Managing Change – Developing a LEAN Leadership …c.ymcdn.com/sites/ a LEAN Leadership Culture ......
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Managing Change: Developing a LEAN Leadership Culture May 25 th , 2017 Alicia Hynek, RN, BSN Rene Salazar, MS, PMP
Transcript of Managing Change – Developing a LEAN Leadership …c.ymcdn.com/sites/ a LEAN Leadership Culture ......
Managing Change: Developing a LEAN Leadership
CultureMay 25th, 2017
Alicia Hynek, RN, BSN
Rene Salazar, MS, PMP
ABOUT US
CLINICAL CARE DELIVERY SYSTEM + HEALTH INSURANCE PROVIDER
75,000+Members
800+Employees
41 Years
Making a Difference in
Our Community
OUR COMMON VALUES
Innovative
Quality Driven
Patient Centered
Community Involved
Non-Profit Cooperative
WHAT WE OFFER
Access to Hospitals
and
Specialty Partners
Primary Care and
Select Specialty Care
PRIMARY CARE SERVICES
Family Practice
Internal Medicine
Pediatrics
Geriatrics
Laboratory
Radiology
Pharmacy
Urgent Care
SPECIALITY CARE SERVICESBehavioral Health
Chiropractic
Clinical Health Education
Complementary Medicine
Dermatology
Eye Care
Occupational Therapy
Physical Therapy
Podiatry
OBJECTIVES
Integrate and adapt MGMA resources to implement a LEAN leadership culture
Motivate and engage front line staff through LEAN concepts
Maintain momentum to sustain a LEAN leadership culture
INTEGRATINGRESOURCES
LEADERSHIP OUR BODY OF KNOWLEDGE
Senior Leader and Chief Nursing Officer sponsorship, extensive quality and practice management knowledge
Clinical Practice Solutions Manager, RN BSN and Yellow Belt Lean Six Sigma
Business Strategy Analyst, Project Management Professional and Green Belt Lean Six Sigma
Practice Operations Specialist, Certified Medical Practice Executive
RESOURCES
MGMA “Using Lean Principles inMedical Practice” – free webinar withMGMA membership
MGMA LEAN Leadership Modules
MGMA LEAN Leadership Project Toolkit
MGMA Final Exam
ADDITIONAL RESOURCES
GHC Project Management Resources
Institute for Healthcare Improvement – ihi.org
2015 Wisconsin LEAN Government Conference Information –wisquality.org
American Society for Quality – asq.org
UW Health Improvement Network Toolkit – uwhealth.org
Catalysis Formerly ThedaCare Center for Healthcare Value –createvalue.org
Mind Tools – mindtools.com
Lucid Charts – lucidchart.com
Poll Everywhere – polleverywhere.com
The Institute for Health Care Improvement “Triple AIM” and “LEAN” Defined
“Triple Aim”:
Improving the patient experience of care (including quality and satisfaction)
Improving the health of populations
Reducing the per capita cost of health care
“LEAN”:A continuous improvement process that systematically seeks to achieve small, incremental changes improving efficiency, quality, and satisfaction.
MOTIVATE & ENGAGE
SETTING THE STAGE
Have any of your organizations encountered…?
Multiple changing methodologies for process improvement
Change fatigue
Limited resources
Limited budget
Without Using the word “LEAN”, use one word or phrase to describe LEAN
GETTING STARTED Planting the Seeds
Senior Leadership Buy-in
Choose your team (Clinic Managers and Site Chiefs)
Introduce LEAN principlesMGMA Lean Leadership
Modules and WebinarMGMA LEAN Final Exam
Obtain LEAN Concepts and Process Improvement techniques from a wide array of resources
Why start with middle management?
• Support local leadership• Create a strong foundation for improvement• Enhance knowledge for our mentors
CURRICULUM DESIGN
Focusing on the patient
Removing unnecessary steps and waste
Making hard to perform steps easier
LETTING TEAMS LEARN THE PROCESS Maintain Flexibility In Learning
Some projects were not “LEAN”
Important for dyads to learn the concepts and tools to be able to share with their teams
Open approach to start out with “LEAN” creates Buy-In
Designed our process to incorporate flexibility with use of tools
Respected peoples leadership voices and uniqueness of each clinic site
PRACTICE MANAGEMENT TEAM PLANNING
12/17/2015 5/24/2016
1/1/2016
12/17/2015
· MGMA Final Exam· Overview of Lean Project
and Learning Module Pathway
1/14/2016
Project Concept Question Poster in Depts/Clinic Sites
1/28/2016
Bring Top 3
1/25/2016
Voting Dots – Poster Questions
1/29/2016 - 3/10/2016
“PLAN” Phase
3/11/2016 - 4/7/2016
DO” Phase
4/8/2016 - 4/21/2016
"CHECK" Phase
4/22/2016 - 5/5/2016
"ACT" Phase
5/19/2016
CLC Mgr Meeting Dry Run
5/24/2016
Mgr Mtg Project Presentation
Started out with simple timeline
Important not to overwhelm the teams
12/1/2015 6/30/2016
1/1/2016
Ongoing Process
Improvement
6/7/2016
Mgr MtgPresentations
· PDSA Model Explained· 5X5 Template
6/2/2016
CLC Mtg 5X5 Project
Presentation Dry Run
1/28/2016
Defining the Project –· Voting Dots· Affinity Diagram· Project Charter Dcmt· A3 Worksheet· SMART Goal Handout
1/14/2016
Project Concept –· Timeline and Talking Points· Brainstorming Poster · Instructions for Clinic Sites
2/4/2016
CLC Meeting – · TOP 3 Discussion· Project Selection
12/17/2015
LEAN Project Overview –· MGMA Final Exam· Learning Module Pathway
1/29/2016 - 3/24/2016
"PLAN" Phase1/29/16 to 2/18/16 --· Brainstorm· Select Project2/18/16 to 3/10/16 --· Draft A3 Project Charter Worksheet
a) Define Problem Statementb) Define Team and Stakeholdersc) Identify SMART Goalsd) Define Project Scopee) Define Organizational Impactf) Define Resources,
g) Draft Brief Project Plan) · Root Cause Analysis (5 Whys) 3/10/2016to 3/24/16 -- · Develop Project Plan
(Identify “Change in Process” to Test)· Identify Current and Future State· Define Measure of Success
4/14/2016 - 4/28/2016
“STUDY” Phase· Create shared understanding · Identify “New state”
4/28/2016 - 5/12/2016
“ACT” Phase· Need to Repeat Cycle?· Set goals for Ideal State· Continue to measure and improve
3/24/2016 - 4/14/2016
"DO" Phase· Carry-out steps in Action Plan for Test of Change· Adjust Plan as needed· Gather data on test of change (Measurement)· Identify Risks to Project
5/12/2016 - 5/30/2016
Manager Mtg Presentation Preparation
5/19/2016
Closing A Project· Create a Sustainability Plan· Lessons Learned
PRACTICE MANAGEMENT TEAM PLANNING –Creating the Timeline
GHC-SCW Clinic Staff Brainstorming Process
PROJECT SELECTION Affinity Diagrams and Voting Dots
CREATING VALUE FOR OUR MEMBERS Eliminating Waste
WASTE = Non-Value Added Activities
PROJECT CHARTER A3 WORKSHEET Combined the MGMA Project A3 Worksheet from the MGMA toolkit with our Project Charter GHC-SCW Document
ROOT CAUSE ANALYSIS5 WHYS
PROCESS MAPPING
Teaching and Tools of the
Trade
FacilitatorPost-It NotesMarkersTeam Ideas
EXAMPLE OF PROCESS MAPPING
REDEFINE and REFOCUS
PROJECT PLAN An organic and dynamic tool used throughout process
MANAGING RISK FAILURE MODES and EFFECTS ANALYSIS(FMEA)
STUDY and ACT PHASES Principles of Forming, Storming, Norming, and Performing –
Understanding the stages of team formation allows teams to recognize, develop strategies and quickly become a high-performing team www.mindtools.org
IHI PDSA Worksheet www.ihi.org and MGMA PDCA Worksheet (MGMA Lean Leadership Project Toolkit)
5X5 PRESENTATIONS
Highlighted growth and success of the project teams
MAINTAINING MOMENTUM
CREATING BUY-IN
Investment in middle management growth
Engagement of frontline staff
Engagement of Senior Leaders
Securing 2017 Budget
PROJECT COMPLETION
• Presentation at Managers’ Meeting
•Celebrate Accomplishments
• Lean Principles used new improvement projects
• Successful projects moving into phase two projects
SUCCESSES – URGENT CARE
SUCCESSES – DEFOREST CLINIC
THE VALUE OF DATA
“Without data, you’re just another person with an opinion.”
W. Edwards Deming
BARRIERS AND CHALLENGES
• Inconsistent Senior Leadership sign-off
•Not all projects were Lean projects
•Selected a fixed set of tools
•Building trust through failure
LESSONS LEARNED
Staff engagement at all levels
Regular check-ins create accountability
Peer group offered space for sharing
Process improvement is not busy work
Measurement is keySponsorship sign-off is critical
to successSimple solutions are usually
the answer
Without Using the word ‘Lean’, use one word of phrase to describe Lean
It’s so simple. I could have done that!
GOING FORWARD
Making it Stick –Creating a New Culture
Continued Senior Leadership Buy-in
Curriculum Development
Fostering Leaders at All Levels
Maintaining a Budget
No Assumptions
Creating Spread
Communication
TimeEncouragement
Engagement
Value Cost
CULTURE CHANGE AND SUSTAINABILITY
