Lean 6 Sigma at HHSA: Advancing the vision of Live Well, San Diego!

County of San Diego, Health & Human Services Agency

Prepared by Jackie WerthSpecial Projects CoordinatorOffice of Business Intelligence, HHSA

2

It’s how we become an “Agency of One”

HHSA is large agency combining health, behavioral health and social services, serving a diverse community

Bold, 10-year strategy, “Live Well, San Diego!”

Critical to success is addressing fundamentals—strong work systems and processes to meet customer needs

3

Vision: Healthy, Safe, Thriving Communities

Action Framework

Build a Better System

Support Positive Choices

Pursue Policy & Environmental Changes

Improve the Culture Within

Advance Operational Excellence

An Agenda for the Future

4

County of San Diego General Management System

Motivation, Rewards & Recognition

Motivation, Rewards & Recognition

StrategicPlanningStrategicPlanning

Operational

Planning

Operational

Planning

Monitoring &

Control

Monitoring &

ControlFunctional ThreadingFunctional Threading

General Management

System

Are we sharing goals & encouraging

success?

Where are we going?

How do we plan to get

where we’re going?

Are we on track?

Are we working together?

5

Fundamentals of top performing organizations

• Senior leaders take action and communicate effectively and frequently to sustain the organization

Leadership

• Strategic challenges addressed and strategic advantages leveragedStrategic Planning

• Actively listening to and engaging the customer, even building relationships with themCustomer Focus

• Performance is measured, analyzed, reviewed and improved at all levels

Measurement & Analysis

• Workforce is supported, actively managed and engagedWorkforce Focus

• Work systems and processes designed, managed and improved to deliver customer valueOperations Focus

• Results data available and utilized across all programs, services, processes and location.Results

Malcolm Baldrige criteria for performance excellence

6

Operational excellence demands:

Approach is effective, systematic, fully responsive to multiple item requirements

Deployment of approach is complete, without significant weaknesses or gaps in any areas or work units

Learning through innovation, ongoing improvement efforts, analysis and sharing

Integration of approach to address current and future organizational needs, and across all process items

Malcolm Baldrige criteria for performance excellence

7

What is L6S?

Lean is about reducing waste in processes so that you get the right result in as few steps as possible

Six Sigma is about reducing variation so that you consistently produce a high quality product, service or outcome

Both sets of tools can make a difference!

8

DMAIC

Define Using the “voice of customer,” the “Big Y” is defined

Measure Process mapping and control charts are key here

Analyze Hypothesis testing and pareto charts help you get to root cause

Improve Evaluating, selecting and testing solutions is next

Control This is how you ensure improvements take and you get the

results you are after

9

Why L6S is culture change

We don’t always think of what we do as a collection of processes

We tend to want to go “fix” a problem before taking the time to determine the root cause

There is always the fear of what L6S will find or reveal

We often lack the data, analytic capacity, time and discipline to undertake this type of analysis, much less do it routinely

We fail to effectively communicate project findings and follow-through by testing and implementing improvements

10

Building capacityFY10-11• Send 2 staff to Black Belt training

(external)• Hire master Black Belt consultant• Green Belt training (3 cohorts of 15

each)• White Belt training for ExecutivesFY 11-12

• White Belt on-line training for ALL 5,000 staff

• Yellow Belt training for ALL 300 managers

• Green Belt training (2 cohorts of 15 each)

• Black Belt training for 5FY 12-13 (proposed)• Targeted Green Belt training for

corrective action and quality control staff

• Green Belts teach Yellow Belt• Deploy Green/Black Belts to priority

projects• Black Belts offer technical assistance

to Executives

11

White Belt On-Line Training for ALL Staff

All 5,000 staff introduced to L6S basics: Interactive with comic

book theme DMAIC explained Illustrated by current

Green Belt Projects Resource sheet Features Agency Director

who solicits improvement ideas

12

Yellow Belt for ALL Managers All 300 managers get

additional training to encourage use of L6S and help getting solutions implemented: Lots of team exercises using

the tools Guest Green Belt highlights

project Affinity exercise on change

management priorities:▪ “What gets in the way of

process improvement at HHSA?”

13

Green & Black Belt TrainingGreen Belt Black Belt

Apply with Executive approval Apply with Executive approval

5 months, 5 full days of class 5 months, 13 full days of class

Pass assessment Pass assessment

Conduct project (process within own department) using DMAIC

Conduct major project (major process, multi-departmental) using DMAIC

Deliver final presentation to Project Sponsors

Deliver final presentation to Executives

Project deck reviewed and approved by Master and Agency Black Belts

Project deck reviewed and approved by Master and Agency Black Belts

New Bench Strength:53 Green, 2 Black

ACS AIS/East BHS Central CWS

3 Green 5 Green 5 Green 3 Green 5 Green

Exec Office First 5 FSSD HR N. Central

3 Green1 Black

1 Green 5 Green 1 Green1 Yellow

2 Green

N. Inland PAPG PHS South SPOS

3 Green 1 Green1 Yellow

7 Green 2 Green 7 Green1 Black

As of May 2012; 1 Black Belt class and 1 Green Belt class in progress.

15

Examples of projects from across the enterprise

Public health

Child welfare

Behavioral health

Eligibility Aging services

Admin services

Improve public health lab reporting accuracy

Reduce time it takes to connect CWS clients with service providers

Increase primary care referrals to substance abuse treatment

Reduce wait times in family resource center lobbies

Increase accuracy of the intake process for In-Home Supportive Services

Reduce time it takes to process a travel claim

16

ROI

Benefits just beginning to be realized Mostly timeliness, accuracy

and service quality improvements

Anticipated ROI of $1.8 million for FY 10-11 projects; modest monetary benefits reported so far

Costs kept to a minimum:•Master Black Belt trainer consultant for all training •Conduct training on site at HHSA’s The Knowledge Center•Use own Black & Green Belts staff to mentor, train in future

17

Biggest benefit is having staff with this skill set to draw upon

New pool of Green Belt staff to task to solve sensitive and complex problems

New Black & Green Belt expertise to tap to look at systems and operations with a whole new perspective Address major risks/problems as emerge Start building L6S into into operations

18

Profiles of early, small successes

Edgemoor Nursing FacilityEnsure

staff get physical exams

San Pasqual

Academy for foster

kidsIncrease

placement

Emergency Medical Technician

sSpeed up certificatio

n

19

What challenges persist? Union concerns Solutions are often not fully

implemented ROI takes time to show; more service

quality benefits than financial benefits No mechanism in place now to ensure

Black and Green Belts are being maximized, or put to best use to advance the vision

20

The biggest room in the world is the room for improvement