A Practical Marriage of Baldrige and Lean Six Sigma

Mike Mike PickelsPickelsDirector of Quality Director of Quality

High Point Regional Health SystemHigh Point Regional Health System

Mike is the Director of Quality at High Point Regional Health Mike is the Director of Quality at High Point Regional Health System, a 400System, a 400--bed hospital in North Carolina. He joined the bed hospital in North Carolina. He joined the healthcare industry five years ago after serving nearly 20 yearshealthcare industry five years ago after serving nearly 20 years in in the Finance industry. He is a Certified Six Sigma Black Belt witthe Finance industry. He is a Certified Six Sigma Black Belt with h over 10 years of experience with project management and softwareover 10 years of experience with project management and softwaresystem development and implementation.system development and implementation.

Mike serves as a Malcolm Mike serves as a Malcolm BaldrigeBaldrige Quality Program Expert at High Quality Program Expert at High Point, leads the Balanced Scorecard process for the Health SystePoint, leads the Balanced Scorecard process for the Health System, m, and serves as a mentor to over 60 Green Belts. He is a graduate and serves as a mentor to over 60 Green Belts. He is a graduate of of Virginia Commonwealth University and is currently working towardVirginia Commonwealth University and is currently working towards s his MHA Degree from Pfeiffer University.his MHA Degree from Pfeiffer University.

Mike and his wife have two girls, ages 4 and 8.Mike and his wife have two girls, ages 4 and 8.

About High Point Regional Health System (HPRHS)About High Point Regional Health System (HPRHS)

�� 400400--bed Health Systembed Health System

�� Private, NotPrivate, Not--forfor--ProfitProfit

�� Level III Trauma CenterLevel III Trauma Center

�� Magnet DesignatedMagnet Designated

�� Level 3 State Baldrige WinnerLevel 3 State Baldrige Winner

�� General medical and surgical inpatient, outpatient General medical and surgical inpatient, outpatient and emergency servicesand emergency services

�� Serve a population of approximately 500,000 Serve a population of approximately 500,000 residents from four counties in central North Carolina residents from four counties in central North Carolina

�� CEO CEO –– Jeff MillerJeff Miller

�� COO COO –– Martha BarhamMartha Barham

�� CNO CNO –– Tammi MengelTammi Mengel

�� CMO CMO –– Dr. Greg TaylorDr. Greg Taylor

�� CFO CFO –– Kimberly CrewsKimberly Crews

�� 2,400 Employees2,400 Employees

�� 6 Black Belts6 Black Belts

�� 64 Green Belts throughout the Health System64 Green Belts throughout the Health System

�� 150 Red Belts throughout the Health System150 Red Belts throughout the Health System

�� 12 Baldrige Internal Experts12 Baldrige Internal Experts

High Point Regional Health System competes in a High Point Regional Health System competes in a

Primary Service Market that includes:Primary Service Market that includes:

A large multiA large multi--system / multisystem / multi--state healthcare providerstate healthcare provider

that covers much of the State of North Carolinathat covers much of the State of North Carolina

A large educationA large education--based healthcare systembased healthcare system

A multiA multi--system healthcare provider that covers much system healthcare provider that covers much

of the Piedmont Triad areaof the Piedmont Triad area

Total Care

Mission: To provide Exceptional Health Services to the People of our Region

Malcolm Baldrige National Quality Program

Six Sigma Projects

Org

anizational Goals

Strategic Planning

Balanced Scorecard

Engagement

MVV

All journeys begin with a vision of All journeys begin with a vision of where you want to gowhere you want to go

Our journey began with leaders that Our journey began with leaders that believed the believed the foundationfoundation Baldrige Baldrige provided and the provided and the structurestructure Six Six

Sigma provided were the Sigma provided were the frameworks necessary to move frameworks necessary to move the needle of our organizationthe needle of our organization

Baldrige Journey began in 2005Baldrige Journey began in 2005

Six Sigma became the sole Process Improvement Six Sigma became the sole Process Improvement

Methodology in 2006Methodology in 2006

Realizing the two work in concert began in 2008Realizing the two work in concert began in 2008

Applying Baldrige Principles with Six Sigma Tools to Applying Baldrige Principles with Six Sigma Tools to

address opportunities became a reality in 2008address opportunities became a reality in 2008

As with any journey, there can As with any journey, there can be barriers, detours, and be barriers, detours, and

wrong turnswrong turns

Patience with the Journey and Patience with the Journey and confidence in the process are confidence in the process are

critical critical

Forward movement doesnForward movement doesn’’t t mean you are always mean you are always

headed in the right direction, headed in the right direction, but it does mean that you but it does mean that you

are movingare moving

Barriers Encountered:Barriers Encountered:

Baldrige Baldrige ““ExpertsExperts””

Vs.Vs.

Six Sigma Six Sigma ““ExpertsExperts””

Impatience with the ProcessImpatience with the Process

Limited view of the futureLimited view of the future

Why ChangeWhy Change

Preconceived BeliefsPreconceived Beliefs

The Light Bulb Finally Turned On WhenThe Light Bulb Finally Turned On When……

We trained our Internal Baldrige Experts on Six Sigma We trained our Internal Baldrige Experts on Six Sigma

and our Six Sigma Belts on Baldrigeand our Six Sigma Belts on Baldrige

We began to realize that Baldrige and Six Sigma We began to realize that Baldrige and Six Sigma

compliment one another (rather than continuing to compliment one another (rather than continuing to

believe they were competing against each other)believe they were competing against each other)

Leadership

Leadership

Leadership

Leadership

B: Strategic PlanningS: Define Scope

B: Measurement, Analysis, & Knowledge ManagementS: Measure, Measure,

Measure

B: Results

S: Control

B: Process ManagementS: Improvements

B: Workforce

S: Cross-Functional Teams

B: Patients, Customers, Markets

S: Analyze, VOC, GAP Analysis

Key Changes as a result:Key Changes as a result:

Systematic, Repeatable, Consistent project approval process Systematic, Repeatable, Consistent project approval process

that addressed Baldrige and Six Sigma Principlesthat addressed Baldrige and Six Sigma Principles

Cycles of Refinement that use Six Sigma tools while addressing Cycles of Refinement that use Six Sigma tools while addressing

Baldrige requirementsBaldrige requirements

Project teams now include Six Sigma and Baldrige expertsProject teams now include Six Sigma and Baldrige experts

Projects now begin with an event that pulls tools from Six Projects now begin with an event that pulls tools from Six

Sigma and BaldrigeSigma and Baldrige

Project KickProject Kick--off Event unique to High Point off Event unique to High Point

Regional Health SystemRegional Health System

DADLI

BaldrigeBaldrige Asks:Asks:

�� Do you have an Do you have an ApproachApproach

�� Have you fully Have you fully DeployedDeployed that Approachthat Approach

�� How do you How do you Learn Learn from your processes from your processes

�� Is your Approach Is your Approach IntegratedIntegrated

DMAICDMAIC Directs:Directs:

�� DefineDefine your Scopeyour Scope

�� MeasureMeasure and and AnalyzeAnalyze DataData

�� Recommend Recommend ImprovementsImprovements

�� ControlControl your Resultsyour Results

DefineDefine refers to the purpose and scope of a given process. refers to the purpose and scope of a given process.

During the Define phase, the process design/reDuring the Define phase, the process design/re--engineering team engineering team

writes a purpose statement specifying the desired scope andwrites a purpose statement specifying the desired scope and

process outcome.process outcome.

1.1. What is the issue this process addresses?What is the issue this process addresses?

2.2. Who are the customers and what are their requirements Who are the customers and what are their requirements

and/or expectations?and/or expectations?

3.3. What is the desired outcome of this process?What is the desired outcome of this process?

4.4. Where and when should this process be performed (scope)?Where and when should this process be performed (scope)?

D

ApproachApproach refers to the methods used by an organization to refers to the methods used by an organization to

perform its work. Approach includes the appropriateness of the perform its work. Approach includes the appropriateness of the

methods.methods.

1. Is the approach systematic (i.e., with repeatable steps, 1. Is the approach systematic (i.e., with repeatable steps,

inputs, outputs, time frames)?inputs, outputs, time frames)?

2. Is there evidence that the approach is effective?2. Is there evidence that the approach is effective?

3. Is this approach (or collection of approaches) a key 3. Is this approach (or collection of approaches) a key

organizational process? organizational process?

4. Is the approach important to HPRHS4. Is the approach important to HPRHS’’ overall performance?overall performance?

A

DeploymentDeployment refers to the extent to which an refers to the extent to which an approachapproach is is

applied in an organization. applied in an organization.

DeploymentDeployment is evaluated on the basis of the breadth and is evaluated on the basis of the breadth and

depth of the depth of the approachapproach to relevant work units throughout the to relevant work units throughout the

organization.organization.

1. Is deployment addressed?1. Is deployment addressed?

2. Is the process in place in all appropriate work units, 2. Is the process in place in all appropriate work units,

facilities, locations, shifts, and organizational levels?facilities, locations, shifts, and organizational levels?

D

LearningLearning refers to new knowledge or skills acquired through refers to new knowledge or skills acquired through

evaluation, feedback, study, experience, and innovation. evaluation, feedback, study, experience, and innovation.

1. Has the approach been evaluated and improved? If it has, was1. Has the approach been evaluated and improved? If it has, was

the evaluation and improvement conducted in a factthe evaluation and improvement conducted in a fact--based, based,

systematic manner (e.g., regular, recurring, datasystematic manner (e.g., regular, recurring, data--driven)?driven)?

2. Is there evidence of organizational learning (i.e., evidence2. Is there evidence of organizational learning (i.e., evidence that that

the learning from this approach is shared with other the learning from this approach is shared with other

organizational units/other work processes)? organizational units/other work processes)?

3. Is there evidence of innovation and refinement from 3. Is there evidence of innovation and refinement from

organizational analysis and sharing (e.g., evidence that the organizational analysis and sharing (e.g., evidence that the

learning is actually used to drive innovation and refinement)?learning is actually used to drive innovation and refinement)?

L

IntegrationIntegration refers to harmonization of plans, processes, information, refers to harmonization of plans, processes, information,

resource decisions, actions, results, and analyses to support keresource decisions, actions, results, and analyses to support key y

organizationorganization--wide goals. Effective integration goes beyond alignment and is wide goals. Effective integration goes beyond alignment and is

achieved when the individual components of a performance managemachieved when the individual components of a performance management ent

system operate as a fully interconnected unit.system operate as a fully interconnected unit.

1. Are there complementary measures and information for plannin1. Are there complementary measures and information for planning, g,

tracking, analysis, and improvement used at three levels: the tracking, analysis, and improvement used at three levels: the

organizational level, the process level, and the department or worganizational level, the process level, and the department or workork--unit unit

level? level?

2. How well is the approach aligned and integrated with items o2. How well is the approach aligned and integrated with items of f

importance to HPRHS? importance to HPRHS?

I

� Needs identified during the Strategic Planning Process

� Feedback provided by State and National Baldrige Examiners

� Process Improvement Suggestions submitted by Staff (TIP

Program) and/or Patients/Visitors

� The Organizational and Departmental Scorecard Results

� Regular Cycles of Refinement with current processes

� Control Plan Review Results

� Baldrige/Six Sigma Process Review Events

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““Baldrige is our framework and guide. Baldrige is our framework and guide. Scorecards tell us how processes are Scorecards tell us how processes are working, and where improvement working, and where improvement opportunities may exist. Lean Six opportunities may exist. Lean Six Sigma is our continuous improvement Sigma is our continuous improvement methodology. Project Teams are the methodology. Project Teams are the vehicle for executing needed changevehicle for executing needed change””Gary Kollm, Six Sigma Black BeltGary Kollm, Six Sigma Black Belt

Level 3 State Winner