Lean Pioneer: Turning Curiosity into Capability at CTSC
Sometimes improvement does not start with a full project plan. It starts with a question.
At the UC Davis Health Clinical and Translational Science Center (CTSC), Jackie Dalke (Operations Manager, CRC Supervisor) and Kate Marusina (Director, Research Staff Workforce Development and Resource Innovation) noticed a persistent issue. Clinical trial invoices were being denied by sponsors at a meaningful rate, creating avoidable rework that spanned multiple teams, including study teams, CTSC Clinical Trials Management Support system, and Aggie Enterprise.
From Observation to Practice
Instead of waiting for a formal project to be launched, they leaned into what they had already learned.
After participating in Lean training, Jackie and Kate began applying Value Stream Mapping and Root Cause Analysis tools directly to their work. What started as a two-hour investment in learning quickly turned into hands-on practice. They mapped the process, gathered data, explored pain points, and began asking deeper questions alongside their collaborators.
With light coaching support from the Office of Business Transformation to help initiate facilitation, they led stakeholders through a structured 5 Why analysis. Together, they uncovered key drivers behind invoice denials, including gaps in clinical research coordinator training, unclear sequencing of steps, and opportunities to better leverage system controls.
As Jackie Dalke observed during the sessions:
“When data entry happens, it can trigger other things in the system that need to be addressed, so having a clear workflow or checklist would make a big difference.”
That insight helped the team connect early process steps to downstream issues and identify where intervention would have the greatest impact.
A Lean Fishbone Diagram is a simple tool that helps teams identify the root causes of a problem by organizing possible contributing factors. It's used to move beyond symptoms and focus on fixing the underlying issues for more effective, lasting improvements.
Turning Insight into Action
The team translated their findings into practical countermeasures, including clearer workflows, improved checklists, stronger contract alignment, and better use of system triggers. Just as importantly, they created shared understanding across roles that had previously experienced the process in isolation.
This is what Lean looks like in practice.
Not perfection. Not waiting. But taking a concept, applying it, and building capability along the way.
Jackie and Kate’s work is a powerful reminder. You do not need to be an expert to begin. A single class, a conversation, or a moment of curiosity can be enough to get unstuck and start improving the systems around you.
Resources
Root Cause Analysis: Learn how to apply Root Cause Analysis (RCA) techniques to identify the underlying causes of problems and implement solutions that prevent recurrence.
Register for Introduction to Root Cause Analysis
Value Stream Mapping Training: Develop skills to map end-to-end processes, calculate cycle time and efficiency, and analyze workflows to identify and eliminate inefficiencies.