Leveraging DMAIC Management for Sustainable Quality ... · 2/24/2017 1 Leveraging DMAIC & Active...
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2/24/2017 1 Leveraging DMAIC & Active Management for Sustainable Quality Improvements: Kristine Koontz, PhD, SSGB Amy Diane Short, MHSA, CSSBB Kristine Koontz, Ph.D. • Clinical Psychology—Science Practitioner • Six Sigma Green Belt • Vice President of Quality and Corporate Integrity • Oversight of Behavioral Health Organization • Residential and Community Settings • Intellectual Disabilities, Mental Health, Autism Spectrum Disorders • Lifespan services • USA: PA, DE & CT • International: Moldova, India
Transcript of Leveraging DMAIC Management for Sustainable Quality ... · 2/24/2017 1 Leveraging DMAIC & Active...
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LeveragingDMAIC&ActiveManagementforSustainableQualityImprovements:
KristineKoontz,PhD,SSGBAmyDianeShort,MHSA,CSSBB
KristineKoontz,Ph.D.• ClinicalPsychology—SciencePractitioner• SixSigmaGreenBelt• VicePresidentofQualityandCorporateIntegrity• OversightofBehavioralHealthOrganization
• ResidentialandCommunitySettings• IntellectualDisabilities,MentalHealth,AutismSpectrumDisorders
• Lifespanservices• USA:PA,DE&CT• International:Moldova,India
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AmyShort,MHSA• BSPsychology• MHSA(Master’sHealthServicesAdministration)• CertifiedSixSigmaBlackBelt• OperationalOversightofHospitalFunctions• QILeadershipofImplementationResearchatAcademicHealthCenter
• PatientAdvisoryCouncilMentor• UniversityofCincinnatiIRBMember• AdministrativeDirectorofCenterofImprovementScience,CincinnatiCCTST
PresentationOverview
• ANewApproach• GettingtoKnowYou• DMAIC• StakeholderEngagement• ControlRevisited• ManagingtheGameofHotPotato• AuditingandActiveManagement
Active Learning
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ChangesfromYOURFeedback
• Broad,ProvenConceptswithaDeeperDiveon1‐2Ideas
• TraceaSuccessfulProject• BalanceBetweenDidacticsandActivities
Icebreaker:WhoAreYou?• AnswerPrivatelyinSocrative.com,• TypeinRoomNumber:
AMYSHORT• LoginasStudent• EnteratLeastOneLetterasaName
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HowExperiencedAreYouinQI?• AnswerPrivatelyinSocrative.com,• TypeinRoomNumber:
AMYSHORT• LoginasStudent• EnteratLeastOneLetterasaName
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SuccessfulOrganizations
• Understandwhattheircustomerswant
• Understandhowtheyaremeasuringup
• Candescribe,monitorandadjustprocesses
• Canexamineandsupportemployeeperformance
andfunctions
• Canquicklyidentifyandrespondtointernaland
externaldemands
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SuccessfulOrganizationsUseDMAIC
DefineMeasureAnalyzeImproveControl
DMAICDefineMeasureAnalyzeImproveControl
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What Compliance IssueKeeps You Up at Night?
DMAICDefineMeasureAnalyzeImproveControl
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Findawaytomaketheimportantmeasurableinsteadofmakingthemeasurableimportant
WheretheJourneyBegins:Data
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WhyData?• YouCannotManagewhatYouCannotMeasure
• DataInformation KnowledgeWisdom
“InGodwetrust.Allothers,bringdata.”‐W.E.Deming
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Measurement101:“Eyeballyourdata”
• TheImportanceofVisualInspection
• FirstStepinAnalyzingandUnderstandingYourData
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Disagree Neutral Agree Strongly Agree
Number of Responses
Shhhhh….It’saSecret
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MeasureThe Process Map
ProcessMappingina Nutshell
“Everysystemisperfectlydesignedtogettheresultsit
gets.”
Theonlywaytogetdifferentresultsistochangethesystem
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WhyProcessMap?
• YouCan’tFixaProblemUntilYouUnderstandthePresentState• …HowItREALLYWorks• ….EveryoneSharestheSameUnderstanding
• ProcessMapsRevealWhereImprovementIsNeededMost
• ProcessMappingHelpsKeepaProjectinScope
ProcessMapErrors
• OnlyWorkingwithThoseDistaltotheProcess• MappingtheImprovedProcessFirst• MappingtheWayaProcessis“SupposedtoWork”• IncorrectLevelofAbstraction• NotVerifyingAccuracy
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DMAICDefineMeasureAnalyzeImproveControl
Analyze• WalktheProcessMapandRefineIt
• SpendTimewiththePeopleWhoDotheWork• Re‐scopeifNeeded• CaptureCycleTimes• BrainstormIdeasforImprovement
• FishboneDiagrams• AffinityDiagrams
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DMAICDefineMeasureAnalyzeImproveControl
PilotingImprovement andChange
Wemustremember…
AllImprovementsstemfromchange,butnotallchangesareimprovements
&
Hopeisnotanimprovementstrategy
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TheEngineforInnovation&Change:PDSACycleSTARTHERE
Plan
• Objective• Predictions• Plan to carry out the cycle (who, what, where, when)
• Plan for data collection (who, what, where, when)Do
• Carry out the plan
• Document observations
• Record data
Study
• Analyze data
• Compare results to predictions
• Summarize what was learned
Act
•What changes need to be made?
• Next cycle?
HoorahforPDSA!• Action‐orientedLearning
• ScientificProcess• Hypothesize• Experiment• Evaluate• Synthesize
• Avoid“AnalysisParalysis”
• LessonsinSTUDYandACTBecomePublicKnowledgeandSpeedsGeneralization
• MinimalExpenditures$$
• VerticalTeamFacilitatesBuy‐in
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TesttheChange
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PDSA:Processchange
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DMAICDefineMeasureAnalyzeImproveControl
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NowWhat?
CONTROL
• “Surface” Key Process and Outcome Measures
• Timely Data Entry =“Knowable” Individual and Group Performance
• Embed Use of Data into Management Repertoire
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CONTROL
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CONTROL• ThisistheMostDifficultPhaseinDMAIC
• MaintainingtheGains
• Safeguards:WhatWillBeDonetoKeepthisonTrack?
• ResponsibilityRestsontheProcessOwner(RoleofKPI)
• WhatHappensinthisPhase?
• PicktheRightControlMethod(Checklists,Monitoring,Reporting)
• WhatisAcceptableVariance?
• DocumenttheResponsePlan
MissionImpossible
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ItTakesaTeam!
But…I’mAllAloneSustainable,transformative,changerequiresanengaged,interdisciplinary,team
• Letyourleadershipknowwhatyouneed
• Worktheseprinciplesasbestyoucaninyouownsphere• Ittakestime• Ittakesconstanteffort• It’sworthit!
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SuccessfulOrganizations
• Understandwhattheircustomerswant
• Understandhowtheyaremeasuringup
• Candescribe,monitorandadjustprocesses
• Canexamineandsupportemployee
performanceandfunctions
• Canquicklyidentifyandrespondtointernaland
externaldemands
…Ismultifactorialandcomplicated!
• Today’sfocusison:• Stakeholderengagement
• Communication(bitesized!)
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StakeholderEngagement
Stakeholder:Anybodywhocanaffectorisaffectedbyanorganization,strategyorproject
FromOGCSuccessfulDeliveryToolkit2005
StakeholderEngagement
Whatyougetfromstakeholderengagement:• Agreementonpurposeanddirection(i.e.buy‐in)ofaprojectorprogram
• Earlyidentificationofpotentialissues,conflictsandbenefits
• Generationofnewideas• Defusionofconflictsituationsbeforetheseimpedeprogress
• Increasedcommunitycohesionandstrengthenedsharedidentity
REVITStakeholderEngagement:AToolKithttp://www.revit‐nweurope.org/selfguidingtrail/27_Stakeholder_engagement_a_toolkit‐2.pdf
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StakeholderEngagementKeyelementsforstakeholderidentification:• Whoisdirectlyresponsibleforthedecisionsontheissues?• Whoisinfluentialinthearea,communityand/ororganization?• Whowillbeaffectedbyanydecisionsontheissue(individualsandorganizations)?
• Whorunsorganizationswithrelevantinterests?• Whoisinfluentialonthisissue?• Whocanobstructadecisionifnotinvolved?• Whohasbeeninvolvedinthisissueinthepast?• Whohasnotbeeninvolved,butshouldhavebeen?
REVITStakeholderEngagement:AToolKithttp://www.revit‐nweurope.org/selfguidingtrail/27_Stakeholder_engagement_a_toolkit‐2.pdf
WhoAreYourStakeholders?
NameandRoleStrategicObjective
ScopeofInfluenceCoherencewith
ObjectiveYes*No*Indifferent
KeyAlliances
Jane Doe, Clinic Manager Care Delivery Clinical site/staff Indifferent Corporation VP HR
Adaptedfrom“MainstreamingParticipation”http://www.fsnnetwork.org/sites/default/files/en‐svmp‐instrumente‐akteuersanalyse.pdf
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PrioritizeYourStakeholders
KeepSatisfied ManageClosely
Monitor(MinimumEffort)
KeepInformed
www.mindtools.com
PowerVs.InterestGrid
StakeholderActions
Someone'spositiononthegridshowsyoutheactionsyouhavetotakewiththem:
• Highpower,interestedpeople:thesearethepeopleyoumustfullyengageandmakethegreatesteffortstosatisfy
• Highpower,lessinterestedpeople:putenoughworkinwiththesepeopletokeepthemsatisfied,butnotsomuchthattheybecomeboredwithyourmessage
www.mindtools.com
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StakeholderActionsSomeone'spositiononthegridshowsyoutheactionsyouhavetotakewiththem:
• Lowpower,interestedpeople:keepthesepeopleadequatelyinformed,andtalktothemtoensurethatnomajorissuesarearising.Thesepeoplecanoftenbeveryhelpfulwiththedetailofyourproject
• Lowpower,lessinterestedpeople:again,monitorthesepeople,butdonotborethemwithexcessivecommunication
www.mindtools.com
UnderstandYourStakeholders• Whatfinancialoremotionalinterestdotheyhaveintheoutcomeofyourwork?Isitpositiveornegative?
• Whatmotivatesthemmostofall?
• Whatinformationdotheywantfromyou?
• Howdotheywanttoreceiveinformationfromyou?Whatisthebestwayofcommunicatingyourmessagetothem?
• Whatistheircurrentopinionofyourwork?Isitbasedongoodinformation?
• Whoinfluencestheiropinionsgenerally,andwhoinfluencestheiropinionofyou?
www.mindtools.com
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UnderstandYourStakeholders• Dosomeoftheseinfluencersthereforebecomeimportantstakeholdersintheirownright?
• Iftheyarenotlikelytobepositive,whatwillwinthemaroundtosupportyourproject?
• Ifyoudon'tthinkyouwillbeabletowinthemaround,howwillyoumanagetheiropposition?
• Whoelsemightbeinfluencedbytheiropinions?Dothesepeoplebecomestakeholdersintheirownright?
www.mindtools.com
StrategicTip:BeCompellingDon't"pushitthrough"– it'smuchbettertoconvincepeoplethatit'simportantandurgent–onlythatwaycanyougetaclearcommitmentfromothers• Whatconditionscreatetheneedforchange?
• Whataretheunderlyingcauses?
• Haveyouidentifiedandmadeacaseforthechange?
• Haveyouidentifiedtheonecrucialreasonforchange?
• “WIIIFM”?www.mindtools.com
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StrategicTip:GettheWordOut
One size does not fit all forcommunication
• Whichstakeholderswillneedregularoneononechats?
• Doyouneedtodoorganizationwide“townhalls”?
• Dopeopleatyourorganizationreademailsreliably?
• Canyouputarticlesinthecompanynewsletter?
• Whichregularoperationalorstaffmeetingsshouldyouattend?
• Isaspecialactivityrequiredtogainattention?www.mindtools.com
But…I’mAllAloneSustainable,transformative,changerequiresanengaged,interdisciplinary,team
• Letyourleadershipknowwhatyouneed
• Worktheseprinciplesasbestyoucaninyouownsphere• Ittakestime• Ittakesconstanteffort• It’sworthit!
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SuccessfulOrganizations
• Understandwhattheircustomerswant
• Understandhowtheyaremeasuringup
• Candescribe,monitorandadjustprocesses
• Canexamineandsupportemployeeperformance
andfunctions
• Canquicklyidentifyandrespondtointernal
andexternaldemands
Focus andStreamline
Typical Desired
Data Collection/Measure
Data Analysis
Data Utilization/Improve
Plan/Define
Follow-up/Control
Changing the Approach is Key to Success
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Quality Services
Quality Assurance
Ongoing measurementof “Vital Signs”
Data
Quality Improvement
Targeted and SystematicChange and
measurement of impact
QualityAssuranceorImprovement?
KeyPerformanceIndicators(KPIs)
• Howdoyoumeasuresuccess
• Typeofperformancemeasurement
• Helpanorganizationdefineandmeasureprogress
• Linkedtoanorganization’smissionandvision
• Shouldincluderegularexaminationsofgoals/expectations
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WhyAreKPIsImportant?
• Sustainabilityinanewera
• Performanceinformationisfrontandcenter
• Increasethepaceofeffectivedecision‐making
• Decisionsneedtobetargetedandinformed
• UseofKPIsembeddedintomanagementwillenabletheseabilities
Scorecard
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ActiveManagementvs.Auditing
ActiveManagementvs.Auditing
Component ActiveManagementwith
Data
Auditing
Scale Population Sample
Time Closetorealtime Retrospective
Opportunitiestoexamine
Performance Status
Frequent Dependentonauditschedule
Focus CurrentandFuture RetrospectiveandFuture
Organizational Risk Catchissues quickly Depends onAudittimeframe
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WhoeverOwnstheProcess,ShoulderstheResponsibility
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Questions?
