Chapter 14

Prioritize and Select the Critical Few Improvement Initiatives across the Organization

Everything that can be counted does not necessarily count; everything that counts cannot necessarily be counted.

—Albert Einstein

In Chapter 13, we learned how to categorize projects into JDI, CI, and organization-wide projects. We also learned about selecting filters (criteria) at an organization level, allocating a weight percentage to each filter, and creating operational definitions for the chosen filters. In this chapter, we will learn how to prioritize projects using these filters.

However, just before doing that, let us understand an important but often misunderstood concept: the difference between standard and standardization. Standard is a rule with no deviation (same as a policy), while standardization is a guiding standard that allows teams flexibility to adapt to it in their respective work areas. Cardiologist Robert Wilson, at ThedaCare, describes standard work as “flexible regimentation.” Regimentation refers to developing a common or standard process for performing a specific service based on the best available evidence; flexible refers to ongoing efforts to improve the standard process. So, how do you deliver results when change depends on people doing their work differently? You create and follow standard work (or a policy) where the failure to do so may lead to defects, part rejects, customer complaints, unacceptable service levels, or risk of harm to equipment, body, or life. In almost all other cases, Lean promotes standardized work, even though you most often hear or read “standard work” (Figure 14.1).

Another important Lean term that finds varied usage is the Japanese word “Kaizen”—some definitions translate it as “change for the better,” while others loosely relate it to “Continuous Improvement.” Jun Nakamuro, disciple of Taichi Ohno, in his article, “Re-Translating Lean from its Origin,” defines “Kaizen” as “Self-Development,” where individuals change their own actions to develop a new mindset. Toyota teaches their employees that they have two jobs: (1) Do their work (follow the standardized work) and (2) To improve their work (“Kaizen”).

Richard Branson, chairman of the Virgin Group, says, “When I think about my life, routine isn’t a word that naturally comes to mind. I love to be adventurous, I love to be unusual and I love to be spontaneous. I also spend a lot of my life on the move. So why would I need a routine? Nevertheless, I do have a routine, and I swear by it.” As a leader, it is your duty to ask (1) Do we have standard work?, (2) Are we following standard work?, and (3) What is wrong with standard work if we are not following it?

Now, let’s continue with our learning on prioritization. Teams across the organization are provided an option to either use the same weight percentage as assigned to the filters at the organizational level or use them as a guideline, in which case teams customize weights to make them relevant to their respective work area. Note that the filters do not change, but the weights may. This allows flexibility to operate within the standard to create a better alignment between the team’s functional area and the organizational strategy.

Once the filters and weights are agreed upon, the team lists all their project ideas in the project prioritization template (Table 14.1). All project ideas are required to pass through these filters and compete for resource allocation. Based on the operational definitions established (see Chapter 13), teams allocate ratings of 1, 3, 5, or 0 depending on each filter’s association to the respective project. For computing the total score, multiply each rating with the respective weight of the filter and add them together. Once the total scores of all projects are computed, arrange the total score column in descending order, i.e., the project idea with the highest score goes to the top (ranked first) and a sequential project list in the order of priority is generated. The projects then receive resource allocation in that order.

Results: The implementation of the above approach at Hospital Heal ( Table 14.2) reduced the number of projects from 634 to 198 in the first attempt and then to 45 after a few more. All projects were completely aligned to the organization’s Health Report Card and impacted the big dot measures of the organization.

Projects where a lead could be assigned without delay were initiated, while others were put in the project pipeline and scheduled as personnel became available. Projects that were mandated by the Ministry of Health and Long Term Care, that affected accreditation, that were infrastructure related, or that received special funding from the ministry were not prioritized using the standardized criteria tool. These projects received priority over other projects identified by the department (Figure 14.2).

Sensei Gyaan: Do not prioritize projects of the following categories along with projects in the general category. Sometimes these projects may not score as high as you may expect them to when compared to the general projects. The categories include

1.Projects that are mandated by any external body such as the government, accreditation office, environmental sustainability officials, or others

2.Special projects for which you have already received or expect to receive additional funding

3.Projects related to infrastructure or asset management, if not undertaken, may be a potential risk to business operations. Examples include annual maintenance of the building, equipment, hardware, or software or replacing old equipment, hardware, or software that is obsolete or in poor condition.