The Aim: A Focus on Flow

The essence of this work is creating flow within and between processes. All work takes the form of a process. Within all the terms found in the quality improvement vocabulary, flow stands by itself. It is emblematic of the continuous delivery of product, service and quality, unblemished by waste, defects or rework.

The aim of Schowengerdt Consulting is to facilitate development or refinement of processes which deliver the right amount of information, product or service, at the right time, to the right place, to meet that patient’s (or other customer’s) needs. When that happens, customers recognize that experience as flow!

The secondary aim of Schowengerdt Consulting is to be engaged by clients only until the knowledge is transferred. Successful organizations will adopt as their own, the principles and tools of workflow.

The use of the four arrows within the logo represents the commitment to use the Plan-Do-Study–Act cycle in this work, as well as the commitment to support, continuously, the work of clients. Introduced by Dr. W. Edwards Deming, and also referred to as the scientific method, the PDSA cycle symbolizes the drive to seek continuous improvement by deliberate and thoughtful actions.

About

Dan Schowengerdt is a former Senior Executive of an Integrated Health System who has converted his learning and skills into a consulting practice. His passion is facilitating the creation of improvement that is recognizable to the patient and sustainable by the health care organization.

His interest in health care improvement began while in graduate school studying Industrial Engineering and Health Care Administration. It grew and matured with his learning and application of Deming-based improvement methods, Six Sigma and the Toyota Production System, also referred to as Lean Production. He applies over 30 years of process improvement at all levels of health care from the point of service to managing cultural change at the executive level. He has a record of consistently improving the organizations he has lead and leaving behind transformational change.

In his consulting practice, Dan supports health care organizations to harness the wisdom within their ranks with proven techniques to deliver value. His style is one of a coach, who enjoys working “on the line” with leaders, clinicians and staff to make fundamental and lasting improvements.

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Dan Schowengerdt

Products & Services

Daily Management of Operations

At the core of operations improvement is understanding how work processes flow to meet the needs of the customer, on a day-to-day or hour-to-hour basis. This product engages leaders, and those who do the work, in creating a tool which provides timely feedback on process capacity and defects. It supports teams to:
                - Be responsive and to prevent defects real-time
                - Monitor and sustain past improvements
                - Promote a culture of continuous improvement
                - Stress standard work and customer focused metrics

The output is development of Daily Management Boards and methods to improve work flow.

Leader Standard Work

To fulfill the promise of continuous improvement, Executives, Physician Executives and other leaders must gain new skills and become competent in their use. From Strategy Deployment to Rounding with a deeper purpose, leaders must adopt a new form of standard work. The output of this coaching in techniques is an engaged leadership group prepared to lead and participate in improvement in a palpable way.

Service Line Development

Breaking through the traditional silos of service delivery, this product stresses improvement across multiple departments resulting in more robust processes of care with fewer defects, enhanced and improved performance on quality metrics, and reduced cost per unit. Working with leaders of the departments examine the patient care experience from the patient’s perspective, impact of work performed up and down stream is made visible and handoffs are improved to assure a more seamless delivery of services. The output is aligned and deeper process capability, and leaders with a focus of working across organizational boundaries to achieve fundamental and meaningful change.

Developing the Infrastructure to Sustain an Improvement Program

Achieving a culture of Continuous Improvement is more than a series of events. It is learning and developing a way to inculcate the methods and the principles into daily work until it becomes a habit and a way of doing business. The output of this product is coaching leadership in proven techniques which transform and anchor methods of improvement, including lean scorecards, process visibility, program audit, review and prioritization of improvement work.

Value Stream Mapping and Strategy Alignment

Value Stream Mapping is a planning tool which matches the improvement tactics to the overall strategies of the organization, all of which is aligned to customer values. The map identifies value adding v. non value adding activities and opportunities to improve flow across the patient’s care. The map includes the flow of the vital resources of production (of patient care or other activities)-patients, material and information-across traditional boundaries. The output is a current and future state map and a series of identified improvement opportunities needed to achieve the future state. Participants are introduced to the benefits of lean thinking and are deeply involved in charting an improvement course.

Rapid Process Improvement Events and Projects

These are 1-4 day workshops focused in targeted areas identified from Value Stream Mapping. During the events, teams of people who “touch the process”, study the current process in depth, find and eliminate waste, and use new tools to assure the change is sustained. Well organized and supported teams strive to remove the most waste possible, some as much as 50 percent. Methods to audit and sustain the improvements are installed, as well. (Improvement Projects utilize the same methods but are staged over a few weeks, in 3-6 hour bursts of team activity, followed by a period to observe the processes changed.) These events, and similar efforts, become the keystone of the organization’s improvement program, teams are coached in use of fundamental lean tools, including;
                - Identifying and Eliminating Waste
                - The importance of, development and implanting Standard Work
                - Characterizes of Flow
                - Mistake Proofing
                - Set-up Reduction and Rapid Changeover
                - Pull (rather than push) Systems
                - Level Loading and Balancing work among Team members
                - Managing Change


The output is energized teams, linked to those who do the work and supported by leadership, with improvements achieved or in sight.

5S Workshops and 5S Program Development

5S is the acronym for five specific actions to achieve workplace organization and standardization. They are: Sort, Simplify, Sweep, Standardize and Sustain. During 2-3 day events, participants learn the benefits of a 5S approach and implement the program in areas designated by the client.

The output of a 5S event/program is:
                - Time savings due to reduced time searching for equipment, supplies and information
                - Improved ergonomics
                - Inventory reductions and better inventory controls
                - Storage space returned for other uses, and better teamwork.
                - Leaders coached in the methods to perpetuate and capitalize on the concept organization-wide.

Lean Work Flow to Lean Facility Design

This work is adapted from Manufacturing’s “Production Preparation Process," or “3P” Workshop. It begins with using volume and capacity data in the pre-design stages. Lean tools are applied to streamline processes and apply the results in the Schematic and Design Development phases of Architectural Design. In turn, the work transitions to a plan of innovating processes to match the new facility, achieving greater capacity and improved flow. The depth and breadth of this product is customized to meet the needs and requirements of the client. The output of this product is a plan which merges Workflow Design with Facility Design in order to create a workplace that supports reduced waste and defect-free work in new or renovated facilities.

Transforming The Healthcare Process

The Aim: A Focus on Flow

Dan Schowengerdt

Seek a match between the needs and interests of the client with this firm’s skills and experience.

Tailor the engagement to the needs and desires of the client. There are no “off the shelf” solutions.

Build a trusting relationship with the client’s team.

Bring value to the relationship, never forgetting the value and contributions of the client’s own team.

Seek to provide lasting solutions and build the infrastructure necessary to support change going forward.

Seek, and be open to, feedback throughout an engagement. Recognize that you are a better coach, if you are a student, forever.