Performance Excellence Process

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2 Performance Excellence Process The Performance Excellence Process is a resultsoriented, long-term approach to the way government does business It uses several best practice methodologies, including Strategy Map, SOMIA, Balanced Scorecard, Visual Daily Management and Lean Six Sigma process improvement Many of these best practices are already being used by leading organizations including other health authorities across North America

3 Vision & Strategy Priorities and Speed! Strategy Map Balanced Scorecard Process Improvement Priority initiatives and projects! SOMIA Performance Accountability, Align and engage teams and people Visual Daily Management Hold the gains! Visual Management Visibility Wall Lean Six Sigma Processes Standard work! Network Operational Dashboards Benchmark Dimension Status Target ALOS - Total Knee Variance (Typ Surgical Network Inpatient Key Performance Indicators Facility Q1 Q2 Q3 Q4 Trend or Performance Performance YTD Indicator Enhanced Quality of Life Ensuring Access to Services that Meet Primary Needs The patient's Typical Average Length of Stay with CIHI's Expected Length Of Stay TMH SJRH Replacement DECRH MRH Horizon Number of days difference between the typical average length of stay and CIHI expected TMH ALOS - ELOS) SJRH Total Knee DECRH Replacement MRH Horizon The percentage of patients occupying beds in a particular unit at discharge that require a different mandate for care than the unit mandate. TMH 14.74% 18.41% 16.50% % % Off Service Patients SJRH 11.28% 9.42% 10.29% % DECRH 18.36% 22.47% 20.39% % MRH 28.23% 35.43% 31.92% % Horizon 17.56% 21.15% 19.34% % Appropriateness Efficiency Efficiency Standard Operating Procedures (SOP)

4 Better Care Alignment Corporate Balanced Scorecard Zero Waits in Emergency why why CEO/VP VP/ ED/ Director Network Dashboard Surgical Network Inpatient Key Performance Indicators why why Performance Dimension Status Performance Indicator Enhanced Quality of Life Appropriateness Efficiency Efficiency Benchmark YTD Facility Q1 Q2 Q3 Q Trend or Target Ensuring Access to Services that Meet Primary Needs The patient's Typical Average Length of Stay with CIHI's Expected Length Of Stay TMH SJRH ALOS - Total Knee Replacement DECRH MRH Horizon Number of days difference between the typical average length of stay and CIHI expected TMH Variance (Typ ALOS - ELOS) SJRH Total Knee DECRH Replacement MRH Horizon The percentage of patients occupying beds in a particular unit at discharge that require a different mandate for care than the unit mandate. TMH 14.74% 18.41% 16.50% % % Off Service Patients SJRH 11.28% 9.42% 10.29% % DECRH 18.36% 22.47% 20.39% % MRH 28.23% 35.43% 31.92% % Horizon 17.56% 21.15% 19.34% % ED / Admin Dir. Unit / Department Visibility Wall TMH ED SJRH ED why why Front Line Managers and Staff

5 Definition of Lean Six A systematic evaluation of a process to identify and eliminate; causes of poor quality, performance that does not meet expectations and non-value added activities using a fact based methodology

6 The Key Principles of Lean Six Sigma Lean Six Sigma is a powerful, proven method for improving business efficiency and effectiveness. Here are the key principles of Lean Six Sigma: Knowing and meeting customer expectations Doing the right things right the first time Understanding and eliminating variation, defects and wastes Measurement of products and processes Managing by Measuring Continuous improvement Challenging Status Quo

7 Lean Six Sigma Methodologies DMAIC Define Measure Analyze Improve Control DMADV Define Measure Analyze Design Verify DMA Define Measure Analyze Improving Process Creating Process Recommendations DMA should only be used to recommend project opportunities and not for improvement opportunities 7

8 DMAIC: Define Define Opportunity : What is the opportunity? An opportunity is identified and a project team is formed and given the responsibility and resources in finding a solution Projects start with a problem/opportunity that needs solving Team works with defined roles and responsibilities Why are you doing this project, and what are you trying to achieve with the project? Then Write project charter Define voice of customer (VOCs) Define CTQs Define (as-is) process

9 DMAIC: Measure Measure Performance: What is the extent of the opportunity? Data that describes how the process is currently working is gathered and analysed to produce some preliminary ideas about what might be the opportunity During the Measure phase you need to baseline the process as is to better understand the opportunity you are dealing with Determine how we will gather baseline CTQ data (data collection plan) and that we have reliable measurement process A map of how the process that is producing the problem is developed Gather and graph baseline CTQ data We can play a role here.

10 DMAIC: Analyze Analyze Opportunity: Identify Root Cause Based upon these preliminary ideas, theories are generated as to what might be causing the issue and, by testing these theories, root causes are identified Now you know what s happening, it s time to confirm why, but don t jump to solutions Manage by fact to check out the possible causes and get to the root cause Develop hypotheses for root causes Sampling plan Analysis of data Brainstorming No mention of solutions yet. Up to here, we can help a lot.

11 DMAIC: Improve Improve Performance: identify and test your solutions to prove or disprove your hypotheses Root causes are removed by means of designing and implementing changes to the offending You know about the process and the opportunity, and the Improve phase is where you need to find a way to address the root cause So it is time to brainstorm on options to fix the problem and evaluate risks. You will need to test/validate the selected options Prove/disprove hypotheses of root causes through Experiments and/or Pilot tests and/or Simulations Achieve sustainable improvement We can provide data to prove or disprove hypothesis

12 DMAIC: Control Control Performance Transfer best practice New controls are designed and implemented to prevent the original problem from returning and to hold the gains made by the improvement Implement and sustain the solution(s) You need to ensure you achieve and hold the gain you re looking for Having a control plan in place is vital to ensure that the process is carried out consistently Write, communicate, train, and implement the control plan Update process map Standard operating procedures, instructions Ongoing performance scorecard We can provide the data (KPI) to demonstrate sustainability Experience + Analysis = Best Solution

13 Basic Tools Tree structure Histograms Cause and effect Lean Six Sigma Tools Lean Tools Just-in-time production Poke Yoke (Mistake Proofing) Spaghetti diagrams 5S implementation Visual Controls/Displays Standard Work Process Design Process mapping Quality Function Deployment Behavior analysis Simulation Statistical Tools Design of experiments Hypothesis tests Statistical process control Change Tools Stakeholder analysis Affinity diagrams Facilitation techniques Project Tools Work plans Gantt charts Business case

14 Summary Lean Six Sigma is a very flexible process improvement methodology that can be applied to any process in any business and Decision Support can play a key role

15 Questions?