Grass-roots driven Six Sigma

Mary Jim Montgomery, COOBrit Watts, Six Sigma Black BeltBay Medical Center, Panama City, FL

What keeps you up at night?

• High turnover?• No money?• Organizational conflict?• Lack of focus?• Unsure direction?• Stakeholder complaints?

Our Journey to Excellence“A Kodak Moment”

• Identified burning platform• Leveraged Six Sigma into strategy• Made the most of limited resources• Built support & demonstrated value• Facilitated grass-roots collaboration

The Burning Platform:Financial Vulnerability

•Break-even margins•Over-extended capital•Takeover threats looming

• Public hospital• Disproportionate share• No tax support• Aging facility (1949)

• Low morale• Low empowerment• Lack of confidence• Crisis management

The Burning Platform:Cultural Crisis

• MD dissatisfaction• Hostile work climate• Antagonistic

The Burning Platform:Lack of Focus

• Dissatisfied customers• Board interference• Delays & wastefulness• No consistency• Quality cycles

• No strategic plan• No shared vision• No goals

Initiated Enterprise-wide Interventions

TO DO LIST:• Create multi-year strategic plan• Educate Board on governance• Restore physician relations• Stabilize financial position• Change the culture

…..In the next two years

Integrated Six Sigma into Organization’s Strategic Plan

• Align 6σ to strategic initiativeso Reduce financial vulnerabilities

• Improve efficiency and eliminate wasteo Contribute to cultural shift

• Build leadership competencies & accountabilities

• Support data-based decision making• Initiate customer focus• Improve communications across

organization

Six SigmaFinancing & Resources

• Begin with internal resourceso Executive sponsoro Industrial engineer/performance

improvement/change management skillso Involve functional leaders with vested

interest (& accountability) for change• Acquire affordable Six Sigma training

o Black Belt: In residence plus project support

o Green Belt: Supported by Black Belt

Building Support & Demonstrating Value

• Align projects to organizational goalso Customer serviceo Financial performanceo Business practice improvemento Employee innovation & knowledge

• Follow DMAIC processo Customer focusedo Data-centeredo Project managemento Tollgate reviews

Speak to Executive Audience• Logic (Logos)

o Chartso Datao Analysis

• Values (Ethos)o Qualityo Best in classo Competitive position

• Emotion (Pathos)o Serviceo Storieso Relationships

Build Momentum Through Teams

• Support teams for successo Prepare for tollgate presentationso Independently confirm resultso Team members deliver findings

• Reinforce communication strategyo MDs, Board & CEO: Strategic impact,

competitive advantage & bottom-line results

o CFO: ROI, efficiency & effectivenesso COO & CNO: Effectiveness,

collaboration, service and quality

Six Sigma.....the rest of the storyTeam

Efficiency & Effectiveness

Satisfaction & Service

Financial Impact/Yr

Reduced wait time from 45 min to less than 10 minReduced cycle time from 180 min to 45 min

Improved charge capture from 56% to over 92% Easier to useImproved layout and eliminated non-value-added steps

Better accountability & tracking

Reduced scheduled no-shows from 36% to less than 8%

Expedited arrival processing

Improved flow capacity for walk-in patients50% reduction in transcription backlog

MD satisfaction rose from 77% to 90%

40% increase in volumesANNUAL TOTAL $ 2,196,671.00

$ 526,146.00

$1,230,000.00

$ 328,525.00

$ 112,000.00

Preoperative AssessmentReduced cancelled

surgeries from 144 to 27/month

MRI Results reporting

Open Pyxis 5-S Redesign

Pre-registration

Organizational Results:Financial Viability

0.41%

1.88%

2.40%

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

2002 2003 2004

585 % increase in operating margin

• Multi-year capital plan• Collaborative priorities• Active business planning

Organizational Results:Cultural Transformation

31.8%

23.1%

16.8%

0%

5%

10%

15%

20%

25%

30%

35%

2002 2003 2004

71% decrease in turnover

Savings & avoided costs = $ 1.4 million

•Competency-focused •Learning leaders•Engaged workforce•Shared confidence

New Strategic DirectionIncludes Six Sigma deployment

• Physician partners• Shared accountability• Centers of Excellence

• Executive sponsors• Performance focused• Values-centered• Employee champions

Questions?