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Reducing Academic Attrition
Through Strategic
Performance Management David “Scott” Hencshel
Director, Lean Six Sigma Training & Deployment
Office of Strategy and Innovation
Army Medical Department Center and School
Fort Sam Houston, Texas
Strategic Performance & Change Management Conference
November 13-15, 2012 in New Orleans, LA
Trivia: Who is this?
• Saved the lives of thousands of British Soldiers in the Crimea.
• Wrote “Notes on Matters Affecting the Health, Efficiency and Hospital Administration of the British Army”.
• Introduced a system of recording sickness and mortality data at military hospitals—pled the case with data.
• Was a pioneer in the uses of social statistics and their graphical representation (invented the polar-area charts).
• Elected to a fellowship in the Royal Statistical Society.
• Honorary member of the American Statistical Association.
• Most effective weapon was the presentation of sound statistical data.
The death rate at
Scutari, calculated here
on an annual basis as a
fraction of the patient
population, reached 415
percent in February.
Sanitary reforms began
in March. This diagram
is taken from the report
of a Royal Commission
set up after the war to
investigate sanitary
conditions in the army.
Polar Area Chart
LINE DIAGRAMS
from the Royal
Commission’s report
compare conditions
in the Army to those
in civilian life.
Mortality in the
peacetime army in
Britain was nearly
twice as high as it
was among civilians
(top).
In the Crimean War
“zymotic” diseases
were the main causes
of death and were far
more prevalent than
they were in England
(bottom).
TSG Guidance for Balanced Scorecard
20 Dec 07—Army Surgeon
General, LTG Schoomaker
memo to Major Subordinate
Commands.
“Use the BSC as a
guide in all command
and management
functions with
conscious disciplined
application, it truly
works!”
What is a Balanced Scorecard?
• Strategic planning and management system
• Decision-making and communication tool
• Provides disciplined framework for planning and
measuring strategy
• Uses performance measures to monitor strategy
execution and make better strategic decisions
• Strategy Map
• Visual/graphic representation of our strategy
• Quick look at our strategic priorities in the form of
strategic objectives (“bubbles” on the map)
• Scorecard
• Developed from the strategy map
• Translates our strategic objectives into a comprehensive
set of performance measures and targets
• Provides the framework for our strategic measurement
and management system
BSC is comprised of
Slide 9 of 30
- Promote, Sustain and Enhance Soldier Health
- Train, Develop and Equip a Medical Force that Supports Full Spectrum Operations
- Deliver Leading Edge Health Services to Our Warriors and Military Family to Optimize Outcomes
For more information go to: https://ke2.army.mil/bscThis is a dynamic, living document
America’s Premier Medical Team Saving Lives and Fostering Healthy and Resilient People
Army Medicine…Army Strong!
Pati
en
t/C
usto
mer/
Sta
keh
old
er
CS 6.0
Inspire Trust
in Army
Medicine
CS 4.0
Responsive
Battlefield
Medical Force
CS 1.0 Improved
Healthy and Protected
Families, Beneficiaries
and Army Civilians
CS 3.0 Improved
Healthy and
Protected
Warriors
CS 5.0 Improved
Patient and
Customer
Satisfaction
IP 10.0
Optimize
Medical
Readiness
IP 13.0 Build
Relationships and
Enhance
Partnerships
LG 18.0 Improve
Training and
Development
IP 11.0 Improve
Information
Systems
CS 2.0 Optimized
Care and Transition
of Wounded, Ill, and
Injured Warriors
IP 12.0
Implement
Best
Practices
IP 14.0 Improve
Internal and
External
Communication
LG 20.0 Improve
Knowledge
Management
LG 17.0 Improve
Recruiting and
Retention of
AMEDD Personnel
Inte
rnal
Pro
cess
Learn
ing
an
d G
row
th
LG 19.0 Promote
and Foster a
Culture of
Innovation
Maximize Value in
Health Services
Provide Global
Operational ForcesBuild the Team
Balance Innovation
with Standardization
Optimize Communication and
Knowledge Management
Fe
ed
ba
ck A
dju
sts
Re
so
urc
ing
Dec
isio
ns
IP 8.0 Improve
Quality,
Outcome-
Focused Care
and Services
IP 7.0 Maximize
Physical and
Psychological Health
Promotion and
Prevention
IP 9.0 Improve
Access and
Continuity of
Care
IP 16.0
Synchronize
Army Medicine to
Support Army
Stationing &
BRAC
R 21.0
Optimize
Resources and
Value
R 22.0 Optimize
Lifecycle Management of
Facilities and
Infrastructure
R 23.0 Maximize
Human Capital
EN
DS
ME
AN
SW
AY
S
Res
ou
rce
IP 15.0 Leverage
Research,
Development and
Acquisition
- Promote, Sustain and Enhance Soldier Health
- Train, Develop and Equip a Medical Force that Supports Full Spectrum Operations
- Deliver Leading Edge Health Services to Our Warriors and Military Family to Optimize Outcomes
For more information go to: https://ke2.army.mil/bscThis is a dynamic, living document
America’s Premier Medical Team Saving Lives and Fostering Healthy and Resilient People
Army Medicine…Army Strong!
Pati
en
t/C
usto
mer/
Sta
keh
old
er
CS 6.0
Inspire Trust
in Army
Medicine
CS 4.0
Responsive
Battlefield
Medical Force
CS 1.0 Improved
Healthy and Protected
Families, Beneficiaries
and Army Civilians
CS 3.0 Improved
Healthy and
Protected
Warriors
CS 5.0 Improved
Patient and
Customer
Satisfaction
IP 10.0
Optimize
Medical
Readiness
IP 13.0 Build
Relationships and
Enhance
Partnerships
LG 18.0 Improve
Training and
Development
IP 11.0 Improve
Information
Systems
CS 2.0 Optimized
Care and Transition
of Wounded, Ill, and
Injured Warriors
IP 12.0
Implement
Best
Practices
IP 14.0 Improve
Internal and
External
Communication
LG 20.0 Improve
Knowledge
Management
LG 17.0 Improve
Recruiting and
Retention of
AMEDD Personnel
Inte
rnal
Pro
cess
Learn
ing
an
d G
row
th
LG 19.0 Promote
and Foster a
Culture of
Innovation
Maximize Value in
Health Services
Provide Global
Operational ForcesBuild the Team
Balance Innovation
with Standardization
Optimize Communication and
Knowledge Management
Fe
ed
ba
ck A
dju
sts
Re
so
urc
ing
Dec
isio
ns
IP 8.0 Improve
Quality,
Outcome-
Focused Care
and Services
IP 7.0 Maximize
Physical and
Psychological Health
Promotion and
Prevention
IP 9.0 Improve
Access and
Continuity of
Care
IP 16.0
Synchronize
Army Medicine to
Support Army
Stationing &
BRAC
R 21.0
Optimize
Resources and
Value
R 22.0 Optimize
Lifecycle Management of
Facilities and
Infrastructure
R 23.0 Maximize
Human Capital
EN
DS
ME
AN
SW
AY
S
Res
ou
rce
IP 15.0 Leverage
Research,
Development and
Acquisition
Cascaded Objectives
AMEDD Center and School: As of 26 Jun 08
Org
an
izati
on
al
Ca
pa
cit
y
Inte
rna
l
Pro
ce
ss
es
Fin
an
cia
l/
Ste
ward
sh
ip
Cu
sto
me
rs/
Sta
ke
ho
lde
rs
Improve Customer
Satisfaction
Enhance
Communication
Reward
StewardshipOptimize and
Diversify
Resources
Improve
Employee
Satisfaction
Improve
Knowledge
Management
Increase
Organizational
Efficiency and
Standardization
Improve
Change
Management
Improve Training
and Working
Environment
Increase
Understanding of
Duties/Responsibilities
Improve
Organizational
Alignment
Optimize
Employee
Education and
Training
Inspire Trust in
Products and
Services
Optimize
Employee
Recognition
Improve Access
to Products and
Services Improve Joint
Integration
Encourage
Innovation
Enhance Medical
Training and
Force
Development
Org
an
izati
on
al
Ca
pa
cit
y
Inte
rna
l
Pro
ce
ss
es
Fin
an
cia
l/
Ste
ward
sh
ip
Cu
sto
me
rs/
Sta
ke
ho
lde
rs
Improve Customer
Satisfaction
Enhance
Communication
Reward
StewardshipOptimize and
Diversify
Resources
Improve
Employee
Satisfaction
Improve
Knowledge
Management
Increase
Organizational
Efficiency and
Standardization
Improve
Change
Management
Improve Training
and Working
Environment
Increase
Understanding of
Duties/Responsibilities
Improve
Organizational
Alignment
Optimize
Employee
Education and
Training
Inspire Trust in
Products and
Services
Optimize
Employee
Recognition
Improve Access
to Products and
Services Improve Joint
Integration
Encourage
Innovation
Enhance Medical
Training and
Force
Development
MEDCOM (our higher headquarters)
AMEDDC&S (us)
10
Org
an
iza
tio
na
l
Ca
pa
cit
y
Inte
rna
l
Pro
cesses
Fin
an
cia
l/
Ste
ward
sh
ip
Cu
sto
me
rs/
Sta
ke
ho
lde
rs
CS 2.0
Improve
Customer
Satisfaction
IP 8.0
Enhance
Communication
FS 5.0
Reward
Stewardship
FS 4.0
Optimize
and Diversify
Resources
CS 3.0
Improve
Employee
Satisfaction
IP 13.0
Improve
Knowledge
Management
IP 12.0
Increase
Organizational
Efficiency and
Standardization
IP 9.0
Improve
Change
Management
OC 16.0
Improve Training
and Working
Environment
OC 17.0
Increase
Understanding of
Duties /
Responsibilities
OC 15.0
Improve
Organizational
Alignment
OC 18.0
Optimize
Employee
Education and
Training
CS 1.0
Inspire
Trust in
Products and
Services
IP 10.0
Optimize Civilian
Employee
Recognition
IP 6.0
Improve
Access to
Products and
Services
IP 7.0
Improve Joint
Integration
IP 14.0
Encourage
Innovation
IP 11.0
Enhance
Medical Training
and Force
Development
11
Objective Objective Statement Measure Targets Initiatives
Quarterly review of projected
budget execution versus
actual execution
TBD Baseline
% compliance with credit card
rebate policy < 5 days
Attrition rates (%) of all MOS
coursesTBD Baseline
Charter attrition
work group .
% deploying BCT receiving
predeployment training across
all COMPOS
AC 100%
NG TBDTBD
TBD TBD TBD
Fin
an
cia
l S
tew
ard
sh
ipIn
tern
al
Pro
ce
ss
es
Reward Stewardship
Recognize efficient use of resources.
Reward innovation that improves
operations and/or increases customer
satisfaction
Budget return from
Credit Card
Rebate.
Enhance Medical
Training and Force
Development
Ensure health services assets of all three
components are trained and modular and
cutting edge to support full spectrum
operation and joint force requirements.
Scorecard (Initial)
Objective Objective Statement Measure Target Initiative
Attrition rates
by class.
TBD /
baseline
# of Graduates
# of Starts
356
400
11%1 - X 1000.89 =
1 - X 100 = Attrition
X 100 =-1 Attrition
68W Attrition rate Attrition rate = (1- (grads/starts))*100
We decided on using a Control Chart. Why?
1. See trending and monitor the process over time.
2. Detect special cause variation. Special cause variation is
data/events that occur outside the Control Limits (approx +/– 3
std dev from the mean = 99.73%) seen as the red lines above
and below the mean.
3. Help us establish the current performance level (baseline) and
then allow us to compare/monitor current performance to the
baseline.
The BSC forced us to find the best
tool to “measure” and “see”
attrition?
This depends on the type of data that you have:
Continuous Data-----Speed, Time, Distance
Discrete/Attribute Data-----Attrit, non-attrit = (P Chart)
What is the right Control Chart to use?
Charts the proportion of
defectives in each
subgroup.
Strategic Objective
Objective Commentary Measure Target
Scorecard (Current)
Ensure health services assets of all three components are trained and modular and cutting edge to support full spectrum operation and joint force requirements.
68W Attrition rate Attrition rate = (1- (grads/starts))*100
Attrition Rate stay between Upper and Lower Control Limit
IP 11.0 Enhance Medical Training
and Force Development
68W Attrition Attrition %
between UCL
and LCL
First Time Pass = Rolled Throughput Yield • What is the final yield (First Time Pass %) after passing
through 5 steps (modules) in a course?
– Each step (module) has a yield of “Y”. • Y = 95%
• Y = 99%
– Assume a class size of 400 for this example
Step 1 Step 2 Step 3 Step 4 Step 5 Output
Y = 95% 380 361 343 326 310 77%
Y = 99% 396 392 388 384 380 95%
Moral of the story--A comparatively small improvement in yield results in an enormous improvement in output productivity and a dramatic reduction in cost!
Last Thoughts
We were . . . . . . . Now we . . . . . . . .
Not measuring correctly (rolling
quarterly average? Really?)
Have a proper definition of Attrition (to
include mathematically) and use the P
Chart to “see” performance and trending
Paying homage to a “false target”
(cookie cutter 10%)
Have meaningful targets based on
historical data and baselines by course
Dealing with Attrition on the 2nd
floor of building 2840
Deal with Attrition throughout our
organization
Strategic Performance & Change Management Conference
Actuate - The BIRT Company™
Spider Strategies, Inc. Association for Strategic Planning Process Excellence Network Strategy Management Group
If you would like to receive the free IQPC brochure
directly email [email protected]
November 13-15, 2012 in New Orleans, LA
View the Strategic Performance
& Change Management program
here: http://tinyurl.com/8wxywgc