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Connecting your Hospital Board of Directors with your Lean Six Sigma Implementation
Presented to: WCBF’s Lean, Six Sigma & Process Improvement in Healthcare
Presented by: Doug Dulin, LM, MBBDate: May 11, 2010
Workshop B: 8:30 – 11:15
Copyright Dulin Consulting Group, LLC.
After this session you will:• Understand why the connection is important
• Understand the changing roles and responsibilities of your executive board within a Lean Six Sigma Environment
• Understand how you can engage your executive board for greater implementation success
Connecting your Executive Board with your Lean Six Sigma Implementation
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Why do we want to connect our executives with our LSS Implementation?
Executives
Leadership
Employees
Customers
LSS Implementation Plan
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What does this mean without connection?
• What if 1 class of 30 students in your A3 or Green Belt Training could deliver $1,000,000 to
the bottom line within 10 weeks?
• What if you held a 5-day kaizen event that resulted in a $2.5 million in revenue to your
hospital?
• What if you held a 10-day Black Belt course over 4 months and were able to solve strategic issues and impact your organization with more
than $1.4 million?
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Why do we want to connect our executives with our LSS Implementation?
ExecutivesLeadership
Employees
Customers
Implementation Plan
Suppliers
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Why do we want to connect our executives with our LSS Implementation?
Executives
Leadership
Employees
Customers
Executives LeadershipCustomers
EmployeesWhich Company are You?
LSS PlanLSS Plan
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Lean Six Sigma as a Strategic Driver
The Lean Six Sigma program enables your company to drive results and can be further developed with a 3-part framework driven by your executive group
This is a key area where executive leadership is needed
1. Achieve alignment across the business leadership team
2. Mobilize teams to take focused action3. Accelerate teams to accomplish the desired results
*Adapted from The Corporate University Handbook by Mark Allen, Ph.D.; “The Corporate University as a Strategic Lever” by Tom McCarty
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Compelling Case for Change
New Healthcare LegislationEconomic ConditionsGreater World CompetitionSlowing ImprovementsNeed to add valuefor the customerEmployee turnover
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10 Minute Workshop Session
What is your Burning Platform?
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Lean Six Sigma as a Strategic Driver
*Adapted from The Corporate University Handbook by Mark Allen, Ph.D.; “The Corporate University as a Strategic Lever”by Tom McCarty
Align Mobilize
Accelerate
Performance and Quality
Improvement
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Lean Six Sigma as a Strategic Driver
Align – (Hoshin Planning)• Success is not measured in terms of hours of coursework
completed, but rather in terms of achievement of results
• These results should be driven by and aligned with your organization’s strategic drivers—these could include:
• Quality of Care• Patient Satisfaction• Operational Efficiency
• Leadership can measure success by establishing stretch goals in these categories
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Traditional View of the Executive Board
Executive Boards view Value> View Value in terms of dividends
and share price appreciation > Value is defined in terms of the
return a shareholder receives as a result of owning shares in a company
> Views values as the present value of all future Free Cash Flow
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The Benefits of Lean Six Sigma
What is the Executive Board looking for in the Lean Six Sigma Implementation?Improved Patient SatisfactionImproved Financial ResultsImproved Return on InvestmentThe Key Advantage within the Market Place
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Lean Six Sigma Client Case Study
Lean Six Sigma Key Improvements
Touching every department of the organization
A3 Implementation Graduation over 50+ Candidates
Green Belt Program with certifying key leaders
Kaizen events for quick, good change
Leadership that drives the implementation
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LSS Implementation Benefit Analysis
Mid-Size Company
$0
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
$7,000,000
Cost Savings Net
Cost
Savings
Net
10 Month Period
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Hospital Location Annual Financial Impact
Rapides Regional Louisiana 1MM
Valley Baptist Health System
Harlington Tx 1.3MM
Yale New Haven Med Center
New Haven Ct 1.2MM
Boston Med Center Boston Ma 2.2MM
University of Pittsburgh Pittsburgh, Pa. 5.2MM
Akron Children’s Hospital Akron, Ohio 6.5 MM
Good Samaritan Los Angeles Ca 6MM
Commonwealth Health Corp.
Kentucky 7MM
Competitive Analysis
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Daily Management
CorporateStrategy
Linking 3 Key Items
ExecutiveTeam
ManagementTeam
Front LineLeaders
Stakeholders
Lean Six Sigma Implementation
All are controlled by process control systemsand measured frequently
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What can your Executive Team Do?• Start with the key drivers (pull from the strategic plan)
• Support to define key goals and objectives of the organization.
• Support in the Hoshin Planning Session.• Make available any needed resources that will support in becoming
successful in the Lean Six Sigma Implementation
• Assure that all barriers are removed
Align Your Executive Board
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Alignment with Implementation
Hoshin Planning – (Strategy Deployment, Policy Deployment)
• Alignment requires something beyond independent creation of strategies
• Linking the Corporate Strategy and Lean Six Sigma Transformation
• Two Key Processes
•Annual Planning Process (Key summit where the executive team can support by taking an active role)
•Monthly Hoshin deployment meeting
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Top LevelImprovement
Priorities
HOW
AnnualBreakthrough
Objectives
HOWFAR
3-5 Year Breakthrough
Objectives
WHAT
Targetsto Improve
HOW MUCH
All itemsare listed
in priority order
RESOURCES
= Primary Responsibility
= Secondary Responsibility
WHO
OWNER
Annual Metrics
Hoshin Planning Matrix
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Mobilize• Ensure that LSS projects and initiatives have leadership buy-in
and support. Project Champions are critical to mobilize and enable project teams.
• LSS students are working on specific projects during training sessions.
• These projects are directly tied to the aligned strategic drivers
• Individuals with critical leadership roles in the implementationmust also receive focused support
Lean Six Sigma as a Strategic Driver
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Mobilize• Practice the new standard work of an executive leader in the Lean
Six Sigma Environment
• Take part in Gemba Walks with the leadership team
• Attend Lean Six Sigma reviews and ask questions• Attend Kaizen Report out sessions and thank the Kaizen Team
Mobilize Executive Board
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The New Role of the LSS Leader
The roles of leaders are changing to drive continuous improvement
Leadership’s sole purpose is to drive continuous improvements to improve the patient experience.
Leaders Coach and MentorLeaders ask probing questions.
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Lean Six Sigma: The Role of the Board of Directors
Challenge the process
Inspire a clear, shared visionEnable others to act
Model the wayEncourage the heart
*Adapted from The Leadership Challenge by Kouzes and Posner (1995)
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Lean Six Sigma: The New Role of the Executive Suite
Personal understanding and commitment to deployment—send a clear message: everyone is responsible for quality and safety
Integration of Lean Six Sigma into other programs and initiativesCreate a sense of urgencyLean Six Sigma program integrity (including people selection,
credibility of results, institutionalization of methods, and reviews)
Demand performance improvement—but know and understand that not every idea will be successful
Expect transparency—and celebrate when teams air their “dirty laundry”
Remove barriersPersonal engagement (including attendance at project kick off
meetings, tollgates, graduations, etc)
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Lean Six Sigma: The New Role of the Vice Presidents
Understand methods and tools enough to ask questionsLinkage of operational performance metrics to business
metricsAccountability—audit standard work, project metrics, etcExpect and demand use of Lean Six Sigma toolsProject identification processDedication of staff time for training and project completionPersonal engagement (including attendance at project kick
off meetings, tollgates, graduations, etc)Remove barriersRecognize project leaders and publicize success
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Lean Six Sigma: The New Role of Leadership
Here are some example Lean Six Sigma questionsThese questions follow the DMAIC problem solving
methodology
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Define Tollgate Questions
Is the project important to our customers? What is the problem statement? When was the problem first
seen, where was it seen, and what is the magnitude?Is the problem measured in terms of Quality, Safety, Cost
Efficiency, Patient Experience, or Employee Experience?Does a goal statement exist that defines the results
expected to be achieve by the process? Is the goal a SMART goal?
Does a financial business case exist, explaining the potential impact in measured in dollars of the project on the business?
Is the project? Have constraints been identified? Who are the customers of the project? How will they be involved in the project? How will progress
be communicated to them?
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Measure Tollgate Questions
Has the team conducted a value-added and or cycle time analysis, identifying area where time and resources are devoted to tasks not critical to the customer?
Has the team identified the specific inputs (x), process (x) and output (Y) measures needing to be?
Has the team developed clear definitions for each measurement and tested them with others to ensure clarity and consistent interpretation?
Has a clear, reasonable choice been made between gathering new data and taking advantage of existing data?
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Analyze Tollgate Questions
Has the team examined the process and identified potential bottlenecks, disconnects and redundancies that could contribute to the problem statement?
Has the team analyzed data about the process and its performance to help stratify the problem, understand reasons for variation in the process and generate hypothesis as to the root causes of the current process?
Has an evaluation been done to determine whether the problem can be solved without a fundamental recreation of the process?
Have any new risks to project success been identified?
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Improve Tollgate Questions
What lean or six sigma techniques were used to generate ideas?
What screening techniques were used to develop potential solutions?
What criteria were used to select a recommended solution or solutions?
Do the proposed solutions address all of the identified root causes, or at least the most critical?
Were the solutions verified with the Project Sponsor and staff members?
Has the proposed solution been documented, including process participants, job descriptions and if applicable, their estimated time commitment to support the process?
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Control Tollgate Questions
Has the team prepared all essential documentation including the Standard Work Instructions, training plan, training matrix, and a control plan?
Has the necessary training for process owners / staff members been performed? If not, when will it?
Has the solution being effectively implemented? How do we know?
Has the financial benefit been approved by the finance team?
Has the process been transitioned to the process owner? Has a final storyboard documenting the project work been
developed?Is there a best case (best practice) from the project be
used by other areas or departments?
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Accelerate• LSS stands apart from other project management techniques in part
due to the accelerated time frame that is built into the process improvement initiative.
• Kaizen (Rapid Improvement Week) = 5 days• Green Belt Training = 10 days (over the course of 4 months)•A3 Training = 16 hours (over the course of 8 weeks)
• Success in an accelerated time frame requires that the team members learn while doing—with enough support so that they can reach breakthrough improvements
• In addition, LSS builds in systematic and clear objectives that are due at each phase of the process.
•Tollgate Sessions (at Define, Measure, Analyze, Improve and Control)•A3 coaching (weekly sessions)
Lean Six Sigma as a Strategic Driver
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Accelerate• Get the Executive Board to understand your Lean Six Sigma
Implementation Tools• Get the Executive Board to conduct Process Owner Training
• Get the Executive Board to attend Belt Toll Gates
• Get the Executive Board to attend kaizen final presentations
Accelerate Executive Board
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Workshop Breakout Session
Deployment Tactics
What types of Lean Six Sigma Training can you do with your Board of Directors?
Lean Six Sigma Journey
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Understand LSS Operating System
A3 Performance Improvement ProgramA3 Process Owner TrainingLean Six Sigma Champion TrainingKaizen—Lean TrainingLean Six Sigma Green Belt Project ManagementLean Six Sigma Blue Belt Project Management
The Lean Six Sigma organization currently supports the following Lean Six Sigma Elements:
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Description> “Essence of Lean”
> Staff driven> Bottom up> Enabling process> Numerous but small projects
Methodology– 8 week course
– 2 hours per class– 1 hour “homework”
– 15-30 students
– Offered twice per week– Complete one project
– Graduation ceremony
Lean Six Sigma A3 Program
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Lean Six Sigma Process Owner Training
• A3 Process Owner Training: Developing Lean Leaders and your business organization• 3 Sessions
• Prior to start of A3 Class• Mid-session• Prior to Graduation
• Designed to help middle-management understand
• What is Lean? • What is A3?• Understanding and Managing Lean Projects• Challenges of Managing Change
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• Managed Care Improvement
• Antibiotics prior to surgery• Nurse Retention Rate
• Tool Cost Reduction• Resident Rounding
• Cytogenetics• MRI Utilization
Lean Six Sigma Belt Examples
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Description>Business strategic plan>Top down>Significant and rapid change
(rapid improvement week)>Short term intensive
concentrated effort by lots of employees
>24 to 36 per year
Examples• CCL Baseline Kaizen
generating 312 UDOs• Increased capacity of Sterile
Processing Department from 13,000 to 16,000 cases annually
• Reduce Inventory by $3.6 Million
Lean Six Sigma Kaizens
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Sustaining LSS Results
Drive toward standardized work in all areas.Embrace constant, rapid continuous
improvement in all departments.
Design the organization for success and change the way we lead by the way we lead.
Support, sustain and share the learning throughout the organization.
Drive the organization toward perfection.
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Conclusions• Their support is key to the LSS implementation success
• Engage them through Align, Mobilize and Accelerate• Have them to go to the Gemba and ask questions
• Attend an A3 Graduations, Green Belt Toll Gates, Black Belt TollGates, Master Black Belt Boards and or a Kaizen Events and ask questions.
• Now is the time for change!
Executive Board Connection to the LSS Implementation
Copyright Dulin Consulting Group, LLC.
What does this mean with a total team connection?
• What if 1 class of 30 students in your A3 or Green Belt Training could deliver $1,000,000 to the botto m
line?
• What if you held a 5-day kaizen event that resulted in a $3.5 million cost avoidance to the capital
budget?
• What if you held a 10-day Black Belt course over 4 months and were able to solve strategic issues and
impact your organization with more than $10 million ?
Copyright Dulin Consulting Group, LLC.
Dulin Consulting Group, LLC.
Doug Dulin – Managing Partner, LM / MBBEmail: [email protected] Site: www.dulinconsultinggroup.com
Areas of Expertise: Dulin Consulting Group, LLC. is one of the leading Lean Six Sigma (LSS) implementation consultants today inthe healthcare industry. With more than 20 years of LSS implementation experience our experience team aligns its LSS solutions with our healthcare client’s strategic business objectives and performance improvement goals. Taking the Dulin Consulting Group model that was developed in manufacturing facilities; we have helped streamline process in many hospitals throughout the United States. One client this past year, recently was recognized by the iSixSigma group for their lean implementation at their 350 bed hospital organization
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Thank You.