Steve Warren

Daniel Yoon

ETM 591 Spring 2014

Lean Healthcare Deployment and Lean Healthcare Deployment and Sustainability Sustainability

Chapter 9 – Ensure Enterprise Chapter 9 – Ensure Enterprise Transformation ResultsTransformation Results

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Ensure Enterprise Transformation (ET) Results

What it ET?

Why do we need to ensure ET results?

Two ways to measure ET results

How do we measure ET results?

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Why ensure ET results?

The corporation has invested (time and money) to implement lean in its business unit.

Important to see that the deployment of the lean initiatives achieve the desired results.

Provides opportunities to remove barriers

Identify new opportunities for transformation

Standardize best practices

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Two ways to measure ET results

Deployment-

The depth and breadth of the enterprise transformation across the organization

A measure of the maturity of the initiative

Outcome-

The organizational impact achieved through the deployment effort.

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Four steps for measuring deployment and outcome

Develop an enterprise dashboard Develop healing pathway dashboards Develop a tollgate dashboard Conduct regular senior leadership team

meetings to review outcomes and deployment

How do we measure ET results?

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An enterprise dashboard will include metrics that reflect:

Measures of the overall health of the enterprise

• Clinical quality- unadjusted overall mortality rate• Clinical utilization – total length of stay (LOS)• Labor/Non-labor – overtime as a % of salaries• HR –salary and wages per adjusted discharge• Financial Strength – debt to capitalization ratio

Develop An Enterprise Dashboard (metrics)

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An healing pathway dashboard will include metrics that:

Are at the highest level, of interest to the senior leadership team

Reflect the key measures of overall health of the healing pathway

Are associated with the transformation efforts

Develop Healing Pathway Dashboards (metrics)

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It is important to note that these healing pathways analyses and transformations will yield three key deliverables:

a roadmap for transforming the healing pathway from the current state to a desired future state

identification of the outcome metrics that will be impacted

identification of the process that will indicate whether the transformation is occurring as planned

Develop Healing Pathway Dashboards (metrics)

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Healing Pathway Dashboard (Example)

SOURCE: Dean (2013) Lean Healthcare Deployment and Sustainability

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12 areas of implementation that are critical to a successful enterprise transformation:

1) Strategic plan and vision

2) Aligning the organization

3) Engaged leadership

4) Enabling infrastructure

5) Focus on value streams

6) Rapid improvement events

7) Engagement in projects

8) Other Lean practices

9) Six Sigma practices

10) Partnering with suppliers/customers

11) Innovative processes

12) Pursuit of perfection

Develop a Tollgate Assessment Tool

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Maturity of deployment in each of the areas can be measured on a scale from 0 to 3.

Tollgate 0 Traditional non-Lean environment

Tollgate 1 Beginning to adopt the Lean Paradigm Beginning to stimulate a cultural transformation Localized or limited improvement visible at value stream level only

Tollgate 2 Institutionalizing the Lean paradigm on a broad scale Broadly impacting the enterprise’s culture of empowerment and

improvement Positively impacting enterprise performance metrics

Tollgate 3 Self-sufficient Lean enterprise Cultural and performance transformation Operating performance at or approaching world class

Tollgate Assessment Tool Scale (0 to 3)

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The results of Healing University’s tollgate assessment over a 4-year period. (p.83)

A Radar Chart Example

SOURCE: Dean (2013) Lean Healthcare Deployment and Sustainability

Strong

Weak

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This step is one of the most critical for ensuring the sustainability of the enterprise transformation effort.

Meetings must be held biweekly early in the transformation and can be decreased to monthly sessions later.

Each meeting should follow a standardized agenda.

Must maximize the effectiveness and efficiency of their time by providing an adequate level of administrative and analytic support.

Conduct Regular Senior Leadership Team Meetings

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Each meeting should follow a standardized agenda, which might include the following items:

1) CEO’s welcome and remarks

2) Review of actions from prior enterprise transformation meeting

3) Review of enterprise operational dashboard

4) Identification of opportunity areas and assignment of responsibility

5) Review of enterprise transformation efforts Deployment High-level outcomes

6) Review of each healing pathway transformation initiative

7) Problem solving and elimination of barriers

8) Evaluation and reprioritization of initiatives as appropriate

9) Action item review

Standardized Agenda (p.84)

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The healing pathway executive should cover the following:

1) Healing pathway dashboard

2) Key accomplishments to date

3) Barriers to success

4) Any recommendations on the following elements: Team structure Team membership Meeting frequency Leadership Work plan Tracking and reporting needs

5) Help needed from the senior leadership team

6) Next steps

Conduct Regular Senior Leadership Team Meetings

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Healing pathway analysis (page 77)A structured and facilitated event during which a cross-functional team progresses methodically through a series of interactive and evaluative steps aimed at eliminating waste, eliminating impediments to healing and improving the flow of patients through the healing pathway.

Transformation Summit (page 77) A planning event during which the CEO and senior leadership team plan the enterprise transformation.

Deployment (page 73) The depth and breadth of the enterprise transformation across the organization. It is a measure of the maturity of the initiative.

Glossary

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Contact Information:Steve Warren10276718@mercer.eduDaniel Yoon10789063@mercer.edu

 Dean, M.L. (2013). Lean Healthcare Deployment and Sustainability. New York, NY: McGraw Hill. (p.73-85)

References/Contact Information