connecting your hospital board of directors with your lean six sigma implementation

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


Why do we want to connect our executives with our LSS Implementation?

Executives

Leadership

Employees

Customers

LSS Implementation Plan


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?



ExecutivesLeadership

Employees

Customers

Implementation Plan

Suppliers



Executives

Leadership

Employees

Customers

Executives LeadershipCustomers

EmployeesWhich Company are You?

LSS PlanLSS Plan


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


Compelling Case for Change

New Healthcare LegislationEconomic ConditionsGreater World CompetitionSlowing ImprovementsNeed to add valuefor the customerEmployee turnover


10 Minute Workshop Session

What is your Burning Platform?



*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



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


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


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


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


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


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


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


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


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


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


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



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


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.


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)


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)


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


Lean Six Sigma: The New Role of Leadership

Here are some example Lean Six Sigma questionsThese questions follow the DMAIC problem solving

methodology


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?


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?


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?


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?


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?


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)



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


Workshop Breakout Session

Deployment Tactics

What types of Lean Six Sigma Training can you do with your Board of Directors?

Lean Six Sigma Journey


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:


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


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


• Managed Care Improvement

• Antibiotics prior to surgery• Nurse Retention Rate

• Tool Cost Reduction• Resident Rounding

• Cytogenetics• MRI Utilization

Lean Six Sigma Belt Examples


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


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.


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


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 ?


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


Thank You.

connecting your hospital board of directors with your lean six sigma implementation

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