Article 78. Its All About Leveraging Labor and Knowledge

Leveraging is a big word on Wall Street it allows a company to grow by borrowing capital.  It is normally only thought of as relating to investment capital but in the real world you can also leverage labor and knowledge.  This is the main principle I have used in my proposed Consulting Agreement with the VA.  See Article 77.  Aug 13 Proposed Consulting Agreement with VA.

To solve the problem of determining with relative accuracy how many Nurses and Doctors are needed to effectively and efficiently meet all VA patient appointment schedules I have used the following process.  This also is the most efficient and least expensive approach for solving difficult and extensive problems in any large organization.

An unnamed VA staff member from the DC office expressed disbelief when he called me last month.  How could a single Consultant from outside the VA make such a major impact on VA operations.  The answer is in knowing how to leverage labor and knowledge to produce an effective and efficient staffing schedule for all VA Medical Facilities and to do it in Three Months.   Starting with just myself  a single Principle Consultant leveraging the labor of ten VA OIG Analysts to be Facilitators to employee Functional Lean Teams involving hundreds of employees.  Enterprise Lean uses employee Functional Lean Teams to determine the most effective and efficient way of doing their functions (jobs).  The Functional Lean Teams also compare standards such as Best Practices with the way they are currently doing their functions and make adjustments.  When standardized the data is documented in a spreadsheet by the OIG Analyst acting as the Facilitator for the Lean Team.

The data from the Functional Lean Team is then passed to a higher level Lean Team lead by a Doctor and members of his nursing staff.  The Doctors Lean Team lays out a detailed sequential schedule involving the activities of  Doctors supporting Nursing staff and patients on a Wall Chart.  The wall chart uses wrapping paper taped to a conference room wall with representations of all activities sequentially represented by taping activities on colored paper to the wrapping paper backing which can be rolled and used in other locations.  The knowledge is with the employee Lean Teams who determine the best way  organize the sequential events in doing a function.  The wall chart is a daily plan of activities showing all processes done by staff without any staff members having to wait on other staff members.

Part 1. Of the Proposed Consulting Agreement
This Consulting Agreement develops a Throughput Schedule plan for each area where medical services are needed to meet increased VA patient loads.  An OIG Analyst will be assigned to each medical area to Facilitate Hospital Employee Lean Teams in applying Best Practices to each of their Functions.  The Lean Data will be captured in a spreadsheet and used in the higher level Doctor’s Lean Team to develop the Throughput document which will be captured in a staffing spreadsheet.  The Throughput spreadsheet will contain a large number of repeated reiterations of the original Best Practices balanced schedule design.  The Throughput Spreadsheet will contain enough reiterations to meet any VA facility’s patient appointment schedule requirements.  Spreadsheets have unique capability such that a specific patient load can be identified on the spreadsheet and matched with the Patient Requirements for a VA Medical Facility before the extensive document is printed.  The Names of existing staff members are added directly to the Throughput Schedule showing exactly how many new hires and their expertise are needed.

Note that the Spreadsheet itself becomes a knowledge leveraging tool.  See Article 76. Detailed Description of the Throughput Process.  Savings from the throughput Schedule is estimated at $3 billion largely from not over hiring staff.

Toyota Developed the Enterprise Lean process for the purpose of leveraging the knowledge of thousands of employees in making their jobs more effective and efficient.  This is one reason why Toyota has grabbed market share from sloppy bureaucratic General Motors which only uses a few hundred Industrial Engineers to make manufacturing decisions.