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
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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
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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
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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?
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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
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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
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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!
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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
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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
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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
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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
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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?”
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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.
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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
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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
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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
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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
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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
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The biggest room in the world is the room for improvement
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