Lean Facilitator Skills: Applying Psychology in the Moment

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Facilitator Skills: Applying Lean Psychology

“In the Moment”

January 21, 2010

© 2010 Karen Martin & Associates

Learning Objectives

Participants will learn how to:

Establish the environment for honest and, yes,

sometimes emotional discussions.

Read body language and behavior to assess

buy-in.

Address both overt and covert resistance.

Gain consensus every step of the way.

Spark innovation in risk-adverse environments.

Help leadership create a worker-initiated

improvement environment.

2

© 2010 Karen Martin & Associates 3

Facilitator: Defined

Facilitator – one who facilitates

fa·cil·i·tate (verb)

1. to make easier or less difficult; help forward (an

action, a process, etc.)

2. To assist the progress of (a person or activity).


Improvement Facilitator

Roles & Responsibilities

Teaching skill sets

Advocating improvements

Facilitating design and implementation activities

Mediating disagreements between functional areas

Encouraging behavioral changes

Coaching teams

Convincing leadership to allocate necessary

resources

Driving execution

Selling the need for improvement

4


The Facilitator’s Many Hats

5


The Facilitator as Psychologist

Figuring out each person’s “what’s in it for

me”

Figuring out each person’s “currency”

Figuring out the root of each person’s

resistance

Reduce cynicism

Generate momentum for change

6


The Facilitator as Salesperson

The need for improvement.

How improvement will benefit your customer.

How improvement will benefit the

organization.

How improvement will benefit the individual.

Why you need what you need.

Time

Resources

Why you need to do things a certain way.

7


Improvement Facilitator

Necessary Traits

Skills / Knowledge Lean tools

Root cause analysis

Project & time management

Team building / facilitation

People effectiveness – from front line workers to execs

Authority / Respect Designated change agent / influence leader

Trustworthy

Comfortable removing obstacles & reaching out to senior leadership

Personality / Energy Challenging, yet supportive

Positive, upbeat, energetic

Pushy without irritating

Objectivity / Fairness Not directly affected by the improvements being made

8


Facilitator Tips – Planning Stage

Execution 2-5 Days

Follow- up

4-8 Weeks Post

Planning

4-6 Weeks Prior


Scope carefully

Clear goals & objectives

People need to clearly understand what they’re allowed to do…

…and what they do NOT have permission to do

Eases leadership apprehension

Clarifies direction

Charters provide “Freedom with Boundaries”

10


Psychology at Work:

Improvement Team Selection

No more than 10

Be very strategic

Include a strong influence leader or two

Include a representative of an area that’s

likely to resist (a particular department,

unions, etc.)

They often become your greatest advocates.

Don’t avoid “whiners.”

11


Psychology at Work

Forming Improvement Teams

No more than 10

Cross-functional composition Process workers

Upstream suppliers (internal)

Downstream customers (internal)

Subject matter experts

Outside eyes

External suppliers / contractors

External customers

Administrative support (if needed)

Union representatives (if relevant)

Maintenance / facilities representatives

Management (limited representation)


Embrace Complainers

Complainers can be your most valuable

resource.

• Give them the proper

forum to be heard

• Invite them to play an

active role in

implementing solutions.


Reducing resistance to

sequestration

Sell the virtues of focus.

Ask about how the department functions if

someone is on jury duty, is ill, or goes on

vacation.

Remind them how long the process has

needed improvement.

Ask if the current improvement approach

is effective.

14


Facilitator Tips – Execution Stage

Execution 2-5 Days

Follow Up

4-8 Weeks Post

Planning

4-6 Weeks Prior


Ground Rules

The team starts and ends the day together.

Being on time is critical.

The team stays 100% committed and 100% focused; no interruptions.

All wireless devices on silent mode or off. No vibration.

Rank has no privilege.

Finger-pointing has no place.

No veto power from outside the team.

No silent objectors. Don’t leave in silent disagreement.

Seek the wisdom of ten, rather than the knowledge of one.

What’s said in the room stays in the room.

It’s okay and encouraged to disagree; it’s not okay to be disagreeable.


Team Dynamics

17

Forming

Storming

Norming

Performing

Tuckman Model

Bruce Tuckman, 1965

Adjourning


Embrace Conflict

Conflict, if well managed, stimulates

innovation.

Embrace it

Encourage it

Manage it


How psychology affects

process performance &

design

19

Transcribe Report

(MDI)

Lead Time = 5 mins.

% C&A = 75 %

Customer Demand:

15 patients per Day

(Takt Time = 32 minutes)

8 hours per day

Check-in

Patient(Admitting)

Cycle Time = 2 mins.

% C&A = 90 %

5

Send

Reports(Imaging)


% C&A = 90 %

6

Current State Value Stream Map

Outpatient Imaging Services

Schedule

Appointment

Cycle Time = 11 mins.Lead Time = 12 mins.

% C&A = 98 %

6

Pre-register

Patient


% C&A = 100 %

5

CT=Cycle Time

LT=Lead Time

%C&A=% Complete & Accurate

0.0833 hrs.

2 mins.

0.0833 hrs.

1 mins.

1.33 hrs.

28 mins.

4.13 hrs.

15 mins.

6.08 hrs.

5 mins.

16 hrs.

1 mins.

1.83 hrs.

1 mins.

2 hrs.

3 mins.

LT = 32.5 hrs.

CT = 56 mins.

CT/LT Ratio = 2.87%

Lead Time = 990 mins.

Prep Patient, Conduct

Exam, Transmit

Images (Tech)


% C&A = 90 %

2

Check-in

Patient(Imaging)


% C&A = 98 %

3

Read/Dictate

Exam(Radiologist)


% C&A = 95 %

2

Review / Sign

Report

(Radiologist)


% C&A = 95 %

2

Print

Reports(Imaging)


% C&A = 99 %

2365 mins. 960 mins. 110 mins. 120 mins.80 mins.

E Pay

Excel

ADS

Symposium

Internet

Waiting Room

Management

System

Fax Order

Solutions

PACS

5 mins.

Lead Time = 10 days

Meditech

234

5 6 78 9

1011 12

Auto Fax 50%

Us Mail 25%

MD Mailbox 25%

Rework Loop

via Fax 25% of

the time

Rolled First Pass

yield = 30%

Patient

1

Value Stream Champion: Paul Scanner

Created July 19, 2005

Refer Patient

(Physician)

% C&A = 65 %

Lead Time = 12 mins. 2

5 mins.248 mins.

LT = 16 hrs

Waste creates avoidance behavior

If it’s too hard to do, we

will delay or avoid doing it.

Builds up work-in-process

Prolongs lead time

May increase process time

May impact quality

Often results in batching


The Power of Real-Time, Visual

Process Monitoring

When we are

monitored, we

perform differently

Cameras

Posted metrics

especially leading

indicators

22

Refer Patient

(Physician)

% C&A = 85 %

Patient

Send

Reports

(Imaging)


% C&A = 90 %

6

Future State Value Stream Map


Schedule appt

Pre-register



% C&A = 98 %

6

CT=Cycle Time

LT=Lead Time


0.0833 hrs.

1 mins.

1 hrs.

28 mins.

2 hrs.

15 mins.

7 hrs.

1 mins.

0.0333 hrs.

1 mins.

0.5 hrs.

3 mins.

LT = 11.4 hrs.

CT = 49 mins.

CT/LT Ratio = 7.14%


Lead Time = 5 days

Prep Patient,

Conduct Exam,

Transmit Images

(Tech)


% C&A = 90 %

2

Check-in

Patient

(Imaging)


% C&A = 98 %

3

Read/Dictate

Exam

(Radiologist)


% C&A = 95 %

2

Review

/Sign

(Radiologist)


% C&A = 95 %

2

Print

Reports

(Imaging)


% C&A = 99 %

22 mins. 30 mins.60 mins.

E Pay

Excel

Symposium

Internet

Waiting Room

Management

System

Fax Order

Solutions

PACS

5 mins.

Set-up

Reduction

Remove

Redundant

Check-in

Standard

Work

Pull System

(Supplies

Kanban)

Visual

Workplace

Voice

Recognition

Batch

Reductions

5S

Co-locate

Standard

Work

Work

Balance

Continuous

Flow

Value Stream

Alignment

Auto Fax 80%

Us Mail 15%

MD Mailbox 5%

Rolled First Pass

yield = 59%

Rework Loop

via Fax 10% of

the time

Customer Demand:

15 patients per Day


8 hours per day

23

4 56 7 8 9

Risk

Reduction

(Joint Commision)

Meditech

420 mins.

1



120 mins.

Reduce Data

Entry

Requirements

Standard

Work

Cross

Training

Standard

Work

LT = 7 hrs


Our “sphere of influence” is

typically greater than we

believe.

We absolutely can influence

customer behavior!

Rethink your true sphere of

influence when when scoping

improvement activities and

selecting teams.

Avoid victim thinking (“we can’t

do anything about that”).

Transcribe Report

(MDI)

Lead Time = 5 mins.

% C&A = 75 %

Customer Demand:

15 patients per Day


8 hours per day

Check-in

Patient(Admitting)


% C&A = 90 %

5

Send

Reports(Imaging)


% C&A = 90 %

6



Schedule

Appointment


% C&A = 98 %

6

Pre-register

Patient


% C&A = 100 %

5

CT=Cycle Time

LT=Lead Time


0.0833 hrs.

2 mins.

0.0833 hrs.

1 mins.

1.33 hrs.

28 mins.

4.13 hrs.

15 mins.

6.08 hrs.

5 mins.

16 hrs.

1 mins.

1.83 hrs.

1 mins.

2 hrs.

3 mins.

LT = 32.5 hrs.

CT = 56 mins.

CT/LT Ratio = 2.87%


Prep Patient, Conduct

Exam, Transmit

Images (Tech)


% C&A = 90 %

2

Check-in

Patient(Imaging)


% C&A = 98 %

3

Read/Dictate

Exam(Radiologist)


% C&A = 95 %

2

Review / Sign

Report

(Radiologist)


% C&A = 95 %

2

Print

Reports(Imaging)


% C&A = 99 %

2365 mins. 960 mins. 110 mins. 120 mins.80 mins.

E Pay

Excel

ADS

Symposium

Internet

Waiting Room

Management

System

Fax Order

Solutions

PACS

5 mins.

Lead Time = 10 days

Meditech

234

5 6 78 9

1011 12

Auto Fax 50%

Us Mail 25%

MD Mailbox 25%

Rework Loop

via Fax 25% of

the time

Rolled First Pass

yield = 30%

Patient

1



Refer Patient

(Physician)

% C&A = 65 %

Lead Time = 12 mins. 2

5 mins.248 mins.

%C&A = 65%

RFPY = 30%


You Can Influence Customer

Behavior

Standard work

designed for

and with the

customer

Refer Patient

(Physician)

% C&A = 85 %

Patient

Send

Reports

(Imaging)


% C&A = 90 %

6



Schedule appt

Pre-register



% C&A = 98 %

6

CT=Cycle Time

LT=Lead Time


0.0833 hrs.

1 mins.

1 hrs.

28 mins.

2 hrs.

15 mins.

7 hrs.

1 mins.

0.0333 hrs.

1 mins.

0.5 hrs.

3 mins.

LT = 11.4 hrs.

CT = 49 mins.

CT/LT Ratio = 7.14%


Lead Time = 5 days

Prep Patient,

Conduct Exam,

Transmit Images

(Tech)


% C&A = 90 %

2

Check-in

Patient

(Imaging)


% C&A = 98 %

3

Read/Dictate

Exam

(Radiologist)


% C&A = 95 %

2

Review

/Sign

(Radiologist)


% C&A = 95 %

2

Print

Reports

(Imaging)


% C&A = 99 %

22 mins. 30 mins.60 mins.

E Pay

Excel

Symposium

Internet

Waiting Room

Management

System

Fax Order

Solutions

PACS

5 mins.

Set-up

Reduction

Remove

Redundant

Check-in

Standard

Work

Pull System

(Supplies

Kanban)

Visual

Workplace

Voice

Recognition

Batch

Reductions

5S

Co-locate

Standard

Work

Work

Balance

Continuous

Flow

Value Stream

Alignment

Auto Fax 80%

Us Mail 15%

MD Mailbox 5%

Rolled First Pass

yield = 59%

Rework Loop

via Fax 10% of

the time

Customer Demand:

15 patients per Day


8 hours per day

23

4 56 7 8 9

Risk

Reduction

(Joint Commision)

Meditech

420 mins.

1



120 mins.

Reduce Data

Entry

Requirements

Standard

Work

Cross

Training

Standard

Work

%C&A = 85%

RFPY = 59%


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

Finance

Review

Budget

PT = 5 mins.

C&A = 60%

6

Corp Purchasing

Manager

Approve in

ERP

PT = 5 mins.

C&A = 90%

1

0.25 days

5 mins.

0.5 days

5 mins.

5 days

5 mins.

1 days

5 mins.

1 days

10 mins.

0.5 days

15 mins.

3 days

5 mins.

7 days

15 mins.

10 days LT = 28.4 days

PT = 65 mins.

AR = 0.477%

Supervisor

Review Req.

PT = 5 mins.

C&A = 95%

2

Sys Engineer

Review

Requisition

PT = 5 mins.

C&A = 90%

1

IS Manager

Review

Requisition

PT = 5 mins.

C&A = 100%

1Financial Mgr

Review

Requisition

PT = 10 mins.

C&A = 95%

1

Admin Asst

Enter

Requisition

PT = 15 mins.

C&A = 98%

1

4 hrs. 40 hrs. 8 hrs. 8 hrs. 24 hrs. 56 hrs.

Originator

Inititate Req.

PT = 10 mins.

C&A = 10%

31

2 hrs.

Form File

File Maker

ERP

Quicken

Vendor

Website

Excel

4 hrs.

Customer Demand:

615 requisitions per y ear

20 ReqsExternal

Supplier

PT = 20 mins.

Hard CopySupplies

Data Entry

Corp Purchasing

Submit PO

to Supplier

PT = 15 mins.

C&A = 98%

6

10 Reqs 63 Reqs

1

2 3 4 5 6 7 8 9 10

RFPY = 4.2%

PT = Process Time

LT = Lead Time

C&A = % Complete & Accurate

AR = Activ ity Ratio (PT/LT x 100)

RFPY = Rolled First Pass Y ield

80 hrs.


Countering Resistance to

“Menial” Work

We resist doing work that’s “beneath us”

until we realize we’re already doing it

Supplies Purchasing - Future State VSM

Customer Demand:

615 requistions per year

Dept.

Manager

Approve

in ERP

PT=5 mins.

C&A = 90%

1

0.5 days

5 mins.

0.75 days

5 mins.

1 days

20 mins.


PT = 30 mins.

AR = 0.508%

Supervisor

Review

Req.

PT=5 mins.

C&A = 95%

28 hrs.

Originator

Enter Req.

in ERP

PT=30 mins.

C&A = 85%

31

File Maker

ERP

Vendor

Websites

6 hrs.

Standard

Work for

review

Additional

IT access

Requisition

Checklist

Cross

Training

Additional

IT access

External

Supplier

PT=20 mins.

Supplies

4 hrs.

Auto Notify

Integrate Form

File with File

Maker

Use budget in place

of Quicken

Dedicated

Buyers

Corp Purchasing

Place

Order

PT=20 mins.

C&A = 98%

6

Approval

1

2 3 4 5

PT = Process Time

LT = Lead Time


AR = Activity Ratio (PT/LT x 100)

RFPY = Rolled First Pass Yield

RFPY = 71%

80 hrs.


Purchasing — Non-repetitive purchases less than $5,000

Lack of awareness

Lack of confidence

Change fatigue


Most inspection (reviews, approvals, audits,

etc.) is grounded in lack of trust or fear.

Low faith in process reliability

Low confidence in people performing the work

Fear of losing control

High “need to know”

Risk aversion

Fear re: outcome

31


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

Finance

Review

Budget

PT = 5 mins.

C&A = 60%

6

Corp Purchasing

Manager

Approve in

ERP

PT = 5 mins.

C&A = 90%

1

0.25 days

5 mins.

0.5 days

5 mins.

5 days

5 mins.

1 days

5 mins.

1 days

10 mins.

0.5 days

15 mins.

3 days

5 mins.

7 days

15 mins.


PT = 65 mins.

AR = 0.477%

Supervisor

Review Req.

PT = 5 mins.

C&A = 95%

2

Sys Engineer

Review

Requisition

PT = 5 mins.

C&A = 90%

1

IS Manager

Review

Requisition

PT = 5 mins.

C&A = 100%

1Financial Mgr

Review

Requisition

PT = 10 mins.

C&A = 95%

1

Admin Asst

Enter

Requisition

PT = 15 mins.

C&A = 98%

1

4 hrs. 40 hrs. 8 hrs. 8 hrs. 24 hrs. 56 hrs.

Originator

Inititate Req.

PT = 10 mins.

C&A = 10%

31

2 hrs.

Form File

File Maker

ERP

Quicken

Vendor

Website

Excel

4 hrs.

Customer Demand:

615 requisitions per y ear

20 ReqsExternal

Supplier

PT = 20 mins.

Hard CopySupplies

Data Entry

Corp Purchasing

Submit PO

to Supplier

PT = 15 mins.

C&A = 98%

6

10 Reqs 63 Reqs

1

2 3 4 5 6 7 8 9 10

RFPY = 4.2%

PT = Process Time

LT = Lead Time


AR = Activ ity Ratio (PT/LT x 100)

RFPY = Rolled First Pass Y ield

80 hrs.

5 “Inspections”


Excessive Approvals &

Authorizations

Is the approval redundant? (same skill set and

perspective as another approver)

Is the approval a “rubber stamp”?

Does the approver have the technical skills and

experience to understand what they are signing?

Does the approver have the authorization to

approve or deny?

Is the approver accessible?

Is the approver on the routing list merely to stay

informed?

33


Lean Approvals

Move authorizations to the lowest level possible

Closest to the work

Create standard work re: decision making and train

lower level approvers accordingly

Audit periodically until trust is assured

Remove approvals that serve merely as

notification devices

Design notification to occur “off-line”

Process design goal: maximum of two

signatures for any decision

34

Supplies Purchasing - Future State VSM

Customer Demand:

615 requistions per year

Dept.

Manager

Approve

in ERP

PT=5 mins.

C&A = 90%

1

0.5 days

5 mins.

0.75 days

5 mins.

1 days

20 mins.


PT = 30 mins.

AR = 0.508%

Supervisor

Review

Req.

PT=5 mins.

C&A = 95%

28 hrs.

Originator

Enter Req.

in ERP

PT=30 mins.

C&A = 85%

31

File Maker

ERP

Vendor

Websites

6 hrs.

Standard

Work for

review

Additional

IT access

Requisition

Checklist

Cross

Training

Additional

IT access

External

Supplier

PT=20 mins.

Supplies

4 hrs.

Auto Notify

Integrate Form

File with File

Maker

Use budget in place

of Quicken

Dedicated

Buyers

Corp Purchasing

Place

Order

PT=20 mins.

C&A = 98%

6

Approval

1

2 3 4 5

PT = Process Time

LT = Lead Time


AR = Activity Ratio (PT/LT x 100)

RFPY = Rolled First Pass Yield

RFPY = 71%

80 hrs.


Purchasing — Non-repetitive purchases less than $5,000

1 “Inspection”


Reducing Resistance &

Building “Process Trust”

Demonstrate how the current state process impacts the customer

Point out that non-value-adding work is typically not stimulating

Facilitate candid conversations

Pose “what if” scenarios

Develop clear and concise standard work and provide excellent training and cross-training around it

Time-limited audits

Improvement pilots

36


Facilitator Skills:

Psychology at Work

37


Tricky Facilitator Moments

Watch for Covert Resistance

38


Pay Close Attention to Body

Language

Body language and

demeanor tell the whole

story

Crossed arms

No eye contact

Sudden change in level

of engagement

Set jaw

Incongruity between

words and actions


Techniques for Using Body

Language Cues

Draw them out.

If safe, ask them directly.

Establish and get agreement re: “Cards on

the table” rule upfront

Allow them to express their feelings.

Make it safe – protect them from ridicule.

Listen carefully – ask others to listen

carefully too.

Ask the team to comment.

40



Keep your radar well-tuned.

41



What if you’re designing

someone out of his/her job?

42


Eliminating Non-Value-Adding Work

Try to anticipate upfront.

Create a game plan for “redeployment.”

Assure the person they won’t lose a paycheck.

Help them find more fulfilling, value-adding work

(doing wasteful work is usually boring and

frustrating.)

Keep tabs on his/her emotions.

Be honest.

Play to their “currency.”

Invite / allow them to emote.

43



What if someone is behaving

outrageously?

44


Dealing with Outrageous Behavior

Your job is to have the team’s back.

Have zero tolerance for disrespect.

Engage leadership if need be.

Have side bars outside the room.

Allow the person to emote.

If they won’t settle down, they must leave the

team.

45



What if the team gets stuck

or goes out of scope?

46


Helping a Team Get Unstuck or Back

on Track

Return to the goals and objectives for the

improvement activity.

Flip chart “parking lot” ideas.

Use the “ticking clock” technique.

Take a break. Go outside. Talk about

something unrelated. Eat.

Reach out to the executive sponsor.

Turn to brainstorming.

Prioritize ideas. 47

PACE Prioritization Matrix

High Low Anticipated Benefit

Ease o

f Im

ple

men

tati

on

Dif

fic

ult

E

as

y

20

7

5 13

4 23

1

22 8 9

2

10

16

11

6

12

14 19

15

17

3 21

18



What if someone is

resisting?

49


Dealing with Resistance

Assess whether it’s valid or “emotional

resistance.”

Ask “why?”

“Would you be willing to try it for 30 days”?

They: “We’ve already tried that.”

You: “Don’t throw the baby out with the bath

water.”

50

Use visuals and data to demonstrate the

degree of dysfunction in the process



What if it’s a risk adverse

environment and

innovation is lacking?

52


Dealing with Risk Aversion or

Lack of Innovation

Get alignment re: risk tolerance across the leadership team.

Facilitate candid conversations.

Pose “what if” scenarios.

Create safety nets.

Audit as needed.

Engage the executive sponsor.

Show them examples, perhaps outside of their industry, or even non-work related. Develop a library of photos

53


Develop a Photo Library

54


Psychology in Use

Issue Resolution

Team is designing someone

out of a job

Quick intervention with

leadership and affected

parties

Professional level workers

feel a task is “beneath” them

Demonstrate the TRUE

impact and benefits

“Difficult person” no one

wants to work with

Involve them – they become

the greatest advocates

Organization is filled with

doubt and skepticism Hold REAL Kaizen Events

Leadership is reluctant to

give up tactical control

Help them see how their role

shifts for the positive

55


Techniques…

Use a charter with clear goals and objectives (that you’ve

obtained consensus on upfront).

Gain consensus on the easy things first.

Makes saying no more difficult

If more than 20% of the affected parties disagree with the

planned direction, don’t do it! (yet)

Keep working it – understand the issues – get to root cause

Revisit improvement objectives.

Use data.

Ask the resistors if they’d be willing to try it for 30 days.

Create a contingency plan in case failure occurs.

Explain WHY!!!!

56


Transforming Organizations

Results

Actions

Beliefs

Experiences

-- From Partners in Leadership


Learning Objectives

Participants will learn how to:

Establish the environment for honest and, yes,

sometimes emotional discussions.

Read body language and behavior to assess buy-

in.

Address both overt and covert resistance.

Gain consensus every step of the way.

Spark innovation in risk-adverse environments.

Help leadership create a worker-initiated

improvement environment.

58


Facilitator Support

The Kaizen Event Planner, Karen Martin &

Mike Osterling

59

http://www.amazon.com/gp/product/1563273519?ie=UTF8&tag=karmarass-20&linkCode=as2&camp=1789&creative=390957&creativeASIN=1563273519


Karen Martin, Principal

7770 Regents Road #635

San Diego, CA 92122

858.677.6799

[email protected]

Additional Questions

Business

Lean Facilitator Skills: Applying Psychology in the Moment