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Aligning Your Program and Accelerating Results:Best Practices in Lean Six Sigma Deployment


Vince SanchezVice President, Operational Excellence

UnitedHealthcare


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• Industry leading resources dedicated to serve a diverse health market

– Fortune 25 Company

– Named America’s Most Admired Health Care Company for Innovation in 2007

• Ability to collect and analyze a wealth of consumer health care data

• Commitment to optimize health outcomes via evidence-based medicine

UnitedHealth Group

Public and Social Markets

Enterprise Services Markets

CommercialMarkets

UnitedHealth Group Overview


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UnitedHealthcare Deployment

• Deployed Operational Excellence (OpX) in late 2004

• 50+ active, full-time Black Belts

• 175+ trained Black Belts, 800+ trained Green Belts

• 1,000+ trained Yellow Belts (Overview and Champion)

• All employee online introductory training

• All training curricula developed and delivered in-house

• Centralized team of Deployment Partners and Master Black Belts supporting Black Belts across the business

• Green Belt, Black Belt and Master Black Belt certification & award programs

• More than $1B in savings and 500+ project completions since program inception

• Completed 80+ joint projects with hospitals and physician groups improving claim payment accuracy and satisfaction

• Deployed Operational Excellence (OpX) in late 2004

• 50+ active, full-time Black Belts

• 175+ trained Black Belts, 800+ trained Green Belts

• 1,000+ trained Yellow Belts (Overview and Champion)

• All employee online introductory training

• All training curricula developed and delivered in-house

• Centralized team of Deployment Partners and Master Black Belts supporting Black Belts across the business

• Green Belt, Black Belt and Master Black Belt certification & award programs

• More than $1B in savings and 500+ project completions since program inception

• Completed 80+ joint projects with hospitals and physician groups improving claim payment accuracy and satisfaction


4… But to What Extent is Six Sigma Delivering Business Results?

Many are Practicing Six Sigma…


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Successful Deployment Today

≠

Successful Deployment Tomorrow

Practicing Six Sigma

≠

Successfully Deploying Six Sigma

Six Sigma Deployment


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Deployment Roadmap

September 2006, Instantis Six Sigma Maturity Model

Generalized roadmaps exist to help you plot the course…

…but every company’s specific roadmap will vary


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UnitedHealthcare’s Roadmap

Aligning Your Program

• Project Selection

• Program Metrics

Accelerating Results

• Building Program Flexibility

• Continuous Learning

• Back to Basics

• Eliciting Extraordinary Execution

• Close, Close, Close!


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Project Selection

Quick winsGrass roots interest

Not sustainable

Injects disciplineIdentifies best of lot

Selection, not identification process

Identification processAligns project success with business success

Requires deft project scoping

Ad Hoc (Who needs help?)

Funnel (Which is “most” important?)

Strategic (How do we get started?)


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Strategic Project Selection

Strategy

Measures

Performance Gaps

Initiatives

Projects

Strategic project selection requires a top-down approach


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Strategic Project Identification at UHC

For illustrative purposes only


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Project Portfolio Assessment at UHC


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Project Scoping

Identifying new areas of project opportunity is easy, scoping appropriate projects is the hard part.

Intermediate Objectives Map

GOAL:The member experiences intake

First Call Resolution

Critical Success Factor:

Caller is not transferred to someone else


Caller’s issue is resolved by the

first contact


Caller does not have to call back

for the same issue


Caller reaches a live person within 30

seconds after entering the queue

Problem: Why does the caller not reach the person who can solve their problem the first time

Necessary Condition:The person

answering the call has the expertise to resolve the call

Necessary Condition:

The intake person has appropriate access to the

correct systems


The intake person has enough

knowledge of the systems to resolve

the call

Necessary Condition:The caller is

satisfied with the first resolution


Resolution to the call must be based on clinical policy


Intake personnel are staffed at the appropriate level


Intake personnel must be available

to take a call


The caller must select the correct prompt

Necessary Condition:Prompting

instructions are clear to the caller

Receive Enter Cust. Data

CustomerLook up

Risk Review

Contact Customer

Enter Prod. Req.

III50

= 24 III125

III55

III60

III35

= 24 = 24 = 4 = 24 = 5

DOR = 25”

Resources = 24

Quality = 50%

DOR = 120”

Resources = 24

Quality = 98%

N/A

Resources = 24

Quality = 90%

DOR = 600”

Resources = 4

Quality = 95%

DOR = 200”

Resources = 24

Quality = 95%

DOR = 60”

Resources = 4

Quality = 92%

III75

34 Min.

20 Secs

23 Min. 57 Min. 25 Min. 27 Min. 16 Min.

21 Secs 25 Secs 600 Secs 19 Secs 22 Secs

CycleTime

Proc.Time

= 182 Min

= 12 Min.

ApplicationReceive Enter Cust.

DataCustomerLook up

Risk Review

Contact Customer

Enter Prod. Req.

III50

= 24 III125

III55

III60

III35

= 24 = 24 = 4 = 24 = 5

DOR = 25”

Resources = 24

Quality = 50%

DOR = 120”

Resources = 24

Quality = 98%

N/A

Resources = 24

Quality = 90%

DOR = 600”

Resources = 4

Quality = 95%

DOR = 200”

Resources = 24

Quality = 95%

DOR = 60”

Resources = 4

Quality = 92%

III75

34 Min.

20 Secs

23 Min. 57 Min. 25 Min. 27 Min. 16 Min.

21 Secs 25 Secs 600 Secs 19 Secs 22 Secs

CycleTime

Proc.Time

= 182 Min

= 12 Min.

Application

Value Stream Map


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Many companies stop here

Program Metrics

As project selection evolves, what about metrics?

Project Approach Associated Metrics

Ad hoc Activity

Funnel Activity + Financial

Strategic Activity + Financial+ Business Goals

+ “Cultural Maturity”


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Financial• Shared Business Goals• Financial Savings

Internal Process• Shared Business Goals• Belt Productivity• Project Completions • Project Improvement %• Number Trained

Customer• Shared Business Goals• OpX Maturity• Stakeholder Satisfaction

(Projects, Coaching, Training)

Vital Assets• Shared Business Goals• Belt Certifications• Talent Development• Advanced Learning• Growth & Retention

Y = f(x), don’t neglect to measure and control your x’s

UHC ‘Balanced’ Program Metrics


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The Nebulous Cultural Maturity

People

Leadership & Strategy

Process Management

Projects

Customers

Results

together guiding

focused on

delivering

empowering

Operational Excellence Maturity Model

Operational Excellence Maturity AssessmentPerformance Category/Criteria Results

0

5

10

15

20

25

30

35

40

45

50

55

60

65

70

75

80

85

90

95

100

1.1 1.2 1.3 1.4 1.5 2.1 2.2 2.3 2.4 2.5 3.1 3.2 3.3 3.4 3.5 3.6 4.1 4.2 4.3 4.4 4.5 5.1 5.2 5.3 6.1 6.2 6.3 6.4

People Project Effectiveness

Process Management

Customer Focus

ResultsLeadership & Strategy

Potential Best

PracticeClear

Improvement Opportunity


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Accelerating Results

Focused and Flexible

• Be disciplined, but not inflexible

• Focus on deliverables, not tools

• Build flexibility into your program– DMAIC, DMADV, Kaizen, Rapid Decision Making,

Quick Sigma DMAIC/DMADV, Systems Thinking Framework


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DMAIC is the process improvement framework

Lean and Six Sigma tools and principles are applied as appropriate within the framework

Not Lean or Six Sigma… Lean Six Sigma


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DMADV 1. A high level business need is identified

2. Does a current business process or product exist in some form?

3. Are your processes or products optimized but still incapable of meeting requirements?

4. Is the solution or part of the solution a new process, product or service?

5. Does the capability of one or more existing design element need to be improved to meet your requirements?

MeasureMeasure

AnalyzeAnalyze

DesignDesign

DefineDefine

AnalyzeAnalyze

ImproveImprove

ControlControl

MeasureMeasure

ValidateValidate

1

A

2NOYES

4

3

5NO

YES

YES

NO

YES

NO

A

Flexible Framework Example

Be adaptive in your approach


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Continuous Learning

Ad Hoc – Best Practices (E-mail)

Monthly – Lunch & Learns (Web conference)

Annually – Leadership Conference (Live event)

Selecting Teams

Kickoff Meetings

Web Conferencing

Status Tracking

Introducing DMAIC to Teams

Executive Summaries

Conflict Resolution

Adv Minitab & Excel

Contagious Leadership

Influence w/out Authority

Time Management

Tool Refreshers

Executive Speakers

Soft Skills Team Building

New Tools

Project Storyboards

Networking


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Don’t Forget the Basics

SixSigma

Project Management

MeasureAnalyze

Planning

DefineImproveControl InitiatingExecutingMonitoring &ControllingClosing

INTEREST

PO

WE

R

LOW HIGH

HIG

HL

OW

Keep Satisfied

Monitor

Manage Closely

Keep Informed

Q1 Q2

Q3 Q4

INTEREST

PO

WE

R

LOW HIGH

HIG

HL

OW

Keep Satisfied

Monitor

Manage Closely

Keep Informed

Q1 Q2

Q3 Q4

Stakeholder Assessment Matrix


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Extraordinary Execution occurs when• The challenge is dramatic and visible• The goal is specific and urgent• The situation clearly requires direct and

instant action • The consequences are unavoidable and

failure is unacceptable• The drama of crisis stirs deep-seated

emotions and commitment

Eliciting Extraordinary Execution

Neiman Robert, A. “Execution, Plain and Simple: Twelve Steps to Achieving Any Goal on Time and on Budget,” McGraw Hill 2004


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Close, Close, Close!

• Think “closure” from kickoff to control• Clarify and stick to measures of success• Seek progress, not perfection• Burn the bridge back to the status quo• Put controls in place to keep the project closed!• Plan an explicit closing event – celebrate!


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Aligning Your Program + Accelerating Results

= Roadmap to Successful Deployment

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