Successful Lean Event Among Two NH State Agencies

Teamwork is pivotal for any project success. Lean project work is no different. Every team member has a role and valuable information to provide. When processes impact multiple organizations or agencies, Lean can offer an avenue for common group and support critical improvement paths.

This State of New Hampshire two-agency (Department of Information Technology and Department of Environmental Services) Lean event team was charged to develop a new and improved software ordering process. The current business process included extra processing steps and periods of waiting, which created confusion at times. The goal for the team was to develop a clear process through using Lean methods and tools.

The multi-agency team came together to address organizational items including:
• Discrepancies with who gets software licenses
• Inconsistent information on order forms
• Current process not documented

Photo: (left to right) Lean Black Belt Candice Weingartner (NHDoIT), Anne-Marie Martin (NHDES), Terri Sabbia (NHDES), Lean Green Belt Dean Robinson (NHDES and Co-facilitator), Elaine Bolduc (NHDES), Lean Green Belt Susan Bergeron (NHDES and Co-facilitator), Lean Green Belt Muriel Lajoie (NHDES and Project Manager), Lean Green Belt Rob Cole (NHDoIT) and Dave Cormier (NHDoIT – not shown).

Overcoming recent staff turnover, three different ordering procedures (due to the class of funds), and multiple-agencies (not to mention involving outside vendors), the team worked hard over three half-days to systematically and deliberately craft a solution, using Lean and continuous improvement practices. Specifically the team used the project charter to identify the central problem and scope, Value Stream Mapping (VSM), identification of 8 Types of Waste (DOWNTIME), identified bottlenecks, brainstormed improvement ideas, through a facilitated Kaizen event.

The team used the VSMP approach to create a detailed map of the process, identified areas that could be improved and then documented a new and improved process. In addition, the team inventoried the list of information included on software order forms, and came up with more effective forms. The solution they developed that was effective, efficient, addressed all the original concerns, while being approved by all stakeholder groups, including the outside vendor.

With new recommendations identified, Muriel Lajoie will lead the charge to implement the improvement actions including creating a shared group mailbox, simplified but thorough software ordering checklists, and communicating a new procedure.

Candice Weingartner, DoIT Lean Coordinator and facilitator shares her insight stating; “DES and DoIT came together and effectively mapped out both current and future states.  They also came up with some fabulous bright ideas which were incorporated into the future state, along with some which will be used with the next phase.  All participants were dedicated to the process and engaged.  Kudos to all involved for a successful event.”

Congrats to the NH Department of Information Technology  and NH Department of Environmental Services on developing a streamlined process for ordering software!

For additional project information contact Candice Weingartner at Candice.Weingartner@doit.nh.gov or Dan Hrobak at Daniel.Hrobak@des.nh.gov.

Visit the State of New Hampshire’s Lean training website for additional information about Lean in NH State Government.

Lean Week at NHDES: April 1-5, 2019!

The New Hampshire Department of Environmental Services (NHDES) is hosting an exciting Lean Week from April 1st – April 5th.

In addition to these activities described below, we are holding a 5S contest, to see who can make his or her desk the cleanest, neatest and most organized. This winner of this contest gets a gift certification to Tucker’s Restaurant.

To see a more detailed description of the fun-filled activities, check out Lean Week Presentation Summaries, under “Hot Topics.”

Contact Dan Hrobak, NHDES Lean Coordinator, to learn more and register for the 5S competition.

Check out the NHDES Lean Webpage for more information about NHDES and Lean.

Local Lean Publication with Kate McGovern, MPA, Ph.D.

The Public-Sector Journey to Lean written by former New Hampshire Bureau of Education and Trainings (BET) professor, Kate McGovern offers a walk through the many contributions made to process improvement efforts. The book details vignettes and in-depth perspectives on the unique work of government.

Kate McGovern, MPA, Ph.D., Trainer, Professor

The book celebrates the accomplishments and challenges of New Hampshire’s Lean work. Kate’s book walks readers through the tough fight of muda (waste) in times of muri (overburden). The story affirms the creativity and diligence of our Lean practitioners, documenting multiple countermeasures to muri, and the innovations on the New Hampshire approach.

Heather Barto’s innovative Lean Wrap-Around Services Model for the Department of Health and Human Services is discussed, as well as the leadership provided in Department of Safety by Commissioner John Barthelmes, Colonel Chris Wagner, Roberta Witham and Sgt. Tom Lencki, and the camaraderie and commitment of those serving in the Lean Executive Committee (LEC).

While crediting remarkable accomplishments of Lean practitioners, the book urges action by elected and administrative officials. A public policy parable is used to illustrate the challenges in New Hampshire, while Vermont’s program is described as an exemplar.

The story closes with a series of recommendations designed to bring the initiative to the strategic level. The book is dedicated to Sam McKeeman who provided the hands-on Lean training model for the New Hampshire BET. Graduates of Sam’s training formed the core of New Hampshire’s movement for continuous improvement in public service, whereby there today much growth still happening.

Kate will be providing a presentation and signing copies of “Public-Sector Journey to Lean” at BET’s Coffee & Conversation on Wednesday March 20, 2019. A 20% discount code is offered towards the purchase Public-Sector Journey to Lean.

For more information on New Hampshire’s Lean efforts visit http://lean.nh.gov.

Dartmouth-Hitchcock Value Institute Offers Conference

Health Care Quality Conference: Tools and Takeaways for Your Journey

Saturday, May 4, 2019

7 am to 4:30 pm

Auditorium H, Dartmouth-Hitchcock Medical Center

Register here

Use this special promo code to save $100 on registration: QCNHLN-100

Description:

Whether your team or organization is just beginning to implement quality improvement projects or you’ve been engaged in such work for years, this conference promises to offer tools and techniques that can be beneficial no matter where you are in your journey to improve quality.

Yellow Belt training is also available pre-conference on May 2-3 at a discounted price.

Keynote speakers and their topics include:

  • Robert Shumsky, PhD, Professor of Operations Management; Faculty Co-Director, Master of Health Care Delivery Science Program, Tuck School of Business at Dartmouth Patient Flow
  • Paul Batalden, MD, Active Emeritus Professor, The Dartmouth Institute; Active Emeritus Professor of Pediatrics and Active Emeritus Professor of Community and Family Medicine, Geisel School of Medicine at Dartmouth Co-Production of Health Care

Other topics include: 

  • 5S Visual Management & Continuous Survey Readiness
  • Community and Critical Access Hospitals: Supporting Quality Improvement Work
  • Strategy Deployment
  • High Reliability Principles
  • Standard Work
  • Lab Lean Journey
  • Tools and Takeaways Q & A Session

To learn more and to register by April 22, visit: https://www.dartmouth-hitchcock.org/classes_events/eventdetail/55656960467

Process Improvement Work with Case Management

Question: What do Public Health and HIV Case Management Work Have in Common?
Answer: Process.

Process impacts all of each and every day. Both good and bad processes affects our home and work lives. Whether it’s waiting in line at the grocery store, making an online purchase, completing a job application, reviewing a grant, or selecting your favorite lottery ticket at the corner store. Improvements can be made to just about any process, including an application for enrollment process.

The NH Ryan White CARE Program has been leading process improvement efforts under leadership of Lean Black Belt student Melissa Richards, Quality Care Coordinator. Melissa is supported by her supervisor, Sarah McPhee, Lean Green Belt to roll out trainings and engagement with stakeholders. Melissa shares, “The value of Lean and engagement with our stakeholders is exciting and rewarding. When we first rolled out Lean, we worked with our contracted AIDS Service Organizations (ASOs) to improve the process of submitting documentation for enrollment in the NH CARE Program. This improvement led to increased satisfaction for both the Case Managers at the ASOs and for the staff at the NH CARE Program. With buy-in from the success of the first project, additional trainings have been conducted. Momentum at this ASO has helped to create further readiness among others and has enabled the NH CARE Program to begin the next iteration of teaching process improvement. By improving the knowledge of Lean and quality improvement at our ASOs, our clients will benefit from smoother processes and improved health outcomes. We are absolutely thrilled.”

The benefits of the improved work flow are being seen at the agency level, within the program, and for clients. The use of the Plan Do Check Act cycles have been pivotal for pulling out lessons learned that later inform adjustments to the process.

Congratulations to Melissa and team members on their investments with process improvement!

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