How Do You Determine Which Way to Go



 Review your past.

  • Study your organization’s vision/mission statement (clearly identify why your team exists in light of this statement).
  • Identify the key milestones your team has accomplished over the last one to five years (the highlights and lowlights).
  • Describe what has happened in the organization and what decisions have affected your team over the last one to five years.

 Assess the current state of your team.

  • Report the data and anecdotal evidence regarding the “multiple bottom lines” your team dealt with.
  • Assess your team’s outcomes.
  • Assess processes your team used to achieve those outcomes.
  • Summarize the assessment of your team with a SWOT statement.

Identify goals that would represent successful resolution to your current problems.

  • Exercise awareness: Which problems deserve attention?
  • Exercise analysis: What are the chief causes of the problems?
  • Consider alternatives: What could be done differently?
  • Plan action: Who should do what with whom by when and how?

Envision the direction and new elements of your future.

  • Identify likely future demands that your team may have to respond to.
  • Picture your ideal/preferred future: What would this team be accomplishing if it were fully living up to its potential?
  • Brainstorm new features/directions for your team.
  • Envision the milestones you would achieve.

Plan the actions/tactics needed for implementation.

  • Identify the forces for and against the new and improved team.
  • Identify the strategies to capitalize on the forces for the team.
  • Identify the strategies to reduce the forces against the team.
  • Identify the steps that must be taken to implement the plan.
  • Identify who is responsible for which elements of the plan.
  • Identify a time for achieving the elements of the plan.


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Value Stream Mapping for Flow in Healthcare (part 2)

Applying flow to healthcare (part 2)

The rules to follow for smooth patient flow are the same as those of the Toyota Production System:

#1: Specify timing, sequence, and outcome of all work
#2: Connect all customers and supplier relationships with “one-piece pull”
#3: Flow product or service directly one at a time
#4: Signal problems at each step through “stop the line”
#5: Start at the process owner solve problems using the scientific method

There are three main problems likely to be encountered with patient flow at any hospital.

These are: 1) scheduling, 2) inflexibility of the layout of hospital facilities, and 3) the functional or “silo” mentality between departments.

1) Smoothing out schedule of capacity of value streams across capacity constrained resources, such as operating rooms, is a theme common to all Lean implementations. One example of a barrier to flow is the lack of beds. One root cause of slow turns of beds is a delay in discharge. The root cause can be something as simple as scheduling discharge times at the convenience of the physician rather than based on the pace of customer demand or a target turn time for beds.

Not having a bed available creates the waste of waiting for the patient, motion for the nurses who must search for an available bed, transportation for the patient who must be relocated to the bed, and extra processing to make sure the charts, meds and resources are diverted to the new location. A common goal must be set to improve patient flow and increase velocity so that competing interests can be resolved and behaviors can change.

2) Compared to a factory layout where equipment and even non-structural walls can be moved with ease to accommodate improved flow, hospitals tend to be multi-story, multi-building structures with complex infrastructures that do not lend themselves to a quick rearrangement processes to accommodate patient flow. Although the best opportunities are to take advantage of new construction or remodeling, we are seeing hospitals that are willing to remove physical walls and convert room, offices, and storage space to accommodate patient flow.

3) As in any industry, a strong “silo” mentality exists in hospitals between the facilities a hospitals provide, physicians, specialists, RNs and staff all trying to optimize their part of the value stream of providing care without looking at it from the perspective of the patient. This must be addressed long-term through a team approach and conversion to value stream management.

Patient flow is an exciting area of Lean Healthcare, as it holds the promise of lower costs, improved quality of care, and a better patient experience for all of us.

For more information on implementing or learning flow through our Value Stream Mapping classes and simulation please contact us- Office- (704) 274-2050 email-

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Value Stream Mapping for Flow in Healthcare (part 1)

The consultants in our Lean Healthcare practice are speaking with an increasing number of hospitals and healthcare organizations interested in Lean. As we all know, healthcare costs are high and patient wait times are long. Anyone who has had experience sitting in a waiting room, examination room, or in a hospital bed can attest to the fact that there is a distinct lack of flow in the way healthcare is provided today.

One of the key ideas in Lean is to increase velocity, or the amount of profit generated over a period of time. Velocity is increased by examining the revenue generating sequence of activities called Value Streams. When waste such as delays, errors, transportation, motion, and so forth are eliminated from these operations what remains is the ability to provide the same value in less time. Flow is the key to increasing velocity.

Assuming that assets such as beds, medical equipment, and surgery rooms are fixed, the revenue generated through these over a set amount of time must increase. We usually cannot add resources without spending money. We cannot increase the amount of time available to us in a 24 hour day. We must increase velocity by speeding up the flow of value through the system. This is done by examining and eliminating the non-value-added and waste (muda) elements of the process of providing care.

What is the impact of better patient flow for hospitals? As waiting time is reduced, the healthcare experience for the patient improves, reducing waiting time and speeding recovery. As patients flow from process to process (from sickness to health) beds turn faster, and more patients can be served. More patients served equals to more revenue for the hospitals. By increasing revenue with the existing fixed costs (rooms, beds, overhead) hospitals can increase profitability.

The first step is to identify the healthcare value streams that are the target of conversion to flow by asking the following questions of process and service mapping: What types of care does the hospital provide? What volumes of patients are experienced for each? What are the resources needed for each? What is the sequence of steps to provide care?

Then, we design a ‘just in time’ system through a relationship of “one-piece pull” of work (patients, samples, x-rays, etc.) at the pace of customer demand (takt time). We do this through a live simulation by walking a patient through the process of care without delay, one at a time. The results are documented, challenges and problems are identified, and a system to support smooth patient flow is defined.

For more information on implementing or learning flow through our Value Stream Mapping classes and simulation please contact us- Office- (704) 274-2050 email-

Feel free to leave comments, if you would like to converse with us on any of our blogs feel free to reach us on

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403 Gilead Rd.,  Suite L
Huntersville, NC 28078

LEANing in on Healthcare

There is a “petition” that is building momentum in the Healthcare industry – “We need to become Lean…”  Although the need has been there for some time, the direction (the how-to) has been nebulous and ill-defined.  “We are unique,”~the healthcare practitioners. With the change in the healthcare structure, and the rules set forth by administration most believe it is virtually impossible for hospitals to become lean. Yet they are highly aware that something needs to change in order to provide the highest of quality to patients.

However, while it is true that there are many unique facets to ANY business, in ANY industry, it is also true that the principles and practices of Lean are applicable to any environment where the management and staff are willing to look at their business through “new eyes.”

The foundation of Lean is the elimination of waste through continuous improvement initiatives.  Anyone who works in the Healthcare industry, or even those of us who have been on the receiving end of healthcare, knows that there is countless waste in the industry: from long waits to astronomical costs, from lack of standardization, inordinate quantities of inventory, massive amounts of paperwork, errors and the one we all love to hate REWORK.

The very recognition of these inadequacies in the existing system(s) means that Healthcare practitioners have already begun the first step of Lean – seeing things more clearly, and realizing that you CAN improve.  Lean simply provides the tools that allow you to attack the individual problems through a structured and systematic approach.

One of the major differences in the healthcare industry, versus say, manufacturing, is the potential consequences.  In manufacturing, if we make mistakes, the cost translates into lost time and money.  In Healthcare, however, mistakes can translate into “life or death”.

Therefore, and most assuredly, because of this fact, it is all the more important for the industry to “Face their fears” and start looking at the systems/processes that allow errors to occur.

  Along with being bested by the U.K., America’s health care system ranked worse than those of Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, and Sweden. In comparison, our doctors and hospitals are terrible at providing low-cost, efficient, and equitable care, and we have much higher infant mortality and low life expectancy. ( June 2014)

Here’s a table that describers where the United States ranks in elements of healthcare compared to other “leading countries”

Healthcare Cost Ranking for leading countries.
Healthcare Cost Ranking for leading countries.

Cost is high and quality is low, of course we would recommend a lean approach (we’ve already done the research) but even if Hospitals decided against it, our question is… What Will They Do?


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Huntersville, NC 28078

Phone: (704) 274-2050


Implementing Lean to Revolutionize Healthcare

Lean Healthcare1

Currently many healthcare organizations spend months (sometimes years) and hundreds of thousands of dollars on assessments and analyses by large, over-budget consulting firms.  Many consulting firms, however, have a deathly fear of implementing any of the recommendations made within their assessments and analyses.  They fear the creation of liability issues during implementation, and implementation is not as lucrative as performing assessments and analyses.  The healthcare organization then fails to implement any real improvement measures because it lacks the expertise from within to facilitate the implementation activities. Not to mention adequate resources and time are not allocated to the improvement effort.

Additionally, the approach to improving a given process often focuses on improving the value-added elements of the patient treatment processes; without any focus given to the non-value-added elements.  These non-value-added elements prolong patient lengths-of-stay, maintain high healthcare facility operating costs, restrict bed availability, and sometimes negatively impact clinical outcomes.  Focusing on the value-added elements results in minimal profitability gains being realized, while patient satisfaction continues to be severely impacted.

So what differentiates us at GDC Total Business Solutions LLC from the large consulting firms?  Similar to the process improvement methodologies we use within the manufacturing sector, we form Kaizen (improvement) teams out of those involved in the organization’s patient treatment processes.  We start with providing training, we then coach and facilitate the teams in their assessment, analysis, and implementation activities to bring about significant improvement.  Our focus is on reducing the non-value-added activities that hinder patient throughput, impact clinical outcomes and create patient dissatisfaction

Process improvement is implemented within the patient treatment value stream through our facilitation of a series of Kaizen events.  These events typically last from one to three weeks in duration.  The results are significant, sustainable gains in treatment throughput, patient lengths-of-stay, clinical outcomes and operating costs within a very short time.

Being that significant improvement is accomplished through a team approach with those involved in the treatment processes, a buy-in of the new processes by the healthcare facility staff is achieved, adding to the sustainability of the process improvements.  Sustainability is further ensured through the development and implementation of a sound performance measurement system.  This measurement system drives the staff’s behavior that produces the desired outcomes in keeping with the organization’s vision, mission, goals and objectives.

Lean Healthcare

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What is Lean?

GDC Lean U The philosophy of Lean actually comes from the Toyota Production System (TPS), where Lean production is a way of life. Toyota has evolved to a way of thinking that focuses on making a product flow through production without interruption, a pull system that cascades back from customer demand by replenishing what the next operation takes away at short intervals and in an environment where everyone works to continuously improve. Lean is focused on eliminating waste in processes. This includes waste in work in process (WIP), finished goods, and raw inventories – the tenets of mass production. Lean is not about eliminating people, but rather about expanding capacity by reducing costs and shortening cycle times between when the customer places an order or request services and when the product is delivered. The idea is to provide exactly what the customer has asked for as soon as possible, and the lead-time is as short as possible. The process of getting to this ‘Lean way of thinking’ is the process of ‘becoming lean’. Lean is all about the elimination of waste in a system. A Lean transformation follows five key steps:

  1. Identify your Value – define value from the perspective of the customer.  Express value in terms of a specific product, which meets the customer’s needs at a specific price and date.
  2. Map the Process –   the set of all specific actions required to bring a specific product through the three critical management tasks of any business: the problem-solving task, the information management task, and the physical transformation task. Create the map of the Current State and the Future State of the value stream, Identify and categorize waste in the Current State, and eliminate it.
  3. Implement Flow – Make the remaining steps in the value stream flow. Eliminate functional barriers and develop a product-focused organization that dramatically improves lead time.
  4. Create Pull – Let the customer pull the products as needed, eliminating the need for a sales forecast or continuously producing parts with no defined system.
  5. Strive for Perfection – There is no end to the process of reducing effort, time, space, cost, and mistakes. Return to the first step and begin the next lean transformation, offering a product, which is ever more nearly what the customer wants.

A Lean Enterprise is a Company that continues to improve all its processes from Administration – Sales – Engineering – Manufacturing by eliminating ALL Non Value Added steps or WASTE (MUDA), using the Lean 18 elements as a frame-work for methodology and consistency throughout the Enterprise. Be sure to follow us on Twitter @Gdc_Tbs and now Facebook !

Visit our Lean glossary to become more familiar with terms and to learn more about GDC Total Business Solutions

Lean Hospitals

Case Study:  Reduce the Risk of Spreading Infectious Diseases

This Case Study was conducted in March of 2005. We’ve recently carefully reviewed several health and hospital articles and it appears that infections related to hospital accidents are still at an alarming rate.


Company Profile

  • Southeastern Michigan hospital ranked in the  top 100 improved hospitals in the nation
  • Committed to continuous improvement, and reaching the most efficient, highest quality patient care available

Business Situation 

At the time hospitals were constantly in a struggle with the battle to reduce the possibility of spreading infectious disease.  The American culture had gone into a prevention frenzy to control the outbreak of infectious diseases.  We adopted the following tools and processes to help reduce the likelihood of contracting an infectious disease.  Some of the tools that were used are:

  • Mandated immunization for school -aged children;
  • washing hands often and before returning to work;
  • cooking food thoroughly;
  • Use of antibiotics.
  • Infectious control practitioners to oversee infection control programs

Even with prevention practices set in place, hospitals still had a staggering  5% infection rate, one of the most critical areas to reduce the infection rate is the hospital operating room.  While a human body is open and exposed in an operating room, the chance of infection increases greatly.

The improvement team therefore started implementing Lean Conversion techniques to four connecting operating rooms, or commonly referred to as a POD.  With the assistance of Lean Sensei Curtis Walker of GDC Total Business Solutions, tools and systems were put in place to drastically reduce exposure to infectious disease.


Lean Conversion has many tools that can be utilized across various industries.  The healthcare industry has recently realized it is time for improvement!  For years the industry has been struggling to provide customer service at an economical price.  With the current situation, hospitals are finding it necessary to compete amongst each other, which means that the institutions must improve their current practices to provide superior, cost- effective care for patients.  The industry has turned to Lean Conversion and Six- Sigma to bring continuous improvement tools and activities to their organization.

To create Workplace Organization by using the foundation of Lean tools, 5S.  This technique was applied to one pod (4 operating rooms).  The 5S standards used are:

  1.  Sort – Identify only those things that are absolutely necessary and remove everything else
  2. Set-in-Order –  Create a place for everything and everything in its place
  3. Shine – Clean and further disburse items
  4. Standardize –  Create and set the standard for cleanliness and orderliness
  5. Sustain – Establishing the discipline to sustain the first 4S’ over time

Over 20 weeks, teams of 3-5 members including a RN and a Pod Aide held training meetings (maximum of 4 hours).  These team members working with other staff members performed assignments lasting no more than 60 minutes per team member.   The Lean tools (in addition to 5 S) used were:

  • Kanban
    • This is a system used to regulate amount of supplies on-hand.  It is a visual system that has a trigger to alert when inventory has dropped below the re-order point.  The system ensured that all supplies were stocked and available during the surgical procedure.
  • Runner
    • This tool is essential for the successful implementation of the kanban system.  The Runner is the person who monitors and adjusts the system to ensure that it is up-to-date and accurate.
  • Visual Controls
  • Inventory Control
Curtis Walker reviewing the project.
Curtis Walker reviewing the project.


  • Decreased staff time spent searching for various  supplies and equipment resulting in increased time available for patient surgery
  • Less time spent by Pod Aides replenishing supplies
  • Less frustration due to the inability to find necessary supplies immediately
  • Less stress for new hires due to clear, specific organizational standards
  • More time available to spend on patient care

After the appropriate lean tools were implemented, in a two week controlled pilot study of the results, GDC Total Business Solutions found the following:

  • 77% increase in reducing the risk of  spreading infectious diseases (See Example)
Incident Improvement
Incident Improvement

866 (25%) hours of additional operating room time

  • $779,000 annual savings
  • Improved customer service
  • less complaints


GDC Total Business Solutions Curtis Walker, working with the hospital teams produced very impressive results by implementing Workplace Organization (5S) tools.  The results were sustainable, continuous and respected by the hospital management team.

Today’s Health industry continues to face problems such as these as well as others. The change in health care coverage along with the growth in new diseases, makes it critical that hospitals begin to increase preventative methods and improve their processes.

For more information on GDC Total Business Solutions please visit our website

Sort, Set in Order,Shine,Standardize & Sustain (5 S)

How GDC-Total Business Solutions Guided Hertz Equipment Rental to Deploy Measurable Solutions and Create Cultural Change



Hertz Equipment Rental Corporation — a wholly owned subsidiary of The Hertz Corporation — operates one of the world’s largest equipment rental businesses. Hertz Equipment offered a diverse line of equipment, including tools and supplies, as well as new and used equipment for sale. Their customers ranged from major industrial companies to local contractors and consumers through approximately 350 branches in the United States, Canada, China, France and Spain. Hertz Equipment Rental Corporation was founded in 1965 upon a commitment to provide the highest quality products and absolute excellence in service.

CEO Mark P. Frissora brought a strong background in Lean principles of continuous improvement when he joined the company in 2006.

Fred Daniels Past Vice President of Operations for Hertz Equipment Rental had been with the company 20 years.


The industrial equipment rental market was growing and Hertz Equipment Rental was facing stronger competition. They were challenged with how to take advantage of the growth opportunities and maintain the highest quality products and service while making their cost structure more competitive.


Mark Frissora’s background in Lean principles and his familiarity with the book The Toyota Way by Jeffrey Liker convinced him that his company could implement similar changes to their processes. So he called Liker directly to get a recommendation and was connected with GDC-Total Business Solutions.

In 2007, GDC president Curtis Walker and Performance Improvement Specialist Janice Roberts began their work in Hertz’s Houston location. First came a week of Lean overview training for key management personnel. This was followed by Kaizen events, based on the Japanese philosophy that focuses on continuous improvement through activities that help employees learn to spot and eliminate waste in business processes.

Everything was taken out of the work area so that the people doing the job could decide what makes the most sense in terms of how they do their job. The 5S system (Sort, Set in Order, Shine, Standardize and Sustain) was implemented to improve work flow. Processes were improved and implemented with the active participation of the people performing them.

5S Project at Hertz Rohnert Park, California

5S Project at Hertz Rohnert Park, California

Over the span of two years, nearly 90% of all Hertz Equipment Rental branch managers completed Lean training. Lean implementation has been completed in nearly all locations.


At Hertz Equipment Rental, trucks arrive at the loading dock, equipment is loaded into the trucks, the equipment is delivered and the trucks return to the dock for more equipment.

Prior to GDC’s involvement, it took a total of 45-90 minutes for a truck to be loaded and back out for deliveries. After the Lean implementation, this process was reduced to only 20 minutes. Implementing Lean ultimately resulted in a dramatic productivity increase.


Employees were initially skeptical. But the method in which GDC-Total Business Solutions approached the project nurtured a counseling, consultative relationship that allowed employees input and gained their trust. All levels of employees and management worked together to find solutions. The culture of the organization began to shift to one where employees felt comfortable and eager to suggest ways to improve processes.

Janice with the Birmingham, AL Hertz Team.
Janice with the Birmingham, AL Hertz Team.

Fred Daniels says, “We owe a lot to Janice, Curtis and GDC. They are severely committed to the customer, putting forth extraordinary effort to make sure we stayed on course. They truly practice what they preach by always looking for ways to improve the way they do things. And Curtis’ experience and expertise is hard to top!”


8days+600labor hrs= complete shop 5s Kaizen
8days+600labor hrs= complete shop 5s Kaizen

3 Ways To Begin Your Development!

Three way to begin your development.
Three ways to begin your development.

GDC Lean University 

GDC Lean University is dedicated to developing the next generation of business professionals. As global markets continue to expand we must educate our workforce by providing the tools, techniques, and “Lean Thinking” to stay competitive in the twenty first century.  GDC’s Lean University includes certification programs and individual workshops that allow the “simply curious” to the “seriously studious” to achieve their Lean goals and objectives.  Our educational options include:

  1. Training
  2. Hands on workshops
  3. Train the Trainer
  4. Lean Master Certification Program

Each course provides the participant with current facts, state-of-the-art Lean tools, hands-on activities, comprehensive workbooks and/or handouts, pre-and post-tests, exclusive forms and formulas on CD (where applicable) and the ability to interact with professionals from other industries and walks-of-life.

GDC Consulting Services 

The GDC team provides quality, value-added services that result in measurable improvements in profitability, productivity, on-time delivery, employee accountability, and customer satisfaction. We offer tailored approaches to integrating Lean Business, proven by our successful partnerships with over 400 clients in various industries. Our strategy is one of guided application that allows us to transfer our knowledge to our clients; our clients learn by doing. GDC is a complete solutions provider, offering services ranging from complete implementations to specialized training of key employees. GDC’s Consulting services include:

  • Business Transformation Services
  • Implementation Services
  • Project Mentoring
  • Coaching
  • Operational Assessments
  • Crisis Management/Turn Around Services

HOLOS Leadership System (HOLOS)

The HOLOS Leadership System provides the most comprehensive business management system available on the market. HOLOS uses a combination of change management, culture problem solving and leadership development to drive the transformation process that is needed to accomplish strategic and financial world-class goals. The revolutionary process that stands behind the HOLOS Leadership System is the comprehensive diligence built into addressing every aspect of your complex organization. Using the HOLOS Leadership System, our team of trained professionals will assess your organizational needs and lead you in a poignant course to either:

  • Analyze the gap between where you are and where you want to be with our GAP Analysis
  • Strengthen your strategic deployment with the Lean Operating System
  • Improve your in-depth processes with the Business Process Optimization System
  • Analyse, optimize and systematize, performance results with the Continuous Improvement Toolkit
  • Empower your diverse workforce with the Human Capital Development System
  • Perfect your financial measures with the Financial Activity Management System
  • Address cultural limitation in driving continuous improvement with the Lean Sustainment Audit

The true beauty of the HOLOS Leadership System lies in the full integration or stand-alone flexibility of each system. We recognize that your company may already hold certain capabilities that do not need immediate consideration. Our goal is not to offer you a solution to something that does not need our attention, which is why we have developed each system to be self-sufficient.

Stay tuned as we continue to describe our services and how Lean can be utilized in every piece of your business.

Looking to learn more about GDC Total Business Solutions visit


Industries We Serve
Industries We Serve

Since 1999, GDC has been providing “Lean Thinking” companies across North America with workforce education, implementation methodologies, and metric systems necessary to survive and thrive in an ever-changing global economy.  In today’s economic times, we can’t wait for change to happen; we need to drive the change. Industry leaders know that it takes more than a strategic plan to drive effective and measurable change.  It takes a shift in the organization’s mindset towards understanding their expectations in making strategies obtainable. GDC combines the following lean tools to create that mindset shift:

  • Lean Operating System (LOS) – measurement tool used in aligning goals, objectives, task, and activities throughout the organization for increased effectiveness .
  • Business Process Optimization (BPO) – training tools used to educate and provide the foundation for improvements across the organization in alignment with the LOS.
  • Human Capital Development (HCD) – our methodology for mentoring employees at all levels to their new roles, responsibility and the techniques to manage cultural change and desired results.

Implementing these organizational tools  will provide companies with the “Total Business Solutions” necessary to execute their strategy.  As partners in this journey, GDC works alongside your  staff  to analyze and understand the real issues and opportunities before identifying an implementation plan that will align customer satisfaction, productivity, and financial goals with the cultural change required to sustain a continuous improvement system.  Our methodology will:

  • Guide your organization towards “Lean Thinking.”  We achieve this by first evaluating your processes and organizational structure. The only way to achieve true flow is by linking all of the internal processes of an organization from a financial perspective, it gives us justification to improve or eliminate it.
  • Deploy measurable solutions that make sense in achieving world-class performance. Once we have guided the organization through the “waste” journey then we help develop the improvement process throughout the organization. We provide you with the knowledge and tools necessary to structure and organize your transformation.
  • Change the culture to support the human side of continuous improvement.  During deployment we work with your staff to help them understand the need for change and their commitment to the company, the improvement process, and accomplishments of the Critical Business Success Factors .  It’s this enlightenment that promotes change.

At GDC, we turn information into insight and insight into strategies that enables companies to build and sustain competitive advantages. In turn, these advantages equip you to remain competitive in a changing and challenging global economy.

Stay tuned as we continue to educate on a holistic approach to LEAN and Consulting!

Feel free to browse our website