Performance Improvement Operating "Model"

High reliability organizations have a model or a system that reflects their mission, vision, and values. PI department uses this model for process improvement in all the departments of an organization.

The PI Operating Model stands on six pillars that represent the way we help different departments to identify projects which needs help and by applying different tools and techniques of Lean Six Sigma achieve the goals. When patients’ needs are in alignment with the business operating model, the results are always employee engagement, patient loyalty and profitable growth.

To achieve what the patient needs, when they need it, with minimum resources, a set of tools have been developed by PI which, when applied will drive a company towards excellence.

Let me describe what each pillar means:

Clean & Organized Workplace:  It is about workplace organization.    “A place for everything, and everything in its place.”  Studies have shown that a clean, organized workplace:

• has higher productivity
• has satisfied employees
• has fewer defects
• better meets deadlines
• has less search time
• has more visible processes
• has happier patients

 A clean, organized, and disciplined workplace is achieved by implementing the tool called 5S.  This tool is the foundation of continuous improvement.

Value Added Flow:  Continuous flow is linking steps in the process so that work flows uninterrupted from one step to the next, never waiting.  What are some of the benefits of continuous flow?  It reduces waste, lead-time, and average unit stay.  The Value Stream Mapping (VSM) tool is used to achieve continuous flow, to identify gaps, and to increase productivity.

Stable & Capable Processes: Stability is achieved by always following the standard work and through proper training. Capability is what determines repeatability and thus reduces process variation. Variation is the mother of all problems, which causes defects, errors, and waste.  Monitoring of data is the ONLY way to determine if your process is predictable, and continuous flow requires stable, capable, and predictable processes.

Quick ‘Test of Change’: ‘Test of Change’ is the best and most cost effective method to try a concept. If it works and shows the required results then implement it; if does not work, go to the drawing board and try another concept. Test of changes are developed after conducting gap analysis and involving the Performance Improvement Department will be the best approach.

Future Growth: ‘Succeed in short term and grow in long term’ should be the mantra of the organization. Invest in the future, but not excessively, and grow while keeping fixed cost constant. It sounds tough but believe in achieving two seemingly conflicting things at the same time. Have the daily dashboards visible to the teams making sure they are achieving their daily targets regularly and at the same time focus on the patients to fulfil their future needs. Its’ about patient-focused strategy*.

(*WINNING NOW, WINNING LATER – By David M. Cote)

Vital Metrics:  “What you measure is what you get”.  Taking the pulse of the entire process is the key to success.  Metrics have to be in place and visible to monitor the day-to-day operations. Data never lies, so make it obvious so that everyone sees. Only measure what is needed for the process and remember the principles of good measure:

·         The measure must be important

·         The measure must be easy to understand

·         The measure promotes appropriate analysis and action

·         The measure must be easy to get

What is one common, underlying theme in all six pillars?  They all focus on how the service should flow like a stream, uninterrupted, from patients walking in to walking out with a WOW! – I call that “Utopia.”  Can we reach that state?  Yes, but it is a journey taken by some of the “best of the best” companies today.  What this means is that we should have an intimate relationship with our patients, and they become an integral part of our process on this journey from ‘Good to Great’.

Sustainability:  A very critical question arises, how to sustain the change(s) after doing all the hard work of implementation with the teams. Studies show that commitment from the Process Owner and the support of Executive Sponsor along with the Performance Improvement (PI) involvement is the key. The role of process owner and executive sponsor should be very clear to them before they take up the project. Both of them have to be 110% committed plus PI to hold their hand till they feel comfortable of solo flight and then should act as a consultant to monitor the progress, otherwise it becomes a flavors of the month and dies its natural death. Following are the roles for each of the responsibilities.

1.  Executive Sponsor:

a.    To provide vision and leadership to help achieve the necessary change for better.

b.   To take full responsibility to ensure desired outcomes are achieved.  

c.    To support the Process Owners to ensure ownership, accountability, and desired results for assigned projects

d.   To meet regularly with Process Owner to review results and to problem solve.

e.    To help Process Owner to recruit Project Team members.

f.     To ensure ownership and accountability and to remove barriers where necessary. 

g.    To facilitate necessary resources to assist Process Owner in achieving outcomes. 

h.   To round at the process level to provide support as necessary. 

i.     To support celebrations when teams meet goals. 

2.  Process Owner:

a.    To assures data integrity for all external reporting.

b.   To resolve all potential data discrepancies.

c.    To consult with other stakeholders and the PI Partner as needed to achieve goals.

d.   To use organization-endorsed tools for improving performance in assigned area.

e.    To report as assigned to the Executive Sponsor, Service Line / Department Leader and the PI Leader on a weekly/monthly basis using the standardized reporting document.

f.     To attend relevant meetings to update progress.

g.    To works with Executive Sponsor and the PI business partner to remove barriers and to assure strong forward movement on a weekly/monthly basis.

h.   To celebrate success.

3.  Performance Improvement (PI):

a.    PI facilitator will be 100% involved in the beginning.

b.   They will support Executive Sponsor and Process Owner with Project Charter.

c.    They will be present in report-out sessions.

d.   They will guide / coach Process Owner with tools and techniques.

e.    They will help Process Owner and the Project Team with the design and execution of each “Test of Change.”

f.     They will be available to the Process Owner and the Project Team for the duration of the project.

4.  Performance Improvement Process Steps

Step #1: Define the problem

Step #2: Draw Current State Process Map (CSPM)

Step #3: Collect Base Line Data

Step #4: Perform Gap Analysis on the CSPM

Step #5: Place them in a Priority (Easy to Hard – Pick Cha

Step #6: List probable solutions of the Gaps

Step #7:  Conduct a Test of Change

Step #8: If positive, implement it, if not, go back to #6

Step #9: Draft Future State Process Map

Step #10: Monitor the progress