Healthcare ProviderCase Study
Learn how an IT team at the leading U.S. healthcare service provider has significantly improved visibility and collaboration since using LeanKit, resulting in more than a 50% improvement in turnaround time.
As the leading provider of healthcare services, this organization is committed to the care and improvement of human life in the communities it serves.
Leading provider of healthcare services employing approx. 199,000 people
20 million patient encounters a year; handles 1 out of 22 of all Emergency Room visits in America
Facilities include about 162 hospitals and 113 freestanding surgery centers
Enterprise-wide, this organization has more than 100 LeanKit boards in use. We interviewed Debbie, an IT Development Manager, to understand how LeanKit is helping her team.
Tell us about your team.
Our team is part of the IT organization, which is divided between clinical applications and enterprise applications. We fall on the enterprise side of the house and are involved with infrastructure, information security, systems development, business analysis and interacting with business partners for application support. We have a distributed team of 10 developers who are responsible for supporting 70 applications. I’m responsible for managing all project-based and operational work associated with these applications.
How were you managing your work before you started using LeanKit?
Prior to LeanKit, team members managed their work in whatever way worked best for them. Some wrote on whiteboards, some used a notebook, some used a spreadsheet… and some people forgot! There was very little communication. We had trouble keeping track of everything, and sometimes things would get overlooked. I relied primarily on email to manage the team and, to be honest, it was not an effective method.
How did this affect the team?
There was no common understanding of how it all fit together. I was concerned because this was affecting our morale and productivity. Our team members were good about getting their work done and managing their own stuff, so nothing went horribly wrong. But we weren’t functioning well as a team.
What were the main challenges with this approach?
First, not understanding our own process made it hard to know how to improve. Because we didn’t have a centralized system for managing our work, we had no insight into basic information like accurate estimates of how long it would take to complete a certain task. I wanted to be able to talk about things like turnaround time more intelligently. I wanted to be able to look back at something similar and say ‘Last time, it took this long.’
I didn’t have the visibility I needed to understand what everyone was working on.
Next, it was difficult to know whether my team was sharing the work appropriately. Sometimes team members would ask me about apparent differences in workload, and I didn’t know why it varied so much. I didn’t have the visibility I needed to understand what everyone was working on so the workload could be distributed more fairly.
Finally, I wanted our process to be more visual. I had to query multiple systems just to get a rough picture of what was happening. This was frustrating because I was spending a lot of time just trying to get to the information I needed to make an intelligent decision.
What led to you selecting LeanKit?
Our company had a Lean initiative underway to encourage more efficient business processes. The person leading it heard about LeanKit, and we agreed to do a pilot. I took one look and was impressed. It instantly appealed to me because I’m such a visual person.
I needed to see the big picture of what was going on in our department, and knew that LeanKit would make that possible.
How did you implement LeanKit?
It was a team effort. We made sure everyone was involved in mapping our process on the board. Initially we had 25 lanes, but the team has since streamlined our processes so that we work together more effectively. The key is to just get started with something that everyone agrees with and then evolve it over time.
What changes did you notice after you started using LeanKit?
We saw two dramatic changes in the first year of using LeanKit. Within two or three months, our efficiency improved so much that we were able to keep the same turnaround time, even after losing a team member.
Another change is that we’ve been able to manage a remote team successfully. About nine months after we started using LeanKit, we were able to smoothly transition the maintenance of all 70 applications to an outsourced organization in India. We couldn’t have even considered doing this without LeanKit due to the communication challenges that globally distributed teams tend to have.
What improvements have you seen since using LeanKit?
LeanKit helps keep everyone on the same page. Our work is transparent now.
The biggest improvements I’ve seen are in communication and collaboration. LeanKit helps keep everyone on the same page in our 15-minute stand-up meetings, where we display the work everyone is doing. We talk about priorities and how to resolve issues people are having. It’s really eliminated the need for status emails and status meetings. Our work is transparent now, and the team is focused on asking “How can we help each other get the work done?”
Have you been able to measure your efficiency improvements?
For high priority items, we’ve seen more than a 50% improvement in turnaround time. Our turnaround time used to be seven to 10 days. Now it’s about three days for high priority items and five to 10 days for normal priority items.
How did LeanKit help with that?
It’s easier to prioritize work. Before LeanKit, high priority items took just as long as low priority items, and we didn’t even know it.
The visibility LeanKit provides has made it easy to measure how much we’ve improved our turnaround times, which has been a huge morale booster.
Now when a high priority item comes in, we can redistribute the workload in a way that maximizes the skillsets of the team. If someone is working on something that is a much lower priority, that person can offer to help - either with the high priority item or by taking over other work that would free up someone else for the high priority item.
When we started out, we had around 20 active cards per person. After using LeanKit for three months, we reduced this to just four or five cards per person. We now focus on finishing projects instead of starting multiple things at once. By limiting the amount of work taken on at a given time by each person, we are able to complete the most important work more quickly.
Overall, the visibility LeanKit provides has made it easy to measure how much we’ve improved our turnaround times, which has been a huge morale booster. Happier teams are more productive teams.
How is visual management helping you as a manager?
As a manager, I have what I need in terms of understanding what is happening in our process. Before, we didn’t know how long each step of the process took. When there were delays, we thought we knew why, but without accurate information, we were only guessing and weren’t sure how to fix things. LeanKit gave us visibility into what the actual problems were. It also helped us figure out how much time we could save by improving our processes.
Could you give an example?
Yes. Before implementing LeanKit, we had what we thought was a bottleneck with code migration. I regularly heard that this bottleneck was slowing down the process. It was such a problem that when we started using LeanKit we even created a lane for “waiting on code migration.” But once we started collecting the metrics and understanding our process, we learned that we weren’t actually waiting on that at all. LeanKit helped us identify the true cause of the delay and quickly resolve it.
What advice do you have for others implementing LeanKit?
When our company first started using LeanKit, the tool belonged to “the lean group.” They created the boards and gave them to the managers who used them in the same way that they used spreadsheets. There wasn’t buy-in from the team in how the process was defined on the board or in terms of commitment in keeping it updated. Managers need to understand that this is a tool for empowering your teams. Yes, it’s great for you as a manager, but the teams need to own the tool and the way it’s implemented. If there isn’t buy-in and ownership at the team level, teams won’t appreciate its power and they won’t actually use it.
I would also encourage other teams to take a little time on the front end. Just a little bit of training goes a long way here.
In a nutshell, why are you such a champion of LeanKit?
I am a visual person, so I enjoy LeanKit’s visual interface. It’s very easy to drag and drop things around. I like being able to link to documents or see history and comments that are associated with a card. I appreciate that I don't have to open a card to see details. I get a title, I see who owns it, I know the priority, I know when it is due, I know how many hours we have estimated for it to take. I know whether it's a bug, an enhancement or something else. I know all of that just by glancing at it. That’s why I love LeanKit.
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