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The Group Health Lean JourneyLaura McMillan – Vice President for Strategic Planning and Deployment

WA State Lessons in Leadership Symposium - March 24, 2011

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Group Health

Consumer governed, not-for-profit financing & care delivery system628,203 insured lives9,599 staff26 primary care centers6 specialty care units82 specialties & subspecialties22 county service area in Washington & IdahoContract with 9,000 practitioners and 39 hospitals

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Why Lean?

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The Strategic Imperative

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Implementing Lean

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“I have my real job and now I have

my Lean job too.”

Sustainability Challenges

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Model Line: A Learning Lab

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Path to Success?

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Lean Management SystemMBO Management System

• Problems are the result of, or lack of accountability

• Decisions are influence and status driven

• Solving problems from a conference room or office

• Being a master of management

• Having all the answers

• Improve the results!...and send me an e-mail when it’s done

• Problems are the result of processbreakdowns and accountability for addressing them is clear

• Decisions are data-driven

• Solving problems in the workplace

• Being a student of leadership

• Asking the questions and expecting others will develop the answers

• Improve your thinking to improve the results and I’ll “check” back to hear your thinking and see the results

Choice Point

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The CEO Factor

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Standard Calendar for Senior Leaders

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From To

Building Leadership Capability

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From

Executive Gemba Thursdays

To

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Visual Systems and Data

Cost = Quality = Service =

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Our Customers

Strategy Deployment

Our Customers

Cross – Functional Management

Pe

op

le S

ys

temF

ina

nc

ial S

ys

tem

Our People

Plan

Set standardsFrom customer requirements

Standardize key processes

Do the work using:Visual Systems that drive action to meet targets

CheckWorkplace Rounding

Standards in place?Standard work?

Adherence?

Linked CheckingMeeting targets?

Act

A3 ThinkingCoach staff,

to identify root cause

Daily Management Continuous improvement in customer care & experience

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Phases of the Journey

Phase Zero:Exploration

Phase One:Building the foundation

Phase Two:Expanding with tools & deeper thinking

Phase Three:Integration and reinforcement

Phase Four:Systematic superior performance

We are here

• Initial exploration into benefits & challenges• Awareness & general understanding• Some use of tools

Act

ivit

y L

evel

• Beginning to understand tools• Uneven application & not tied to management systems• Education begins in earnest – learning, applying, reflecting

• Marked by intentional learning• Initial establishment of systematic approach• Broad education across enterprise• Specialized resources developed & deployed

• Integrated into management processes that have feedback mechanisms to reinforce them• Increased and deeper systematic work

• The way we do business and we are getting the results that reinforce that expectation

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Results

Staff engagement

Medical Home

Care Transitions

Administrative costs flat

Clinical cost trend far below national average

Care delivery improvements

Medicare Value Stream

Awards: JD Power, Consumer Reports, Puget Sound Health Alliance, NCQA etc.

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What are we working on now?

Stability of system – both what and why (Principles)

More front line driven continuous improvement

Use of lean principles in design (products, services, buildings)

Broader value streams across organizations

Implementation of large systems

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Our Lean Journey…

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Mental Models of Leadership

As leaders, what has made us successful in the past, may not serve us as well into the future…

Reflections