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Western Maryland Health System Facing Financial Issues

Caldwell Butler & Associates (CBA) implemented an on-site mentoring and apprenticing program for selected members of WMHS staff. Leaders and managers received training in the 100 Day Workout Methodology and support from Lean-Six Sigma Blackbelts for the purpose of optimizing patient flow and capacity. Each cycle of the 100 Day Workout method focused on a different priority:

WMHS Implements 100 Day Workout Productivity Series

WMHS's Needs

  • Reduce total system operating cost
  • Rapid implementation at the manager level
  • Optimization of their OR and ED capacity
  • Increase accountability and tracking of results

Cycle 1-Waste Walk Prior to launching the program, CBA assisted WMHS in establishing aggressive benchmarks and setting non-negotiable goals. This was accomplished through the use of Caldwell Butler & Associates' propriety benchmarks featuring data from LA county, one of the most cost-competitive markets in the country. The benchmarks, along with concepts of the 50% Gap Closure technique of goal setting, were presented to hospital management during a Goal Setting Workshop. Managers were also provided with the tools and support to achieve their non-negotiable goals- they received training in the seven categories of waste followed by mentoring in the creation of department-level 100 Day Action Plans. To help ensure success, CBA developed a customized system for reporting managers' progress on the 100 Day Action Plan for senior management.

Cycle 2-Focus - Rapid Cycle Productivity Variance Hardwiring: Productivity Variance Hardwiring: During the second cycle, CBA assisted WMHS's leadership and management team in defining the frequency of productivity variance response for each department (e.g. daily, biweekly, monthly or quarterly) and then established contingency plans (similar to JCAHO's Failure Modes Effects Analysis [FMEA] process). These actions improved reaction times to variations by predetermining an immediate response to deviations to plan without requiring direct executive intervention.

100-Day Workout Productivity Series

Cycle 3-Staffing to Demand: During this third cycle of the 100 Day Workout, CBA assisted WMHS's managers in defining "Quality Staffing" based upon hour-by-hour variances in workload demand and staffing plan assumptions. In addition, CBA developed the reporting systems necessary for managers to proactively manage and adjust to deviations in demand. Due to the success of Cycles 1 and 2, WMHS was able to self-implement Cycle 3 of the 100 Day Workout.

Demonstrated Results of WMHS Implementation

As a direct result of the services provided by Caldwell Butler & Associates, WMHS achieved:

Measurable Benefits:

  • A $2.5 million improvement in financial operating performance in the first cycle of the 100 Day Workout
  • A 30-hr reduction in hours worked per day
  • An ROI on Caldwell Butler & Associates services of 7:1 (only includes savings from the first cycle)

Intangible Benefits:

  • WMHS has tackled costs in "Fixed Overhead Departments" as a result of the 100 Day Workout
  • Organization-wide determination to close operating gaps
  • Rapid deployment of proven methods and techniques for improving productivity and performance
  • Certified one Black Belt who is now appropriately trained to certify future Black Belts without outside assistance