Steve Warren Daniel Yoon ETM 591 Spring 2014

1. Lean Healthcare Deployment and Sustainability Chapter 9 – Ensure Enterprise Transformation Results Steve Warren Daniel Yoon ETM 591 Spring 2014

2. What it ET? Why do we need to ensure ET results? Two ways to measure ET results How do we measure ET results? Ensure Enterprise Transformation (ET) Results ETM 591 SW/DY Lean Healthcare

3. 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 Why ensure ET results? ETM 591 SW/DY Lean Healthcare

4. 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. Two ways to measure ET results ETM 591 SW/DY Lean Healthcare

5. How do we measure ET results? • 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 ETM 591 SW/DY Lean Healthcare

6. Develop An Enterprise Dashboard (metrics) • 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 ETM 591 SW/DY Lean Healthcare

7. Develop Healing Pathway Dashboards (metrics) • 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 ETM 591 SW/DY Lean Healthcare

8. Develop Healing Pathway Dashboards (metrics) • 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 ETM 591 SW/DY Lean Healthcare

9. Healing Pathway Dashboard (Example) SOURCE: Dean (2013) Lean Healthcare Deployment and Sustainability ETM 591 SW/DY Lean Healthcare

10. Develop a Tollgate Assessment Tool • 12 areas of implementation that are critical to a successful enterprise transformation: • Strategic plan and vision • Aligning the organization • Engaged leadership • Enabling infrastructure • Focus on value streams • Rapid improvement events • Engagement in projects • Other Lean practices • Six Sigma practices • Partnering with suppliers/customers • Innovative processes • Pursuit of perfection ETM 591 SW/DY Lean Healthcare

11. Tollgate Assessment Tool Scale (0 to 3) • 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 ETM 591 SW/DY Lean Healthcare

12. A Radar Chart Example • The results of Healing University’s tollgate assessment over a 4-year period. (p.83) Strong Weak SOURCE: Dean (2013) Lean Healthcare Deployment and Sustainability ETM 591 SW/DY Lean Healthcare

13. Conduct Regular Senior Leadership Team Meetings • 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. ETM 591 SW/DY Lean Healthcare

14. Standardized Agenda (p.84) • Each meeting should follow a standardized agenda, which might include the following items: • CEO’s welcome and remarks • Review of actions from prior enterprise transformation meeting • Review of enterprise operational dashboard • Identification of opportunity areas and assignment of responsibility • Review of enterprise transformation efforts • Deployment • High-level outcomes • Review of each healing pathway transformation initiative • Problem solving and elimination of barriers • Evaluation and reprioritization of initiatives as appropriate • Action item review ETM 591 SW/DY Lean Healthcare

15. Conduct Regular Senior Leadership Team Meetings • The healing pathway executive should cover the following: • Healing pathway dashboard • Key accomplishments to date • Barriers to success • Any recommendations on the following elements: • Team structure • Team membership • Meeting frequency • Leadership • Work plan • Tracking and reporting needs • Help needed from the senior leadership team • Next steps ETM 591 SW/DY Lean Healthcare

16. Glossary 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. ETM 591 SW/DY Lean Healthcare

17. References/Contact Information Dean, M.L. (2013). Lean Healthcare Deployment and Sustainability. New York, NY: McGraw Hill. (p.73-85) Contact Information: Steve Warren 10276718@mercer.edu Daniel Yoon 10789063@mercer.edu ETM 591 SW/DY Lean Healthcare