Monthly Archives: March 2020

What Do You Do, Paraic?

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When people ask me what I do and I tell them I'm an accountant 😱, they understand what that means. But saying I'm a consultant leads immediately to what kind 🤔? And this is where I tell them I'm a Common Sense Consultant.
Common sense is often referred to as being "uncommon" and somehow lacking. It is true that in our search for worthwhile solutions to important problems, we sometimes forget to consider simple answers but it is not necessarily true that the simple answer is the right or best one...
To me, common sense is about stating the obvious, and it helps us to uncover or discover hidden assumptions and other factors to which we may be blind. My step-father used to say that the cemetery was full of people who had the right of way. In a similar fashion, the business graveyard has plenty of examples where people operating blind or on false assumptions met the hard face of reality. Common sense tells us to look both ways before crossing the road. It can also warn us to not believe our own propaganda.
And what is consulting? Taking advice, taking soundings, asking for and receiving advices and input... Is one consulted or providing advice necessarily a consultant? Or does consultant mean something different? These days, consultant is almost a pejorative term - visit any business that uses consultants and gauge the enthusiasm of the staff for them. Consulting is a guise under which large accounting and legal firms up-sell services. It also comfortably shelters the unemployed former executive and the semi-retired professional.
I have some very basic ideas about consulting and consultants. First, a consultant brings something you don't have - be it advice, professional service, or fresh eyes. Businesses above a certain size, say over 100 employees, should not need to hire consultants - divert 5% of your workforce to the project and you have a team of 5 or more to run it. Second, the consulting process needs a definite purpose and desired end. Thirdly, you should make a profit on your investment in consulting.
Finally, what is common sense consulting? Apart from paying me to tell you what you already know?
It's bringing a pair fresh eyes to see what you've become blind to. It's asking basic questions that, for whatever reason, you can't answer. It's being an independent voice that tells you the truth. It's also finding the simplest and most effective ways to profit from your investment.
It's being a helping hand where and when you need it most 😊 because we all need someone to lean on.
Please comment below. Or if you want to contact me, just click here

 

Lean Six Sigma

Making Lean Six Sigma Work For You

In October 2019, I presented a workshop on applying Lean Six Sigma in Hospitals to a group of 25 Health Information Managers at the 2019 HIMAA/NCCH National Conference held in Paramatta, NSW, Australia. HIMAA is the Health Information Management Association of Australia while NCCH is the National Centre for Classification in Health, The University of Sydney. The workshop was designed to help participants to:
  1. Assess a problem or area for improvement.
  2. Identify possible routes to dealing with it.
  3. Evaluate potential solutions.
  4. Choose an approach that has a reasonable chance of success.
  5. Select tools and methods suited to the problem and the approach chosen.
  6. Use the tools and methods to address the problem.

Background

While Lean is now regarded as synonymous with the Toyota Production System (TPS), pure lean is concerned with the elimination of waste (“muda”). Lean methodologies “allow an organisation to efficiently and effectively design workflow processes by eliminating mudas (or wastes).”(1) The seven original “muda” are transport, inventory, motion, waiting, over-production, over￾processing and defects. The TPS has two fundamental pillars, Just-in-Time and Automation, is concerned with the improvement of flow and focuses on three key forms of waste: • “muda” is work which adds no value; • “muri” is work which is too complicated or uncontrolled; and • “mura” is work which lacks uniformity or consistency. Six Sigma, developed and applied in manufacturing industry, is a “process-focused, statistically based approach to business improvement…” (2) The structured method used is to Define, Measure, Analyse, Improve and Control (DMAIC) and the core performance metric is the number of defects per million opportunities (DPMO).(3) Lean Six Sigma is an amalgam of aspects of each, balancing the qualitative, value driven 'doing the right thing' of Lean with Six Sigma’s empirical quantitative measurement of 'doing things right'. The framework introduced in this workshop was developed in an attempt to answer the apparent failure of Lean Six Sigma in healthcare. While the framework is focused on Lean Six Sigma, it is not necessary to adopt the philosophy as the tools and methods can be, and have been, utilised in many different settings.

In the first part of the workshop we explored and discussed:

(i) The topic of Lean Six Sigma, including the philosophy, strengths, weaknesses and critical success factors; and some of the most widely used methods and tools; (ii) What makes healthcare different from other settings, especially key characteristics unique to healthcare, including individual patient variation and clinical independence; (iii) The concept of simplification as an alternative to complexity and intensification.

The second part of the session considered:

(iv) the potential usefulness and transferability of a decision support framework designed for the acute hospital setting; (v A new decision support framework designed for the acute hospital setting; and (v) The seven basic tools of quality

The final portion of the workshop:

focused on using the framework to examine some real life case studies to better understand the framework, methods and tools proposed.

Please feel free to comment below. For a copy of the workshop slides, just click here

 

References:

  1. Kuo, A. M-H., Borycki, E., Kushniruk, A., Lee, T.-S., 2011. A Healthcare Lean Six Sigma System for Postanesthesia Care Unit Workflow Improvement. Quality Management in Health Care, 20(1), pp.4-14
  2. Bisgard, S., Hoerl, R.W., Snee, R.D., 2002. Improving Business Processes With Six Sigma. Quality Congress ASQ's Annual Quality Congress Proceedings, pp.701-704
  3. Schroeder, R.G., Linderman, K., Liedtke, C., Choo, A.S., 2008. Six Sigma: Definition and underlying theory. Journal of Operations Management, 26(4), pp.536-554
Click here to download a copy of the Workshop Abstract directly from the Conference Proceedings   Proceedings of the HIMAA/NCCH 36th National Conference, Health Information Management: Engaging the Next Generation. 23 - 25 October 2019, Western Sydney Stadium, Parramatta, New South Wales, Australia Copyright 2019 Health Information Management Association of Australia Ltd/National Centre for Classification in Health, The University of Sydney

Lies, damned lies & statistics

According to Mark Twain there are three kinds of lies: "lies, damned lies and statistics" while Winston Churchill reportedly said that "the only statistics you can trust are the ones you have falsified yourself".
You might wonder why statistics have such a bad reputation. I guess one basic contributing factor is that a majority of people do not feel comfortable or confident dealing with numbers.  Many suspect that arguments and reasons that include or rely on numbers are deliberately made more complicated than is necessary, that we are being manipulated. Take the term "average", a commonly used word that is not as simple as we may be led to believe. In statistical terms, averages are measures of central tendency and there are three common measures - the mean, median and mode. However, within the mean there are three variations - simple, trimmed and weighted. Simple Average A simple mean is the sum of all the values in the population or sample being measured and is sensitive to extreme values, e.g. I have 100 people in a group: 10 have $10,000 25 have $1,000 15 have $100 40 have $10 10 have $1 The total amount of money they have together is $126,910 and the simple average per person is $1,269.10 Trimmed Average A trimmed mean is calculated by excluding extreme values from the average. The drawback here is that the decision on what should be included or excluded is necessarily arbitrary and may create a misleading impression. If we exclude the top 10 values of $10,000 each and bottom values of $1 each: The total amount of money the remaining 80 people have is $26,900 and the trimmed average is $336.25 Weighted Average A weighted mean is computed by attributing a weight to each value. If the example above were weighted according to the proportion of people at each value (i.e. 10% have $10,000; 25% have $1,000; 10% have $100; 40% have $10, and 10% have $1): The weighted sum is $16,636, the weighted number is 26.5 and the weighted average is $627.77 Median The median value is the middle value in a population or sample. If the population or sample contains an even number of items, the median is the simple average of the two middle values. In the example give above the median is the simple average of the 50th value which is $100 and the 51st value which is $10 = $100 + $10 = $110 / 2 = $55. Mode The mode is the value that occurs with the greatest frequency - in the example given, the mode is $10 because there are 40 people with $10. So now we have five distinct values for the average, depending on how we choose to calculate it: Simple average (mean) $1,269.10 Trimmed average (mean) $   336.25 Weighted average (mean) $  627.77 Median $    55.00 Mode $    10.00 If you intend to use and/or rely on averages in planning your business, it is important to know what those averages actually mean. If I create my marketing plan assuming that the average person has $1,269.10 and am not aware that 50% of this group have $10 or less I am inviting disaster. Key questions to consider when looking at averages are:
1. What kind of average is this? 2. Is it based on a population or on a sample? 3. How is the population or sample defined? 4. How reliable is the data? I will talk about populations and samples in a later post, highlighting some of the main aspects of each as well as the relative advantages and disadvantages.