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Four key approaches to change SeCtion one
The final stage of Lean is ‘managing towards perfection’, with an emphasis on using live data to understand how a referral is ‘flowing’ through the system. Manager B set up a large white board in the middle of the office which provided an overview of the number of people in each stage of the process – this was updated every morning and afternoon so that the whole team could see what the current demand and response was. When new issues arose in the process, a short term action group would be set up to explore and respond to the problem through the use of Plan Do Study Act cycles.
One of the issues raised by external partners such as the learning disability healthcare service was that one of the main ‘values’ of the team members was their specialist expertise in working with people with different support needs. Team members had raised losing of this expertise as a potential danger of them being put together into a generic team. Manager B therefore raised with his fellow team managers the possibility of developing ‘communities of practice’ around the support needs of different user groups. These would enable workers with a special interest to meet with colleagues and share experience, insights and resources.
Sustaining the change
The ‘performance board’ remained in use to provide a visual overview of how the process was working each day. Every 3 months the standards of ‘value’ that had been developed were reviewed, and 12 months post the improvement event the team reviewed the whole process again. This included repeating the data collection exercise to understand stakeholder perspectives.
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