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Just Four CBA 100 Day Workouts Deliver Over 1,200 Completed Changes, Some with 98% CFO Approval


As a winner of the 2011 Malcolm Baldrige National Quality Award, patient satisfaction is important to the Henry Ford Health System, a not-for-profi t corporation founded in 1915 by auto pioneer Henry Ford and consisting of hospitals, medical centers and the Henry Ford Medical Group of more than 1,200 physicians practicing in over 40 specialties. This study is part of a larger look at three hospitals in the system, and how each organization uses CBA 100 Day Workouts differently to drive change and solve challenges specifi c to each location.

West Bloomfield Hospital is part of the larger Henry Ford healthcare system and the first to adopt CBA’s 100 Day Workouts. They are located in a very competitive market in Detroit, MI. They were led by a new CEO who understood they needed tremendous turnaround to close the budget gaps. She engaged CBA to move at a faster pace to impact the change needed.

Key challenges included:

  • New facility that had a $7M loss the first year.
  • Leadership turnover – in a turnaround situation.
  • Employee Engagement and Care Experience suffering.
  • While they had an internal performance (PI) support team, that group was not driving the change in metrics that were important to the organization.
    • PI team did not engage the entire organization.
  • Wanted to develop inclusion of patient & family.
  • Needed to increase responsiveness / reduce wait times.
  • Care coordination needed revamping.

Solution Applied

Henry Ford West Bloomfield Hospital engaged CBA, tapping its expertise and 15 years of ensuring continuity and sustainable work through leadership coaching that delivers improved margins while driving change and overcoming obstacles.

Engaging Leaders

Engaging directors, executives and managers in tactical, process-oriented organizational change to increase margin in their cost centers was necessary to improve accountability and to position Henry Ford

West Bloomfield reach its organizational goals. CBA’s 100 Day Workout structure makes progress, or its absence, instantly visible, thus demanding a corrective response from leadership when unacceptable variations from workout goals occur.

In all, Henry Ford West Bloomfield Hospital has completed 100-Day Workouts focused on the following high-opportunity areas:

  • Quality Waste: The first 100 days were spent focused on quality waste, and getting dollars out on the expense side. To do this, managers were exposed to Lean concepts and an easy-to-understand overview of the seven categories of waste. By the end of day one, each manager had recorded several ideas and was expected to have eight plans recorded that they could fully implement in the next 100 days.
  • In Quality Staffing: Utilizing CBA’s proprietary In Quality Staffing approach in which managers are coached to detect variations in quality staffing standards, combined with 35 change concepts.
  • Patient Experience: CBA delivers the structure and proactive methods that enable all teams to help caregivers at the bedside by focusing on key strategic areas that drive the improvement of patient experience scores. This next-gen focus on patient experience goes beyond attitudinal changes alone, to creating an environment that focuses on responsiveness to patients and their families.
  • LEAP (Leadership Effectiveness and Accountability Program) focused on Quality Waste: This leader development approach assesses each director, sorts them into one of three groupings and then assigns them to accountable workgroups. Workgroups are given one percent margin improvement for their cost centers. Should any member fall behind, the remainder must be made up by the team to build on accountability, skill-sharing and camaraderie of purpose.

Each workout required all managers, directors, and senior leaders to be engaged by creating successful process changes every month. This creates a sense of urgency and encourages the commitment to change to run throughout the organization while moving the hospital toward its financial goals.

Building Sustainability with the Right Tools

Throughout this process CBA also taught Henry Ford West Bloomfi eld Hospital’s staff how to leverage its core programs like Rapid Cycle Testing and the resources of the CBA ToolBOX, so they could act on the information they were receiving to improve operating margin as a whole. This approach creates an experimental mind set, reducing the fear of failure, increasing speed and reducing barriers to change.

Most importantly, this introduced CBA’s EXCELeratorTM - an online accountability tool giving Henry Ford West Bloomfield Hospital a structure for:

  • Taking ownership of changes, assigning accountability and tracking key plans.
  • Providing a way to monitor implementation.
  • Validating process changes that affect the bottom line.
  • Creating a sense of urgency.


PI support is no longer the driver. Instead they support the leadership team with the use of tools and data gathering – a better use of their core competency.

When you get a critical mass of people focused on a goal it’s easy to see improvement and movement.

While specific financial metrics may not always be directly tied to patient experience or LEAP leadership training, the results can be measured in other ways, including in patient satisfaction scores and the overall margin improvements.

Everyone can influence patient or customer experience regardless of their department.

The hospital’s leadership involvement throughout the planning and implementation processes helped align the new management team, instill buy-in and create a strong culture of accountability.

A series of performance improvement 100-Day Workouts enabled Henry Ford West Bloomfield Hospital to realize $5M in implemented savings, with $1.8M of that figure budgeted by the CFO.

Plans were designed with a constant focus on implementation and accountability through coaching and mentoring for sustainable results beyond the initial engagement.

Below is a detailed look at Henry Ford West Bloomfield Hospital’s results:

100-Day Workout 1: Quality Waste Recovery – Directors and Physician Leaders

The first 100-Day Workout produced over 351 completed changes with $1.32M in CFO-validated savings – positively impacting to their $7M deficit.

Savings from Detailed Plans   $1.35M
Completed Changes   $1.35M
Validated & Budgeted by CFO   $1.32M (98% approval!)
Director/Manager Changes   351: 7 per manager
Percentage of Plans Implemented:   87.75%

100-Day Workout 2: Patient Experience

For their second workout, West Bloomfield wanted to ensure its patient experience levels were still high performing. Several measurable results noted:

Patient Willingness to Recommend scores have consistently been above 95%for three year’s running for Inpatient, ED, AS and Home Care divisions

Workforce Willingness to Recommend Physicians has been at nearly 100% for three year’s running.

Plans Completed for Patient Experience 338
Targeted Plans 400
Average Plans Per Manager 6.76

100-Day Workout 3: IQS (In Quality Staffing)

This third 100-Day Workout helped directors and managers understand staffing to current demand and how to adjust demand scheduling to close the 50% gap toward 95% In-Quality Staffing using Rapid Cycle Testing. Plans focused on improving Patient Experience and In-Quality Staffing.

Savings from Detailed Plans $1.77M
Completed Changes $1.77M
Validated & Budgeted by CFO $93K
Director/Manager Changes 272: 5.44 per manager
Percentage of Plans Implemented: 68%

100-Day Workout 4: LEAP (Quality Waste)

This fourth 100-Day Workout kicked off in January 2016. Its focus is on developing world class leaders, with teams of six to eight each collaborating to create 48 or more plans in just 100 days. Below are a few initial results.

  • Patient Willingness to Recommend scores have consistently been above 95%for three year’s running for Inpatient, ED, AS and Home Care divisions
  • Workforce Willingness to Recommend Physicians has been at nearly 100% for three year’s running.
Savings from Detailed Plans $4.45M
Completed Changes $3.29M
Validated & Budgeted by CFO $198K
Director/Manager Changes 243: 4.86 per manager
Percentage of Plans Implemented: 81%

Summary of all Henry Ford West Bloomfield Workouts

Despite changing their CFO and finance, they were still able to accomplish $1.62M in validated savings.

Plans Completed for All Workouts 1,204
Targeted Plans 1,600 (that’s a lot!)
Average Plans Per Manager 6
Completed Changes $6.5M
Validated & Budgeted by CFO $1.62M

Caldwell Butler, LLC

Caldwell Butler is an innovative firm specializing in strategic deployment of Lean-Six Sigma resulting in cost position improvement, financial turnarounds, and patient throughput optimization. Caldwell Butler has assisted hundreds of clients increase productivity, maximize patient throughput, and improve patient satisfaction. Our team is exclusively dedicated to healthcare and brings extensive practical experience in hospital operations to each project. Our knowledge of the healthcare environment allows us to implement effective performance improvement programs tailored to the specific needs of your organization. Caldwell Butler is the trainer of choice for both the American College of Healthcare Executives and the American Society of Quality. During the past decade, Caldwell Butler has personally trained thousands of senior hospital executives in the effective healthcare application of Lean-Six Sigma.

Unlike traditional consulting firms, Caldwell Butler believes on-site mentoring and apprenticing are the most effective methods for achieving sustainable gains in performance. Our on-site programs empower your employees by providing them with the tools to attain new levels of performance. We offer proven techniques and methods for enhancing personal accountability, monitoring progress of initiatives and tracking your ROI on each project. Where most consulting firms are satisfied with finding “identified savings,” Caldwell Butler works along side your team throughout implementation thus providing you with a sustainable process for managing the entire productivity improvement cycle.