Value Stream Mapping
& Lean Event
Education
What Is a Value Stream?
Defines value from the customers
perspective
All of the actions and tasks, both value added
and non-value added, required to bring an
item (an idea, information, product or service)
from its inception through delivery.
These include actions to process information from
the customer and actions to transform the product
on its way to the customer.
Value streams vary in scope: reach beyond
the enterprise to single process size
Lean Guiding Principles
VALU
E
VALUE
STREA
M
PERFECTIO
N
PULL
FLOW
What Flows Through the
Value Stream?
Products, information, or services flow
through a value stream
In manufacturing or distribution, materials are
what flow
In health services, patients are what flow
In office areas, information is what flows
In service areas, external customer needs flow
through the value stream
In administration, internal customer needs flow
through the value stream
In many cases, the item flowing in service or
administration is a document, an order, or a request
Purpose of Value Stream
Mapping & Analysis
Develop a common understanding of the
current process
The relationship of process steps
A true picture of the process
Create a baseline to measure improvements
against
Define a vision of the future process
Establish common leadership objectives
Identify opportunities for improvement
Design an implementation plan for
improvements
If you
cant describe what you are doing as a process,
you dont know what youre doing.
W. Edwards Deming
Value of a Value Stream
Map
The Value Stream Map provides
visibility of the entire process
The process may cross functional
boundaries
Without the map, you may focus on
the wrong areas to try to improve
Sub-optimization may result
Analyzing the Value Stream
Planning tool to optimize
results of eliminating waste
future state VSM
current state VSM
Lean
Basics
Key Tool: The Charter
Project Information
Leadership
Executive Steering
Committee:
VP
Dr.
Dr.
VP
Dr.
VP
Director
VP
Management Guidance:
Executive Sponsor:
VP
Co Facilitators:
XXX
YYY
Participant/Process
Representatives
Process Owners:
XXX
YYY
Team Members:
RN
RN- Primary nurse
LVN
HUC
ED tech
EVS
ED resident
ED Reg
Bed Board
Floor nurse
IT (ad hoc)
Observers: (Outsiders & next PO)
TTTT
UUUU
VVVV
Process Scope: In/Out
In Scope:
End:
Out of Scope:
Last Update:
Problems/Case for Change
Time
Quality
Pt Sat
Cost
Project Goals
Project Time Frame
Milestone/Date
Lean Coach:
ZZZ
Process Scope:
Start/Stop
Start:
Process Purpose
Scoping Session #1
Scoping Session #2 sponsor meeting
Scoping Session # 3
All Team Prep Phone Con (1 hr, 11-noon)
Training day
VSM Vision & Implementation plan
Follow-up
Working sessions
14 day follow-up
30 day follow-up/Audit (25% of Action s done)
60 Day follow-up/Audit (50% of Actions done)
90 Day follow-up/Audit (75% of Action s done)
Charter Owner:
Setting up and Scoping a Lean Value
Stream Mapping Project
Charter and other Pre-work
Roles for the VSM Team
Executive Sponsor
Process Owner
Lean Coach (Facilitator)
Workshop Participants
Role of the Executive Sponsor
Owns the Charter!
Addresses necessary cross-functional involvement
Ensures appropriate participating in the workshop
(make sure the subject matter experts are freed up
full-time for the 3-day event, and part-time to
implement Action Items)
Serves as a proactive roadblock buster for the
project
Presents project status to leadership
Participates in:
Scoping
Workshop Kick-of
Leadership Panel
Project Reviews (30/60/90 day follow-up audits)
Role of the Process Owner
Owns the Setup Tasks and Action Plan!
Leads VSM project from pre-scoping through implementation
Ensures action item pre-work is complete for scoping, workshop, and
reviews
During VSM event, takes over ownership during Action Item assignments
Responsible for project meeting scheduling, preparation, and minutes
Documents the implementation plan after the workshop and schedules
30-, 60-, and 90-day reviews
Drives implementation plan activities for completion of the project
Provides updates to Sponsor
Monitors post-workshop process performance seeking opportunities to
continuously improve and standardize work
Role of Lean Coach
Coaches Process Owner in the application of
lean principles and tools
Leads project scoping while mentoring Process
Owner
Prepares Process Owner for workshop
Trains team and facilitates most of the
workshop activities, sometimes with the
Process Owner
Transfers lean skills to leaders and participants
Helps participants track and measure future
state improvements
Serves as the subject matter expert in driving
and institutionalizing lean throughout the
organization
Role of Workshop Participants
Participate in the 3-day event as
Subject Matter Expert (SME) (full-time);
be the change agent for implementing
Action Items (part-time)
Representative staf as SME from each
area that touches the process
Staf who are well respected within their
area
Group of less than 15 is ideal
Value Stream Process Steps
1. Prepare
2. Gather Data & Develop Current State
3. Develop Future State & Action Plan
4. Execute to Plan
5. Align
Value Stream Process
Step 1 - Prepare
Gather Preparatory Information
Document the Case for Change
Define the Scope (start and end of process)
Identify the Requirements
Review/establish Measurements
Set Logistics for Event
Participants
Location
Materials
Meals/Refreshments
Etc.
Value Stream Process
Step 2 - Gather Data (Develop Current
State)
Observe and gather data
Walk the value stream - see the actual work place
Follow and make notes about item and information flow
Gather data for each step in the flow
Trigger/done
actual lead time output
Actual cycle time
on time delivery staffing
Defect rate
batch sizes
overtime
Quality
variations
work in process
Map the flow of items
Map the flow of information
Add data and issues
Value Stream Process
Step 3 Future State & Action Plans
Discuss the ideal state
Develop the future state map
Develop action plans & cadence tracking
Build draft time line for implementation
Communication & training as required
Action Plan Template
Process
Step or
Function
Original
Problem
Action Items
Person
Responsibl
e
Due
Dat
e
Metrics and
Comments
10
11
12
13
14
15
16
17
Value Stream Process
Step 4 Execute to Plan
Implement improvements
Conduct Workshops, events, projects, bursts per
implementation plan
Achieve value stream objectives
Create an environment of continuous
improvement
Value Stream Process
Step 5 Align
Conduct Value Stream Alignment Meeting
Periodic basis (based on action plan schedule)
Agenda
Review event implementations & results
Review impact to value stream metrics (individual events and
overall)
Review next quarter events
Review changes in business environment
Communicate results
Update value stream as required
Update implementation plan as required
Address resistance and sustainment issues
Value Stream Process
Additional Tips for Success
Capture as you go:
Establish a time each day for Leadership to visit the workshop
Status update
Ask questions
Barrier busting
Capture at the end of each day:
Issues
Acronyms / terminology
Parking Lot issues
Action items
Lessons Learned
Agenda for next day
Champion summarization for Leadership at end of each day (email):
Team accomplishments for the day
Agenda for next day
Customer Need:
Stapled pages
A Simple Example
Info: Location of stapler Info: Where to place staple
Pick Up Paper
Time: 1 sec.
Distance: 0
Walk to Stapler
Time: 5 sec.
Distance: 20 ft.
Staple Paper
Time: 2 sec.
Distance: 0
Excess Travel
Walk to Desk
Time: 5 sec.
Distance: 20 ft.
Put Down Paper
Time: 1 sec.
Distance: 0
Total Time: 14 sec.
Total Dist: 40 ft.
Value Added Time: 4 sec.
Value Added Dist: 0
Value Added Time: 28%
Emergency Room Current
State
Treatment
Information
Patient
Attending
Nurse
Hospital
Records
Attending
Physician
Patient history
Vital Statistics
Insurance
Company
Treatment
Information
Information Flow
Insurance Info
Nature of Injury
Patient ready
for Treatment
Available Room
Patient history
Patient Info
Patient history
Vital Statistics
Diagnosis &
Supply Needs
Patient history
Vital Statistics
Diagnosis &
Departing Inst.
Wait
Out Patient
Registration
Go to
Waiting
Area
Wait
Taken to ER
Room
Wait
Nurse
Examines
Patient
Wait
Doctor
Examines
Patient
Wait
Nurse brings
Medical
Supplies
Departing
Instructions
Material Flow
Wait
Doctor Treats
Patient
Departing
Instructions
Patient Goes
Home
Emergency Room Current
Add data for Material and Information Flows
State
Treatment
Information
Attending
Nurse
Hospital
Records
Patient
Treatment
Information
Insurance Info
Nature of Injury
Patient history
Vital Statistics
Patient Info
Patient history
Vital Statistics
Information Flow
Patient ready
for Treatment
Available Room
Patient history
Diagnosis &
Supply Needs
Patient history
Vital Statistics
Diagnosis &
Departing Inst.
Wait
Go to
Waiting
Area
Out Patient
Registration
Insurance
Company
Attending
Physician
Patient his tory
Vital Statistics
Taken to ER
Room
Wait
Wait
Nurse
Examines
Patient
Doctor
Examines
Patient
Wait
Departing
Instructions
Nurse brings
Medical
Supplies
Doctor Treats
Patient
Departing
Instructions
MAT'L FLOW
Trigger:
Done:
Yield:
Flow Time:
MCT:
Queue Time:
# of People:
MAT'L FLOW
Trigger:
Done:
Yield:
Flow Time:
MCT:
Queue Time:
# of People:
M AT'L FLOW
Trigger:
Done:
Yield:
Flow Time:
MCT:
Queue Time:
# of People:
M AT'L FLOW
Trigger:
Done:
Yield:
Flow Time:
MCT:
Queue Time:
# of People:
MAT'L FLOW
Trigger:
Done:
Yield:
Flow Time:
MCT:
Queue Time:
# of People:
MAT'L FLOW
Trigger:
Done:
Yield:
Flow Time:
MCT:
Queue Time:
# of People:
MAT'L FLOW
Trigger:
Done:
Yield:
Flow Time:
MCT:
Queue Time:
# of People:
M AT'L FLOW
Trigger:
Done:
Yield:
Flow Time:
MCT:
Queue Time:
# of People:
INFO FLOW
From/To:
Frequency:
Yield Rate:
Queue Time:
FTE's:
TCT:
MCT:
INFO FLOW
From/To:
Frequency:
Yield Rate:
Queue Time:
FTE's:
TCT:
MCT:
INFO FLOW
From/To:
Frequency:
Yield Rate:
Queue Time:
FTE's:
TCT:
MCT:
INFO FLOW
From/To:
Frequency:
Yield Rate:
Queue Time:
FTE's:
TCT:
MCT:
INFO FLOW
From/To:
Frequency:
Yield Rate:
Queue Time:
FTE's:
TCT:
MCT:
INFO FLOW
From/To:
Frequency:
Yield Rate:
Queue Time:
FTE's:
TCT:
MCT:
INFO FLOW
From/To:
Frequency:
Yield Rate:
Queue Time:
FTE's:
TCT:
MCT:
INFO FLOW
From/To:
Frequency:
Yield Rate:
Queue Time:
FTE's:
TCT:
MCT:
0
15-30
0
30-60
5
0
5
5
0
30-120
10-15
0
30
10-15
0
0
0
5
Material Flow
Wait
15-30
15-30
15-30
0
MATERIAL FLOW
Patient Goes
Home
INFORMATION FLOW
Queue = 125-275 min
5
0
Touch =70-110 min
Total Cycle Time = 3.4 to 6.3 hrs
Touch Time = 1.2 to 1.8 hrs
Queue Time = 2.0 to 4.5 hrs
9 Process Steps
6 Wait Points
Remember
The Value Stream Map is a plan
Helps you get from the current state to the
future state
A good plan creates the opportunity for
success even if you cant see the path to
get there
Pre-Transplant Current Value Stream Map
Undesirable
Effects (UDEs)
Total Leadtime: 270 days (ave.)
VSM
Example
Used with permission from UM Health System
Pre-Transplant Future Value Stream Map
Kaizen Bursts
(changes to Flow)
Total Leadtime: <<90 days (ave.)
67%
Used with permission from UM Health System
Types of Lean
Events
Value Stream
5S
Kaizen
Project
Do-it
Burst
Kaizen event
3-5 days
Scope significant - can be cross-functional
6-12 people or more
Quick impact
80% of improvements implemented during
event
20% of improvements implemented within 30
days
Implementation per prior management
agreement
Typical Kaizen Schedule
Day
Day
Day
Day
Day
1
2
3
4
5
Training
Analyze Current Process
Define New Process
Test & Finalize New Process
Report Out & Celebrate
Some of these days may be reduced to hours, depending
on the scope of the efort
Burst Event
Short duration (2-4 hours)
Minimal scope/Single issue
4-6 people
Quick impact
Intended for relatively simple tasks
Do-It
Very short duration (1-2 hours)
Simple scope/Single task
1-3 people
Immediate impact
No decisions or management
intervention required
Project
Long duration (3-12 months)
Complex scope
Multiple departments/functions
Long-term impact
5S
Typically a 3-5 day event
Provides workplace organization
6-12 people
Provides framework for monitoring
& continuous improvement
How do we know which
event type to use?
Type of activity
Scope of process/task
Resources required
Dont worry about fitting the event type
into a specific category
Keys to Successful Events
Have the right people in the room
Empower the team to make immediate
changes to the process
Full participation from all team members
Attack process, not people
Agree on measures and how they will be
collected
Review action plan frequently for progress
Questions?
