Rapid Improvement Event (RIE)
Purdue Healthcare Advisors (PHA) uses A3 thinking, which is a well established lean problem solving method for making rapid-cycle process improvements. PHA’s approach to A3 problem solving involves nine steps and three stages as outlined below.
Identify team members and the challenge they must tackle. It is important to have a clear focus area for the Rapid Improvement Event (RIE). The target area is a small but important segment of the revenue cycle process where the team can make immediate workflow and behavior changes to meet improvement goals without spending money or adding staff.
Scoping also involves defining the current and target state for the focus area in terms of metrics. The event team needs to know which metrics they must move and by how much.
PHA can assist in all aspects of preparing for the event including team and target area selection, baseline data analysis, setting goals and A3 documentation. Scoping typically takes 30 days.
Once scoped, the next stage brings the team together and a facilitator delivers a 3-4 day rapid improvement event to solve the challenge. This includes:
- just-in-time lean training;
- understanding the current state;
- uncovering root causes;
- generating solution ideas using lean thinking;
- testing solutions via rapid experiments;
- defining specific tactics to hard wire the changes;
- planning to complete the implementation;
- and setting up a lean daily improvement process within the target area.
These are called rapid improvement events because 50-80% of the change or improvement is made during the event rather than after it.
PHA can assist in all aspect of delivering the event by providing a facilitator, co-facilitator or coach to support a client facilitator. The precise role PHA will play is detailed in the next section.
Once lean solutions have been defined and tested, the implementation plan is completed and Lean Daily Improvement will start. Daily improvement means:
- collecting data;
- updating graphs and other forms of visual management;
- conducting team problem-solving huddles; and
- when necessary implementing counter measures or small adjustments to ensure the new standard work from the improvement event hits the target metrics.
It begins to build the habit of continuous improvement with a group much larger than the RIE team. Area or value stream leadership will monitor the improvement by reviewing data weekly for a month to ensure the improvement works, and then monthly for two months to be sure it is sustained. A designated staff member from the client will be responsible for insuring the implementation of the completion plan and facilitating the RIE to closure over a 90-day period.
PHA can assist in all aspects of facilitating the event to closure by providing coaching to the client’s staff, participating in Lean Daily Improvement setup and team huddles, and working with leadership to remove barriers.
Preparing for (scoping), delivering (solving) and facilitating to closure (sustaining) a rapid improvement event typically spans 3 or 4 months. Most of this time (90 days) is spent in the sustain phase where dozens of smaller improvements are made to refine and hold in place measurable improvements.
Once closed, the demonstrated improvements created by the event may be systematically spread to other parts of the organization using different lean methodologies.
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