Introduction to Performance Improvement

1. Introduction to Performance Improvement Leadership Program

2. Performance Improvement?

3. Outline • What is Performance Improvement? • Performance Improvement in Healthcare • Performance Improvement Tools/Approaches • Lean Philosophy

4. What is Performance Improvement?

5. Performance is… • Fitness for use. • Conforming to specifications/requirements. • Having no defects. • The best combination of price and features. • The degree to which a specific product satisfies the wants of a specific customer. • Staying in business. The degree to which a set of inherent characteristics fulfills requirements. - ISO 9000

6. What is Performance Improvement? • A formal approach to the analysis of performance and systemic efforts to improve Performance. • Performance Assurances vs. Performance Improvement

7. Performance Improvement Models • Six Sigma • Lean Philosophy • Continuous Performance Improvement • Total Quality Management • PDSA

8. Performance Improvement in Healthcare

9. Examples of Performance Improvement in Healthcare • Improvement in Patient Flow • Reduction in Patient Wait Time • LOS Reduction in Emergency Room and Hospital • Inventory Reduction • Improvement in Supply Chain Expenses and Management • Reduction in Patients Left without Being Seen in Emergency Room • Hiring Process Improvement • CLABSI Elimination • Patient Satisfaction Improvement • Radiology/Laboratory Results Turn around Time Improvement • OR First Case Start on Time Improvement • OR Room Utilization Improvement • Reduction in Patient Cancellations

10. QI in Healthcare New York nursing homes - post acute pain • Interdisciplinary performance improvement team • Assessed pain management tools • Streamlined tool and improved user-friendliness • Reduced unnecessary work • Increased the timeliness • Implemented data tracking tools 26% 4%

11. Benefits of QI Level of Service Profitability Patient Satisfaction Cost

12. Performance Improvement Approaches

13. Plan-Do-Study-Act

14. Lean Philosophy • Systematic elimination of waste • Loss of resource • Non-value added activities • Primary objectives • Reduce production resource requirements and costs • Increase customer responsiveness • Improve product quality

15. Lean Philosophy *http://images.fedex.com/us/autodistrib/LeanTransportationFinal101606.pdf

16. Six Sigma • Reduce process variation • Drives production and quality improvements • Process improvements • Performance gaps

17. Six Sigma

18. Lean vs Six Sigma Lean Six Sigma Reducing variation Process under statistical control “Just quality” • Optimizing manufacturing • Reduce invested capital • “Just speed”

19. Lean Six Sigma • Eliminate waste and cost • Reduce customer defects • DMAIC model with lean tools • Improves • Quality • Speed • Variation and defects • Process flow

20. Keys to Lean Six Sigma Lean Six Sigma Delight Customers Improve Processes Quality Speed Variation and Defects Process Flow Teamwork Data and Facts

21. Rapid Cycle Improvement • Fast-paced improvement methodology • Rapid PDCA cycles • Identifies, implements and measures changes • Many changes/ideas at one time

22. Comparison of Approaches

23. Comparison of Approaches

24. Performance Improvement Tools

25. Value Stream Mapping • Analyze the flow of materials and information • Visualized the flow • Waste in a process • Priorities for improvement efforts • Basis for a implementation plan

26. 5S Set in Order Sort Sustain Standardize Shine

27. Mistake Proofing • Poka-Yoke or fail-safe • Eliminate product defects • When to apply • Possibility of defect • Downstream problems • Expensive or dangerous

28. Visual Process Controls Current Service Level • Help employees know the status of a system’s performance • Can communicate large amounts of quantitative information using transformed data • Examples • Dashboards • Control Charts • Warning Lights • Digital Displays