Discuss the following in your conversation:
- How is your employer responding to your project?
- Review your experiences of your Gemba with your instructor.
- What internal and external data sources have you identified?
- What successes and challenges have you encountered requesting or accessing data?
- How is the data helping to narrow down to a viable, short-term executable project?
- What other challenges are you encountering?
- What are you doing to work around the challenges?
Running head: GEMBA WALK1
GEMBA WALK 7
Gemba walks involve visiting the frontline workplace, watching how processes are conducted, and having conversations with those doing the work according to Amatayakul (2017). It is all about learning from and intermingle with the staff who create value and closest to work. When the executive in an organization listen to the teams and take action on the feedback, it creates a culture of cooperation. Valuing and acting upon the opinions and ideas of the staff is an excellent way of employee engagement and ensures continuous improvement of the organization.
I worked as Chief information officer at Brigham and Women’s Hospital in the Boston state. The hospital had several issues with system failures and poor patient safety. There was a need to digitize the system to modern technology. I participated in a monthly executive walks on the safety of our facility for several months. The walk rounds were undertaken every week, led by the Chief Medical Informatics Officer (CMIO), the Executive Director and Chief Nursing Officer. We visited different departments of inpatient units to hear from the staff of their progress. As an IT leader, like in every industry, we do walk-rounds to hear from the front line users of the systems we put into operation and support.
The objectives/goals of the Gemba walk was to gather information about what works and what doesn’t from the frontline staff perspective. We get to discover our user’s experiences with the systems and tools they require for optimum performance of their tasks. Gemba walks make us understand what the frontline workers need from us. We conducted patient safety rounds visits led by Chief Medical Officer every two weeks and took about one hour. All hospital head staffs and representatives from Material service, Pharmacy, Risk management Infectious Disease participated in the Gemba. The objective is to get information from the team about the hindrances of patient safety. We seek to find out what is the next fault likely to occur. The staffs respond willingly about the system and patient safety issues. The feedbacks were regularly reviewed during the team meeting by the Chief Medical Officer. During the patient safety rounds, I learnt about many System and Patient Safety issues. Some of the issues raised I was aware of and was working on them, while others new come up too.
Analysis of the Observations
The executive was tasked with looking into infection control, safe use of medical drugs, and safety of the hospital equipment, safe clinical practices, and safe surroundings. Also, to address the lack of standardized methods of identifying, measuring and reporting various clinical occurrences. After all these problems were identified and discussed, a meeting was organized for all the departments from the admission unit to the care unit to come up with solutions. We took all the observations and initiated plans to address the identified issues in the systems. The staff learned how to request for system repairs, and how to act on their observations instead of ignoring them. As a result, the staff’s perspective was seen to have changed, and their patients’ safety perception improved over a time which corresponds with the hospital facility’s goal.
In response to the practical issues observed, the hospital launched a mobile app for staff to report patient safety occurrences. The physicians and the nurses could share photos taken and uploaded them in the system for follow-up by other interested departments or personnel. These eased reporting because there before staffs never bothered to fill paperwork for every incident. The mobile app significantly increased the reporting rate.
We were walked through the flow of issues from the point when patients enter the facility, to the check-in, the operation manager and other staffs kept on directing patients on the right place. Better signage and clarity about where to do their check-ins are needed. Also, I noticed problems at check-in with the printing system that created delays hence long queues. Improvement on desk support process for quick receipting services is another opportunity for advancement.
According to Ciulla (2020), interacting with your staff as a leader is a crucial aspect of leadership in an organization. It becomes easier to engage your employees and ask for their wisdom on solving various issues. It creates s virtuous cycle as leaders show respect to their staff; they also tend to respect them in turn. A Gemba walk is not the opportunity for a manager or supervisor to issue commands on how to do things the right way. It is not supposed to impose fear or discipline but to watch, observe, ask questions and learn from staffs which are the experts on what they do. The basis of improving the services in a health facility is by empowering the team, eliminating waste in processes and creating better patient experiences.
As a health care management leader, It required that, to create an accessible, comfortable environment of the staff. Under such circumstances, they tend to provide quality services. From the Gemba walks activities, I learn that the role of a quality leader is not essential to solve problems but to help other staffs observe the existing difficulties themselves. Gemba walks enable the management and the staff to learn by stepping out of their daily routine and view their institution and workflow with a new perception.
Gemba walk evaluation/interview sheet
The following are some of the Gemba walk questions used while conducting interview for staff in their places of work.
|Gemba Walk Checklist/Interview Sheet|
|Interviewer:||Department:||Note: take pictures of the interviewees and the venue.|
|What are you working on right now?|
|Is there a traditional process for completion of the task?|
|1. What challenges are you facing while performing your duties?|
|1. How do you discover a challenge?|
|What can you repair on your own?|
|What do you need assistance with fixing?|
|Who do you talk to when there are errors?|
|What system is being used for this level? How do you track the required information (reports, spreadsheets, etc.)? #Information flow:|
|What issues or barriers to make this work painful or time-consuming? #Barriers to flow, waste identified:|
New healthcare safety goals are needed, but the effort to continue improving locally daily for patients, more aspects are required. It requires a resilient and long-term leadership, the constancy of purpose, time and space for those working with patients to try out new techniques for value flow. Gemba walks are recognized to improve work processes, value production increases, and reducing waste according to Powell & Thürer (2020, August. By keeping the Gemba walks as part of daily routine, makes a leader visible to his/her team, creates open discussion, and provides feedback, proposals and ideas. All of these aspects can be used to improve the process continually. Practically, the frontline worker fully understands the complexity of their work area. The staffs appreciate when they see their input put into actions, and this installs a lasting company culture.
Amatayakul, M. (2017). Process Improvement with Electronic Health Records: A Stepwise Approach to Workflow and Process Management. CRC Press.
Ciulla, J. B. (2020). Leadership and the problem of bogus empowerment. In The Search for Ethics in Leadership, Business, and Beyond (pp. 177-195). Springer, Cham.
Romero, D., Gaiardelli, P., Wuest, T., Powell, D., & Thürer, M. (2020, August). New Forms of Gemba Walks and Their Digital Tools in the Digital Lean Manufacturing World. In IFIP International Conference on Advances in Production Management Systems (pp. 432-440). Springer, Cham.