Sustaining ImprovementSustaining Improvement&&

Maintaining the SpiritMaintaining the Spirit

Grace DuffyGrace DuffyPublic Health FoundationPublic Health Foundation

quality improvement consultantquality improvement consultant

ACTION Campaign Webinar

July 9, 2008

Joey Valdez, NIATx NPO, 5/15/06.

The NIATx model

Encouraging Improvement and Encouraging Improvement and ChangeChange

Why should we lead people away from the status quo? Why should we lead people away from the status quo?

What strategic tradeoffs and risks are we willing to make?What strategic tradeoffs and risks are we willing to make?

How can we balance creativity and productivity?How can we balance creativity and productivity?

Where do we reduce the burden of measuring what Where do we reduce the burden of measuring what matters? matters?

When can we engage in conversations and promote When can we engage in conversations and promote collaboration in our social networks? collaboration in our social networks?

Whose needs do we address, anticipate, and prioritize? Whose needs do we address, anticipate, and prioritize?

Who are our customers?Who are our customers?

Sometimes we choose our Sometimes we choose our customers. Most often, they customers. Most often, they

choose us.choose us.

Three ways customers establish Three ways customers establish expectations:expectations:

1.1. ValueValue

2.2. Fitness for UseFitness for Use

3.3. TranscendentTranscendent

An eye-opener for me…An eye-opener for me…

2006 Orange County Health Department2006 Orange County Health Department Public Health Foundation grantPublic Health Foundation grant STD and HIV/AIDS process improvementSTD and HIV/AIDS process improvement Customer identification, flowcharts, teams, Customer identification, flowcharts, teams,

and measurementsand measurements 2008 return to OCHD for Environmental 2008 return to OCHD for Environmental

Health improvement projectHealth improvement project

How to Improve a Process:How to Improve a Process:

Define the objective.Define the objective. Document current knowledge.Document current knowledge. Use an improvement cycle.Use an improvement cycle.

Plan

DoStudy

Act

Improvement Across the OrganizationImprovement Across the Organization

Improvement across the whole Improvement across the whole systemsystem

Ensby, 2003

Where is the highest impact for Where is the highest impact for improvement and change?improvement and change?

Participant input:Participant input: Time allotted: 5 minutesTime allotted: 5 minutes

Share areas within your organization OR Share areas within your organization OR client/supplier environment where a little client/supplier environment where a little improvement can make a BIG difference.improvement can make a BIG difference.

Discussion DebriefDiscussion Debrief

Are these different than the improvements Are these different than the improvements you have implemented in your own you have implemented in your own organization?organization?

How do you feel when you complete an How do you feel when you complete an improvement project?improvement project?

What actions create the biggest positive What actions create the biggest positive impact for your clients?impact for your clients?

Improvement from the Improvement from the customer’s perspectivecustomer’s perspective

Who is your customer? (External, internal)Who is your customer? (External, internal) WIIFM … who benefits from improvement WIIFM … who benefits from improvement

and how much?and how much? Change is an opportunity, not a threat.Change is an opportunity, not a threat. Involve those who will live with the Involve those who will live with the

change.change. NIATx web resources for sustainability and NIATx web resources for sustainability and

change.change.

Customers and SuppliersCustomers and Suppliers

Seminole County Child Support Seminole County Child Support ServicesServices

ASQ Community Good Works grantASQ Community Good Works grant

Partnership with ASQ Orlando Florida, County and Partnership with ASQ Orlando Florida, County and Corporate sponsorCorporate sponsor

Assist recently privatized Child Support vendors Assist recently privatized Child Support vendors establish infrastructure for operationsestablish infrastructure for operations

Six Sigma project with University of Central Six Sigma project with University of Central Florida students and ASQ Six Sigma Black BeltsFlorida students and ASQ Six Sigma Black Belts

9-month design, training, pilot and 9-month design, training, pilot and implementation effortimplementation effort

Returned to Central Florida with Department of Returned to Central Florida with Department of Children and Families major process redesign Children and Families major process redesign project in 2007-08project in 2007-08

Keep an eye on the ball:Keep an eye on the ball:

Focus on the end resultFocus on the end result

Keep it simpleKeep it simple

Know how you will benefit from what you Know how you will benefit from what you are doingare doing

Communicate with EVERYONE!!Communicate with EVERYONE!!

Use quantitative and qualitative measures Use quantitative and qualitative measures to track progressto track progress

Brag about what you are doingBrag about what you are doing

What are we sustaining?What are we sustaining?

What is your most pressing What is your most pressing organizational need at this time? organizational need at this time? (Current state)(Current state)

Where do you want to be?Where do you want to be?

If you could instantly fix your If you could instantly fix your organization’s current state, what would organization’s current state, what would the future state look like?the future state look like?

How will we benefit from the How will we benefit from the change?change?

How is it impacting your organization’s:How is it impacting your organization’s: People?People? Processes?Processes? Performance?Performance? Culture?Culture? Morale?Morale? Shareholders?Shareholders?

Sustaining Effective ChangeSustaining Effective ChangeTwo Key QuestionsTwo Key Questions

1.1. How does the process under study How does the process under study support the organization’s strategic support the organization’s strategic mission?mission?

2.2. Is the process under study necessary Is the process under study necessary to meet the demands of our clients?to meet the demands of our clients?

Are you on the journey already?Are you on the journey already?

Do you currently have a plan to move Do you currently have a plan to move your organization to this desired future your organization to this desired future

state?state?

What does your map look like?What does your map look like?

If you have a plan, what are the If you have a plan, what are the major obstacles to implementing the major obstacles to implementing the plan?plan?

If you do not have a plan, If you do not have a plan,

how soon do you need one?how soon do you need one?

Focus on Strategic Priorities:Focus on Strategic Priorities:

Vision: Vision: Vision is to an organization Vision is to an organization what what purpose is to an purpose is to an individual. individual.

Strategy:Strategy: The few high value things The few high value things that are that are critical to success.critical to success.

Values:Values: Will the culture support the Will the culture support the strategy?strategy?

Alignment

Strategic Planning moves Strategic Planning moves

verticallyvertically and and laterallylaterally within the within the organizationorganization..

Sr. Mgt

Front Line

Function

Function

Function

Function

Function

T E A M S

T E A M S

Modern Strategic Planning Format

Keep the feeling and results aliveKeep the feeling and results alive

Show short term resultsShow short term results

Align improvements to organization Align improvements to organization goalsgoals

Coordinate changes across multiple Coordinate changes across multiple improvementsimprovements

Integrate the changes into daily activityIntegrate the changes into daily activity

Share ideas and initiate “spread”Share ideas and initiate “spread”

Celebrate the results and the behaviorsCelebrate the results and the behaviors

Participant Input: 5 minutesParticipant Input: 5 minutes

What short-term results are important to What short-term results are important to your organization?your organization?

How do the short-term results get in the How do the short-term results get in the way of your long-term goals?way of your long-term goals?

How do you balance any conflict?How do you balance any conflict?

Alignment “Vertically” Within the Alignment “Vertically” Within the OrganizationOrganization

Measures help us sustainMeasures help us sustain

Report those measures that truly matter.Report those measures that truly matter. Promote open sharing of performance data Promote open sharing of performance data

across business lines.across business lines. Encourage commitment to the Encourage commitment to the

measurements initiative.measurements initiative. Provide clear linkages between reward Provide clear linkages between reward

systems and achieving strategic goals.systems and achieving strategic goals. Accountability and follow-through are Accountability and follow-through are

crucial.crucial.

Key tasks for successful Key tasks for successful measuresmeasures

Identify results to be achieved through a Identify results to be achieved through a report card.report card.

Identify core business functions and Identify core business functions and processes of critical impact.processes of critical impact.

Engage multidisciplinary leadership staffEngage multidisciplinary leadership staff Define success metrics, comparative Define success metrics, comparative

performance measures, goals and targets.performance measures, goals and targets.

Critical “measures” success Critical “measures” success factorsfactors

Senior-leadership-drivenSenior-leadership-driven Senior leader commitment and involvementSenior leader commitment and involvement Clear and rational objectivesClear and rational objectives Focus on behaviors and processes, not numbersFocus on behaviors and processes, not numbers

Other critical success factorsOther critical success factors

Long-term visionLong-term vision Merged into organizational cultureMerged into organizational culture Flexible and adaptableFlexible and adaptable

How do you celebrate now?

Who do you include in the celebration?

What benefits do you see from celebrating?

Keep your head and heart on Keep your head and heart on task…task…

You are the value. Yours is the success. Thank you.