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 Summit May 2011
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The Balanced Scorecard & Lean Six Sigma In Us Army Medical Command
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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
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,
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
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
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
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
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
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
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
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
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
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
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
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