(Improvements in Methods)

Although a practice may benefit from individual or on one shot improvements. A practice must look at a general level unlock the potential for exponential improvements. Value Analysis (VA) is a means of facilitating this. VA looks at every step, action and process. VA looks for any waste or action that adds no value. VA will create efficiency and potentially, reduced costs. VA uses a Operations Improvement Sheet and empowers an individual to double productivity.

When adapting this to general practice MODAPTS has been dropped to simplify its implementation. Instead it relies on judgement of practice staff. In practices that have a good culture this is more valuable than collecting metrics.

Note: This key relies heavily on the over keys, therefore if you are employing each key in order then it may be wise to leave this key until the end.

SECOND NOTE: It is of upmost importance that this key is not abused. Abuse of this key can fundamentally damage the culture and well being of a practice. Specifically if metrics come before people. It is also conducive to the ‘Pace Setting Leadership Style’.

Level 1

At level one there is no interest in VA and a shotgun method is preferred to implementing improvements. Improvements are being made in SGAs however, improvements made here are local to group and can tend to be orientated to making the job easier rather than those that improve a process as a whole. To move to level 2 the changes that have to happen are in a practices culture. Until the culture changes there will be little or no improvement. To this end provide training, raise in huddles, improvement events and meetings a system wide view. This should focus on promoting:

• Five W’s and one H (Why, What, When, Where and How)
• Importance of recording how long long a step, process or system takes.
• How those closest to the work being done are in the best position to identify improvements.
• To look at the above in the context of the entire practice.
• To look at each operation in context of the entire process.
• Make improvements systematically.

Level 2

• All processes are broken down (systematically) into their components and each component assessed to see if it adds value.
• As wasteful components are discovered they are reviewed either using an improvement event or an SGA. Which ever process is followed a corrective action should be implemented with lead to implement the changes to deadlines and report the results. As found on the Operations Improvement Sheet.
• Ask the 5 Whys for every process.
• Provide training for identifying waste
• Provide training for finding areas of improvement

Level 3

• The Operations Improvement Sheets are customised by the team. They are tailored to specifics of the various roles within the practice.
• There is a 30% improvement in processes across the practice. This includes cleaning and organising.
• Development of corrective plans happens naturally, habitually.
• Remove productivity obstacles that come to light.
• The practice can run on autopilot, will automatically complete Value Analysis, SGA’s and Quick Changeovers.

Level 4

At Level 4 there is a 50% overall improvement (step reduction, waste elimination) across the practice.

• Only improvements that have been identified that have actual value (see Identifying Waste and Finding Areas of Improvement)
• Coordinate efforts between teams. Further enhancements can be found in communication, task creation (recording all the information needed for those actioning the task)
• Introduce new tools (such as AI) to increase improvements or identify improvements missed by the practice or offer office automation. These should only be used once all other methods have been exhausted.

Level 5

• Systematic change occurs at all levels between teams and there is a two thirds improvement in all processes.

Final Note

Care needs to be taken the improvements made do not result in inflexibility of the practice (See Quick Changeover Systems).