patients and service users, but it will be impossible to achieve an effective health service without the cooperation and input of front-line staff.

Effective processes are ones that engage front-line teams in their design and transformation, but also where the benefits are realised by staff as well as patients. The knock on effect of this can be seen in reduced absence rates, turnover rates and agency spending and an increase in patient and staff satisfaction.

To find out how to engage your team in transformation contact us on 0870-446-1002 or email us on info@amnis.uk.com.

Visit us on www.amnis.uk.com