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A Commitment to Strategic Performance Excellence:
The Balanced Scorecard & Lean Six Sigma
in US Army Medical Command
“Measuring Results of Organizational Performance”WCBF's 10th Annual Lean Six Sigma and
Process Improvement in Healthcare SummitMay 2011
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 2 12 April 2011 Unclassified
BRIEFING OUTLINE
1. Lean Six Sigma in America’s Army
2. Army Medicine’s Strategic Management System
3. Lean Six Sigma Implementation
4. Lean Six Sigma Return on Investment
5. Lean Six Sigma Case Study
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 3 12 April 2011 Unclassified
The Army’s Lean Six Sigma Program
We’re a Nation at war, and the Army is challenged to remain relevant and ready in an era of uncertainty, unpredictability, and diminishing/changing resources (money, time, people, materiel).
There currently exist non value-added activities hindering performance, and without a consistent, Army-wide framework to
best provide continuous, measurable improvement.
The Army will execute a phased, full deployment of Lean Six Sigma to accelerate Business Transformation by creating a
culture of continuous, measurable improvement that eliminates non value-added activities and improves quality and responsiveness for Soldiers, civilians, Army families,
and the Nation.
Situation
Mission
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 4 12 April 2011 Unclassified
The Army’s Lean Six Sigma Program
What has the Army done?• LSS deployed in 2006
• $19.1B dollars saved through Army process improvements:
improved materiel flow in Iraq and Afghanistan
cost savings in current Army programs
cost avoidance in future programs
revenue generation from reimbursable activities
• In 2011, 2,111 process improvement projects are underway representing $3.6B in potential financial savings
• 48 LSS Deployment Directors
• Trained 5,700 Green Belts, 2,400 Black Belts and 175 MBB
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 5 12 April 2011 Unclassified
So MEDCOM uses the Balanced Scorecard…
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 6 12 April 2011 Unclassified
…and MEDCOM Uses Lean Six Sigma!
So MEDCOM uses the Balanced Scorecard…
…as a Performance Improvement Engine addressing BSC performance gaps
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 7 12 April 2011 Unclassified
LSS “Fits” in MEDCOM’s Toolkit
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 8 12 April 2011 Unclassified
•BSC defines our organizational strategyLSS “Fits” in MEDCOM’s Toolkit
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 9 12 April 2011 Unclassified
•BSC defines our organizational strategy•LSS fits as a BSC Improvement Engine
LSS “Fits” in MEDCOM’s Toolkit
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 10 12 April 2011 Unclassified
•BSC defines our organizational strategy•LSS fits as a BSC Improvement Engine
– Evaluate objective targets, gaps to reach them
LSS “Fits” in MEDCOM’s Toolkit
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 11 12 April 2011 Unclassified
•BSC defines our organizational strategy•LSS fits as a BSC Improvement Engine
– Evaluate objective targets, gaps to reach them– ID initiatives to close gaps
LSS “Fits” in MEDCOM’s Toolkit
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 12 12 April 2011 Unclassified
•BSC defines our organizational strategy•LSS fits as a BSC Improvement Engine
– Evaluate objective targets, gaps to reach them– ID initiatives to close gaps– Those initiatives become LSS projects!
LSS “Fits” in MEDCOM’s Toolkit
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 13 12 April 2011 Unclassified
LSS “Fits” in MEDCOM’s Toolkit•BSC defines our organizational strategy•LSS fits as a BSC Improvement Engine
– Evaluate objective targets, gaps to reach them– ID initiatives to close gaps– Those initiatives become LSS projects
•Aligns commitment, resources, and effort against strategically-focused projects!
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 14 12 April 2011 Unclassified
MEDCOM’s LSS Implementation…
NORTHERN RMC
Dir SI2 Army MBBsTng Tech
WESTERN RMC
Mil Dir SI/Army MBBContract BBMgmt Analyst
TAMC
JapanKorea
WRAMC
WAMC
BAMC
CRDAMCDDEAMCWBAMC
MAMC
Dir SI/BBContract MBBArmy BBMgmt Analyst
Dir SI/Army MBBPACIFIC RMC
SOUTHERN RMCDir SIContract MBBArmy BBMgmt Analyst
AMEDDC&S
MRMCDir SI /Army BBArmy BBContract MBBMgmt Analyst
PHCDir SIContract MBBMgmt Analyst
WARRIOR TRANS CMDDir SIArmy MBBContract MBB5 Contract BBs
EUROPE RMC
MEDCOM/OTSGHQs OneStaff
Dir SI & Mil Dpty2 Army MBBs2 Army BBsTng Coord
DENCOMDir SI/Army BBMgmt Analyst
Dir SIArmy MBB
3 Army MBBsLRMC
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 15 12 April 2011 Unclassified
• Command-wide…centralized guidance…decentralized executionMEDCOM’s LSS Implementation…
NORTHERN RMC
Dir SI2 Army MBBsTng Tech
WESTERN RMC
Mil Dir SI/Army MBBContract BBMgmt Analyst
TAMC
JapanKorea
WRAMC
WAMC
BAMC
CRDAMCDDEAMCWBAMC
MAMC
Dir SI/BBContract MBBArmy BBMgmt Analyst
Dir SI/Army MBBPACIFIC RMC
SOUTHERN RMCDir SIContract MBBArmy BBMgmt Analyst
AMEDDC&S
MRMCDir SI /Army BBArmy BBContract MBBMgmt Analyst
PHCDir SIContract MBBMgmt Analyst
WARRIOR TRANS CMDDir SIArmy MBBContract MBB5 Contract BBs
EUROPE RMC
MEDCOM/OTSGHQs OneStaff
Dir SI & Mil Dpty2 Army MBBs2 Army BBsTng Coord
DENCOMDir SI/Army BBMgmt Analyst
Dir SIArmy MBB
3 Army MBBsLRMC
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 16 12 April 2011 Unclassified
• Command-wide…centralized guidance…decentralized execution• Leverages short-term contracted experts as we “build our own bench”
MEDCOM’s LSS Implementation…
NORTHERN RMC
Dir SI2 Army MBBsTng Tech
WESTERN RMC
Mil Dir SI/Army MBBContract BBMgmt Analyst
TAMC
JapanKorea
WRAMC
WAMC
BAMC
CRDAMCDDEAMCWBAMC
MAMC
Dir SI/BBContract MBBArmy BBMgmt Analyst
Dir SI/Army MBBPACIFIC RMC
SOUTHERN RMCDir SIContract MBBArmy BBMgmt Analyst
AMEDDC&S
MRMCDir SI /Army BBArmy BBContract MBBMgmt Analyst
PHCDir SIContract MBBMgmt Analyst
WARRIOR TRANS CMDDir SIArmy MBBContract MBB5 Contract BBs
EUROPE RMC
MEDCOM/OTSGHQs OneStaff
Dir SI & Mil Dpty2 Army MBBs2 Army BBsTng Coord
DENCOMDir SI/Army BBMgmt Analyst
Dir SIArmy MBB
3 Army MBBsLRMC
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 17 12 April 2011 Unclassified
• Command-wide…centralized guidance…decentralized execution• Leverages short-term contracted experts as we “build our own bench”• 249 completed LSS projects: $194.2M benefit
MEDCOM’s LSS Implementation…
NORTHERN RMC
Dir SI2 Army MBBsTng Tech
WESTERN RMC
Mil Dir SI/Army MBBContract BBMgmt Analyst
TAMC
JapanKorea
WRAMC
WAMC
BAMC
CRDAMCDDEAMCWBAMC
MAMC
Dir SI/BBContract MBBArmy BBMgmt Analyst
Dir SI/Army MBBPACIFIC RMC
SOUTHERN RMCDir SIContract MBBArmy BBMgmt Analyst
AMEDDC&S
MRMCDir SI /Army BBArmy BBContract MBBMgmt Analyst
PHCDir SIContract MBBMgmt Analyst
WARRIOR TRANS CMDDir SIArmy MBBContract MBB5 Contract BBs
EUROPE RMC
MEDCOM/OTSGHQs OneStaff
Dir SI & Mil Dpty2 Army MBBs2 Army BBsTng Coord
DENCOMDir SI/Army BBMgmt Analyst
Dir SIArmy MBB
3 Army MBBsLRMC
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 18 12 April 2011 Unclassified
• Command-wide…centralized guidance…decentralized execution• Leverages short-term contracted experts as we “build our own bench”• 249 completed LSS projects: $194.2M benefit• FY11 tipping point: sustaining our own training and execution
MEDCOM’s LSS Implementation…
NORTHERN RMC
Dir SI2 Army MBBsTng Tech
WESTERN RMC
Mil Dir SI/Army MBBContract BBMgmt Analyst
TAMC
JapanKorea
WRAMC
WAMC
BAMC
CRDAMCDDEAMCWBAMC
MAMC
Dir SI/BBContract MBBArmy BBMgmt Analyst
Dir SI/Army MBBPACIFIC RMC
SOUTHERN RMCDir SIContract MBBArmy BBMgmt Analyst
AMEDDC&S
MRMCDir SI /Army BBArmy BBContract MBBMgmt Analyst
PHCDir SIContract MBBMgmt Analyst
WARRIOR TRANS CMDDir SIArmy MBBContract MBB5 Contract BBs
EUROPE RMC
MEDCOM/OTSGHQs OneStaff
Dir SI & Mil Dpty2 Army MBBs2 Army BBsTng Coord
DENCOMDir SI/Army BBMgmt Analyst
Dir SIArmy MBB
3 Army MBBsLRMC
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 19 12 April 2011 Unclassified
Our Lean Six Sigma Program…
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 20 12 April 2011 Unclassified
Source: PowerSteering 31 Dec 09
Ret
urn
on In
vest
men
t % (R
OI)
Trai
ned
Bel
ts a
nd C
ertif
ied
Bel
ts
0
125
250
375
500
625
750
875
1000
0%
100%
200%
300%
400%
500%
600%
700%
800%
Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4
MEDCOM Lean Six Sigma Deployment - Key Metrics
ROI Target ROI Actual Belts Certified - Target
Belts Certified - Actual Belts Trained - Target Belts Trained - Actual
Our Lean Six Sigma Program…
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 21 12 April 2011 Unclassified
An Army Medicine example:at a high level…
linking Organizational Strategyto Performance Improvement
usingLean Six Sigma
and
Best Practice Transfer!
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 22 12 April 2011 Unclassified
We align all MEDCOM LSS projects to our
organization’s strategy…our Balanced
Scorecard…
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 23 12 April 2011 Unclassified
We recognize we have a performance gap in Access to Care…
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 24 12 April 2011 Unclassified
Value Stream #9: Improve Access and Continuity of CarePVC #1: Maximize Value in Health Services
• Patient Satisfaction
• Access to Care Standards (e.g., achieve acute care appt. within 24 hours)
• Support Staff to Primary Care Provider Utilization ratio
• Call Hold and Handle Times, Call Abandon Rate
• Care Appointment Availability
• Schedule Availability
• Facility Availability
• Call Volume
• # of Appts. Requested
• Type of Care Requested
• Staff Availability
• Facility Scheduling
• DOD Title 10 patients
• Non-Title 10 patients
Suppliers Inputs Process Outputs Customer
Customer Input Metrics Process Metrics Output Metrics
• Satisfied beneficiary• Accessible
appointments• Standardized, utilized
support staff• Optimized provider
productivity• Optimized referral
execution, delivery• Increased utilization of
on-line appointment system
• DOD Title 10 patients (e.g., Soldiers, retirees, families)
• Non-Title 10 patients (e.g., civilian emergencies, contractors, foreign officers and families, etc.)
• Customer Service
• Telephone Services
• Provider Support Staff Utilization
• Primary Care Exam Room Utilization
• Patient Appointing, Referral Mgt.
• TRICARE Online Appointment
• Patients
• DOD Healthcare Professionals
• IMCOM
• Need for Care (preventive, acute)
• Healthcare staff
• Facilities and infrastructure
High level process maps (SIPOCs) help us better focus on the problem/s
in our work…
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 25 12 April 2011 Unclassified
Value Stream #9: Improve Access and Continuity of CarePVC #1: Maximize Value in Health Services
• Patient Satisfaction
• Access to Care Standards (e.g., achieve acute care appt. within 24 hours)
• Support Staff to Primary Care Provider Utilization ratio
• Call Hold and Handle Times, Call Abandon Rate
• Care Appointment Availability
• Schedule Availability
• Facility Availability
• Call Volume
• # of Appts. Requested
• Type of Care Requested
• Staff Availability
• Facility Scheduling
• DOD Title 10 patients
• Non-Title 10 patients
Suppliers Inputs Process Outputs Customer
Customer Input Metrics Process Metrics Output Metrics
• Satisfied beneficiary• Accessible
appointments• Standardized, utilized
support staff• Optimized provider
productivity• Optimized referral
execution, delivery• Increased utilization of
on-line appointment system
• DOD Title 10 patients (e.g., Soldiers, retirees, families)
• Non-Title 10 patients (e.g., civilian emergencies, contractors, foreign officers and families, etc.)
• Customer Service
• Telephone Services
• Provider Support Staff Utilization
• Primary Care Exam Room Utilization
• Patient Appointing, Referral Mgt.
• TRICARE Online Appointment
• Patients
• DOD Healthcare Professionals
• IMCOM
• Need for Care (preventive, acute)
• Healthcare staff
• Facilities and infrastructure
…and we decided to start by improving the Telephone
Appointing Process
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 26 12 April 2011 Unclassified
Project Summary: Carl R. Darnall AMC Telephone Appointing
Overall average hold time reduced to 33 secondsOverall call abandon rate reduced: 3%Peak time call abandon rate reduced: 22%Call volume reduced 20% due to less call backsCalls handled increased from 4700 to 7300 / weekAgent training time reduced from 6 weeks to 4 weeksAgent turnover reduced
• REPLICATION / WAY-AHEAD• RESULTS / BENEFITS
Agent scheduling changes to handle peak timesAgent training, area setup, shift change by SOPPhone menu tree and call handling improvedFuture ACD design requirements specified
• IMPROVEMENTS• PROBLEM / BASELINE / GOAL
BEFORE AFTER
Hol
d Ti
me
PROBLEM STATEMENTThe telephone appointing process at CRDAMC has observed low patient satisfaction scores and long process hold times. Over the last six months, it takes an average of 3:14 minutes to answer customer calls to make an appointment. This has led to numerous customer complaints which have led to lower patient satisfaction scores for telephone appointing services.
BASELINE
Decrease process hold time to less than 90 seconds per callDecrease overall abandoned call rate to less than 10%Decrease peak time call abandon rate to less than 25%
Army’s largest call center: 10,000+ calls a weekLow customer satisfaction: 68%Average wait time: 3:14 minutesCalls answered under 90 seconds: 65%Overall call abandon rate: 26%; Peak time: 49%
GOAL
Performance Action Plan Completed; Access to Care Initiative 17.2Adjust MEDCOM BSC telephone appting standards NLT 20 Apr 07Establish CMS metric for telephone appting NLT 1 May 07Publish MEDCOM Telephone Appting Policy NLT 1 May 07Replicate LSS projects across MEDCOM MTFs NLT Dec 08
…the initial project was conducted at Fort Hood’s Carl R. Darnall Army Medical Center
(CRDAMC)…
Mark Hernandez – Black Belt Candidate
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 27 12 April 2011 Unclassified
Overall average hold time reduced to 33 secondsOverall call abandon rate reduced: 3%Peak time call abandon rate reduced: 22%Call volume reduced 20% due to less call backsCalls handled increased from 4700 to 7300 / weekAgent training time reduced from 6 weeks to 4 weeksAgent turnover reduced
• REPLICATION / WAY-AHEAD• RESULTS / BENEFITS
Agent scheduling changes to handle peak timesAgent training, area setup, shift change by SOPPhone menu tree and call handling improvedFuture ACD design requirements specified
• IMPROVEMENTS• PROBLEM / BASELINE / GOAL
BEFORE AFTER
Hol
d Ti
me
PROBLEM STATEMENTThe telephone appointing process at CRDAMC has observed low patient satisfaction scores and long process hold times. Over the last six months, it takes an average of 3:14 minutes to answer customer calls to make an appointment. This has led to numerous customer complaints which have led to lower patient satisfaction scores for telephone appointing services.
BASELINE
Decrease process hold time to less than 90 seconds per callDecrease overall abandoned call rate to less than 10%Decrease peak time call abandon rate to less than 25%
Army’s largest call center: 10,000+ calls a weekLow customer satisfaction: 68%Average wait time: 3:14 minutesCalls answered under 90 seconds: 65%Overall call abandon rate: 26%; Peak time: 49%
GOAL
Performance Action Plan Completed; Access to Care Initiative 17.2Adjust MEDCOM BSC telephone appting standards NLT 20 Apr 07Establish CMS metric for telephone appting NLT 1 May 07Publish MEDCOM Telephone Appting Policy NLT 1 May 07Replicate LSS projects across MEDCOM MTFs NLT Dec 08
…high call volume, low patient satisfaction, long process cycle
time, high variation…
Project Summary: Carl R. Darnall AMC Telephone Appointing
Mark Hernandez – Black Belt Candidate
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 28 12 April 2011 Unclassified
Overall average hold time reduced to 33 secondsOverall call abandon rate reduced: 3%Peak time call abandon rate reduced: 22%Call volume reduced 20% due to less call backsCalls handled increased from 4700 to 7300 / weekAgent training time reduced from 6 weeks to 4 weeksAgent turnover reduced
• REPLICATION / WAY-AHEAD• RESULTS / BENEFITS
Agent scheduling changes to handle peak timesAgent training, area setup, shift change by SOPPhone menu tree and call handling improvedFuture ACD design requirements specified
• IMPROVEMENTS• PROBLEM / BASELINE / GOAL
BEFORE AFTER
Hol
d Ti
me
PROBLEM STATEMENTThe telephone appointing process at CRDAMC has observed low patient satisfaction scores and long process hold times. Over the last six months, it takes an average of 3:14 minutes to answer customer calls to make an appointment. This has led to numerous customer complaints which have led to lower patient satisfaction scores for telephone appointing services.
BASELINE
Decrease process hold time to less than 90 seconds per callDecrease overall abandoned call rate to less than 10%Decrease peak time call abandon rate to less than 25%
Army’s largest call center: 10,000+ calls a weekLow customer satisfaction: 68%Average wait time: 3:14 minutesCalls answered under 90 seconds: 65%Overall call abandon rate: 26%; Peak time: 49%
GOAL
Performance Action Plan Completed; Access to Care Initiative 17.2Adjust MEDCOM BSC telephone appting standards NLT 20 Apr 07Establish CMS metric for telephone appting NLT 1 May 07Publish MEDCOM Telephone Appting Policy NLT 1 May 07Replicate LSS projects across MEDCOM MTFs NLT Dec 08
…the project sought to decrease process cycle time
and call abandon rate to improve patient satisfaction…
Project Summary: Carl R. Darnall AMC Telephone Appointing
Mark Hernandez – Black Belt Candidate
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 29 12 April 2011 Unclassified
Overall average hold time reduced to 33 secondsOverall call abandon rate reduced: 3%Peak time call abandon rate reduced: 22%Call volume reduced 20% due to less call backsCalls handled increased from 4700 to 7300 / weekAgent training time reduced from 6 weeks to 4 weeksAgent turnover reduced
• REPLICATION / WAY-AHEAD• RESULTS / BENEFITS
Agent scheduling changes to handle peak timesAgent training, area setup, shift change by SOPPhone menu tree and call handling improvedFuture ACD design requirements specified
• IMPROVEMENTS• PROBLEM / BASELINE / GOAL
BEFORE AFTER
Hol
d Ti
me
PROBLEM STATEMENTThe telephone appointing process at CRDAMC has observed low patient satisfaction scores and long process hold times. Over the last six months, it takes an average of 3:14 minutes to answer customer calls to make an appointment. This has led to numerous customer complaints which have led to lower patient satisfaction scores for telephone appointing services.
BASELINE
Decrease process hold time to less than 90 seconds per callDecrease overall abandoned call rate to less than 10%Decrease peak time call abandon rate to less than 25%
Army’s largest call center: 10,000+ calls a weekLow customer satisfaction: 68%Average wait time: 3:14 minutesCalls answered under 90 seconds: 65%Overall call abandon rate: 26%; Peak time: 49%
GOAL
Performance Action Plan Completed; Access to Care Initiative 17.2Adjust MEDCOM BSC telephone appting standards NLT 20 Apr 07Establish CMS metric for telephone appting NLT 1 May 07Publish MEDCOM Telephone Appting Policy NLT 1 May 07Replicate LSS projects across MEDCOM MTFs NLT Dec 08
WOW!
Project Summary: Carl R. Darnall AMC Telephone Appointing
Mark Hernandez – Black Belt Candidate
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 30 12 April 2011 Unclassified
Overall average hold time reduced to 33 secondsOverall call abandon rate reduced: 3%Peak time call abandon rate reduced: 22%Call volume reduced 20% due to less call backsCalls handled increased from 4700 to 7300 / weekAgent training time reduced from 6 weeks to 4 weeksAgent turnover reduced
• REPLICATION / WAY-AHEAD• RESULTS / BENEFITS
Agent scheduling changes to handle peak timesAgent training, area setup, shift change by SOPPhone menu tree and call handling improvedFuture ACD design requirements specified
• IMPROVEMENTS• PROBLEM / BASELINE / GOAL
BEFORE AFTER
Hol
d Ti
me
PROBLEM STATEMENTThe telephone appointing process at CRDAMC has observed low patient satisfaction scores and long process hold times. Over the last six months, it takes an average of 3:14 minutes to answer customer calls to make an appointment. This has led to numerous customer complaints which have led to lower patient satisfaction scores for telephone appointing services.
BASELINE
Decrease process hold time to less than 90 seconds per callDecrease overall abandoned call rate to less than 10%Decrease peak time call abandon rate to less than 25%
Army’s largest call center: 10,000+ calls a weekLow customer satisfaction: 68%Average wait time: 3:14 minutesCalls answered under 90 seconds: 65%Overall call abandon rate: 26%; Peak time: 49%
GOAL
Performance Action Plan Completed; Access to Care Initiative 17.2Adjust MEDCOM BSC telephone appting standards NLT 20 Apr 07Establish CMS metric for telephone appting NLT 1 May 07Publish MEDCOM Telephone Appting Policy NLT 1 May 07Replicate LSS projects across MEDCOM MTFs NLT Dec 08
6-Fold Improvement!
Project Summary: Carl R. Darnall AMC Telephone Appointing
Mark Hernandez – Black Belt Candidate
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 31 12 April 2011 Unclassified
Overall average hold time reduced to 33 secondsOverall call abandon rate reduced: 3%Peak time call abandon rate reduced: 22%Call volume reduced 20% due to less call backsCalls handled increased from 4700 to 7300 / weekAgent training time reduced from 6 weeks to 4 weeksAgent turnover reduced
• REPLICATION / WAY-AHEAD• RESULTS / BENEFITS
Agent scheduling changes to handle peak timesAgent training, area setup, shift change by SOPPhone menu tree and call handling improvedFuture ACD design requirements specified
• IMPROVEMENTS• PROBLEM / BASELINE / GOAL
BEFORE AFTER
Hol
d Ti
me
PROBLEM STATEMENTThe telephone appointing process at CRDAMC has observed low patient satisfaction scores and long process hold times. Over the last six months, it takes an average of 3:14 minutes to answer customer calls to make an appointment. This has led to numerous customer complaints which have led to lower patient satisfaction scores for telephone appointing services.
BASELINE
Decrease process hold time to less than 90 seconds per callDecrease overall abandoned call rate to less than 10%Decrease peak time call abandon rate to less than 25%
Army’s largest call center: 10,000+ calls a weekLow customer satisfaction: 68%Average wait time: 3:14 minutesCalls answered under 90 seconds: 65%Overall call abandon rate: 26%; Peak time: 49%
GOAL
Performance Action Plan Completed; Access to Care Initiative 17.2Adjust MEDCOM BSC telephone appting standards NLT 20 Apr 07Establish CMS metric for telephone appting NLT 1 May 07Publish MEDCOM Telephone Appting Policy NLT 1 May 07Replicate LSS projects across MEDCOM MTFs NLT Dec 08
10-Fold Improvement!
Project Summary: Carl R. Darnall AMC Telephone Appointing
Mark Hernandez – Black Belt Candidate
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 32 12 April 2011 Unclassified
Overall average hold time reduced to 33 secondsOverall call abandon rate reduced: 3%Peak time call abandon rate reduced: 22%Call volume reduced 20% due to less call backsCalls handled increased from 4700 to 7300 / weekAgent training time reduced from 6 weeks to 4 weeksAgent turnover reduced
• REPLICATION / WAY-AHEAD• RESULTS / BENEFITS
Agent scheduling changes to handle peak timesAgent training, area setup, shift change by SOPPhone menu tree and call handling improvedFuture ACD design requirements specified
• IMPROVEMENTS• PROBLEM / BASELINE / GOAL
BEFORE AFTER
Hol
d Ti
me
PROBLEM STATEMENTThe telephone appointing process at CRDAMC has observed low patient satisfaction scores and long process hold times. Over the last six months, it takes an average of 3:14 minutes to answer customer calls to make an appointment. This has led to numerous customer complaints which have led to lower patient satisfaction scores for telephone appointing services.
BASELINE
Decrease process hold time to less than 90 seconds per callDecrease overall abandoned call rate to less than 10%Decrease peak time call abandon rate to less than 25%
Army’s largest call center: 10,000+ calls a weekLow customer satisfaction: 68%Average wait time: 3:14 minutesCalls answered under 90 seconds: 65%Overall call abandon rate: 26%; Peak time: 49%
GOAL
Performance Action Plan Completed; Access to Care Initiative 17.2Adjust MEDCOM BSC telephone appting standards NLT 20 Apr 07Establish CMS metric for telephone appting NLT 1 May 07Publish MEDCOM Telephone Appting Policy NLT 1 May 07Replicate LSS projects across MEDCOM MTFs NLT Dec 08
>2-Fold Improvement!
Project Summary: Carl R. Darnall AMC Telephone Appointing
Mark Hernandez – Black Belt Candidate
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 33 12 April 2011 Unclassified
Overall average hold time reduced to 33 secondsOverall call abandon rate reduced: 3%Peak time call abandon rate reduced: 22%Call volume reduced 20% due to less call backsCalls handled increased from 4700 to 7300 / weekAgent training time reduced from 6 weeks to 4 weeksAgent turnover reduced
• REPLICATION / WAY-AHEAD• RESULTS / BENEFITS
Agent scheduling changes to handle peak timesAgent training, area setup, shift change by SOPPhone menu tree and call handling improvedFuture ACD design requirements specified
• IMPROVEMENTS• PROBLEM / BASELINE / GOAL
BEFORE AFTER
Hol
d Ti
me
PROBLEM STATEMENTThe telephone appointing process at CRDAMC has observed low patient satisfaction scores and long process hold times. Over the last six months, it takes an average of 3:14 minutes to answer customer calls to make an appointment. This has led to numerous customer complaints which have led to lower patient satisfaction scores for telephone appointing services.
BASELINE
Decrease process hold time to less than 90 seconds per callDecrease overall abandoned call rate to less than 10%Decrease peak time call abandon rate to less than 25%
Army’s largest call center: 10,000+ calls a weekLow customer satisfaction: 68%Average wait time: 3:14 minutesCalls answered under 90 seconds: 65%Overall call abandon rate: 26%; Peak time: 49%
GOAL
Performance Action Plan Completed; Access to Care Initiative 17.2Adjust MEDCOM BSC telephone appting standards Establish CMS metric for telephonePublish MEDCOM Telephone Appting Policy NLT 1 May 08Replicate LSS projects across MEDCOM MTFs NLT Jun 09
Disciplined, Corporate Action to
Transfer Best-Practice Across
MEDCOM
Project Summary: Carl R. Darnall AMC Telephone Appointing
Mark Hernandez – Black Belt Candidate
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 34 12 April 2011 Unclassified
Overall average hold time reduced to 33 secondsOverall call abandon rate reduced: 3%Peak time call abandon rate reduced: 22%Call volume reduced 20% due to less call backsCalls handled increased from 4700 to 7300 / weekAgent training time reduced from 6 weeks to 4 weeksAgent turnover reduced
• REPLICATION / WAY-AHEAD• RESULTS / BENEFITS
Agent scheduling changes to handle peak timesAgent training, area setup, shift change by SOPPhone menu tree and call handling improvedFuture ACD design requirements specified
• IMPROVEMENTS• PROBLEM / BASELINE / GOAL
BEFORE AFTER
Hol
d Ti
me
PROBLEM STATEMENTThe telephone appointing process at CRDAMC has observed low patient satisfaction scores and long process hold times. Over the last six months, it takes an average of 3:14 minutes to answer customer calls to make an appointment. This has led to numerous customer complaints which have led to lower patient satisfaction scores for telephone appointing services.
BASELINE
Decrease process hold time to less than 90 seconds per callDecrease overall abandoned call rate to less than 10%Decrease peak time call abandon rate to less than 25%
Army’s largest call center: 10,000+ calls a weekLow customer satisfaction: 68%Average wait time: 3:14 minutesCalls answered under 90 seconds: 65%Overall call abandon rate: 26%; Peak time: 49%
GOAL
Performance Action Plan Completed; Access to Care Initiative 17.2Adjust MEDCOM BSC telephone appting standards NLT 20 Apr 07Establish CMS metric for telephone appting NLT 1 May 07Publish MEDCOM Telephone Appting Policy NLT 1 May 07Replicate LSS projects across MEDCOM MTFs NLT Dec 08
And Today?
Project Summary: Carl R. Darnall AMC Telephone Appointing
Mark Hernandez – Black Belt Candidate
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 35 12 April 2011 Unclassified
Overall average hold time reduced to 33 secondsOverall call abandon rate reduced: 3%Peak time call abandon rate reduced: 22%Call volume reduced 20% due to less call backsCalls handled increased from 4700 to 7300 / weekAgent training time reduced from 6 weeks to 4 weeksAgent turnover reduced
• REPLICATION / WAY-AHEAD• RESULTS / BENEFITS
Agent scheduling changes to handle peak timesAgent training, area setup, shift change by SOPPhone menu tree and call handling improvedFuture ACD design requirements specified
• IMPROVEMENTS• PROBLEM / BASELINE / GOAL
BEFORE AFTER
Hol
d Ti
me
PROBLEM STATEMENTThe telephone appointing process at CRDAMC has observed low patient satisfaction scores and long process hold times. Over the last six months, it takes an average of 3:14 minutes to answer customer calls to make an appointment. This has led to numerous customer complaints which have led to lower patient satisfaction scores for telephone appointing services.
BASELINE
Decrease process hold time to less than 90 seconds per callDecrease overall abandoned call rate to less than 10%Decrease peak time call abandon rate to less than 25%
Army’s largest call center: 10,000+ calls a weekLow customer satisfaction: 68%Average wait time: 3:14 minutesCalls answered under 90 seconds: 65%Overall call abandon rate: 26%; Peak time: 49%
GOAL
Performance Action Plan Completed; Access to Care Initiative 17.2Adjust MEDCOM BSC telephone appting standards NLT 20 Apr 07Establish CMS metric for telephone appting NLT 1 May 07Publish MEDCOM Telephone Appting Policy NLT 1 May 07Replicate LSS projects across MEDCOM MTFs NLT Dec 08
Mean Hold Time at CRDAMC = 3 seconds!
Project Summary: Carl R. Darnall AMC Telephone Appointing
Mark Hernandez – Black Belt Candidate
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 36 12 April 2011 Unclassified
Overall average hold time reduced to 33 secondsOverall call abandon rate reduced: 3%Peak time call abandon rate reduced: 22%Call volume reduced 20% due to less call backsCalls handled increased from 4700 to 7300 / weekAgent training time reduced from 6 weeks to 4 weeksAgent turnover reduced
• REPLICATION / WAY-AHEAD• RESULTS / BENEFITS
Agent scheduling changes to handle peak timesAgent training, area setup, shift change by SOPPhone menu tree and call handling improvedFuture ACD design requirements specified
• IMPROVEMENTS• PROBLEM / BASELINE / GOAL
BEFORE AFTER
Hol
d Ti
me
PROBLEM STATEMENTThe telephone appointing process at CRDAMC has observed low patient satisfaction scores and long process hold times. Over the last six months, it takes an average of 3:14 minutes to answer customer calls to make an appointment. This has led to numerous customer complaints which have led to lower patient satisfaction scores for telephone appointing services.
BASELINE
Decrease process hold time to less than 90 seconds per callDecrease overall abandoned call rate to less than 10%Decrease peak time call abandon rate to less than 25%
Army’s largest call center: 10,000+ calls a weekLow customer satisfaction: 68%Average wait time: 3:14 minutesCalls answered under 90 seconds: 65%Overall call abandon rate: 26%; Peak time: 49%
GOAL
Performance Action Plan Completed; Access to Care Initiative 17.2Adjust MEDCOM BSC telephone appting standards NLT 20 Apr 07Establish CMS metric for telephone appting NLT 1 May 07Publish MEDCOM Telephone Appting Policy NLT 1 May 07Replicate LSS projects across MEDCOM MTFs NLT Dec 08
Project Summary: Carl R. Darnall AMC Telephone Appointing
Mark Hernandez – Black Belt Candidate
Mean Hold Time at CRDAMC = 3 seconds
WOW!
Commitment to Continuous Performance Improvement!
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 37 12 April 2011 Unclassified
Conclusions
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 38 12 April 2011 Unclassified
Conclusions• Engaged leaders are critical!
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 39 12 April 2011 Unclassified
• Engaged leaders are critical!…set urgency, walk, and talk
Conclusions
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 40 12 April 2011 Unclassified
• Engaged leaders are critical!…set urgency, walk, and talk
• Strategy-focused organization!
Conclusions
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 41 12 April 2011 Unclassified
• Engaged leaders are critical!…set urgency, walk, and talk
• Strategy-focused organization!…a rudder in the storm
Conclusions
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 42 12 April 2011 Unclassified
• Engaged leaders are critical!…set urgency, walk, and talk
• Strategy-focused organization!…a rudder in the storm
• Commitment to continuous improvement!
Conclusions
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 43 12 April 2011 Unclassified
• Engaged leaders are critical!…set urgency, walk, and talk
• Strategy-focused organization!…a rudder in the storm
• Commitment to continuous improvement!…enabled by data transparency & P4P
Conclusions
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 44 12 April 2011 Unclassified
• Engaged leaders are critical!…set urgency, walk, and talk
• Strategy-focused organization!…a rudder in the storm
• Commitment to continuous improvement!…enabled by data transparency & P4P
• Active reuse of organizational knowledge!
Conclusions
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 45 12 April 2011 Unclassified
• Engaged leaders are critical!…set urgency, walk, and talk
• Strategy-focused organization!…a rudder in the storm
• Commitment to continuous improvement!…enabled by data transparency & P4P
• Active reuse of organizational knowledge!…incremental to enterprise improvement
Conclusions
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 46 12 April 2011 Unclassified
• Engaged leaders are critical!…set urgency, walk, and talk
• Strategy-focused organization!…a rudder in the storm
• Commitment to continuous improvement!…enabled by data transparency & P4P
• Active reuse of organizational knowledge!…incremental to enterprise improvement
• Accountability throughout the organization!
Conclusions
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 47 12 April 2011 Unclassified
• Engaged leaders are critical!…set urgency, walk, and talk
• Strategy-focused organization!…a rudder in the storm
• Commitment to continuous improvement!…enabled by data transparency & P4P
• Active reuse of organizational knowledge!…incremental to enterprise improvement
• Accountability throughout the organization!…Leader driven!
Conclusions
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 48 12 April 2011 Unclassified
For additional information on these topics in the US Army Medical Command,
ContactDirectorate of Strategy and Innovation
703.681.5000
Select SLIDE MASTER to Insert Briefing Title Here
27-Apr-11Name/Office Symbol/(703) XXX-XXX (DSN XXX) / email address
Commitment to Strategic Performance Excellence
US Army MEDCOM/Strategy & Innovation/703-681-5000 Slide 49 12 April 2011 Unclassified Slide 49
The Army’s Home for Health…Saving Lives and Fostering Healthy and Resilient People
~ Partnerships Built on Trust