VALUE STREAM MAPPING

WORKSHOPS
Purpose:
To restructure the process for designing
and permitting California hospitals in order
to generate more value for stakeholders
and to eliminate waste, anything not
needed to generate value.
 VALUE STREAM MAPPING
WORKSHOPS
Desired Outcomes:
Agreement to a preliminary value stream
map of the current state process
Assigned action items to provide
supplementary data to flesh out the
current state process map
 VALUE STREAM MAPPING
WORKSHOPS
Thursday Oct 5
Understanding and documenting goals and expected outcomes
First pass at current state process map
Wednesday Oct 11
Understanding and benchmarking the current state process,
including value added %
Wednesday Oct 18
Creating a future state process map
Wednesday Nov 1
Creating an implementation plan
Thursday Nov 16
Creating standard work
 VALUE STREAM MAPPING
WORKSHOPS
Agenda:
Start up
Value Stream Mapping Basics
Adding Value and Improving Process
Map the current state processes of each owner:
CHW, Kaiser, St. Joseph, Sutter
Identify processes to be exploded into greater
detail. Generate list of needed information and
get commitments to providing it.
Wrap Up
 Ground Rules for Current
State Mapping
Stay in the current state. We will add detail later.
Avoid war stories.
As future state ideas surface, park them in the
parking lot.
Dont take it, or make it personal.
Treat people with respect.
Practice active listening.
Treat failure and/or breakdown as opportunity
 ASSUMPTIONS
100-bed hospital
adjacent hospital support building, OSHPD 3
on-site structured parking
design-assist contractors, including major
subcontractors, on-board from beginning
produce "drawings" using 3D model
No assumptions about who owns the 3D model (ie. subs
vs. engineers)
Use 3D model in different ways for different audiences
(ie produce 2D drawings for permit; use by sub to
fabricate sheet metal, etc.)
No assumptions about contract relationships are
necessary
Contracts with owner are cost plus, with a fixed fee
VALUE STREAM MAPPING

What it is

Why do it

How do it
 But first

In the process of designing and permitting a

hospital, information moves from one party
to another. Sometimes the information is
used to make decisions or generate
designs, but much of the time it sits waiting,
or is being inspected, or is being redone.
What are the states in which we can find
materials or information in a process?

Undergoing transformation
Being moved
Waiting
Being inspected
Being reworked
 Value and Waste
Value is that for the sake of which a process exists; e.g., to produce
designs that meet customer needs within the constraints of time,
money, and regulatory requirements.

Waste in a process is anything not needed to get the job done to the
satisfaction of the customer and other stakeholders.

Only processing adds value.

All the rest is waste:

Waiting
Moving
Inspecting or Approving
Reworking
 Ohnos 7 Types of Waste
Inventories of goods awaiting processing or
consumption

Unnecessary transport of goods

Defects in products

Overproduction of goods not needed

Unnecessary processing

Waiting by employees for process equipment to finish

work or for an upstream activity to complete.

Unnecessary movement of people

 Swimlane Diagram of the RFI
Process for Placing Drawings
Prepare
Structural Check details
Engineering
& modify as
Engineer Drawings based on
appropriate
Loads

Modify Check details

Prepare Architectural Return modified
Architect Drawings
Engineering & modify as
details to fabricator
Drawings appropriate

General Check details

Subcontract Detailing
& modify as
Contractor to Fabricator
appropriate

Check details
Subcontract Detailing
Fabricator To Detailer
& modify as
appropriate

Detailer Prepare Details

2005 Z.K. Rybkowski

All rights reserved.
 RFI Process for Placing Drawings

Q?
What is the percentage of actual
processing time of an RFI compared to
the amount of time it sits in someones In
tray?
LEAD
TIME

Structural Check RFI

& modify drawing as
Engineer appropriate

PROCESS
TIME

2005 Z.K. Rybkowski and I.D. Tommelein

All rights reserved.
 Lead time
(LT)

Time spent
Sample entry: to respond
to RFIs
(VAT)

Assumptions:
8 hour work days (weekends not deducted)
Sections of RFI log where time spent was not recorded
are not included in the calculation.

2005 Z.K. Rybkowski and I.D. Tommelein

All rights reserved.
VALUE STREAM MAPPING

Current State Future State with Future State without Future State with
Rework Rework EDI

Steps % Steps % Steps % Steps %

87 100 67 100 32 100 11 100

Total steps
73 84 46 69 11 34 3 27
Non-Value adding
Non-value adding 12 14 19 28 19 60 6 55
but necessary
2 2 2 3 2 6 2 18
Value-adding
 Observe and Gather Data
Walk (in your mind)
the flow of items and
information
gather data, thinking
about...
Touch Time:
Cycle Time:
People:
VALUE STREAM MAPPING
What it isa way of making waste evident
in a process

Why do itto eliminate the waste

How do ituse swimlane diagrams and, for

now, show only lane changes, and
document touch time, cycle time & people
involved in each process step