Using Lean to Make Government More Effective, Efficient and Elegant

Transcription

1 Using Lean to Make Government More Effective, Efficient and Elegant Thursday, May 22, 2014 Kathleen Newberg, Lean Leader Department of Health Care Policy and Financing 1

2 What s inside tonight 1. Lean at a State government agency 2. Your questions 2 2

3 2 C s of Lean 1. Continuous Improvement 2. Customer Focus 3

4 Health Care Policy and Financing Health Care Coverage for Coloradans Kathleen Newberg, Lean Leader 4

5 Who We Serve To qualify for Your Annual Income cannot exceed Medicaid: Children & Pregnant Women $29,726 for a family of 4 Medicaid: Parents $22,350 for a family of 4 Medicaid: Elderly & Disabled Medicaid: Long-Term Services & Supports Medicaid: Adults without Dependent Children $8,088 for an individual $24,264 for an individual $1,089 for an individual Child Health Plan Plus $58,884 for a family of 4 5

6 Colorado is transforming Medicaid and the programs and services we provide into an innovative, effective and efficient nationally recognized model of care. ~ Susan E. Birch, MBA, BSN, RN 6

7 Our Mission: Improving health care access and outcomes for the people we serve while demonstrating sound stewardship of financial resources 7

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9 Lean is a Journey, Not a Destination A Lean organization makes a collective effort toward continuous improvement and elimination of waste from all activities, by each and every employee. 9

10 Lean Community The Department created a Lean Community to empower engaged employees to eliminate waste and maximize value. The Lean Community Vision: The Department s workforce is highly efficient and fulfilled through a strong commitment to continuous improvement. 10

11 From Lean Leadership: Helping Leaders Understand Their Role In The Improvement Process by Karen Martin & Associates, LLC on Mar 02,

12 Health Care Policy and Financing LEAN AWARENESS & TRAINING 12

13 Screenshot of Department s SharePoint Lean Site 13

14 Department Staff with Some Lean Training Trained Not Trained 14

15 Culture of Improvement Academy Required Courses Instructor led courses 1. Orientation 2. Process Improvement Line-of-Sight* 4. Cause & Effect Analysis 5. Change Management 6. Critical Thinking & Decision Making 7. Risk Management* E-learning modules 1. 5 S* 2. ADKAR Model 3. Process Mapping* 4. Visual Management/Standard Work* * Items marked with a red asterisk require a deliverable 15

16 Health Care Policy and Financing LEAN IN ACTION 16

17 Lean QUICK HIT What is a Lean QUICK HIT? Using basic Lean tools such as visual management, 5S, process mapping and brainstorming to quickly solve problems and make minor improvements during a QUICK HIT session. How long is a Lean QUICK HIT Session? A typical session is 3 4 hours. If multiple sessions are needed to address related issues within a process, the cumulative total is less than 16 hours. What are some examples of Lean QUICK HITs? Using visual management to improve instructions for an existing form Thinking through a decision before implementation by using the Six Hats brainstorming technique Creating a SIPOC or process map of the work you do 17

18 QUICK HIT Session Results QUICK HIT Session Name Colorado Choice Transitions (CCT) Prioritization Single Case Agreements (SCAs) Lean Tools/Methods Used Brainstorming Prioritization Change Control Risk Analysis Process Mapping Risk Analysis Prioritized process list Impact/effort analysis Change control plan Risk management plan Process map Risk management plan Standardized rates Outcomes Long-Term Services Supports Brainstorming Prioritization Process Mapping Division Strategy Map & Strategic Alignment S.M.A.R.T. Performance Measures 18

19 Colorado Eligibility Process Improvement Collaborative (CEPIC) What is CEPIC? A grant funded program that allows the Department to work with counties to help improve their processes for determining Medicaid eligibility. CEPIC is: Improving processing times Improving quality and efficiency in office processes Helping County staff solve problems 19

20 Health Care Policy and Financing DEPARTMENT-WIDE PROJECTS 20

21 Department-Wide Lean Projects Facilitated/Lead by Dept. Lean Leader Fiscal Year Time-to-Hire 2. LTC: Waiver Plan Development 3. PETI 4. Security LAN/Systems Access 5. Travel Process Fiscal Year Client Appeals 7. Innovation & Design 8. Managing Operating Expense Budgets 9. Conference Room Usage 10. Website Redesign* (make Client-friendly) 21 *Project lead and completed by Policy & Communications Office

22 FY Lean Projects Results Goal / Purpose To fully utilize the conference room space (avoid duplicative reservations and rooms being reserved but not used) / In addition, the Department is adding Division of Developmental Disabilities and spread to 3 separate buildings in Feb KPIs: Process Average Lead Time: 60 minutes to 15.5 days (to process a single request) Inputs Staff Time: Using internal resources Outputs Increased Efficiency: TBD* Outcomes Employee Satisfaction: survey results to establish baseline & measure progress More Effective Meetings: survey results to establish baseline & progress * Minor improvements made, but output measures will occur in August 2014, after installation of a fully automated room reservation system 22

23 FY Lean Projects Results Goal / Purpose To identify root causes and solutions related to federal deferrals and disallowances / Reduce the fiscal impact and employee resources (time) associated with responding to deferrals and disallowances KPIs: Process N/A the purpose of the sessions was to identify root causes of deferrals and disallowances and develop solutions to prevent deferrals/disallowances Inputs Staff Time: Using internal resources Outputs Root Causes Identified: 15; Solution Ideas Developed: more than 600 Outcomes Participants Satisfaction: Satisfied with results Replication of Results: address root causes that impact multiple programs and will results in improvements across the Department 23

24 FY Lean Projects Results Goal /Purpose Reduce the total number of day to hire by at least 20% and improve the quality of hire KPIs: Process Average Lead Time: Reduced to an average of 60 days from approximately 142 days Approvals: Reduced from 36 to 7 approvals Inputs Staff Time: Used internal resources Outputs Improved Customer Service: created a partnership between human resources and hiring managers Outcomes Customer (Hiring Manager) Satisfaction: Above average satisfaction with results Control and Sustainment: Human Resources is sustaining and improving the process 24

25 Lean Projects: Lessons Learned Lesson Learned First 2 Projects: Lack of buy-in from project participants (executive team selected projects and outside consultant facilitated) Staff lacked basic Lean training Staff and managers did not understand the value of Lean Culture resistant to tracking/using metrics Improvement Made 1. Developed a SharePoint form for staff to suggest Lean projects 2. Used priority matrix to select projects 3. Implemented Prosci ADKAR Model of change management 1. Developed & rolled out in-house Lean training for project teams and all staff 2. Encouraged staff to complete free, online, ondemand Lean training 1. Used the ADKAR Model to develop a targeted communications plan that addressed What s In It for the Stakeholder 2. Created a Lean newsletter that is published twice/month 1. Dept. created a metrics/roi position to help all programs including Lean Projects too long; results not evident for more than 1 yr 1. Developed and rolled out QUICK HITs 25 25

26 Health Care Policy and Financing HOW WE RE DOING 26

27 Organizational Lean Maturity Assessment Lean Implementation progress Part A Improvement Projects (7 categories) 1 Goal Met Part B Culture (6 categories) 1 Goal Met Part C Strategy (9 categories) 3 Goals Met Part D Training and Coaching (4 categories) 4 Goals Met 27

28 Organizational Results Favorable Ratings from Dept. Staff 86% are familiar with Lean 71% see benefits of using Lean methods 80% believe the Dept. leaders support Lean 70% feel encouraged to come up with new/better ways of doing things Results based upon the Colorado Department of Personnel and Administration s Annual Employee Engagement Survey (published Feb. 2014) 28

29 QUESTIONS? Kathleen Newberg, Lean Leader Finance Office, Strategy Section 29 Colorado Department of Healthcare Policy and Financing