August 16, 2024 • 17 mins
In this month’s episode of “Lab Medicine Rounds,” Justin Kreuter, M.D., interviews Jessica Stellmaker on creating a culture of continuous improvement using Kaizen events.
Timestamps:
0:00 Intro
00:40 What is a kaizen event?
04:01 Kaizen week
06:28 Create a culture of continuous improvement
09:54 Resources
11:31 Fail point
13:15 Impacts on laboratory functions
17:02 Outro
Resources:
Continuous Improvement: Kaizen Events - Insights (mayocliniclabs.com)
For additional learning:
- Flug J, Stellmaker J, Sharpe R, et al. Kaizen Process Improvement in Radiology: Primer for Creating a Culture of Continuous Improvement. RadioGraphics, 42(3), 919-928.
- Flug J, Stellmaker J, Tollefson C, et al. (2022). Improving Turnaround Time in a Hospital-based CT Division with the Kaizen Method. RadioGraphics, 42(E125-E131).
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
(bright music)
- This is "Lab Medicine Rounds",
a curated podcast for physicians,
laboratory professionals, and students.
I'm your host, Justin Kreuter,
a transfusion medicine pathologist
and assistant professorof laboratory medicine
and pathology at Mayo Clinic.
Today, we're roundingwith Jessica Stellmaker,
(00:22):
an instructor in laboratorymedicine and pathology
and supervisor of the Specimen Operations
and Department of LaboratoryMedicine and Pathology
at Mayo Clinic.
And we're gonna be talkingabout Kaizen Events.
Thanks for joining us today, Jessica.
- Thanks for having me.
- So for our audience out there,
some of them may be savvy to this event.
(00:44):
I know when we were doingsome initial planning,
looking out there
for what some greatconversations would be,
I actually didn't knowwhat a Kaizen Event was.
Can you kinda introducethis to our audience
and then also maybe ifyou could kinda elaborate
on why they're important for laboratories?
- Yeah, absolutely, so alot goes into Kaizen Events.
(01:07):
I think starting with,what is a Kaizen Event?
Is a pretty good question.
So it encompasses a lot.
I'm gonna start with the people,
'cause our people are super important.
They're the experts at thework that they do every day.
And so what I think KaizenEvents allow us to do as a team,
is bring all of thosestakeholders together
(01:28):
to really look at what that problem is
and find ways to testthings and reduce waste.
And so I always say KaizenEvents are good change,
because it's change that you're making
that you're going to testand make sure that it works
before you just go inand implement something
because you have an idea.
And so during that Kaizen Event Week,
(01:49):
you're gonna be doing lots of PDSAs,
testing a lot of different ideas out,
using data, obviously,seeing what works better
for the process and flowand how do you reduce waste.
I think that's probably oneof the biggest things too,
is teaching people along the way,
all of the waste that existsin all of our processes.
And then giving them thetools and the resources
(02:12):
to then reduce that waste
and have the time to really focus on it
and have a chance to lookat things differently
and then try different things
and find what really ishelpful to those processes.
It is all about processes.
We try to take the focus off people,
'cause our people are gonna be successful
if our processes are good.
(02:33):
And so that's kinda the focus.
How do we make better processes?
How do we reduce waste?
How do we get our peopleinvolved, the ones doing the work?
So that they can test and see,
it really adds the buy-in to it, right?
We talk about change management,
change management's builtright into Kaizen Events,
'cause you have the people there.
The communication, the linksbetween everybody within,
(02:55):
you know, the stakeholders.
And it's just a really good way
of bringing about fast change too.
I know sometimes whenyou go into projects,
they can last and last and last,
and a year later, you maybe made a change,
and then we kinda forgotwhat the problem was.
And so you can get a lot donein that week of rapid testing.
(03:16):
- So I'm hearing you,
if I can paraphrase it for the audience.
And let me know if I'm getting this right.
It's sounds like...
'Cause I'm hearing alot of the same language
that I hear in some of the thing,
like you brought up PDSA,
the Plan-Do-Study-Act cyclesthat we might go through.
You talking about bringingin all the stakeholders
(03:38):
to the process.
You talk about theimportance of communication,
the reduction of waste.
A lot of those I thinkthat some of our audience
may be familiar with as far as topics
within quality improvement or tactics,
strategies on how to navigate it.
- I love that.
- [Justin] Oh.- Yeah, I love that.
(03:59):
- Is this a overarching,
like let's bring allthese components together
and how do we bring that all to bear?
- Yes, I love it.
That's kind of bringingeverything together,
all those tools and the people
and then doing it just more efficiently.
It is fast change, it is rapid,
but it's change that isbetter for the processes
(04:22):
and the people.
- And I think I heard you also say like
the Kaizen Week, right?
Is that something about howthese tools are brought to bear?
Is there's a certain time component
that this is operating in?
- Yeah, perfect question.
So usually a Kaizen Event isheld within about five days.
(04:45):
I've done Kaizen Events toothat are two or three days long.
It depends on how much waste there is
and what you're trying to tackle.
If it's a specific, I alwayssay if it's a specific waste
and you kinda know where it's coming from,
you can really tackle thatprobably in two or three days.
If you're starting out in an area
and there's a lot of waste
and there's just a lot to look at,
then I tend to go with the five days.
(05:05):
I do do some pre-work
and post-work in theKaiser Events that I do.
I found that to be very helpful
in doing some of the teaching
'cause that's kind of mygoal along the way too
is to teach all of this andthe coaching piece of it
and the tools along the way
and bring everybody along on that journey.
And so the pre-work I usually do is,
you know, really diving intowhat is the actual problems.
(05:27):
We're trying to solve what is the waste
that we're trying to eliminate?
If we need to do value stream mapping,
we'll do that before we go intothat five-day Kaizen Event.
Really getting that rootcause analysis done.
And then that way,
you can go into thefive days ready to test
and you can get a lot moredone in those five days.
I've ran Kaizen Events
where we've tested up to 60different things in a week.
(05:50):
So it's rapid,
it is good.
And then usually I do some post-work too
on the control plan.
Okay, now that we'veimplemented these new processes
and these new ways of doing things,
how are we gonna keep that going?
Who do we need to train?
What do we need to update for SOPs?
Things like that.
And really put thatcontrol plan into place.
(06:13):
- I was really fascinatedto hear you talking about
and unpack that about thatpre-work and post-work, right?
'Cause I think a lot of us
are used to doing quality improvement
and thinking about quality improvement
as this is the thing in frontof us that we're focusing on.
But I think what you'rehighlighting for everybody
is the importance of settingourselves up for success,
(06:35):
such as, as you elaborated,
identifying what is theactual specific problem.
But then also I love thiskind of almost like, you know,
if we're use like a baseball analogy,
like the follow throughon the swing, right,
of looking at afterwards
like how do we keep this going
versus that was goodfor a week, we did it,
but how to keep thatchange being successful.
(06:58):
I'm curious about what are your thoughts?
I mean, you obviously, Ithink you're supervisor
of very busy complex laboratory setting.
How do you kind of, you know,
I'm curious for how youcould talk to our audience
about how you create that kind of culture
(07:21):
of continuous improvement
without everybody justfeeling a lot of burnout.
If you're talking about pre-work,
setting yourself up for success,
these rapid dealing with60 changes at a time
and then post-op,
I feel like I need to gohave a break right now.
(07:43):
How do you hold this off?
- Good question.
I really believe that theway that I coach and lead
and develop people
and empower people brings thebuy-in into all that, right?
This isn't me coming in and saying,
"This is what you need to do
(08:04):
and here's the change we're gonna make."
This is change that iscoming from our people
that are actually doing the work.
It's their processes thatwe're trying to improve.
And so they see that it's better for them
and it works better
and it takes away a lot ofthose pebbles in their shoes
or things they didn'tunderstand that were done,
the reason they were done before
and why they just kept doing 'em,
'cause that's how we'vealways done 'em, right?
(08:24):
And this was their opportunity to come in
and have a say in that work that they do.
It builds a culture where
they get to be a partof improving their work
and they get a say in their work,
and it gets them excited again about,
"Hey, this isn't so bad anymore.
It's working."
We get time with our patients
(08:45):
or whatever it is thatyou're trying to do.
I've done 'em all over Mayo Clinic,
but we aren't losing as many specimens.
I mean, it's whatever you're measuring,
but it just, I think thatchange management is built into
that sustainability and that control plan,
and then it gets people excited about it.
We not only do Kaizens here,
(09:06):
and I'm going on my third onejust in a year and a half.
We also have an improvementboard where our staff,
and I have 83 staffunderneath me right now
have the opportunity to,I call 'em Kaizen cards.
So they fill out Kaizen cardsif they are seeing something
that's not working in thearea that they're working.
And the three questions we ask is,
what problem are you trying to solve?
(09:26):
If they have some data surroundinghow often it's happening
or when it's happening,we like to hear that.
It helps us kind ofinvestigate a little bit more,
and then if they do have anyideas on how to make it better,
we have them put that on there too.
And so that's another avenue of
how we get people involvedin continuous improvement.
And I think the change that is difficult
(09:47):
for people is the changethat's forced upon them
that doesn't really maketheir processes better,
where this is change
that actually makes the processes better.
And so I think that is a key,
is it better for the people?
And if it is, they're gonna buy-in
and they're gonna do it'cause it makes it easier.
It's less frustrating.
So it just, I think,
(10:08):
I'm pretty sure that'swhere it comes from,
the buy-in and the control plan.
- I love that,
and I think that you justgave me a new question
to be asking as I look atquality improvement projects
and how we kinda go about these efforts.
If I'm critical of myself,
sometimes there are cases
(10:28):
where it sometimes feellike there's change
that's implemented justbecause it's a change.
That doesn't actually get tothe heart of what the issue is.
Which is why this conversationis so fascinating.
I'm curious for our audiencethat may be listening
to this that, you know, work outside Mayo
(10:48):
and other institutions.
Are there resources that you recommend
that are out there availablethat people can go to
to learn more aboutKaizen and the process?
- Absolutely.
I mean, from books to organizations to...
(11:11):
I'm kind of a self-taught learner myself.
The quality academy has a lot.
I actually learned a lot through there
and some of the people that were,
have been my mentors over the years.
But really self-taught.
A lot of good books out there.
I think one of probablythe difficult thing
about Kaizens is,
(11:33):
I get the question all thetime, "How can we do these?"
And you can't just go out and do 'em.
Facilitators that have experience
are pretty important in this
because there's a lot ofcoaching that goes into it.
Like you said, you don't want just changes
to start happening, right?
You gotta guide those, askthe powerful questions,
get to the root cause, keep digging in.
(11:53):
And so that facilitator is so important
to running impactful Kaizens.
Usually when I train or do them,
I kinda follow a processof see one, help with one,
do one with some coaching on the side,
and then if you feel comfortable,
we'll kinda let you go out on your own.
But it is a process and it'sa lot to lead the big groups
(12:17):
and keep them focusedand all that kinda stuff.
But the facilitators are veryimportant in Kaizen Events
and having some experience behind them.
- I think we'll work with you
and get a couple maybe resources
that we'll put in the show links here
as far as for wherepeople might get started,
becoming kind of like thisself-initiated education.
(12:38):
And I'm curious then,
you know, as you've participatedin several of these,
is there kind of a commonfail point that you think?
So just to kinda put in the audience,
if there's somebody outthere in the audience
that's interested intaking these next steps,
gets a little educated,partners with a coach,
(12:59):
is there a common fail point
that you just want to kinda heads up,
be on the lookout,
here's something I struggledwith maybe, for example?
- I think there's a fewthings to look out for.
If you already have a solution,
then Kaizen Events aren't for that.
Like, that's then justan implementation, right?
(13:20):
It's not process improvement.
So if somebody comes to you and say,
"Hey, I wanna implement this.
Can you just do a Kaizen Event?"
That's not really whatKaizens are for, right?
You're going in, you'rebringing people to the table.
You're talking about the value stream maps
where the waste is, howcan we eliminate 'em?
Going in with no solutionsis really the key there.
(13:40):
And letting people kind of workthrough the problem solving
and solving and have a say in that.
I think the other thingto be very aware of is,
there's gonna beresistance at the beginning
'cause this is new to a lot of people,
but by day two or three,
they're usually like,"Oh this is amazing."
(14:00):
So you gotta really persevere through
and coach through someof those that resistance
and the difficult firstcouple days where it's new
and they're learning.
Usually I get everybodythere, and they're on board.
And they're like, "Okay, this is great.
Why we haven't been doing this forever?"
(14:20):
So.
- Well, you're good at navigatingchange management clearly.
What do you think of,
you know, if you lookat your laboratory now
versus if you go kind of back a few years
kind of pre-Kaizen,
like we were talking abouta lot of these elements
or tools that we've been aware of,
but you're really kind ofbringing these things together
(14:43):
in kind of a overarching holistic way.
How has bringing the holistic,all these tools together?
How is this kind of impacted the way
that your laboratory functions?
- Good question, so we use data.
I've measured a lot.
And data's important more forthe leadership side, right?
(15:04):
Our people aren't reallyso invested in that data.
Obviously, they wanna do agood job for our patients
and get the results to them,
but they're really,
they're focusing on howwell does it work for them.
And so there's a,
you know, I go back when I started
in specimen operation 16 months ago
and it was a tad bit chaotic.
I mean, we're trying to deliver40 to 60,000 specimens a day
(15:30):
to the labs all over Mayo Clinic.
And we wanna do that asefficiently as we can
and as well as we can.
And so putting some,
just some of this Kaizen work into play
and building better processes,
our lab, our culture, ourpeople are just happier
(15:52):
that you go out on the floor,they love coming to work,
they're laughing,
we've built that commitmentto the lab and to our vision,
which is to service our patients
and do what we need to doto get them the answers
that they need to get or the physician
so they can make their decisions faster
(16:13):
and better for the patients.
But I think the culture is the big thing
and getting everybody alignedwith the direction we're going
and give them some guidance in that area
and then let them work towards that
has been pretty effective.
As well as if you comeout our areas organized,
you know exactly what needs to be done,
'cause we're using, youknow, like the 5S tools
(16:36):
and things like that in someof our Kaizens to clean up
and give direction via visual management,
which is super importantwhen you have 80 staff
and they're rotating throughfive different pods of work,
and having to know what they need to do.
And so it just makeseverything flow better as well,
which is really what we want.
(16:57):
And so, but we are measuring too,
like the one Kaizen that wedid in our post archiving.
So we save everythingthat goes out to the labs
that comes back to us so thatif you need to rerun tests
or do stuff like that,we can pull them again
and get those specimensback out to the labs.
And it was taking that area,that pod of work to pull
(17:17):
and get those specimens back to the labs
for rerunning tests aboutsometimes up to over 24 hours.
We're down to under 30 minutes.
So you request and we got itback out to you in no time.
- Wow. (laughs)
- And that was all the result
of the great stuff in thearea that did the Kaizen
and went through the process
(17:37):
and really improved howthey were doing the work,
which is, that's what happens.
I don't know how excitedthey are about that time,
but they're excited thattheir area's no longer chaotic
and it's calm and theyknow exactly what to do
and they're getting the work done.
- Wow, so if I go back tosomething I said earlier
in our conversation about like,
you know, bringing allthese tools to bear,
(18:02):
is this just burning everybody out?
It actually sounds justexactly the opposite.
And I guess the sense is,
it's the opposite becausebringing them together together
creates an effective change.
And I guess to your point,
an effective change thatis empowering people
(18:23):
and it's creating a processthat is better for the people.
- Yeah, and you mightfeel a little bit chaotic
in the moment when you'rerunning the events,
and it can be 'causeyou're doing rapid testing.
Once you get past that though,the end result is always...
I mean, I've done 25, 30 of these,
you always get some sortof good result out of them.
(18:45):
They're all different results, right?
But there's something that comes out of it
that makes it better for thepeople and for our patients.
And that's really the goal.
And then you just keep working on it
and it's just continuous improvement.
And once people see that,
they get excited about thecontinuous improvement,
then it doesn't really become that burden,
kinda takes some of the way.
I actually just had oneof my leads say to me
the other day that she'slike, "It's so quiet and calm.
(19:07):
I'm a little bit bored."
I'm like, "Careful what you ask for."
(laughs)
We got lots more to work on.
More opportunities for improvement, so.
- And on that note,
we've been routing with Jessica Stellmaker
talking about Kaizen Events.
We really appreciate you takingthe time to talk about this,
introduce this concept to us.
(19:27):
Thank you so much for joining us, Jessica.
- Yeah, thanks for having me.
- To all of our listeners,thank you for joining us today.
We invite you to share your thoughts
and suggestions via emailto mcleducation@mayo.edu.
If you've enjoyed thispodcast, please subscribe.
Until our next rounds together.
We encourage you to continueto connect lab medicine
(19:48):
and the clinical practice througheducational conversations.
(bright music)
(bright music)
- This is "Lab Medicine Rounds",
a curated podcast for physicians,
laboratory professionals, and students.
I'm your host, Justin Kreuter,
a transfusion medicine pathologist
and assistant professorof laboratory medicine
and pathology at Mayo Clinic.
Today, we're roundingwith Jessica Stellmaker,
(00:22):
an instructor in laboratorymedicine and pathology
and supervisor of the Specimen Operations
and Department of LaboratoryMedicine and Pathology
at Mayo Clinic.
And we're gonna be talkingabout Kaizen Events.
Thanks for joining us today, Jessica.
- Thanks for having me.
- So for our audience out there,
some of them may be savvy to this event.
(00:44):
I know when we were doingsome initial planning,
looking out there
for what some greatconversations would be,
I actually didn't knowwhat a Kaizen Event was.
Can you kinda introducethis to our audience
and then also maybe ifyou could kinda elaborate
on why they're important for laboratories?
- Yeah, absolutely, so alot goes into Kaizen Events.
(01:07):
I think starting with,what is a Kaizen Event?
Is a pretty good question.
So it encompasses a lot.
I'm gonna start with the people,
'cause our people are super important.
They're the experts at thework that they do every day.
And so what I think KaizenEvents allow us to do as a team,
is bring all of thosestakeholders together
(01:28):
to really look at what that problem is
and find ways to testthings and reduce waste.
And so I always say KaizenEvents are good change,
because it's change that you're making
that you're going to testand make sure that it works
before you just go inand implement something
because you have an idea.
And so during that Kaizen Event Week,
(01:49):
you're gonna be doing lots of PDSAs,
testing a lot of different ideas out,
using data, obviously,seeing what works better
for the process and flowand how do you reduce waste.
I think that's probably oneof the biggest things too,
is teaching people along the way,
all of the waste that existsin all of our processes.
And then giving them thetools and the resources
(02:12):
to then reduce that waste
and have the time to really focus on it
and have a chance to lookat things differently
and then try different things
and find what really ishelpful to those processes.
It is all about processes.
We try to take the focus off people,
'cause our people are gonna be successful
if our processes are good.
(02:33):
And so that's kinda the focus.
How do we make better processes?
How do we reduce waste?
How do we get our peopleinvolved, the ones doing the work?
So that they can test and see,
it really adds the buy-in to it, right?
We talk about change management,
change management's builtright into Kaizen Events,
'cause you have the people there.
The communication, the linksbetween everybody within,
(02:55):
you know, the stakeholders.
And it's just a really good way
of bringing about fast change too.
I know sometimes whenyou go into projects,
they can last and last and last,
and a year later, you maybe made a change,
and then we kinda forgotwhat the problem was.
And so you can get a lot donein that week of rapid testing.
(03:16):
- So I'm hearing you,
if I can paraphrase it for the audience.
And let me know if I'm getting this right.
It's sounds like...
'Cause I'm hearing alot of the same language
that I hear in some of the thing,
like you brought up PDSA,
the Plan-Do-Study-Act cyclesthat we might go through.
You talking about bringingin all the stakeholders
(03:38):
to the process.
You talk about theimportance of communication,
the reduction of waste.
A lot of those I thinkthat some of our audience
may be familiar with as far as topics
within quality improvement or tactics,
strategies on how to navigate it.
- I love that.
- [Justin] Oh.- Yeah, I love that.
(03:59):
- Is this a overarching,
like let's bring allthese components together
and how do we bring that all to bear?
- Yes, I love it.
That's kind of bringingeverything together,
all those tools and the people
and then doing it just more efficiently.
It is fast change, it is rapid,
but it's change that isbetter for the processes
(04:22):
and the people.
- And I think I heard you also say like
the Kaizen Week, right?
Is that something about howthese tools are brought to bear?
Is there's a certain time component
that this is operating in?
- Yeah, perfect question.
So usually a Kaizen Event isheld within about five days.
(04:45):
I've done Kaizen Events toothat are two or three days long.
It depends on how much waste there is
and what you're trying to tackle.
If it's a specific, I alwayssay if it's a specific waste
and you kinda know where it's coming from,
you can really tackle thatprobably in two or three days.
If you're starting out in an area
and there's a lot of waste
and there's just a lot to look at,
then I tend to go with the five days.
(05:05):
I do do some pre-work
and post-work in theKaiser Events that I do.
I found that to be very helpful
in doing some of the teaching
'cause that's kind of mygoal along the way too
is to teach all of this andthe coaching piece of it
and the tools along the way
and bring everybody along on that journey.
And so the pre-work I usually do is,
you know, really diving intowhat is the actual problems.
(05:27):
We're trying to solve what is the waste
that we're trying to eliminate?
If we need to do value stream mapping,
we'll do that before we go intothat five-day Kaizen Event.
Really getting that rootcause analysis done.
And then that way,
you can go into thefive days ready to test
and you can get a lot moredone in those five days.
I've ran Kaizen Events
where we've tested up to 60different things in a week.
(05:50):
So it's rapid,
it is good.
And then usually I do some post-work too
on the control plan.
Okay, now that we'veimplemented these new processes
and these new ways of doing things,
how are we gonna keep that going?
Who do we need to train?
What do we need to update for SOPs?
Things like that.
And really put thatcontrol plan into place.
(06:13):
- I was really fascinatedto hear you talking about
and unpack that about thatpre-work and post-work, right?
'Cause I think a lot of us
are used to doing quality improvement
and thinking about quality improvement
as this is the thing in frontof us that we're focusing on.
But I think what you'rehighlighting for everybody
is the importance of settingourselves up for success,
(06:35):
such as, as you elaborated,
identifying what is theactual specific problem.
But then also I love thiskind of almost like, you know,
if we're use like a baseball analogy,
like the follow throughon the swing, right,
of looking at afterwards
like how do we keep this going
versus that was goodfor a week, we did it,
but how to keep thatchange being successful.
(06:58):
I'm curious about what are your thoughts?
I mean, you obviously, Ithink you're supervisor
of very busy complex laboratory setting.
How do you kind of, you know,
I'm curious for how youcould talk to our audience
about how you create that kind of culture
(07:21):
of continuous improvement
without everybody justfeeling a lot of burnout.
If you're talking about pre-work,
setting yourself up for success,
these rapid dealing with60 changes at a time
and then post-op,
I feel like I need to gohave a break right now.
(07:43):
How do you hold this off?
- Good question.
I really believe that theway that I coach and lead
and develop people
and empower people brings thebuy-in into all that, right?
This isn't me coming in and saying,
"This is what you need to do
(08:04):
and here's the change we're gonna make."
This is change that iscoming from our people
that are actually doing the work.
It's their processes thatwe're trying to improve.
And so they see that it's better for them
and it works better
and it takes away a lot ofthose pebbles in their shoes
or things they didn'tunderstand that were done,
the reason they were done before
and why they just kept doing 'em,
'cause that's how we'vealways done 'em, right?
(08:24):
And this was their opportunity to come in
and have a say in that work that they do.
It builds a culture where
they get to be a partof improving their work
and they get a say in their work,
and it gets them excited again about,
"Hey, this isn't so bad anymore.
It's working."
We get time with our patients
(08:45):
or whatever it is thatyou're trying to do.
I've done 'em all over Mayo Clinic,
but we aren't losing as many specimens.
I mean, it's whatever you're measuring,
but it just, I think thatchange management is built into
that sustainability and that control plan,
and then it gets people excited about it.
We not only do Kaizens here,
(09:06):
and I'm going on my third onejust in a year and a half.
We also have an improvementboard where our staff,
and I have 83 staffunderneath me right now
have the opportunity to,I call 'em Kaizen cards.
So they fill out Kaizen cardsif they are seeing something
that's not working in thearea that they're working.
And the three questions we ask is,
what problem are you trying to solve?
(09:26):
If they have some data surroundinghow often it's happening
or when it's happening,we like to hear that.
It helps us kind ofinvestigate a little bit more,
and then if they do have anyideas on how to make it better,
we have them put that on there too.
And so that's another avenue of
how we get people involvedin continuous improvement.
And I think the change that is difficult
(09:47):
for people is the changethat's forced upon them
that doesn't really maketheir processes better,
where this is change
that actually makes the processes better.
And so I think that is a key,
is it better for the people?
And if it is, they're gonna buy-in
and they're gonna do it'cause it makes it easier.
It's less frustrating.
So it just, I think,
(10:08):
I'm pretty sure that'swhere it comes from,
the buy-in and the control plan.
- I love that,
and I think that you justgave me a new question
to be asking as I look atquality improvement projects
and how we kinda go about these efforts.
If I'm critical of myself,
sometimes there are cases
(10:28):
where it sometimes feellike there's change
that's implemented justbecause it's a change.
That doesn't actually get tothe heart of what the issue is.
Which is why this conversationis so fascinating.
I'm curious for our audiencethat may be listening
to this that, you know, work outside Mayo
(10:48):
and other institutions.
Are there resources that you recommend
that are out there availablethat people can go to
to learn more aboutKaizen and the process?
- Absolutely.
I mean, from books to organizations to...
(11:11):
I'm kind of a self-taught learner myself.
The quality academy has a lot.
I actually learned a lot through there
and some of the people that were,
have been my mentors over the years.
But really self-taught.
A lot of good books out there.
I think one of probablythe difficult thing
about Kaizens is,
(11:33):
I get the question all thetime, "How can we do these?"
And you can't just go out and do 'em.
Facilitators that have experience
are pretty important in this
because there's a lot ofcoaching that goes into it.
Like you said, you don't want just changes
to start happening, right?
You gotta guide those, askthe powerful questions,
get to the root cause, keep digging in.
(11:53):
And so that facilitator is so important
to running impactful Kaizens.
Usually when I train or do them,
I kinda follow a processof see one, help with one,
do one with some coaching on the side,
and then if you feel comfortable,
we'll kinda let you go out on your own.
But it is a process and it'sa lot to lead the big groups
(12:17):
and keep them focusedand all that kinda stuff.
But the facilitators are veryimportant in Kaizen Events
and having some experience behind them.
- I think we'll work with you
and get a couple maybe resources
that we'll put in the show links here
as far as for wherepeople might get started,
becoming kind of like thisself-initiated education.
(12:38):
And I'm curious then,
you know, as you've participatedin several of these,
is there kind of a commonfail point that you think?
So just to kinda put in the audience,
if there's somebody outthere in the audience
that's interested intaking these next steps,
gets a little educated,partners with a coach,
(12:59):
is there a common fail point
that you just want to kinda heads up,
be on the lookout,
here's something I struggledwith maybe, for example?
- I think there's a fewthings to look out for.
If you already have a solution,
then Kaizen Events aren't for that.
Like, that's then justan implementation, right?
(13:20):
It's not process improvement.
So if somebody comes to you and say,
"Hey, I wanna implement this.
Can you just do a Kaizen Event?"
That's not really whatKaizens are for, right?
You're going in, you'rebringing people to the table.
You're talking about the value stream maps
where the waste is, howcan we eliminate 'em?
Going in with no solutionsis really the key there.
(13:40):
And letting people kind of workthrough the problem solving
and solving and have a say in that.
I think the other thingto be very aware of is,
there's gonna beresistance at the beginning
'cause this is new to a lot of people,
but by day two or three,
they're usually like,"Oh this is amazing."
(14:00):
So you gotta really persevere through
and coach through someof those that resistance
and the difficult firstcouple days where it's new
and they're learning.
Usually I get everybodythere, and they're on board.
And they're like, "Okay, this is great.
Why we haven't been doing this forever?"
(14:20):
So.
- Well, you're good at navigatingchange management clearly.
What do you think of,
you know, if you lookat your laboratory now
versus if you go kind of back a few years
kind of pre-Kaizen,
like we were talking abouta lot of these elements
or tools that we've been aware of,
but you're really kind ofbringing these things together
(14:43):
in kind of a overarching holistic way.
How has bringing the holistic,all these tools together?
How is this kind of impacted the way
that your laboratory functions?
- Good question, so we use data.
I've measured a lot.
And data's important more forthe leadership side, right?
(15:04):
Our people aren't reallyso invested in that data.
Obviously, they wanna do agood job for our patients
and get the results to them,
but they're really,
they're focusing on howwell does it work for them.
And so there's a,
you know, I go back when I started
in specimen operation 16 months ago
and it was a tad bit chaotic.
I mean, we're trying to deliver40 to 60,000 specimens a day
(15:30):
to the labs all over Mayo Clinic.
And we wanna do that asefficiently as we can
and as well as we can.
And so putting some,
just some of this Kaizen work into play
and building better processes,
our lab, our culture, ourpeople are just happier
(15:52):
that you go out on the floor,they love coming to work,
they're laughing,
we've built that commitmentto the lab and to our vision,
which is to service our patients
and do what we need to doto get them the answers
that they need to get or the physician
so they can make their decisions faster
(16:13):
and better for the patients.
But I think the culture is the big thing
and getting everybody alignedwith the direction we're going
and give them some guidance in that area
and then let them work towards that
has been pretty effective.
As well as if you comeout our areas organized,
you know exactly what needs to be done,
'cause we're using, youknow, like the 5S tools
(16:36):
and things like that in someof our Kaizens to clean up
and give direction via visual management,
which is super importantwhen you have 80 staff
and they're rotating throughfive different pods of work,
and having to know what they need to do.
And so it just makeseverything flow better as well,
which is really what we want.
(16:57):
And so, but we are measuring too,
like the one Kaizen that wedid in our post archiving.
So we save everythingthat goes out to the labs
that comes back to us so thatif you need to rerun tests
or do stuff like that,we can pull them again
and get those specimensback out to the labs.
And it was taking that area,that pod of work to pull
(17:17):
and get those specimens back to the labs
for rerunning tests aboutsometimes up to over 24 hours.
We're down to under 30 minutes.
So you request and we got itback out to you in no time.
- Wow. (laughs)
- And that was all the result
of the great stuff in thearea that did the Kaizen
and went through the process
(17:37):
and really improved howthey were doing the work,
which is, that's what happens.
I don't know how excitedthey are about that time,
but they're excited thattheir area's no longer chaotic
and it's calm and theyknow exactly what to do
and they're getting the work done.
- Wow, so if I go back tosomething I said earlier
in our conversation about like,
you know, bringing allthese tools to bear,
(18:02):
is this just burning everybody out?
It actually sounds justexactly the opposite.
And I guess the sense is,
it's the opposite becausebringing them together together
creates an effective change.
And I guess to your point,
an effective change thatis empowering people
(18:23):
and it's creating a processthat is better for the people.
- Yeah, and you mightfeel a little bit chaotic
in the moment when you'rerunning the events,
and it can be 'causeyou're doing rapid testing.
Once you get past that though,the end result is always...
I mean, I've done 25, 30 of these,
you always get some sortof good result out of them.
(18:45):
They're all different results, right?
But there's something that comes out of it
that makes it better for thepeople and for our patients.
And that's really the goal.
And then you just keep working on it
and it's just continuous improvement.
And once people see that,
they get excited about thecontinuous improvement,
then it doesn't really become that burden,
kinda takes some of the way.
I actually just had oneof my leads say to me
the other day that she'slike, "It's so quiet and calm.
(19:07):
I'm a little bit bored."
I'm like, "Careful what you ask for."
(laughs)
We got lots more to work on.
More opportunities for improvement, so.
- And on that note,
we've been routing with Jessica Stellmaker
talking about Kaizen Events.
We really appreciate you takingthe time to talk about this,
introduce this concept to us.
(19:27):
Thank you so much for joining us, Jessica.
- Yeah, thanks for having me.
- To all of our listeners,thank you for joining us today.
We invite you to share your thoughts
and suggestions via emailto mcleducation@mayo.edu.
If you've enjoyed thispodcast, please subscribe.
Until our next rounds together.
We encourage you to continueto connect lab medicine
(19:48):
and the clinical practice througheducational conversations.
(bright music)
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