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A Practical Marriage of Baldrige and Lean Six Sigma
Mike Mike PickelsPickelsDirector of Quality Director of Quality
High Point Regional Health SystemHigh Point Regional Health System
Mike is the Director of Quality at High Point Regional Health Mike is the Director of Quality at High Point Regional Health System, a 400System, a 400--bed hospital in North Carolina. He joined the bed hospital in North Carolina. He joined the healthcare industry five years ago after serving nearly 20 yearshealthcare industry five years ago after serving nearly 20 years in in the Finance industry. He is a Certified Six Sigma Black Belt witthe Finance industry. He is a Certified Six Sigma Black Belt with h over 10 years of experience with project management and softwareover 10 years of experience with project management and softwaresystem development and implementation.system development and implementation.
Mike serves as a Malcolm Mike serves as a Malcolm BaldrigeBaldrige Quality Program Expert at High Quality Program Expert at High Point, leads the Balanced Scorecard process for the Health SystePoint, leads the Balanced Scorecard process for the Health System, m, and serves as a mentor to over 60 Green Belts. He is a graduate and serves as a mentor to over 60 Green Belts. He is a graduate of of Virginia Commonwealth University and is currently working towardVirginia Commonwealth University and is currently working towards s his MHA Degree from Pfeiffer University.his MHA Degree from Pfeiffer University.
Mike and his wife have two girls, ages 4 and 8.Mike and his wife have two girls, ages 4 and 8.
About High Point Regional Health System (HPRHS)About High Point Regional Health System (HPRHS)
�� 400400--bed Health Systembed Health System
�� Private, NotPrivate, Not--forfor--ProfitProfit
�� Level III Trauma CenterLevel III Trauma Center
�� Magnet DesignatedMagnet Designated
�� Level 3 State Baldrige WinnerLevel 3 State Baldrige Winner
�� General medical and surgical inpatient, outpatient General medical and surgical inpatient, outpatient and emergency servicesand emergency services
�� Serve a population of approximately 500,000 Serve a population of approximately 500,000 residents from four counties in central North Carolina residents from four counties in central North Carolina
�� CEO CEO –– Jeff MillerJeff Miller
�� COO COO –– Martha BarhamMartha Barham
�� CNO CNO –– Tammi MengelTammi Mengel
�� CMO CMO –– Dr. Greg TaylorDr. Greg Taylor
�� CFO CFO –– Kimberly CrewsKimberly Crews
�� 2,400 Employees2,400 Employees
�� 6 Black Belts6 Black Belts
�� 64 Green Belts throughout the Health System64 Green Belts throughout the Health System
�� 150 Red Belts throughout the Health System150 Red Belts throughout the Health System
�� 12 Baldrige Internal Experts12 Baldrige Internal Experts
High Point Regional Health System competes in a High Point Regional Health System competes in a
Primary Service Market that includes:Primary Service Market that includes:
A large multiA large multi--system / multisystem / multi--state healthcare providerstate healthcare provider
that covers much of the State of North Carolinathat covers much of the State of North Carolina
A large educationA large education--based healthcare systembased healthcare system
A multiA multi--system healthcare provider that covers much system healthcare provider that covers much
of the Piedmont Triad areaof the Piedmont Triad area
Total Care
Mission: To provide Exceptional Health Services to the People of our Region
Malcolm Baldrige National Quality Program
Six Sigma Projects
Org
anizational Goals
Strategic Planning
Balanced Scorecard
Engagement
MVV
All journeys begin with a vision of All journeys begin with a vision of where you want to gowhere you want to go
Our journey began with leaders that Our journey began with leaders that believed the believed the foundationfoundation Baldrige Baldrige provided and the provided and the structurestructure Six Six
Sigma provided were the Sigma provided were the frameworks necessary to move frameworks necessary to move the needle of our organizationthe needle of our organization
Baldrige Journey began in 2005Baldrige Journey began in 2005
Six Sigma became the sole Process Improvement Six Sigma became the sole Process Improvement
Methodology in 2006Methodology in 2006
Realizing the two work in concert began in 2008Realizing the two work in concert began in 2008
Applying Baldrige Principles with Six Sigma Tools to Applying Baldrige Principles with Six Sigma Tools to
address opportunities became a reality in 2008address opportunities became a reality in 2008
As with any journey, there can As with any journey, there can be barriers, detours, and be barriers, detours, and
wrong turnswrong turns
Patience with the Journey and Patience with the Journey and confidence in the process are confidence in the process are
critical critical
Forward movement doesnForward movement doesn’’t t mean you are always mean you are always
headed in the right direction, headed in the right direction, but it does mean that you but it does mean that you
are movingare moving
Barriers Encountered:Barriers Encountered:
Baldrige Baldrige ““ExpertsExperts””
Vs.Vs.
Six Sigma Six Sigma ““ExpertsExperts””
Impatience with the ProcessImpatience with the Process
Limited view of the futureLimited view of the future
Why ChangeWhy Change
Preconceived BeliefsPreconceived Beliefs
The Light Bulb Finally Turned On WhenThe Light Bulb Finally Turned On When……
We trained our Internal Baldrige Experts on Six Sigma We trained our Internal Baldrige Experts on Six Sigma
and our Six Sigma Belts on Baldrigeand our Six Sigma Belts on Baldrige
We began to realize that Baldrige and Six Sigma We began to realize that Baldrige and Six Sigma
compliment one another (rather than continuing to compliment one another (rather than continuing to
believe they were competing against each other)believe they were competing against each other)
Leadership
Leadership
Leadership
Leadership
B: Strategic PlanningS: Define Scope
B: Measurement, Analysis, & Knowledge ManagementS: Measure, Measure,
Measure
B: Results
S: Control
B: Process ManagementS: Improvements
B: Workforce
S: Cross-Functional Teams
B: Patients, Customers, Markets
S: Analyze, VOC, GAP Analysis
Key Changes as a result:Key Changes as a result:
Systematic, Repeatable, Consistent project approval process Systematic, Repeatable, Consistent project approval process
that addressed Baldrige and Six Sigma Principlesthat addressed Baldrige and Six Sigma Principles
Cycles of Refinement that use Six Sigma tools while addressing Cycles of Refinement that use Six Sigma tools while addressing
Baldrige requirementsBaldrige requirements
Project teams now include Six Sigma and Baldrige expertsProject teams now include Six Sigma and Baldrige experts
Projects now begin with an event that pulls tools from Six Projects now begin with an event that pulls tools from Six
Sigma and BaldrigeSigma and Baldrige
Project KickProject Kick--off Event unique to High Point off Event unique to High Point
Regional Health SystemRegional Health System
DADLI
BaldrigeBaldrige Asks:Asks:
�� Do you have an Do you have an ApproachApproach
�� Have you fully Have you fully DeployedDeployed that Approachthat Approach
�� How do you How do you Learn Learn from your processes from your processes
�� Is your Approach Is your Approach IntegratedIntegrated
DMAICDMAIC Directs:Directs:
�� DefineDefine your Scopeyour Scope
�� MeasureMeasure and and AnalyzeAnalyze DataData
�� Recommend Recommend ImprovementsImprovements
�� ControlControl your Resultsyour Results
DefineDefine refers to the purpose and scope of a given process. refers to the purpose and scope of a given process.
During the Define phase, the process design/reDuring the Define phase, the process design/re--engineering team engineering team
writes a purpose statement specifying the desired scope andwrites a purpose statement specifying the desired scope and
process outcome.process outcome.
1.1. What is the issue this process addresses?What is the issue this process addresses?
2.2. Who are the customers and what are their requirements Who are the customers and what are their requirements
and/or expectations?and/or expectations?
3.3. What is the desired outcome of this process?What is the desired outcome of this process?
4.4. Where and when should this process be performed (scope)?Where and when should this process be performed (scope)?
D
ApproachApproach refers to the methods used by an organization to refers to the methods used by an organization to
perform its work. Approach includes the appropriateness of the perform its work. Approach includes the appropriateness of the
methods.methods.
1. Is the approach systematic (i.e., with repeatable steps, 1. Is the approach systematic (i.e., with repeatable steps,
inputs, outputs, time frames)?inputs, outputs, time frames)?
2. Is there evidence that the approach is effective?2. Is there evidence that the approach is effective?
3. Is this approach (or collection of approaches) a key 3. Is this approach (or collection of approaches) a key
organizational process? organizational process?
4. Is the approach important to HPRHS4. Is the approach important to HPRHS’’ overall performance?overall performance?
A
DeploymentDeployment refers to the extent to which an refers to the extent to which an approachapproach is is
applied in an organization. applied in an organization.
DeploymentDeployment is evaluated on the basis of the breadth and is evaluated on the basis of the breadth and
depth of the depth of the approachapproach to relevant work units throughout the to relevant work units throughout the
organization.organization.
1. Is deployment addressed?1. Is deployment addressed?
2. Is the process in place in all appropriate work units, 2. Is the process in place in all appropriate work units,
facilities, locations, shifts, and organizational levels?facilities, locations, shifts, and organizational levels?
D
LearningLearning refers to new knowledge or skills acquired through refers to new knowledge or skills acquired through
evaluation, feedback, study, experience, and innovation. evaluation, feedback, study, experience, and innovation.
1. Has the approach been evaluated and improved? If it has, was1. Has the approach been evaluated and improved? If it has, was
the evaluation and improvement conducted in a factthe evaluation and improvement conducted in a fact--based, based,
systematic manner (e.g., regular, recurring, datasystematic manner (e.g., regular, recurring, data--driven)?driven)?
2. Is there evidence of organizational learning (i.e., evidence2. Is there evidence of organizational learning (i.e., evidence that that
the learning from this approach is shared with other the learning from this approach is shared with other
organizational units/other work processes)? organizational units/other work processes)?
3. Is there evidence of innovation and refinement from 3. Is there evidence of innovation and refinement from
organizational analysis and sharing (e.g., evidence that the organizational analysis and sharing (e.g., evidence that the
learning is actually used to drive innovation and refinement)?learning is actually used to drive innovation and refinement)?
L
IntegrationIntegration refers to harmonization of plans, processes, information, refers to harmonization of plans, processes, information,
resource decisions, actions, results, and analyses to support keresource decisions, actions, results, and analyses to support key y
organizationorganization--wide goals. Effective integration goes beyond alignment and is wide goals. Effective integration goes beyond alignment and is
achieved when the individual components of a performance managemachieved when the individual components of a performance management ent
system operate as a fully interconnected unit.system operate as a fully interconnected unit.
1. Are there complementary measures and information for plannin1. Are there complementary measures and information for planning, g,
tracking, analysis, and improvement used at three levels: the tracking, analysis, and improvement used at three levels: the
organizational level, the process level, and the department or worganizational level, the process level, and the department or workork--unit unit
level? level?
2. How well is the approach aligned and integrated with items o2. How well is the approach aligned and integrated with items of f
importance to HPRHS? importance to HPRHS?
I
� Needs identified during the Strategic Planning Process
� Feedback provided by State and National Baldrige Examiners
� Process Improvement Suggestions submitted by Staff (TIP
Program) and/or Patients/Visitors
� The Organizational and Departmental Scorecard Results
� Regular Cycles of Refinement with current processes
� Control Plan Review Results
� Baldrige/Six Sigma Process Review Events
Bal
drig
e an
d Si
x Si
gma
Eng
agem
ent
““Baldrige is our framework and guide. Baldrige is our framework and guide. Scorecards tell us how processes are Scorecards tell us how processes are working, and where improvement working, and where improvement opportunities may exist. Lean Six opportunities may exist. Lean Six Sigma is our continuous improvement Sigma is our continuous improvement methodology. Project Teams are the methodology. Project Teams are the vehicle for executing needed changevehicle for executing needed change””Gary Kollm, Six Sigma Black BeltGary Kollm, Six Sigma Black Belt
Level 3 State Winner