Improvement Method Olympics – Day 4

Posted by: NHS Horizons - Posted on:

  1. Value stream mapping (method)

Value stream mapping (VSM) allows us to create a detailed visualisation of all steps in our work process or care process. It uses a system of symbols to depict various work activities and information flows. VSM is especially useful to find and eliminate waste. Items are mapped as adding value or not adding value from the standpoint of your customer or patient, with the purpose of rooting out items that don’t add value.

Value stream mapping from NHS Improving Quality, Bringing Lean to Life

2. Kaizen (method)

Kaizen is a Japanese word which literally means “improvement”. Kaizen is understood to be a set of methods that are undertaken to improve processes on all levels, involving people at all levels of the organisation as well as service users.

The main goal of the Kaizen philosophy is to improve quality and productivity while reducing waste. This is achieved through continuous small – and often relatively simple – measures and actions. But when these are made to all levels of organisation and on an ongoing basis, and most importantly when they are done correctly, these small measures can lead to big changes and major improvements in quality and productivity, as well as create a better work environment.

Here are the Kaizen steps as set out in the book Toyota Kaizen Methods: Six Steps to Improvement

  • Step 1: Discover improvement potential
  • Step 2: Analyse current methods
  • Step 3: Generate original ideas
  • Step 4: Develop an implementation plan
  • Step 5: Implement the Plan
  • Step 6: Evaluate the New Method
Circle showing the six steps of Kaizen

From The Knowledge Academy

3. Safety I and Safety II (method)

A Safety I perspective takes harm or accidents as the focus point and tries to prevent bad things from occurring. Safety-II puts emphasis on ensuring that as much as possible goes right, expanding much more than the area of incident prevention and promoting a comprehensive safety management over a simple risk assessment.

In a more simplified way, Safety II seeks to dislodge the interest from ’what goes wrong’ to ‘what goes right’, reminding that safety management should not only be reactive, but proactive as well. An accident investigation under the scope of Safety-I is to identify the causes of adverse outcomes, while risk assessment aims to determine their likelihood. On the contrary, accident investigations under Safety-II seek to understand how things usually go right, as this forms the basis for explaining how things go wrong, while risk assessment aims ‘to understand the conditions where performance variability can become difficult to control’.

Safety-II does not seek to supersede what is already being done, but to complement the current approach, which means that many of the existing practices can continue to be used, just ‘with a different emphasis’. However, one cannot exist without the other.


Safety II in practice in radiotherapy - a new approach to analyse the safety of care

Source: Sylvie Theller and Valerie Vassent

Further reading

4. McKinsey 7S (method)

The McKinsey 7S framework sets out seven elements that we need to align in an organisation for it to be successful. The model can be used in multiple contexts, for instance to examine the likely effects of future changes in the organisation, or to align departments and processes during a restructure or redesign project. We can also apply the McKinsey 7-S model to elements of a team or a project.

There are three “hard” elements:

  • Strategy: this is your organization’s plan for achieving its mission and building and maintaining a healthy future
  • Structure: this how your organisation is structured (that is, how departments and teams are structured, including who reports to whom).
  • Systems: the daily activities and procedures that people use to get the job done.

These are relatively easy to identify, and leaders can influence them directly.

There are four “soft” elements:

  • Shared values: these are the core values of the organisation, as shown in its corporate culture and general work ethic.
  • Style: the style of leadership adopted.
  • Staff: the people in the organisation and their general capabilities.
  • Skills: the actual skills and competencies of the people in the organisation.

These can be harder to describe, less tangible, but just as important as the hard elements if the organization is going to be successful.

Placing shared values in the centre of the model emphasizes that these values are central to the development of all the other critical elements

Diagram centre circle text says 'shared values' interconnecting lines to other circles with text structure, systems, styles, staff, skills, strategy

From: MindTools