How Kata is Being Used to Deploy TWI at Baptist Memorial ...twisummit.com/wp-content/uploads/2017/02/TWI_Brandon-Brown-Baptist...2/15/2017 1 How Kata is Being Used to Deploy TWI at

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How Kata is Being Used to Deploy

TWI at Baptist Memorial Healthcare

Endurance + Discipline = Success

1 Rev. 20170203

MAIN THOUGHTS ON DAILY, DELIBERATE PRACTICE OF KATA

EXPERIMENTATION ON ORGANIZATIONAL CULTURE…

Drives the formation of new Habits

Habit formation leads to either open or closed

Mindset

The sum of an organization’s Mindsets and

Behaviors = Culture

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Deliberate Practice of

new Behaviors

KATA STARTS HERE.…….. SO WE CAN MOVE THIS

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ENDURANCE + DISCIPLINE = SUCCESS

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A QUICK TIMELINE TO CATCH YOU UP…...

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Jan. 2014 = TWI–JI started at Baptist DeSoto Hospital, Southaven, MS June 2014 = TWI-JI at NEA Baptist Hospital and NEA Clinic, Jonesboro, AR Aug. 2014 = TWI-JI Baptist Collierville Hospital, Collierville, TN Oct. 2014 = TWI-JI Baptist Golden Triangle Hospital, Columbus, MS Jan. 2015 = TWI-JR at NEA Baptist Hospital and NEA Clinic, Jonesboro, AR Spring 2015 thru Spring 2016 = TWI-JI Expands to many of Baptist’s 19 Hospitals April/May 2016 = Begin experimenting with using Kata to Deploy TWI–JI and TWI-JR

with external Kata Coaching at NEA Baptist Hospital and NEA Clinic, Jonesboro, AR Sept. 2016 = Begin experimenting TWI-JI Shepherding at Baptist Memorial Memphis,

Memphis, TN, and NEA Baptist Hospital and NEA Clinic, Jonesboro, AR; about the same time Begin using Kata to Deploy TWI-JI at Baptist Golden Triangle Hospital, Columbus, MS, as well as incorporating Kata with TWI JI at North Mississippi, Oxford, MS

Oct. 2016 = 1st Annual Baptist TWI Summit held at Baptist Golden Triangle Hospital, Columbus, MS. Many Hospitals within Baptist attend and share successes and struggles

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A QUICK TIMELINE TO CATCH YOU UP…...

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Currently (approximate numbers): 19 Hospitals, 160+ clinics, 15,000 employees; Memphis (largest)

700+ beds, 450-550 daily census, currently experiencing 250 ED daily census. NEA Jonesboro 228 beds, 200+ daily census.

45 Certified TWI – JI Train the Trainers can teach the 10-hr Job Instruction class

6 Certified TWI – JR Train the Trainers can teach the 10-hr Job Relations class & Foundations

JI and JR has been taught over 100+ times at Baptist to several hundred people

Baptist has worked with the TWI Institute to make TWI materials that “fit Healthcare”

1 TWI – JM class taught at NEA Baptist Hospital Jonesboro, AR (Emergency Dept.)

MANY WAYS TO GET FROM HERE TO THERE……

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Strategic A3 Deployment

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Hoshin Kanri X-Matrix


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Traditional Project

Management

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Baptist Management

System Experiment…. Kata your TWI

WHAT ARE KATA?

They're practice routines. Kata are structured routines to practice deliberately, especially at the beginning, so their pattern becomes

a Meta-habit and leaves you with new abilities

KATA:

• Are for learning fundamentals to build on.

• Are a way of transferring skills and developing shared abilities and mindset in a team or organization. By Mike Rother

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What drew us to using Kata over other deployments….

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• Wanted a process that aligned strategically – “Don’t train just to train”

• Wanted a process that was sustainable – low chance of scope creep

• Wanted daily, deliberate attention via coached practice to ensure we were forming habits

• Wanted a process whereby one or two individuals didn’t shoulder the burden – promote teamwork top down and horizontally throughout the organization

• Wanted to form a network whereby individual hospital entities shared success and struggles

TWI – JI Shepherding Group – Baptist Memphis

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Guide the long term deployment of TWI using Kata

Comprised of 5-6 of the sites senior leaders who are TWI

Certified Trainers plus 1-2 at Executive level

Develop Target Conditions to achieve concrete

outcome metrics as they advance toward The

Overarching Challenge

Monitor actual performance and progress of the plan relative to

their responsibilities in areas such as:

Auditing draft JIBS and validating the Training process

Seek out areas that may be struggling and offer

support, coaching, and resources

Actual attainment of target conditions toward

meaningful organizational objectives

Development of TWI Trainer and Job skills within targeted

members of the organization

“What do you think? If a man has a hundred sheep, and one of them has gone astray, does he not leave the ninety-nine on the mountains and go in search of the one that went astray?” Matthew 18:12 ESV

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CONNECTING STRATEGY & EXECUTION

By Mike Rother

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Leaders establish the organizationʼs strategic concept (the “rallying point” or overall direction)

Managers develop people by coached practice of the Improvement Kata in the direction of the challenge

The role of Challenge in an organization

Vision

Next Target

Condition Current

Condition Obstacles Challenge

Execution Strategy

1 week – 1 month

Successive T/Cs to achieve the

Challenge

Distant

Often General

“Principles”

1-3 years

Concrete Hard Metrics


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Challenge: It would be “KATAstic” if by 9/30/2017, Baptist Memphis has achieved clinical TWI trainer ratio 1:7 and non-clinical trainer ratio of 1:10 and is consistently using JI tools to train staff on a minimum of 3 JIBs per department so we achieve: Outcome Metrics: 1. 100% alignment of JIB training with strategic A-3 initiatives and FY17 LEM goals 2. 100% of JIBs will go through approval process and added to the SharePoint site with appropriate dates 3. 100% Nursing trainer ratios 1:7 4. 100% Clinical (non-nursing) trainer ratios 1:7 5. 100% non-clinical trainer ratios 1:10 6. 100% training on 3 JIBs per department 7. 100% Training Validation with Skill Level Each Quarter 8. TWI Trainer Skill Levels - 30% Beginner Skill Level , 30% Moderate Skill Level, 30% High Skill Level, 10%

High Skill Level and can train others 9. Metrics aligned with JIB training at target or challenge

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Process: Deployment of Wave 1 and 2 JIBs Achieve-by Date: January 31, 2017

Total:

Process Metrics: Process Metrics:

3 classes scheduled and filled to capacity with 80% participant completion for nursing & clinical combined

5 certified TWI trainers to teach classes in January: 4 classes scheduled, 1/15 class complete: 8 completed ; cancelled two classes 1/23 week due to low registration; class scheduled: 1/30 = 8 out of 10 registrants

217 trainers needed to meet 1:7 Nursing ratios for FY17; 142 current trainers. Target for TC: 12 144 trainers currently for Nursing towards meeting 1:7 Nursing ratios

95 trainers needed to meet 1:7 Clinical ratios for FY17; 78 current trainers. Target for TC: 86

80 trainers currently for clinical services towards meeting 1:7 Clinical ratios

2 non-clinical trainers (transportation, EVS, clinical engineering, facilities, food & nutrition) 3 trainers for Non-nursing

Total:

Outcome Metrics: Outcome Metrics:

100% alignment of foley insertion and peri-care with FY17 CAUTI reduction goal NS

100% alignment of foley insertion and peri-care with FY17 CAUTI reduction goal

100% alignment of hand hygiene with FY17 Quality Scorecard goals NS 100% alignment of hand hygiene with FY17 Quality Scorecard goals

100% Foley Insertion, Peri-Care, and Hand Hygiene JIBS approved and added to the sharepoint site

100% Foley Insertion, Peri-Care, and Hand Hygiene JIBS approved and added to the sharepoint site

70% of Nursing Trainer Ratios 1:7 63% Nursing Ratios 1:7

88% Clinical (non nursing) Trainer Ratios 1:7 82% Clinical (non-nursing) Trainer Ratios 1:7

5% Non- Clinical Trainer Ratios 1:10 5% Non-Clinical Trainer Ratios 1:10

FY17 CAUTI rates= Challenge on LEM goals, FY17 CAUTI - <= 16 annual FY17 CAUTI rates = FY17 year to date = 5,

Target Condition Current Condition Obstacle Parking Lot How will you measure that?

We do not have a champion for JIB training in Pharmacy Champion named

We do not have non-clinical service shared site up for JIB tracking See folders loaded and forms being completed

We do not know what JIBs will be included and have the greatest impact for Wave 2 JIB Training for non-nursing JIBs identified and aligned with strategic goals

We do not know the barriers for some clinical and non-clinical areas to reach their clinical staff to trainer ratios Improved Ratios

We do not know what impact TWI Insertion for identified leads and eventually all trained staff will have on CAUTI rates CAUTI rate

We do not know the best method to measure the quality and skill level of TWI trainers and overall training on JIBs Method development with positive outcomes

Can contracted services (EVS, Food & Nut, FS) staff be included in 1:10 Trainer Ratios (trainers - not staff) due to contracts? Discussion with Cyndi P and Scott C. During Wave One

TWI Trainer class average attendance is 80% of those registered and class attendance is not considered "required". i.e.mandatory. Actual Attendance of those Registered

Gathering valid numbers of JIB training and validation is not possible as forms are not complete and outcome of training numbers not currently tied to Safety Huddles

Auditing by Leadership & ask Michelle to start addressing this is Huddle, asking for % of completions.

Schedules are full making it difficult for Credentialed Trainers to schedule additional classes 5 days a week # of classes scheduled

Revision 2.0 – 09.15.2016

PDCA CYCLES RECORD (Each row = one experiment)

Date: January 2017 Process: TWI Training for Non-Nursing is new to all other areas; it will take more time to get them going; We do not know the barriers for some clinical and non-clinical areas to reach their clinical staff to trainer ratios; TWI Trainer class average attendance is 80% of those registered and class attendance is not considered "required". i.e.mandatory.

Process Metric:

Learner: Judy Mann Coach: Tabetha Polly

Step What do you expect?

Co

ach

ing

Cyc

le

Exp

erim

ent

Result (Observe Closely) What We Learned Determine where contracted employees

are in roll-out? EVS and Dietary particularly

Determine if we can proceed with 1:10 Ratios or if we need to alter our plan.

Discussion with Cyndi resulted in sending inquiry to corporate for

answer

Best in this circumstance to work the process fully

Present to clinical services TWI class attendance requirement to be

considered "required" and work on proposal to give to Senior Leaders

regarding counting no shows/absences into attendance for employee.

Have proposal by second to third week of January.

Have not been able to focus on this yet

Needs to be addressed.

Obstacle/Opportunity: Follow up on RT JIB rework meeting

Have author set meeting time with author of JIB

Met with author, performed JIB training and realized the large volume of editing needed. Is performing edits.

Using the "training" environment where the author had to train

someone who knew nothing was an excellent approach for growth vs. just

fixing it.


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Safety/Quality Areas for utilizing TWI - Job Instruction Breakdown Sheets are any tasks related to: Hand Hygiene

Catheter-associated Urinary Tract Infections (CAUTI)

Central Line-associated Bloodstream Infection (CLABSI)

Falls Prevention and Patient Safety

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17

0

20

40

60

80

100

120

140

160

Month 1 Month 2 Month 3

77

134 142

55

78 78

2 3 3

Number of Trainers - Memphis

Nursing Trainers Clinical Trainers Non-Nursing Trainers

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Month 1 Month 2 Month 3

35%

62% 63% 71%

82% 82%

5% 5% 5%

Percentage Complete toward Trainer Ratios - Memphis

Nursing Trainer Ratio 1:7 Clinical (non-Nursing) Trainer Ratio 1:7

Non-Clinical Trainer Ratio 1:10

Trainer : Staff Ratios

TWI – JI Shepherding Group – CAUTI

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0

10

20

30

40

50

60

70

80

90

FY 15 FY16 FY17

25 16

5

90

41

5

CAUTI

First quarter Total

“Because of TWI – JI Shepherding KATA we have had a planned and controlled deployment with follow up validation, we have seen wonderful outcomes in many areas. Most significantly would be deployment of Foley Insertion/Peri Care JIB’s to nursing, with the contingency that only nurses who have received the JIB training can insert foley catheters. We are confident this has led to the steady decline in CAUTI events in our hospital due to the JIB, TWI training, and validation on-going. TWI training with the JIB has provided our staff the training and tools for standard work to prevent harm and reduce infections relating to foley catheters. “ - Judy Mann, TWI-JI Shepherd, Education

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TWI - JI Shepherding Group – CLABSI

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“Pioneering the KATA TWI Shepherd group has been a challenging journey that is showing great outcomes for the members, our staff and our patients. Without the leadership of the Shepherds, we are certain that TWI training, use of JIB’s and continued deployment (especially in clinical services departments such as lab, radiology, blood bank) that TWI would not have been embraced and integrated into practice in the positive manner we have seen. Thus, our outcomes would have been reduced and processes less effective.” - Judy Mann, TWI-JI Shepherd, Education

0

20

40

60

80

100

120

140

FY 14 FY 15 FY 16 FY 17

133

104

43

0

CLABSIs

Started Kata May FY 16

Started TWI - JI Shepherding Kata work on CLABSI - Oct FY 17

Fall Prevention MasterKata Storyboard – Baptist Memphis

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“Being a 2nd coach on the Master Falls Board has been very eye opening. To see the work and accomplishments of the team as a whole is amazing. The learners are continuously growing their knowledge of the obstacles and using this information daily to impact change. We have a 30% reduction since starting this Kata from 10.5 Falls/ 2 week Target Condition to a rate of 7.36 Falls/ 2 week Target Condition.

- Jackie Barton, Director of Med/Surg Nursing

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2

4

6

8

10

12

Wk 1 Wk 2 Wk3

10.5

7.42 7.32

Falls Rate - Rolling 2 weeks

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Fall Prevention TIED to Daily Safety Briefing – Baptist Memphis

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LOS FALLS

CAUTI CLABSI BLOOD

TAKE-AWAYS

Fall Prevention TIED to Daily Safety Briefing – Baptist Memphis

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RN 5 Question Kata

(Questions for Post Safety Briefing Huddle)

1. What is the status of the unit validation

on the percent Trained to TWI-Job

Instructions on 4P Hourly Rounding?

And on any Falls Prevention JIBS?

2. The person on this unit whose patient

fell, are they TWI trained on these TWI-

JI Job Instruction Breakdowns?

a. If Yes, we need to continue

with our “Just Culture” Process

b. If No, when can we go and see

what this person has learned

from the TWI-JI Training?

--------Turn Card over-------

4. What is your Next Step/Next PDSA

Experiment?

5. When can WE go, and see what WE

have Learned from take this step?

Reflection on Previous Work

Completed

1. What was our Last step/Last

PDSA Experiment on this unit?

(Unit Manager reads their last PDSA

step)

2. What did you Expect?

3. What Happened?

4. What did you Learn?

(Repeat for each RN Unit Manager

with a Fall incident)

----------Return to Question 4-----------

“I absolutely love watching this master board mature and already start to show results. I especially enjoy watching the team run through their PDSA cycles and have those collective “ah ha” moments where they find common ground and realize they are all facing similar challenges/obstacles. I believe this work is going to prove to be some of the “secret sauce” that will allow us to replicate results throughout the organization.”

- Michelle Smith, CNO

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TWI – JR Kata – NEA Baptist

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Challenge: It would be OUTSTANDING if by 12/31/2017, NEA Baptist has a method to verify to what extent that the JR 4-step method/4 foundations are being utilized to limit the number of critical problems brought from the Director/Manager level to HR for resolution and JR is applied consistently across the NEA Health system so we achieve: Outcome Metrics:

1. 4.15 score on the Foundation

2. < 126 Written warnings (10% reduction)

3. < 35 Involuntary terminations (10% reduction)

4. 100% - All managers/directors are trained on Job Relations

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Revision 2.0 – 09.15.2016


Process Metric

% of First 40 complete 8w Follow-up

and % Attendance to JR class

Process: JR Training Challenge: 2016 JR Deployment Challenge Achieve-by Date:

Process Characteristics Process Characteristics

We do know which supervisors have Tier 2 or 3 depts, and we know if they have been We will know which tier 2 and tier 3 managers have been through the JR traning and are using

trained. See supervisor training tab. the four foundations

We do not know if the 13 tier 3 action plans correlate to one of the 4 foundations We do know if the 13 tier 3 action plans correlate to one of the 4 foundations

6 of the 6 Certified JR Trainers have taught a 10 hr JR course; however we will be down to 5

Of the 61 that have been JR trained, we DO NOT know to what extent they are utilizing

- the 4 foundations

Process Metrics Process Metrics

70/224 supervisors are in process of training 31% 70/224 supervisors have been trained 31%

1 supervisors will be non-compliant for attending follow-up classes 1 supervisors will be non-compliant for attending follow-up classes

Calendar year 2016

Total JR Trained Non JR trained Used Method Total JR Trained Non JR trained

Ww 138 106 32 70 Ww 110 78 32

IvT 39 23 16 4 IvT 31 16 15

% JR Ww 77% 23% 51% % JR Ww 71% 29%

% JR IvT 59% 41% 10% % JR IvT 52% 48%

Outcome Metrics Outcome Metrics

% score on the foundations survey (unknown) % score on the foundations survey (unknown)

140 Written warnings have been issued CY16 YTD (2.69 per week) 52 weeks 110 Written warnings have been issued CY16 YTD

(182 Written warnings issuesd in 2015 - 3.5 per week) (182 Written warnings issuesd in 2015)

39 Involuntary Terminations issued CY16 YTD (0.75 per week) 52 weeks 31 Involuntary Terminations issued CY16 YTD

(57 Involuntary terminations issuesd in 2015 - 1.10 per week) (57 Involuntary terminations issuesd in 2015)

TARGET CONDITION PLANNING FORMOutcome Metric

Foundation Survey Score 80%; <136 Written

warnings; <56 Involuntary terminations

Step 1: Fill in current condition

data

Step 2: Fill in what you will keep the same

Step 3: Fill in what you want to changeCurrent

ConditionTarget

Condition

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Revision 2.0 – 09.15.2016


Number Assignee Obstacle

We do not know how to use the employee engagement survey results in our deployment/alighment of JR in

such a limited amount of time

We have not addressed the coaching of a CT with high number of WW and/or IVT

Some Managers are too dependent on HR to assist with the 4 step method.

DO NOT know if Corporate could customize the e-tool specifcially to require the managers to answer the 4 step

method

Melanie Conflict w/ Studer rounding and how the 4 foundations will fit into the Studer model

James

Managers are only using the 4 step method for large problems. They are not using it with small issues in order

to avoid large disciplinary issues.

OBSTACLE PARKING LOT

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Learner:

Step What do you expect? Result (Observe Closely) What We Learned

Schedule a meeting with all supervisors To set clear expectations regarding the Have yet to schedule meeting. Unclear on direction from Brad.

that have completed the JR training to use of the 4-step method when bringing

reinforce what they have learned problems to HR and to check and adjust

how the foundations/4 step method is

being utilized at the department level

Schedule time for next training class I expect for the class to be filled The class was scheduled for the week We learned that we were able to get 10 people signed

for Rebecca/Melanie P. of August 22-26. The class is at capacity up for the class.

with 10 participants.

Send email to Admin team for names I expect to receive a list of possible names We were able to slot 10 people for this We learned that 10 are able to attend the class, but

that need to be in next class. to attend the class class. This puts the class at capacity we still have several more managers that need to attend

Set up coaching sessions with CT Trainer- I expect to establish a consistent time We set up this meeting to occur every We learned that Rebecca is open to the coaching

Rebecca Ewert. This is to help coach her to meet with her on a weekly basis. Monday at 1000. Craig has also asked especially after she saw her employee engagement

on using the four foundations. to be a part of this meeting. scores.


Date: 07/26/2016 Process:

We do not know how to use the employee engagement survey results in our

deployment/alighment of JR in such a limited amount of time

Process Metric:

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Revision 2.0 – 09.15.2016

TWI – JR Kata – NEA Baptist Data & Key Learnings

Key Learning: We did see a trend in the number of increases in involuntary terminations after the job relations training due to the fact that our managers had the tools to properly address the issues.

- James Keller, Director of Human Resources, NEA Baptist Memorial Hospital

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Revision 2.0 – 09.15.2016

TWI – JR Kata – NEA Baptist Data & Key Learnings

Jan Feb Mar April May June July Aug Sept Oct Nov Dec

2016 14 16 13 21 16 6 10 5 14 8 8 9

2015 25 16 12 13 15 10 17 13 14 18 14 15

JR Training 2016 1

0

5

10

15

20

25

30

Nu

mb

er

of

Wri

tte

n W

arn

ings

Written Warnings Key Learning: Because of KATA we feel there was a steady decline in written warnings because job relations provided tools to our managers so they could begin to address issues early instead of waiting until the situation blew up.


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Revision 2.0 – 09.15.2016

TWI – JR Kata – NEA Baptist Overall Deployment

“Because of using KATA to deploy TWI – JR, we have been able to properly implement the four foundations across the organization to help managers stay of ahead of ‘trouble areas’ and either address them early or prevent them from happening all together. Using KATA to deploy TWI – JR, has laid the foundation on which we can provide a structure to continue to improve the way in which we perform and deploy TWI - Job Relations. Without KATA we would be lost. KATA truly is a remarkable thinking pattern and routine and one that has kept us grounded and driven to continue to improve our TWI - Job Relations processes. "


Utilizing Deep Dives – with Patrick Graupp

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A "deep dive" at Baptist is when we take a group of people who have "skin in the game" on a particular task that needs to be trained and performed more consistently in the hospital or clinic. A “deep dive” results from a JI Trainer or a group of Trainers that have found they have some very complex jobs that almost everyone is doing differently. These sessions can be 5-8 hours of writing, coming to consensus on important steps, key points, testing and experimenting, re-writing, agreeing on reasons why, so we get it right!

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Utilizing Deep Dives – with Patrick Graupp

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“More than anything else, it has been a tremendous learning experience for me to work with the fine people of Baptist Memorial Health Care in several of their facilities throughout the Mid-South. They have been my teachers. I have watched them across the board transform into a kaizen oriented mindset where they no longer accept health care delivery as "just the way it is done" and now actively look under every corner to find improvement to do the work more efficiently, with more stability, and in a way that truly delivers outstanding outcomes to patients. Most of all, they are motivated to deliver on the high goals they are striving to achieve.” - Patrick Graupp, Senior TWI Master Trainer, TWI Institute

Where is Baptist going from here? Job Methods

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Baptist 1ST Annual TWI SUMMIT OCT. 2016

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Step What do you expect?Result (Observe

Closely)What We Learned

Lessons

Learned

Person

Responsible

&/or Week of

PDCA

All who attend

class are not

prepared to

author JIB's.

Tabetha, Karen &

Judy 1/10/2017

Co

ach

ing

Cyc

le

Exp

eri

me

nt

Review status of clinical

services JIB's - approval and

deployment: disscuss

options with Shepherds

regarding group meeting

agenda and presentations

Be able to provide leaders

with a flow chart/ process

for JIB topic selection to

approval.

Found several JIB's were

well written and needed

few updates. Also

determined one JIB needed

completely reworking. Was

a procedure merly copied

and pasted into a JIB

format.

Learned that best process

for JIB reconstruction is to

have the author meet with

a Shepherd and teach the

JIB to an innocent/non-

knowing person and treat

the expereince just as we

do when teaching class.

This allows us to provide

constructive critiques, help

author identify deficients,

and make corrections

together.


Date: January 2017 Process:

TWI Training for Non-Nursing is new to all other areas; it

will take more time to get them going; We do not know

the barriers for some clinical and non-clinical areas to

reach their clinical staff to trainer ratios; TWI Trainer class

average attendance is 80% of those registered and class

Process Metric:


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Step What do you expect? Result (Observe Closely) What We Learned Lessons LearnedWeek of

PDCA

Confirm TC for Dec 31st is approved

by TWI KATA shepherds

Some revisions will need to

be made for approval

Post Dec 5, 6, 7 KATA sessions,

we obtained TWI Shepherd

group approval

TC draft required some

discussion and revision but

ended with a good

challenging TC

Struggle to Ah Ha: Shepherd

Group and KATA process must

stay far ahead. Real time

work can end in numberous

delays.More we progress in

this process, the more we are

gathering a good platform for

working and making a

difference in patient care and

outcomes.

Dec 5 - 7

Struggle: Communication

with whole KATA Shepherd

group. Conflicting schedules

require alternative methods -

over and over.

5-Dec

Co

ach

ing

Cyc

leEx

pe

rim

en

t

Discussion among TWI KATA

Sheperds regarding how Sheperds

want to audit forms and

compliance in JIB training. As in,

determine who will follow which

areas, or how they percieve we

should breakdown the audits.

Determine auditing

process that works for all

Shepherds

During Shepherds meeting, we

agreed we would finalize via

email due to time constraints.

Get a consensus from team as

to method and assignments.

Flexibility and Alternate

methods work


Date: December 5, 6, 7, Process:

TWI Training for Non-Nursing is new to all other areas; it will take

more time to get them going; We do not know the barriers for

some clinical and non-clinical areas to reach their clinical staff to

trainer ratios

Process Metric:



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Step What do you expect? Result (Observe Closely) What We Learned Lessons LearnedWeek of

PDCA

Determine ideas in next TWI KATA

group meeting: auditing

assignment finalization; Teaching

schedule finalization; folders

location; future L, C, 2C, Observer

schedule that will occur in 2017.

Expect progress and

decisions to continue to

mold foundation of TWI

KATA Shepherd group.

Did not get to discuss due to

time constraints

Place on agenda for next

Shepherd meeting.

If we could start over: Find

alternate ways to determine

final decisions; attendance of

all members is critical for

forward movement as we are

trying to get a structure/

foundation established.

12-Dec

Determine ideas in next TWI KATA

group meeting: auditing

assignment finalization; Teaching

schedule finalization; folders

location; future L, C, 2C, O

schedule. Continue to address in

KATA sessions: training schedule,

potential audit breakdown, future L-

2C overview.

Expect progress (and

sending out spreadsheet

for all to review via email

too).

Teaching Schedule sent out vai

email. Karen, Judy and Tabetha

responded to email.

Email was not successful in

getting class schedule

instructors signed up. We

will take to KATA shepherd

meeting Dec 13 with

updated schedule sign up

and discussion of auditing

and other assignments.

Current Struggle: Email

outcomes not optimal, email is

not the best method - just a

method.

Possibly need deadlines.

Dec 15 - 20

Determine ideas in next TWI

KATA group meeting: auditing

assignment finalization;

Teaching schedule finalization;

folders location; future L, C, 2C,

O schedule. Continue to

address in KATA sessions:

training schedule, potential

audit breakdown, future L-2C

overview.

Expect decisions

Training Schedule finalized,

with waiting list. Auditing

with nursing - will be by

Directors with due date of

first Monday of month.

Clinical Services returning

with selected JIB topic and

good % completion for HH.

Future L, C, 2C, O schedule

discussed - no final

decisions. Continue through

February 2107.

Shepherds can make

great progress when all

are present.

Learned: Scoring

December TC helps view

outcomes. This is truly

reflective of the

clinical/KATA work that we

are doing. Allows pause for

reflection and brief

celebration of hard

work/outcomes.

22-Dec


Date: December 5, 6, 7, Process:

TWI Training for Non-Nursing is new to all other areas; it will take

more time to get them going; We do not know the barriers for

some clinical and non-clinical areas to reach their clinical staff to

trainer ratios

Process Metric:


Coac

hing

Cyc

leEx

perim

ent

2/15/2017

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FINAL THOUGHTS ON DAILY, DELIBERATE PRACTICE OF KATA

EXPERIMENTATION ON ORGANIZATIONAL CULTURE…

Drives the formation of new Habits

Habit formation leads to either open or closed

Mindset

The sum of an organization’s Mindsets and

Behaviors = Culture

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Deliberate Practice of

new Behaviors

KATA STARTS HERE.…….. SO WE CAN MOVE THIS

THANK YOU for the

Gift of your Time!

Brandon Brown, P. E., MSE

[email protected]

+1-479-856-1919

Focus on the PEOPLE, and the numbers will COME. Focus on

the NUMBERS and the people will GO!TM

38

TM

Documents

How Kata is Being Used to Deploy TWI at Baptist Memorial ...twisummit.com/wp-content/uploads/2017/02/TWI_Brandon-Brown-Baptist...2/15/2017 1 How Kata is Being Used to Deploy TWI at