Agnesian Healthcare, an integrated, not-for-profit, community-based healthcare system, faced several key challenges, including:
As such, Agnesian needed to enhance their focus on, and execution of, strategic initiatives - to not only correct budget and other issues right now, but to also achieve their goals long term.
Initially, Agnesian considered expanding their Lean Six Sigma efforts by providing their staff with expanded Lean training. However, the leader-ship team realized that additional, traditional training alone would not produce the strategic or financial gains they required. Nor would it help them fully engage managers and directors, or break down the barriers protecting the status quo.
To meet the rapid changes occurring in their environment they needed an action-oriented approach that would go beyond just planning, to involve the entire staff in leading change, increasing accountability, and increasing agility.
Agnesian Healthcare engaged CBA, tapping its expertise and 15 years of national research on the attributes of top performing organizations. Together they focused on designing a system for accelerating transformational work that included:
First, Agnesian adopted CBA's 100-Day Workout accountability structure for three initial key business areas to make progress, or its absence instantly visible, thus demanding a corrective response when deviations from plans are unacceptable. Each workout included mandatory action targets of a minimum of two successful process changes for all managers, directors, and senior leaders, per month, that would move the hospital toward its financial goals. This created a sense of urgency and encouraged the commitment to change to run throughout the organization.
Hospital leadership elected to focus its first 100 days on removing quality waste in all its forms by exposing managers to Lean concepts and an easy-to-understand overview of the 7 categories of quality waste. By the end of day one, each manager had recorded several ideas and was expected to have 8 plans identified in the first 30 days that they could fully implement in the next 100 days.
Each leader utilized core CBA approaches to improvement like Rapid Cycle Testing and the resources of the CBA ToolBOX. This included teaching Agnesian's staff how to leverage its ToolBOX apps and act on the information they are receiving to improve operating margin as a whole. Think of it as an approach that creates an experimental mind set, reducing the fear of failure, increasing speed to action and identifying and eliminating barriers to change. These methods spurred Agnesian to increase the number of plans implemented and achieve results quickly.
Most importantly, this introduced CBA&'s EXCELerator™ - giving Agnesian a structure for:
In addition to engaging directors and managers in tactical, organizational change, senior leaders embarked on a series of parallel, High Impact Margin improvements to focus on high-level, high-impact results that would directly affect Labor.
Caldwell Butler's hands-on, High Impact Margin Improvement Program began with a six to eight week assessment to validate needs and prioritize opportunities using CBA's High Impact checklist. From there, the implementation phase, featuring on-site "Chief Implementation Officer" support provided by one of CBA's former turnaround CEOs, provided hands-on guidance and support to help Agnesian's staff actually reach the planned results.
100-Day Workout 1: Quality Waste Recovery
| Savings from detailed plans | $3,381,534 |
| Completed changes | $3,212,749 |
| Validated & budgetized by CFO | $3,093,349 |
| Director/manager changes | 667: 9 per manager |
100-Day Workout 2: In-Quality Staffing
| Savings from detailed plans | $1,902,960 |
| Completed changes | $1,748,455 |
| Validated & budgetized by CFO | $1,244,681 |
| Director/manager changes | 566: 8 per manager |
100-Day Workout 3: One-More-Throughput
| Savings from detailed plans | $2,649,142 |
| Completed changes | $2,414,862 |
| Validated & budgetized by CFO | $1,182,658 |
| Director/manager changes | 511: 7 per manager |
High Impact Results
Key highlights included and overall ROI of 5:1 and a reduction of $522K (21%) in planned annualized OT expense, despite a $13.8M (10%) increase in Regular Earnings. Of the total projected annualized savings; a $298K year-over-year reduction from July through October were attributed to the efforts of the IQS Workout. A remaining $224K corresponded to the focus and implemented system-wide management controls from the High Impact work.
| Labor | |
| Savings from detailed plans | $716,756 |
| Validated & budgetized by CFO | $597,497 |
Charges Not Submitted >16 Days After Clinic: Cumulative Net Revenue Improvements Service Was Provided