State of New Hampshire Lean Continuous Process Improvement Introduction and Overview

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1 State of New Hampshire Lean Continuous Process Improvement Introduction and Overview Presented by: Kate McGovern, Department of Administrative Services and Heather Barto, Department of Health and Human Services October 20, 2016

2 Objectives Describe the Bureau of Education and Training s model for Lean within New Hampshire's public and non-profit sector. Report on the use of Lean process improvement techniques in a range of State agencies and nonprofit organizations, including the delivery health and human services. Discussion The linkage between Lean training, Lean projects, and the development of a Lean Network as a community of practice. Potential opportunities for joint projects between State agencies and health care organizations?

3 What Is Lean Continuous Process Improvement? Lean is an organizational improvement philosophy and set of tools and methods that originated in manufacturing but has been expanded to government and service sectors. Lean enables government agencies to work more effectively and efficiently to serve the citizens, while protecting human health and the environment, by identifying and eliminating waste in government processes.

4 NH Bureau of Education s Lean Training Model Introduction to Lean and basic overview, typically provided to leadership and management Uses a Lean project while learning the tips and formal process of Lean at the same time Training for Lean facilitation of events Advanced training for Lean Practioners, includes theory and practice, systematic approaches, and culture champions

5 State of NH s Lean Secret Lean Formula Bureau of Education and Training + Supportive agency leadership for practice and implementation of Lean + Lean Executive Committee + Lean Network Meetings + Lean Practioners telling the story + Mentoring/continuing education & training = A comprehensive Lean formula

6 Cumulative Growth of Lean Deployment in NH Government Lean Projects Agencies

7 NH Lean Network A Community of Practice All are welcome! Annual Lean Summit Quarterly Network Meetings

8 Lean Executive Committee (LEC) Lean coordinator of each state agency Representative from Governor s staff Collaborative leadership model Plans Lean Summits and Lean Network events Meets 1 st Wednesday of each month Identifies opportunities for cross-silo Lean events John MacPhee, LEC Co-Chair addressing the 2013 Lean Summit

9 Attendees at the Lean 2014 Summit DoIT Commissioner Denis Goulet provides opening remarks at Lean 2016 Summit Showcasing Lean in State Government Governor John Lynch with panelists at the Lean 2012 Summit Governor Maggie Hassan recognizes the Dept. of Revenue for their Lean project at the Lean 2013 Summit

10 Lean Black Belt Class of 2015 Front row left to right: Danielle Fuller, Sharyn Goddard, Diane Dawson, Heather Barto, Jill Fournier, Michelle Marshall, Mike Moranti (Professor) Middle row left to right: Roberta Emmons, Angela Linke, Dagmar Vlahos, Tyler Brandow, Paul Raymond Back row left to right: Thomas Lambert, and Todd Ringelberg Missing: David Jenkins and Laura Holmes

11 Lean Works! Examples of waste identified with Lean methods: Defects typos, missing data, errors Overproduction Extra copies, reviews, signatures Waiting approval cycles, missing information Non-utilized/underused employees front line employees who are process experts Transportation report routing for approvals Inventory backlog of work, s needing responses Motion trips to copier, file cabinets, meetings Excess processing multiple reviews, approvals

12 What are the benefits of Lean Continuous Process Improvement? By using Lean tools, an organization may: Eliminate or dramatically reduce wait times or back logs Reduce costly errors Improve stakeholder satisfaction Streamline business operations; simple and complex Save time and reduce frustration from a broken process Enhance process transparency to internal and external audiences Reallocate critical resources for mission supporting work Improve staff morale and teamwork

13 Lean Methods Continued A3 On 11x17 piece of paper, this format is used to depict the problem identification and solutions Concisely communicates continuous improvement activities in this format. Background Describe the problem and indicate how it affects business. Use data whenever possible Current Condition/Problem Statement Indicate the magnitude of the problem on a qualitative scale. Use graphics if possible. Root Cause Analysis Why are we experiencing this problem? Dig deep to find the root cause using Pareto diagram, fishbone diagram or 5 why s analysis Target Condition/Goal Statement Indicate what you are trying to achieve and by when. Predict the expected improvement, specifically and quantitatively Implementation Plan List of actions that will be taken and by whom and by when. Follow-Up How will the effectiveness of the improvement be measured and by whom?

14 Questions Used in Lean What value is added for the customer? Does this save us time, money or something else? How does this change our current process? How can we streamline Lean work into our business? What tool is appropriate to use in the Lean analysis? What is our baseline data measurement? How do we explain this process to someone that is not close to it?

15 Lean Application in State of NH Gov t Adjutant General Administrative Services Banking Corrections Cultural Resources Employment Security Environmental Services Information Technology Insurance Judicial Labor Health & Human Services Lottery Public Utilities Commission Resources & Economic Dev. Revenue Safety Transportation University of NH University System of NH

16 DHHS Lean Examples: Women Infants Children Program Management Tool Infectious Disease Program Lyme Disease Surveillance System

17 DHHS Lean Example: Emergency Preparedness Lean results: an emergency preparedness plan template, clear review structure, group account, training staff on common terms, protocols, etc.

18 DHHS Lean Example: Hospital Billing and Reimbursement Lean Results: Significantly increased reimbursement revenue, by 6% ($800,000) for calendar year 2012, reduced insurance payment denials, shortened billing & reimbursement time, resolved prior authorization confusion and delays, added transparency, and employee satisfaction increased

19 Final Thoughts on Lean Lean works because it s simple, digestible, and requires group participation Lean trained professionals have a unique skill set that is marketable to employers Lean thinking happens every day in every setting; healthcare is using and has massive potential for Lean application for lowering costs and reducing medical errors and business challenges Lean trained staff get promoted!

20 For more questions please contact: Kate McGovern, MPA, Ph.D, Lean Black Belt Adjunct faculty, Bureau of Education & Training Heather Barto, MS, Lean Black Belt Administrator, Medicaid Managed Care Thank you for your time!