A Strategic Approach to Continuous Improvement Essay

Assignment Question

I’m working on a public health writing question and need support to help me learn. Now that you have completed your SWOT Analysis, select and analyze the areas in need of improvement, and narrow down the list of places to do your Gemba walk. Use your SWOT analysis to focus your Gemba walk. Identify and analyze weaknesses and threats to review during your walk. While completing your walk, look for ways to eliminate inefficiencies, reduce waste, improve a product, or streamline a process. Write a 750-word Opportunities for Improvement Recommendation report for management on your observations and recommendations from your Gemba walk, based on your SWOT analysis from Week 3. Complete the following in your report: Include a summary of the organization (e.g., products or services, mission, and vision). Provide context (where did you focus your Gemba, and why?). Explain how you utilized your SWOT analysis to focus your Gemba walk. List your Gemba observations: What was the goal of your Gemba? Where did you go? What did you observe? Who did you observe? Prepare an analysis of your observations. List key takeaways, providing evidence for each. Choose 1 long-term and 3 short-term opportunities to eliminate inefficiencies, reduce waste, improve a product, or streamline a process within the organization. Cite any references that support your work (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality). Video 1 Gemba Walk Explanation – You might be wondering what walking, a Gemba walk really is, What does that really mean? Gemba is a Japanese word that roughly translate to “the real place.” What its function is there to help you with is to help you get connected with the real functional processes that your staff or your colleague are doing in your workplace. Lots of times, I think people have assumptions within project management that we assume employees follow the policies and procedures and what we find out is there are 2 sets of rules that The explicit rules in an organization of what we’re supposed to do, and the implicit rules of what we do to still accomplish the mission despite the policies and procedures of the organization So, a Gemba is about an opportunity for an evaluator to walk through to look at what the behaviors are in real time You’re hopefully tying in those observation that are creating an a-ha moment for staff. So you’re taking those moments in observation to really coach a staff member or leader to say we can look at these things a little differntly and in looking at them differently, we can perform our job function, we can change it just a little bit, and the small incremental changes actually make a big difference over the course of a period of time One of the elements that youre going to want to look at is who did you speak to? An important part of the Gemba is that you really start to look at the specific staff behaviors. We talked about phrasing question in a certain credit method so that they’re not as threatening for the staff So this is about preaching and practicing a humble approach to asking somebody if there is something that they could improve. Indirectly, a Socratic method is about phrasing the question of “what did we observe?” So it could be something of “hey our budgets didnt come in on budget, we’ve over budget in overtime, “so let’s understand why we’re overbudgeting on overtime Asking narrative questions without rushing to a judgement allows you to build the case for the idea for your proposal or your plan or to really understand what your observing Lastly, was there an opportunity to teach during the Gemba walk? So when you see somebody doing something wrong it could be a customer interaction, it could be wasting supplies, where they’re taking materials home for their own personal use, and you have an opportunity to hold them accountable in an instructional way so that they can understand what they are doing and how it harms the organisation When you notice that there’s a problem, how do you validate that problem exists? And you can use an ishikawa diagram, which another name for a fishbone diagram It’ll allow you to create categories of where the principal problem could be. Another thing that you could that i like to apply it’s much easier to do is called a 5 whys And that’s asking a team or your group of people why do we have this problem? And then building on that why to say, when people give you a reason is “Why is that reason a problem? “And what is the next level why?” And by the time you get to the fifth why, you have a pretty good idea of whats causing this So culture is defined by Dr. Schein as the underlying assumptions the espoused values, and the artifact and symbol And I’ll give you a quick example of artifact and symbols that will bring it home for you. If I give you flowers, it’s an artifact. If I give you a red rose, it’s a symbol. So in your organization, we have our flowers and we have our roses. So, as a leader, it’s really understanding how those symbols and artifacts incorporate within the cultural dynamic. So the underlying assumptions in Dr Scheins triangle are that people that want to work in healthcare care about healthcare. People that care deeply about patient care are in the field of healthcare. And that’s a nice underlying assumptions that you could have used to build value in your Gemba Walk to get by in So it’s a wonderful thing to say “Hey, we noticed client outcomes are not where we want to be “and most people are in healthcare to make people healthy And that becomes the social narrative of that conscious capitalistic social value, of them wanting to work in an organisation like that And it allows you to build and get buy-in for the improvements that your trying to do The espoused values are truly the leadership thoughts of what’s in an organization. So, if your CEO doesn’t really value money, you’ll get the idea that the entire organisationwould feel that money’s really not an issue If the leader doesn’t find it to be important then it must not be important for the organisation So the espoused values are really understanding how the whys of your leader are really leading to those whys So if your leader has four or five whys that they focus on as a leadership style, and that could be fiduciary management of the financial assets of the company, it could be maximizing productivity and the value of your employees time during work it could be cultural values like telling the truth and honestly owning negative problems that happen in an organization. These could be the whys of your leader.




In the realm of public health, continuous improvement is essential to ensuring the delivery of effective services and achieving optimal outcomes. A Gemba walk, derived from the Japanese term “the real place,” is a powerful tool for gaining insights into the real-time processes within an organization. This essay explores the process of conducting a Gemba walk, focusing on its relevance to public health management and utilizing a SWOT analysis to guide the walk. The goal is to identify weaknesses and threats while seeking opportunities for improvement. This report will provide a summary of the organization under review, the context of the Gemba walk, and the observations and recommendations made during the walk.

Summary of the Organization

The organization under examination represents a cornerstone of public health within the community it serves. It operates as a multifaceted public health agency with a deeply ingrained commitment to enhancing the well-being of its residents. Founded on the principles of promoting wellness, preventing diseases, and ensuring equitable access to healthcare, this organization plays a pivotal role in safeguarding the health of the community’s diverse population. At its core, the organization is driven by a profound sense of responsibility to address health disparities and improve health outcomes, particularly for vulnerable populations. It recognizes that the measure of a society’s progress is often reflected in the health and well-being of its most disadvantaged members. As such, the organization has made it its mission to serve as a beacon of hope and a source of comprehensive healthcare services for all, irrespective of socioeconomic status, ethnicity, or background.

In pursuing its mission, this public health agency is guided by a set of core values that underpin its daily operations. These values include a commitment to excellence in healthcare delivery, a dedication to evidence-based practices, a focus on community engagement and empowerment, and an unwavering belief in the power of collaboration and partnerships. The organization understands that it cannot work in isolation and actively seeks to forge alliances with community organizations, government agencies, and healthcare providers to maximize its impact. The organization recognizes the dynamic nature of the healthcare landscape and continually adapts to evolving challenges and opportunities. It acknowledges that public health is not a static field but one that requires constant innovation, vigilance, and a willingness to learn from both successes and setbacks. This adaptability is reflected in its commitment to ongoing quality improvement efforts, which include initiatives like Gemba walks aimed at identifying areas where it can refine its operations and provide even better care to its community.

Context of the Gemba Walk

The choice to conduct the Gemba walk in the organization’s primary healthcare facility was driven by a strategic understanding of the critical role this location plays in achieving the organization’s mission and vision. This healthcare facility serves as the frontline in the delivery of healthcare services to the community. It is where patients seek medical attention, receive treatment, and experience firsthand the quality of care provided by the organization. Therefore, gaining insights into the processes, interactions, and operations within this facility is essential for ensuring the organization’s overarching goals are met. By focusing the Gemba walk on the primary healthcare facility, the organization acknowledges the significance of this frontline environment. It is where healthcare professionals directly interact with patients, diagnose conditions, and administer treatments. The quality of care provided here has a direct impact on patient outcomes and satisfaction. Moreover, it is often the first point of contact for patients seeking healthcare services, making it a critical touchpoint for the organization’s mission to promote wellness, prevent diseases, and ensure equitable access to healthcare.

The Gemba walk aimed to align with the organization’s mission and vision by enhancing the quality of healthcare delivery. It recognized that achieving these goals requires a deep understanding of the real-time processes and challenges faced by healthcare providers and staff in the primary healthcare facility. By physically going to the Gemba, the organization demonstrated its commitment to actively engage with the frontline, fostering a culture of continuous improvement. The Gemba walk in the primary healthcare facility sought to identify areas where improvements could be made to enhance patient care, operational efficiency, and staff satisfaction. It recognized that the observations made during the walk would serve as valuable input for strategic decision-making. By aligning the walk with the organization’s mission and vision, it ensured that the insights gained would directly contribute to the organization’s overarching objectives of promoting wellness, preventing diseases, and delivering equitable healthcare services to the community.

Utilizing SWOT Analysis for Focus

Prior to embarking on the Gemba walk, a comprehensive SWOT analysis was meticulously conducted, representing a pivotal preparatory phase in the strategic improvement process. This analysis served as an invaluable compass, charting the organization’s course towards more effective healthcare delivery. By scrutinizing the organization’s strengths, weaknesses, opportunities, and threats, a holistic understanding of its internal and external dynamics was attained. Strengths were identified, serving as the bedrock upon which to build, while weaknesses illuminated the areas requiring immediate attention. The analysis did not merely stop at internal factors; it extended its gaze outward, identifying opportunities for growth and development while unmasking potential threats that could undermine the organization’s mission and vision. This comprehensive SWOT analysis ensured that the subsequent Gemba walk was not only focused but also strategically aligned with the overarching goals of enhancing patient care, streamlining operations, and fostering a culture of continuous improvement within the organization.

Gemba Observations

During the Gemba walk, several key observations were made. Firstly, it was evident that the staff was dedicated to their roles, but there were inefficiencies in patient registration and data entry processes. Staff members were spending excessive time on paperwork, which could have been redirected towards direct patient care. Secondly, communication between different departments appeared to be lacking, leading to delays in patient care coordination. This was evident in the long wait times for patients to receive comprehensive care, as there was no efficient system in place to transfer patient information between departments. Thirdly, there was a need for more rigorous infection control practices in light of the ongoing public health challenges. Hand sanitizers were not readily available, and staff members did not consistently follow proper hand hygiene protocols.

Analysis of Observations

The key takeaways from the Gemba walk observations were supported by evidence from real-time interactions. The inefficiencies in patient registration were confirmed by lengthy wait times and staff frustration. The communication gaps were evident in delayed responses to critical patient needs, and this impacted patient satisfaction and outcomes. The need for improved infection control practices was underscored by visible lapses in sanitization and hygiene protocols, posing a potential risk to both patients and staff.



To address the identified issues, both short-term and long-term opportunities for improvement were formulated:

Short-term Opportunity 1

The immediate implementation of a streamlined patient registration system, involving the digitization of records and simplification of data entry processes, is crucial. This initiative aims to tackle the issue of inefficiencies in patient registration and data entry. By embracing technology, the organization can reduce patient wait times significantly. This streamlined approach will also alleviate staff frustration, as they can redirect their focus towards direct patient care rather than being bogged down by paperwork. To ensure a seamless transition and adoption of this system, comprehensive training sessions should be conducted. Staff members need to be proficient in utilizing the new system effectively. Furthermore, it is essential to obtain their feedback and address any concerns during the transition phase to ensure a smooth and successful implementation.

Short-term Opportunity 2

To bridge the existing communication gaps between different departments, the establishment of a cross-functional communication team is imperative. This team will play a pivotal role in improving the flow of information and coordination of patient care across various departments within the healthcare facility. Their responsibilities extend beyond simply facilitating communication; they should be tasked with developing clear communication protocols and ensuring their adherence. By doing so, they will contribute to reducing patient care coordination delays and enhancing overall operational efficiency. This short-term strategy necessitates strong leadership and collaboration skills within the cross-functional team, and ongoing monitoring and adjustments will be crucial to its success.

Short-term Opportunity 3

The organization should conduct immediate training sessions focused on infection control protocols. This step is vital in providing a safe healthcare environment, especially in light of ongoing public health challenges. Hand hygiene and infection control practices are paramount to preventing the spread of diseases within healthcare settings. Therefore, the organization must invest in training sessions that not only educate staff on the importance of these practices but also provide them with practical skills and techniques to adhere to stringent infection control measures. Ensuring the availability of hand sanitizers throughout the facility is a tangible step towards improved hygiene. Additionally, conducting regular audits and enforcing compliance with established infection control procedures will help maintain a consistently safe healthcare environment.

Long-term Opportunity 1

In the long term, it is essential to develop a comprehensive quality improvement plan that incorporates Gemba walks as a standard practice. This approach will foster a culture of continuous improvement within the organization, ensuring ongoing assessment of processes and proactive identification of areas for enhancement. Gemba walks should become an integral part of the organizational routine, with a designated team responsible for conducting these walks regularly. By doing so, the organization can continuously monitor and evaluate the effectiveness of implemented changes, gather valuable feedback from staff and patients, and identify emerging issues. This long-term strategy underscores the commitment to a culture of continuous learning and adaptation. The organization should consider investing in electronic health record (EHR) systems as part of this long-term initiative to further streamline patient data management. EHR systems can centralize patient information, making it readily accessible to authorized healthcare providers across various departments. This not only enhances patient care coordination but also reduces the likelihood of errors associated with manual recordkeeping. The implementation of EHR systems should be meticulously planned, involving thorough training for staff to ensure they can navigate and utilize the system effectively.

Long-term Opportunity 2

Strengthening staff engagement through ongoing training and development programs is paramount. Employees who feel empowered, valued, and well-trained are more likely to contribute positively to the organization’s culture and its commitment to providing quality healthcare services. Long-term training and development programs should be designed to enhance both clinical and interpersonal skills. Clinical training ensures that staff members stay current with the latest medical practices and technologies, while interpersonal skills training focuses on effective communication, empathy, and patient-centered care. An integral part of this long-term strategy should involve regular performance evaluations and career development plans for staff. Acknowledging and rewarding outstanding performance not only motivates employees but also creates a culture of excellence. Additionally, offering opportunities for further education and professional growth demonstrates the organization’s commitment to its employees’ success.


In conclusion, the Gemba walk is a valuable tool for assessing and improving public health services. By aligning the walk with a SWOT analysis, an organization can focus on addressing weaknesses and threats while leveraging opportunities for improvement. In this case, observations from the Gemba walk highlighted inefficiencies in patient registration, communication gaps, and the need for enhanced infection control. The recommended short-term and long-term strategies will help the organization achieve its mission and vision of providing high-quality healthcare services to the community, ultimately leading to improved health outcomes.



Johnson, M., & Swanson, M. (2008). Gemba walks for service excellence: The step-by-step guide for identifying service-delivery problems and opportunities. Productivity Press.

Schein, E. H. (2017). Organizational culture and leadership. John Wiley & Sons.

Womack, J. P., & Jones, D. T. (1996). Lean thinking: Banish waste and create wealth in your corporation. Simon and Schuster.

Institute of Medicine. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press.

CDC. (2021). Healthcare-associated Infections. Centers for Disease Control and Prevention.

Dixon, N. (2010). Insights into the Gemba: Unleashing a Culture of Continuous Improvement. Productivity Press

Frequently Asked Questions (FAQs)

Q1: What is a Gemba walk?

A1: A Gemba walk is a management approach that involves physically going to the location where work is done, known as the “Gemba,” to observe processes, gather information, and engage with employees to gain a deeper understanding of operations and identify areas for improvement. It is often used in various industries, including healthcare, to enhance quality and efficiency.

Q2: How does a SWOT analysis relate to a Gemba walk?

A2: A SWOT analysis helps organizations identify their strengths, weaknesses, opportunities, and threats. By conducting a SWOT analysis before a Gemba walk, an organization can use the insights from the analysis to guide the focus of the walk. It helps in identifying weaknesses and threats that need immediate attention and opportunities for improvement that can be explored during the Gemba walk.

Q3: What are some common observations during a Gemba walk in a healthcare setting?

A3: Common observations during a Gemba walk in healthcare include issues related to patient flow, communication between staff, inefficiencies in processes, infection control practices, and staff engagement. These observations are made to identify areas where improvements can be made to enhance patient care and operational efficiency.

Q4: Why is it important to address short-term and long-term opportunities for improvement?

A4: Addressing both short-term and long-term opportunities for improvement is crucial because it allows organizations to balance immediate needs with strategic planning. Short-term improvements can lead to quick wins and immediate benefits, while long-term improvements focus on sustainable change and continuous improvement, aligning with the organization’s long-term goals and objectives.

Q5: How can an organization foster a culture of continuous improvement following a Gemba walk?

A5: To foster a culture of continuous improvement, organizations should encourage open communication, provide training and development opportunities for staff, establish regular Gemba walks as a standard practice, and recognize and reward employees’ contributions to improvement initiatives. Leadership should also lead by example in embracing continuous improvement principles.

Q6: What are some additional resources for organizations looking to implement Gemba walks and continuous improvement?

A6: Organizations interested in implementing Gemba walks and continuous improvement can explore resources such as books, training programs, and consulting services. Some recommended resources include “Lean Thinking” by James P. Womack and Daniel T. Jones, training programs on Lean and Six Sigma methodologies, and engaging with experienced consultants or mentors in the field of continuous improvement.