So Many Tools So Many Projects

March 2006

So Many Tools So Many ProjectsSo Many Tools

So Many Projects

Susan McGann RN, BSN, MBB

Virtua Health

4th Annual Conference on Successfully Implementing

Six Sigma In Healthcare

WCBF – Las Vegas

March 30, 2006

March 2006

Virtua Facilities

March 2006

Virtua Health….Today Four hospital system in Southern New Jersey Two Long Term Care Facilities Two Home Health Agencies Two Free Standing Surgical Centers (JVs) Two Medical Staffs (currently merging) Ambulatory Care - Camden Fitness Center 8000 employees + 2000 physicians 7,752 deliveries 8% Operating Margin - #1 in the state of NJ STAR Culture

March 2006

Virtua Locations

March 2006

The Virtua STAR

CaringCulture

ExcellentService

Clinical Quality

& Safety

ResourceStewardship

BestPeople

Outstanding Patient

Experience

March 2006

S1&S2Business Acumen

LeanSpeed & Efficiency

DFSSNew Product/Service

OE ToolsAssessment, Recognition

BP ReviewPerformance & Values

Virtua U.Skills & Knowledge

Leadership andManagement Development

Process Improvement

Six SigmaEliminate Errors

Change Acceleration ProcessManaged Change

WorkOutEmployee Engagement

L&M SystemsStrategy & Operations

ME ToolsOptimization &

Quantitative Methods

STAR PERFORMANCE

Coaching Performance and Development

President’s SeriesLeadership Enhancement

March 2006

The Problems

ED Cash Collections Process

Emergency Department Discharge Process

Patient Access Create a Vision for Breast

Cancer Care Determine whether or not

to add O.R.s Buy in for the New Salad

Bar

Six Sigma

Lean

DFSS Work Out

M.E. Optimization

CAP

The Tool Solutions

March 2006

Six Sigma

Defect Reduction or Elimination Move a mean Reduce Variation Xs or drivers are not clear Process requires rigorous measurement and

evidence of improvement 4-6-8 months DMAIC training

March 2006

Optimization/M.E. Tools

Process is known Xs are known Want to know the impact of change on a current

process No Teams No Training Skill set required Software required

March 2006

DFSS (Design for Six Sigma)

Process is so broken might need to start over Focus on Voice of the Customer Design Defects out of the process Data oriented 6-8 months DMADV Training

March 2006

CAP: Change Acceleration Process Change is inevitable - how do you ease the

blow? Is its own tool set Used when a decision has been made Garners buy-in Can be used with all other tools Common sense just not common practice Tools that all management can use – should be

ingrained in the organization 3 days of training – constantly practicing

March 2006

Work Out

Process problems Need the “wisdom of the group” Frequently “cross silo” issues Not heavily data oriented Might be data supported 1-3 days Facilitator needed Training just in time with the tools

March 2006

LEAN

Need for Velocity (in process and results) Reduce waste and non value added steps Xs are pretty clear Use of Value Stream Mapping Kaizen Event Done live Event takes a week – total up to a month Training is JIT

March 2006

How do you do it

Culture of the organization CEO ownership and leadership Data heavy organization? Commitment One tool at a time Go for the quick wins Value Stream Mapping – funnel creation Not mutually exclusive

Annual STAR Launch

G&O review & signoffPOE report & Final S1

G&O Review #1 QMM

QMM & celebration POE S2 review

G&O Review #3QMMEOS

Best PeopleUpdateBudget Process

Best People Review

G&O Review #2QMM

January

February

April

May

June

September

August

July

November

December

October

Outstanding Patient Experience

Stewardshi

pPatient Safety

Best People

Caring CultureClinical

March

Virtua Values

1st Quarter

2nd Quarter

3rd Quarter4th Quarter

Virtua Health STAR Management System 2006

Resource

Service Excellence

Quality &

January

4Q G&O Report Out

Strategic Imperatives for 2007 for goals & budget planning

POE S2 review

POE S2 review & S1 draft

March 2006

Value Proposition: Quantitative ValueSix Sigma Benefit

12 Waves 60 Six Sigma Projects $14,339,245 Gross $ 9,839,245 Net Does not include

financial benefit from WorkOut

Oct 2000-Sept 2005Yellow Belts: 271Green Belts: 56Black Belts: 22Master Black Belts: 5Star Coaches 170

March 2006

The Problems

ED Cash Collections Process

Emergency Department Discharge Process

Patient Access Create a Vision for Breast

Cancer Care Determine whether or not

to add O.R.s Buy in for the New Salad

Bar

Six Sigma

Lean

DFSS Work Out

M.E. Optimization

CAP

The Tool Solutions

March 2006

CAP WorkOut Lean Six Sigma DFSS

ProblemI know the answer but I’m going to meet a lot of resistance

I have a rough idea of where we need to go. I want my team to work together to improve the process quickly.

I have to do more, faster with less. I want to be sure my team is as productive as possible

The process is important and it isn’t working. I’m not sure why. I need to understand my process better and pick the right solutions.

The process is so broken in so many places I’m not sure where to start. We might as well blow it up and start over.

Deliverable

- Change management- Dealing with resistance- Maintaining the gains

- Helping those who do the work come up with and own great solutions

- Speed - Efficiency- Productivity- Removing waste

- Meeting customer expectations- Eliminating defects

-A new process- Defects designed out of the process- Exceeding customer expectations

Catch phrase“Why are we

always surprised by resistance”

“The people who do the work know

it best”

“We need to do more with less…. and faster too!”

“We need to get it really right for our

customers!”

“Now that we have a blank sheet of paper, lets get it right”

Turnaround < 1 day 1 – 2 days 3.5 - 5 days 6 – 9 months 6 – 9 monthes

Facilitator CAP/WorkOut Coach

CAP/WorkOut Coach

Lean leader Black Belt Black Belt

At a Glance