Appendix B. High Reliability Organization Learning Network Operational Advice From the Exempla Healthcare Site Visit (continued)

1. ___ Select area and topic.
2. ___ Determine coleader and team members.
3. ___ Complete Team Charter.
4. ___ Ask a few hard questions, e.g.:
   —Will this team improve your value stream?
   —Will this team improve the area's key measurements?
5. ___ Prepare the business case for this improvement event.
6. ___ Define the objectives and deliverables expected from the event team.
7. ___ Define the measurements and targets for the team. Make sure there are only three or fewer key measurements.
8. ___ Review action deliverables, measurements, and targets with the external or internal consultant. Revise if needed.

Details

9. ___ Schedule event team meetings for next 2 weeks.
10. ___ Schedule meeting to educate stakeholders (ssc/ managers/directors of involved departments).
11. ___ Send invitations to join to team members.

Schedule Team Meetings

1. ___ Determine actual customer demand.
2. ___ Determine backlog or wait times.
3. ___ Determine actual output.
4. ___ Determine total hours worked to create this output.
5. ___ Calculate productivity: output/total hours worked.
6. ___ Calculate relevant cycle times.
7. ___ Determine top 5–10 problems.
8. ___ Review occurrences/complaints in the past 12 months, if applicable.
9. ___ Review customer and patient satisfaction comments. List top five issues from complaints, rework, and delays.

Communication

10. ___ Post announcement about rapid improvement event date, time, and focus.
11. ___ Put up a blank flipchart to get suggestions/feedback. Ask questions, clarify, and put these ideas on a list.
12. ___ Discuss rapid improvement event in staff meetings. Explain objectives, measurements, and targets.
13. ___ Review and confirm team members. Confirm entire week commitment.

Team Meeting

14. ___ Team introductions
15. ___ Why are we here? What is the scope?
16. ___ Lean orientation
17. ___ Event schedule, measurements, targets, and action deliverables
18. ___ Business case and Team Charter
19. ___ Tasks to team for data preparation

1. ___ Resolve open items.
2. ___ Define clearly the boundaries of the event:
   —Who are the customers? What are the outputs? What triggers the area to do something for a customer?
   —Who are the suppliers? What are the inputs?
   —Prepare additional flowcharts, spaghetti diagrams, layouts, and time studies, as needed.
3. ___ Brief the consultant.
4. ___ Prepare supplies and logistics for the team:
   —Locations and schedules
   —Food, supplies

Team Meeting

5. ___ Review measurements, targets, and objectives.
6. ___ Review data collected to date.
7. ___ Ask for feedback; try to address concerns.
8. ___ Reinforce what's in it for them.
9. ___ Establish group norms.
10. ___ Discuss roles of team members during week.
11. ___ Reconfirm scheduled commitments with each team member, supervisor, etc.