The Living Pareto Chart

imageWhen starting any performance improvement initiative the challenge most managers face is where to start. This is a result of constant “fire fighting”. We are constantly handling problems and issues as they come up but we are not tracking them to see if our improvement efforts are effective. Conversely, because we have never tracked issues as they arose, we don’t know where to start.

In any performance improvement initiative such as QAPI the focus must always be on work on the most pressing issues first. That gives us the best return for our efforts.

Deciding on what exactly to work on first can be the most difficult decision in any performance improvement initiative. The focus must always be on the most pressing problem that, when resolved, will give us the best return for our efforts.

If this is the case, the first step you should take is to gather the data. This is a very simple process, using a Pareto Chart. Using the chart will bring what to work on into crystal clear focus.

The use of the Pareto Chart brings this into crystal clear focus.

Start by spending the first month gathering data.

Put a Pareto Cart on your gemba Board or a prominent spot in your department. Enlist the help of your staff to track performance failures in a no blame, no shame environment. It’s not about who made a mistake or that something happened, it’s about tracking those incidents and resolving the root cause so they don’t happen again.

Completing the form is very simple. Write in the department or unit. Indicate the period you are measuring. Keep it simple and track by calendar month, indicating the month. Whenever something happens such as: a fall from a wheelchair, fall from a bed, a resident is left in the bathroom for an excessively long time, a medication error, bedsores, write it in the category column and write the date beside it n the date column. If it happens again, write the date in the next box over. In a month, it will be very evident visually, to you and your staff, exactly what your biggest problems are and the order you need to fix them.

Review the chart every day to see if you can determine any trends that may indicate the performance improvements efforts you are doing are not effective.

Whenever an incident occurs, a 5 Whys analysis (the tool and its use is described in this chapter) should be done immediately to determine the root cause and a countermeasure  should be done to eliminate the cause of the incident

What Others Have Said…

Michael developed a LEAN program for our hospital. This involved training both managers and front line staff in LEAN and its application in every department. Two LEAN projects were conducted in an effort to reduce inventory. There was a reduction of $135,000 in pharmacy inventory and $200,000 reduction in OR inventory."
Richard E. D’Alberto, FACHE
President & Chief Executive Officer
Laurens County Hospital

"Michael is a great speaker. He is inspirational and knows his trade."
Lynn Yarbrough

"Great quality- appreciate his openness to field question on the spot"
Rita Jones
CEO, Dundy County Hospital

"Michael is an outstanding, knowledgable speaker, keeps the flow going an involve the audience well."
Stephen Stewart
CEO, Artesian Valley Health System

"I like the process in implementation"
Brad Langdorf
VP Clinical Services, Community Hospital

“Michael is an excellent speaker. Content is exciting and educational.”
Mollie Heisel
Human Resource Coordinator
Brown County Regional Health Care
“Very good; usable; informative; real; encouraging”
Valerie Gigolyk
Loewen Windows

“Without your personality, coaching and spirit, we wouldn’t have made it so far.”
Ann Corrigan, RN
VP of Patient Services
Henry County Health Center

“We are utilizing the information on a regular basis. It has been exciting to see this growth.”
Pat Hales , Director of Quality and Educational Services Misericordia Health Center

“Excellent speaker- funny yet seriously important to improve our daily lives.”
Rebecca Ricartti, HR Director
Pacific Alliance Medical Center

“Michael is fantastic. Keeps the learning Entertaining and interesting.”
Stephen Stewart CEO
Artesian Valley Health System

“Great. Enjoyed the session.”
Curtis Hawkinson CEO
Community Memorial Healthcare

“Very clear and concise presentation. Always includes stories that make you think.”
Heather Greenwood, Med Tech
CHI St. Alexius Health

“Michael is a great presenter and presented he content in a manner that made it interesting and useful.”
Lynne Yarbrough, OR Director
Johnson Regional Medical Center

“Knowledgeable and energetic.”
Valerie Hangman, QI Coordinator
Providence Medical Center

I was impressed by the content and the clarity of the speaker.”
Jennifer Russell
Government of Manitoba

“Excellent quality, excellent information & keeps his agenda enthusiastic and timely.”
Terri Davis, RN
Providence Medical Center

“Dynamic speaker who leads the group to discover the answers for themselves.”
Jeff Dolan
Canada Cases Ltd.

“Mike is inspirational. A Great Motivator.”
Glen W. Buckler
Two Small Men with Big Hearts

“You have to see Michael Bayer’s presentation.”
Lois French

Investors Group

“Excellent speaker with an important message”
Rob Vineberg
Regional Director General
Citizenship & Immigration Canada

“Excellent speaker- funny yet seriously important to improve our daily lives.”
Rebecca Ricartti,
HR Director
Pacific Alliance Medical Center

“Fantastic! My cheeks hurt from laughing so much, yet I also gained so much knowledge too! Thanks!”
Daiva Griese
One Legacy

“Excellent, worthwhile. It was as good as it gets.”
Stephanie Bloodworth
Case Manager, New Directions

“Fantastic speaker. Great for any industry.”
Ron Farmer
Personal Banker, CIBC

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