Gemba Walks are simply good business…you can help your healthcare front line staff provide better patient service and find opportunities for improvement. Gemba walks are easy (and fun!).

What is a Gemba Walk?

Simple and easy…a manager/supervisor walks into a section with eyes and ears open, asks a few specific questions and makes notes for follow up. Do a few of these a week and you’ll learn an amazing number of things you can do to help your staff excel.

While I was in the Air Force, I was in most duty sections at least weekly for Gemba Walk purposes and visited other times to talk to section leaders. The Gemba Walk gave me tremendous insight into what was actually happening in each duty section of my hospital.

How do I do a Gemba Walk?

It helps to have an idea of how the process works in a department. That starts with a value stream map and a process map. (You can start doing Gemba Walks without a value stream map, but you’ll want to develop one eventually)

First, a value stream is any given process in your facility that is of value to your patients, or your operationValue streams maps show you where you are giving the patient something useful (a visit with the provider). They also show you were you’re not delivering valvue (time spent i
The best way to understand a value stream is to start with a process map. A process map is an outline of how a specific process is supposed to function.
A simple example of a process map would be a breakdown of how the reception staff receives a patient—what the the tasks or steps that the reception staff does?
Generally, start at the last step in value stream you’ve selected to Gemba Walk, and then walk up-stream. . If you are following the patient care value stream, start the same way one of your patients would start, at the front door.

Now have a friendly staff member walk you through the process so you can make some general observations on your own:
• Is the patient reception area easy to find (signage)?
• How does the reception staff operate (what are their major tasks and challenges)?
• Is the patient care area easy to find from patient reception?

You continue this walk through the patient’s experience to get the full picture of what your patients encounter every time they come to your facility.

What questions should I ask?

You want to ask the staff who work in the process some questions. The three classic questions in Lean are:
1. What are the tasks do you do in this process?
2. How do you know you are doing them correctly?
3. Who do you go see when you need help?

Staff usually have a good idea about 1 & 3 They often have trouble with (2) – knowing how they are doing them correctly. Problems there can be fixed with job aids, checklists, and a number of other Lean tools.

The trick is to do Gemba Walks consistently.

Make a checklist to follow in your Walk. Modify your checklist as you get more comfortable in the Walk. Add it to your calendar as an appointment so you make time for the Walk.

Tips:

• Visit high perfoming sections and those that are struggling to insure you visit everyone.

• Share your findings in a positive manner. You want your staff to be honest when you visit.

• Define ahead of time what negative performance issues will require immediate intervention (i.e. safety, abuse, illegal activity, HIPPA, etc.). How will you positively reinforce wonderful performance?

Your leadership team needs to act consistently in an agreed upon manner across the board. Staying focused on “it’s the process, not the people,” usually helps limit the blame game.

In worst case scenarios, a Gemba Walk may be the only time a supervisor or manager may actually step foot in the ‘real work area’ (definition of Gemba is ‘the real place’). More than a few visits are necessary to get a solid understanding of your value streams.

Realistically, the frontline staff are the only ones who fully understand the intricacies of their workcenter. SigmaMed Solutions encourages involving front-line workers in Lean Six Sigma (LSS) projects, and thereby avoiding a supervisor/manager misinterpreting information from limited Gemba Walks during our projects.

So, try a few, Did your Gemba Walks instill confidence in your service, or did it not?

If it didn’t you have the data you need to help your staff improve!