Process Improvement Is for Everybody

Transcription

1 Process Improvement Is for Everybody Bo Snyder Learning Objectives De-mystify process improvement and view it from a practical eye Encourage all leaders to use process improvement, from C-suite executives to front line supervisors and employees Encourage the broad application of PI thinking, including to some functions you may have never thought of as processes 2 1

2 Agenda What is a process? What is process improvement? Questions and insights for leaders Examples of some high-impact processes Some that you may have never considered before 3 Opening question When you think of Process Improvement what do you think of? Lean Six sigma Baldrige PDCA/PDSA Nerds in horn-rimmed glasses A department in the basement 4 2

3 How about A way of thinking that can be used by all leaders at all levels of the organization to achieve exceptional results And, on a personal level, a way to become a superstar leader and to accelerate your career 5 What is a process? A series of actions or steps taken in order to achieve a particular end Systems or clocks (Collins and Porras) Formalized ways to get something done Sometimes steps exist, other times they do not 6 3

4 A question for leaders What are the key processes you lead? The best leaders can name them, and tell you which are most important If you don t know which processes are yours, you ll have a hard time improving them If a process doesn t have an owner, it probably is unimproved Reverse-engineering the process from how you know things are going well 7 What is process improvement? Dr. Shewhart almost 100 years ago You may have heard of his more well known protégé, Ed Deming The breakthrough: Learning and improvement is not linear It occurs in repetitive cycles 8 4

5 Plan, Do, Check, Act (PDCA) Deming explained this in lay language Design it, build it, put it on the market, see how it does Based on what you learn, re-design it You ll only fail if: You never adopt this way of thinking You give up Your competition does its cycles quicker 9 Questions for leaders How do I know my process is working as well as it could be? Or What are my process key requirements? How are we doing on those? 10 5

6 Key requirements Just a few key ones less is more How do we determine them? Ask your customers Ask those who participate in the process Also, ask what you could get fired for: Regulatory requirements Cost #1 mistake: Too much focus on costs 11 How are we doing on those? Collect some data But don t get bogged down Convene a few focus groups Customers, employees Sometimes you can just get a few key players into a room and have a frank discussion Example: The budget process 12 6

7 Very special data Some of the most powerful data is comparison data Clinical quality Patient satisfaction Physician engagement Employee engagement Publicly available and purchased privately Externally and internally compared 13 Decisions and execution Ideas for improvement Brainstorming Best practices Execution: Talk is cheap; doing is hard Has anyone heard that change is hard? Especially if it involves changing behaviors Standing up a new process, education, etc. 14 7

8 Monitoring and adherence Collecting new data Rounding Spot checks And the cycle begins anew 15 Pulling it all together Imagine the walls of your department s breakroom: 3-4 key processes 3-4 key requirements for each process Performance trends for each requirement Key bullet points of issues from customer/employee feedback Current changes being implemented A schedule for review and next steps on each 16 8

9 How to start Choose one key process Or Identify a few ways you know if your department is doing a good job 17 Examples for the C-suite The cascade Establishing the few biggest organization-wide priorities, then cascading them throughout the organization, providing support to achieve them, and monitoring to assure accountability Most organizations do this poorly Bad alignment (some dodge important goals), poor schedule, unrealistic goals, sandbagged goals, people blow it off, too much subjectivity 18 9

10 Examples for the C-suite Strategy development and deployment Typical: The strategy is put in a binder and sits on the shelf Problems: It s mostly an academic exercise No schedule to check progress Plan never delegated Strategic priorities not aligned with budget Plan not aligned with individual leaders accountabilities 19 Examples for the C-suite The budget process Observation from a client: Why do we always notice 2 weeks before the budget is due to go to the board that we re $10M off target? How could this be improved? Start earlier Build speed bumps into the process Begin with preliminary targets for each division/ department that all add up to the overall target 20 10

11 Examples for the C-suite The leadership process Leader standard work Rounding, for example Questions Is rounding an expectation of all leaders? Do they actually do it? What happens if they don t? Do they do it in the prescribed way? How do we support leaders to do it better? 21 Examples for the front lines How a doctor interacts with patients Do you have satisfaction scores by physician? Do they compare scores to each other? Is this routinely discussed at staff meetings and in huddles? Does each physician focus on improving just one key behavior change at a time? 22 11

12 Examples for the front lines How patients experience their time with you What are our patient satisfaction scores? How long do we make them wait? What are their major complaints? 23 Other examples How new employees are selected, hired and retained Do we hire too many people with poor attitudes? What is our turnover rate for employees with less than 2 years tenure? 24 12

13 Other examples How physician concerns and input is handled Do you do this formally? How can physicians voice concerns? How are they prioritized? Do physicians have a voice in this? How is progress tracked? 25 Presenter Biography & Contact Info Bo Snyder is a healthcare consultant, speaker, author and coach. He began his career with Bronson Healthcare Group (Kalamazoo, MI), serving in several administrative roles for 18 years. He was deeply involved in efforts that led to Bronson s receipt of the Malcolm Baldrige National Quality Award. Inspired by Bronson s improvements, he formed his own consulting company to help other organization s similarly transform. Snyder volunteers his time as a Baldrige examiner at the national and state levels, and he has led Baldrige teams and site visits. He has a passion for helping C-suite executives make decisions that have big impacts, and he is equally energized on the front line with the doctors, nurses, and others who directly benefit patients. He is the author of The Best Patient Experience: Helping Physicians Improve Care, Satisfaction, and Scores. Bo s address: Bo@BoSnyderConsulting.com 26 13

14 Bibliography/References Moen, R. Foundation and History of the PDSA Cycle. Accessed March 6, oen.pdf. Baldrige Performance Excellence Program Baldrige Excellence Framework. Updated February 4. Griffith, J. R., and K. R. White The Revolution in Hospital Management. Journal of Healthcare Management 50 (3): McChesney, C., S. Covey, and J. Huling The 4 Disciplines of Execution: Achieving Your Wildly Important Goals. New York: Free Press. Barnas, K ThedaCare s Business Performance System: Sustaining Continuous Daily Improvement Through Hospital Management in a Lean Environment. Joint Commission Journal on Quality and Patient Safety 37 (9): , AP1-AP8. Collins, J. C., and J. I. Porras Build to Last: Successful Habits of Visionary Companies, 3 rd ed. New York: HarperCollins