2015 Strategy Execution Summit Presentation - Ina Gjikondi & Sheryl Vogt: Lean Six Sigma & the Balanced Scorecard

1. Ina Gjikondi, Director, Executive Education & Coaching
Sheryl Vogt, Adjunct Faculty & Master Black Belt
Lean Six Sigma &
the Balanced Scorecard

2. THE PRESENTERS
Sheryl Vogt,
Master Black
Belt
Ina Gjikondi,
Executive
Education
Director

3.  About the Center & Our Program Offerings
 Our Approach to Lean Six Sigma in the Government
 LSS contribution for the BSC
 A few examples of our work
 Identifying projects in your organization
 Questions
AGENDA

4.  Part of the College of Professional Studies
 Our Mission:
The Center for Excellence in Public Leadership develops public leaders who make a
positive difference in their organizations and the lives of people they serve.”.
The Center partners with the
Balance Scorecard Institute to
offer certification programs.
THE GWU-CEPL:

5.  Founded in 1997
 Celebrated 15 years in 2012
 Evolutionary Development
• Municipal Leadership Development Programs
i. Program for Excellence in Municipal Management (PEMM) - 1999
ii. Regional Executive Development Program (REDP) – 2000
• Federal Executive Development Programs – 2000
• Agency-Centered Leadership Development Programs – 2003
ABOUT THE CENTER

6. • Agency-Centered Leadership Development Programs
i. Internal Revenue Service
ii. Food and Drug Administration
iii. National Institutes of Health
iv. Defense Information Systems Agency
v. U.S. Department of Agriculture
vi. U.S. Customs and Border Protection
• Incorporated Lean Six Sigma Green Belt Training Certification in the CPM
Program(Cohort 22) in partnership with Beauchamp Consulting in 2010
• Master of Professional Studies in Public Leadership with a Specialization in
Multi-Sector Management – 2012
• Graduate Certificate Program in Organizational Performance Improvement
– 2013
• Lean Six Sigma Certification-2013

7. • Lean Six Sigma Consulting (Program Design, Delivery and Culture Change
Integration)
• Lean Six Sigma Champion Training Certification
• Lean Six Sigma Green Belt Certification
• Lean Six Sigma Black Belt Certification
NOW THE CENTER OFFERS:

8. OVERVIEW OF LEAN SIX SIGMA:

9. • A Vision & Philosophy
– Processes with no waste, empowered employees who know what
to do, a continuous improvement culture, focus on the customer,
lean principles in action
• A Program
– The method and strategy used to begin moving the organization
toward the vision
• A Set of Tools
– The actual tools and methods applied to specific projects within the
organization
What is Lean Six Sigma?

10. • W Edwards Deming PhD
• American Mathematical Physicist & Statistician sent
to Japan after WWII to study and assess post-war
problems (1946 & 47)
• Asked by the Japanese to help train engineers in
statistical methods in quality (1950s)
• Begins working with US companies on Quality
(1980s)
• Manufacturers Adapt Principles
• Motorola coins the phrase “six sigma” to define
close to zero defects by variation reduction(mid
1980’s)
• Toyota continues their drive for efficiency and
quality through “TPS” and waste elimination which
gets branded as Lean in the late 1980’s.
• Principles Embraced by Non-Manufacturing
Organizations
• Service
• Healthcare
• Government
A Little History
Japan adapts Statistical
Quality Tools
US asks “Why Can’t We?”
Toyota
Productio
n System
Motorola
Focus on
Quality
Method evolve to
become Lean Six
Sigma

11. Another Application

12. • A perfectly efficient method of delivering
customer value with no waste
Lean Vision
Lean Method
A systematic approach to identifying and eliminating
waste (non-value-added activities)
through continuous improvement

13. • Only value adding steps and time
• No scrap or rework – every output
meets customer expectation while using
minimum inputs
• Balanced, continuous flow exactly to the
pulse of customer demand
What would the perfect flow of
value look like?

14. Ideal state: Allow value we’re adding
to flow without interruptions
Value
Customer
Functional depts with inadequate resources, policies
Batch processes
Excessive inventory
Unnecessary documents & approvals, waiting
Inspections, defects, and rework
Many obstacles
to flow of value!

15. • Value Added
• Any activity that increases the form or function of the product or
service. It moves it closer to being what the customer wants. These are
things people would agree that they want to see their tax dollars do.
– Examples: Issuing a building permit, providing drinking water, filling
potholes, patrolling neighborhoods.
• Non-Value Added
• Any activity that does not add form or function, doesn’t get their product
or service closer to being delivered, or is maybe not even necessary.
These are things the people wouldn’t agree their tax dollars should be
used for.
– Examples: Waiting for a plan review, answering water bill questions,
looking for potholes, fixing police vehicle breakdown.
Another way to think about value

16. How Do We Fix This?
We attack the Non-Value Added Activities (Waste)
Value
Customer
Functional depts with inadequate resources, policies
Batch processes
Excessive inventory
Unnecessary documents & approvals, waiting
Inspections, defects, and rework
We chip away at the things
that are blocking our flow
of value

17. 8 Wastes in the Office
Waste Definition and Examples
Defects Work that contains errors or is lacking information and results in rework and delay
Overproduction Producing a product, service, or information before the customer (internal & external) needs it
Waiting Waiting for people, paper, machines, information, responses, approvals, signatures or supplies
Not Fully Utilizing
People
Not utilizing a person's full mental, creative and physical abilities
Transportation
Moving materials and information from place to place. Using temporary locations. i.e. handoffs &
approvals, poor office layout, server storage; email attachments
Inventory
Having more information or material on hand than the process needs right now. i.e. extra copies,
extra supplies, extra files, etc.
Motion
Unnecessary work movements (searching, walking, mousing, arranging) that‘s not necessary for
successful completion of the task or activity
Excess Processing
Providing or creating more than the customer wants. i.e. excessive & redundant reviews, sign offs,
over checking, cc'ing the world on email "just in case", replying to "all"

18. • Predictable processes which use the
minimum amount of resources and time
to create products and services that
meet customer expectations
Six Sigma Vision
Six Sigma Method
Systematic approach to efficiently reducing defects and
variation in characteristics that are important to the
customer - DMAIC

19. 90807060504030
Number of Days
Days to Resolve an Appeal
Process
After
Before
How does variation in executing the
process feel for the customer?
Unpredictability makes customers upset
… They don’t know what to expect from
you

20. Who is the better archer?

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21. • We get variation in outcome (Y) because one or
more of the inputs (x) is changing
• Most of the variation in our outcomes is likely coming
from a few of all the potential sources or x’s
• We can identify which ones are really causing most
of the trouble
• Once we have verified we know which x’s are the
culprits, we can make changes to eliminate that
source of variation
How do We Apply Six Sigma?
Focus on Reducing Variation

22. The
Process
Inputs Outputs
Y = f(x,x,x,x)
Yx’s
How do We Apply Six Sigma?

23. We use the Power of Experience and
Data Together
Subjective
Words
“Theory”
Objective
Proof
“Data”
We’ll circle this loop over and over again

24. In Lean Six Sigma terms . . .
Describe your “Y” in words
Describe your “Y” with data
Describe your x’s in words
Describe your x’s with data
Describe your ways to fix the x’s in words
Describe your ways to fix the x’s with data
Describe your Controls in words
Describe your Controls with data
Define
Measure
Analyze
Improve
Control
D
M
A
I
C

25. Culture Changes As We Know
More
Fire Fighting Problem Solving Problem Prevention
Crisis Management Know how to solve problems Design out problems
No Understanding of Variation
Know how to measure
variation
Knowledgeable of variation and
capabilities
No Control (Can’t maintain the
gain)
Know how to control &
manage problems
Products and processes in control,
have math models of processes &
products
Rely on peoples’ judgment &
experiences
Have problem solving
experts
Have problem prevention and
problem solving culture
Few or no problem solving
process, methods & tools
Have problem solving
process, methods and tools
Have risk management process
Customer tells us of problems Catch problems at backdoor
Catch problems at source (within
process)
Don’t understand customer
requirements
Understand and meet
customer requirements
Anticipate customer needs, exceed
expectations
No trust relationship between
customer and supplier
Moderate trust and building
relationships between
customer and supplier
High level of trust and relationship
with customer and suppliers
Knowledge

26. • Lean Six Sigma was first developed by Motorola, and is today used
throughout Global Corporations and Governments because it works to drive:
– Cost Down
– Quality and Customer Satisfaction Up
– Better communication across agencies & from suppliers to customers
• The methodology focuses a team on customer-centric process improvement
methodology using data to make decisions
• LSS revealed to the District over $26 Million in savings opportunities since
2009
• Project results have had significant impact upon District’s customers,
residents and raise opportunity for World-class leadership
WHAT IS LEAN SIX SIGMA AND WHY USE IT?

27. • Accurate Reporting
• Cost Reduction
• Reduced Cycle Time
• Increased Revenue
• Expanded Program Participation
• Maximized Return on Investment
• Efficient Resource
Allocation/Sharing
• Manpower/Capital Reduction
• Simplified Process Steps
• Increased Provider Satisfaction
• Increased Employee Satisfaction
• Reduced Documentation Errors
• Improved Safety
• Reduced Appeals Time
• Improved Customer Service
• Simplified Licensing Processes
• Enhanced Compliance
GWU-CEPL HAS SUCCESSFULLY USED THE LEAN SIX
SIGMA METHODOLOGY TO IMPROVE OUR CLIENTS’
ORGANIZATIONAL EFFORTS IN THE FOLLOWING AREAS:

28. OUR VISION is to create a culture of
continuous process improvement in the
organizations that we serve, by fueling in-
house consulting practices that will cultivate
sustainable solutions in time and resources,
to drive ongoing results.

29. • 78 certified Lean Six Sigma Green Belts
• All led agency-identified projects
– $27MM in savings – over half of this amount has been proven as
realized
– 811 documented days saved from citizen-facing processes
– Several projects provided window of data into processes previously not
visible … “We didn’t know what we didn’t know.”
• 22 more certify in September 2015
• 100% of surveyed participants use their Lean Six Sigma skills in their
current jobs
• 34% were promoted within 1 year of Green Belt training
• Only 16% left District for alternative employment
THROUGH THE CPM PROGRAM, GWU IN PARTNERSHIP
WITH DCHR, HAS INVESTED IN A CADRE OF HIGH CALIBER
PROJECT LEADER/PROBLEM SOLVERS

30. LSS HELPS RETAIN EMPLOYEES: 84% OF CANDIDATES ARE STILL
WITH DISTRICT GOVERNMENT AND 34% HAVE BEEN PROMOTED
WITHIN 6 MONTHS OF PROGRAM COMPLETION
84
16
DC Employment Status:
May 2015
With District of
Columbia
Government
Left DC
Government
34
66
Promotion Status
Promoted
within 6
months
In similar
Position or
left DC

31. • World-class expertise
• Hands-on training
• Highly-interactive simulation component
• Public Sector distinction
• Project Coaching through completion
• Flexible schedule customized to client needs
• Change Leadership component
• Peer learning experience
OUR UNIQUE FEATURES:

32. Lean Six Sigma
support
• LSS is a discipline that continually uses data
needed to drive projects & action plans
• Uncovers & Addresses real “root causes” of
performance problems
• Uses ongoing performance metrics
• Supports the development of the Scorecard
• Identifies best improvement opportunities
• Makes key issues visible by increasing
transparency
LSS CONTRIBUTION TO THE BSC:

33. “The process mapping used in Lean Six Sigma was eye opening to us in
identifying where are gaps really are in our process, so we can better
address them.″ - Mark Poindexter, Deputy Chief Administrative Law Judge
Project Champion
PROJECT EXAMPLES:

34. • Long complicated licensing process deters
applicants in US city
• The city loses revenue and compromises
safety if no inspection/compliance confirmed
• The goal was to issue licenses in 30 days
EXAMPLES#1: LICENSING LSS
SUCCESS STORY

35. 5 days 7 days 7 days 1 day 16 days
1 day 0 days 3 days 1 day 2 days
1 2 3 4
38 days Total
8 days Total
Current Process
Proposed Process
Application
accepted
Case entered
in Accela
Inspection
requested
Inspection
scheduled
Inspection
Conducted
License
Issued
License
Mailed
Application
accepted
Case entered
in Accela
Inspection
requested
Inspection
scheduled
Inspection
Conducted
License
Issued
License
Mailed
2 days
1 day
Licenses can be issued in as few as 8 business days

36. • Customer Surveys, Process Mapping and 83 actual applications were
used to collect data
• Surveys showed incorrect information and unreliable staff were the
main issues
• Applicants say process takes too long and requires multiple agency
staff contacts
• Process analysis and application review showed that 85% of licenses
were late and the inspection request and license issuance took the
longest amount of time; 95% of process non-value adding
EXAMPLE#1: LICENSING LSS SUCCESS
STORY

37. • Reducing batching and collapsing steps
• Clear consistent communications reduced interactions for applicants
• Integrating systems and online applications are key to smooth
processing
• A control plan, SOPs and training are key to making improvements
last
EXAMPLE#1: RECOMMENDATIONS

38. Lean Six Sigma:
• Uncovered and eliminated batching and redundant process steps to
save time
Standard Approach:
• Add expensive technology to improve throughput and additional
personnel to manage quantity of applications
LICENSING: LSS DIFFERENCE VERSUS
STANDARD APPROACH

39. • Reduce patient wait time from arrival at ER through both EMS and
door to completed “Folder” required for Dr. to see patients
• National average is 28 minutes; Facility average 99 minutes
Data collected:
• Extensive interviews with hospital staff and patients
• 60 hours of live observation
EXAMPLE#2: HOSPITAL LSS SUCCESS
STORY

40. • Bed Space needed – use 2 recliners for 1 bed to save space where
patients not recumbent
• Double the triage staff to improve admissions cycle time
• Improve workflow by having lead nurses help triage to “pull until full”
and do blood work in patient room or bed versus moving
• Stop “Batching “ charts so nurses take file folder to “rack”
immediately instead of waiting
Pilot Results:
• Patients in door to folder in rack 169 to 90 minutes average
• Patients in EMS to folder in rack 75 to 40 minutes average
EXAMPLE#2: MAJOR OPPORTUNITIES
IDENTIFIED:

41. Lean Six Sigma:
• Identified space saving alternatives to accommodate more patients
• Improved staff workflow by filling beds and doing testing in “bed”
space versus moving
• Eliminated batching to save time
Standard Approach:
• Increase existing space and add staff without identifying backlogs and
process efficiencies
HOSPITAL: LSS DIFFERENCE VERSUS
STANDARD APPROACH

42. • A city government was experiencing increased demand for
Emergency Medical Services (EMS) due mainly to a growing
population, an increased reliance on EMS system to provide primary
care and a system that transports all calls for service versus on site
service for non emergencies
• A new ambulance costs $1.2MM to buy, staff and fully stock for one
year
• Current resources needed to be maximized to increase the availability
of medical transport units by examining both transport unit drop
times at hospitals and out of service times
EXAMPLE#3: FEMS LEAN SIX SIGMA
SUCCESS STORY

43. Out of service time is defined as time that a unit is not available for
service due to an Emergency Liaison Officer (ELO) approved activity
• Examples are:
– Decontamination
– Refueling
– Mechanical Problems
– Personnel Issues
– Equipment Problems
43
OUT OF SERVICE TIME

44. • Transport Unit Drop Time is defined as the time the transport unit
arrives at the hospital to the time the transport unit goes back in
service after leaving the hospital.
• Long Transport drop times mean:
– fewer ambulances are available to respond to emergency calls
– remaining transports must travel longer distances to emergency
calls and other hospitals
• Also, if the number of ambulances at each hospital increases, patients
get routed to other hospitals to spread the transport load, thus
increasing the distance the ambulance travels, further compounding
the problem.
44
TRANSPORT UNIT DROP TIME

45. • Performed over 55 hours of live observation at two high volume
hospitals
• 800# call center/dispatch data analyzed
• Conducted interviews and surveyed various groups involved in the
EMS delivery system:
– Transport Crews
– Triage Nurses and supervisors
– Emergency Liaison Officers (ELOs)
DATA COLLECTION:
Key Problems causing delays identified:
• Completing the Electronic Patient Record
• Driveway blocked/ER Crowded
• Restocking Ambulance and Break

46. • Improve Electronic Patient Care Report – hardware, software,
training for speed
• Track Actual Ambulance arrival at door not in driveway – Tighten
“halo” on GPS
• Give Drivers hourly status updates on hospital ER capacity --
prevent dispatching to overcrowded hospital
• Create EMS “Substations” for use by selected units -- Centralize
to Decontaminate Unit & Take Break
EXAMPLE#3: RECOMMENDATIONS:

47. Lean Six Sigma:
• Improved electronic patient care report to save time
• More carefully track ambulance location and hospital capacity
• Use “Substations” for much needed stocking and breaks
Standard Approach:
• Add an extra ambulance and crew for $1.2MM
FEMS: LSS DIFFERENCE VERSUS
STANDARD APPROACH

48. Selecting Good Projects
48

49. • Key Role
• Articulate business case for Lean Six Sigma and fit with
organizational strategy
• Set priorities for improvement
• Champion projects
• Act as manager, coach, and provider of resources
• Responsibilities
• Select projects focused on organizational priorities
• Ensure project delivers benefits
• Provide visibility and recognition to Teams
• Control resources required to complete projects
• Review project status regularly
Champion Role
49

50. • Our Customers come to us because we provide
them something they value. So, let’s start by
discussing the idea of customers and value.
• Who are your customers?
• They can be internal or external, direct or indirect, and you
probably have more than one
• What do give them of value?
• It could be a product, a service, some information. What do
they care about concerning that product, service or
information?
Picking Projects—It’s All About Value!
50

51. Now that we know customers and what we
provide them, we ask the important question:
“What are our customers not happy about?”
Or
“Where are we failing to fully satisfy our
customers?”
Project Areas
These are project areas, but usually too big to be projects! 51

52. • Now that we have some project areas, we need to scope out
good Lean Six Sigma projects
• Most of the areas have multiple project opportunities within
them
Potential Project Areas
My Potential Project Areas
52

53. Moving from a Project Area to a LSS Project
ProcessInput Output
We Need to Know the Process, What the Process Gives Us, and What We Don’t
Like About it
Process Output Defect
Contract Setup Vendor Information Inaccurate
Permitting Permit Too slow
Staffing Schedule Information Not visible to
the right people
(Defect)
53

54. Potential Projects
Pick one of your areas and identify one process, output and defect
Process Output
(Defect)
Input
Process Output Defect
54

55. Criteria for a Good Project:
• I can name the process, output and defect
• This is something the business, customers, and employees care
about fixing
• We can change the process either through our own authority or
we have the buy in of the stakeholders to make changes
• A new output occurs frequently (ideally once per day, at least
once per week)
• We can collect data on the process but it doesn’t have to be
automated
• There isn’t another major initiative to fix this (or at least we have
agreement to make this project part of that initiative)
What Makes a Good Project?
55

56. Picking a Project from the List
Process/ Output/
Defect
We Care Change is
Possible
Frequency Data is
Available
Other
Initiative
56

57. QUESTIONS
Contacts:
Ina Gjikondi Sheryl Vogt
gjikondi@gwu.edu sherylvogt@gwu.edu
202-994-5313 321-890-7479