Human Resources and Lean Talent strategies to support

Human Resources and Lean: Talent strategies to support a high performance culture – lessons from healthcare October 4, 2011 Lisa Zankman Beth Israel Deaconess Medical Center Senior Vice President Human Resources Kevin Klinvex Select International Executive Vice President & Co-Founder Share your thoughts using #leanhealthcare with @select_intl

Beth Israel Deaconess Medical Center’s Lean Journey Lisa Zankman Beth Israel Deaconess Medical Center Senior Vice President Human Resources

3 Core Values of Lean 1. Respect for People Easier Better Faster Cheaper Tru • “People” = everyone – patients (our e. N orth customers), staff, managers, etc. • People are the greatest asset • Develop people to become problem solvers (Human Development) 2. Continuous Improvement (CI) • Continuously strive for “True North” – “True North” Aim for Easier, Better, Faster, Cheaper • Don’t wait for perfect! 3. Human Development

Why Lean in Healthcare? • Proven methodology in manufacturing • Looks at processes vertically & horizontally • Healthcare industry faces change on multiple fronts: • • • Aging population (employees & patients) Increasing operating costs Increasing competition from private providers Health Care Reform Global Payment proposals

Why Lean at BIDMC? • Strategic Plan – Ambitious quality & safety goals – Must be highest quality, affordable, accessible – The need to improve patient satisfaction – How can we reduce the expense budget (e. g. labor, supplies)? – Employee engagement in improvement

“Difference between BEING there & GETTING there. ” Easier Better Faster Cheaper Transformational Transitional Traditional

“Difference between BEING there & GETTING there. ” Transformational Respect for Humanity Idea Systems Spread of best current thinking Traditional Targeted Value Streams Gemba Consultations RIEs Quick Wins Model Lines Leaders go to Gemba Big & Little Kaizens All Key Value Streams Identified Human Development Employee Engagement Practiced & Coached by Leaders Embraced by Executives Continuous Improvement Everyone – Everyday Visual Management Systems Transitional Easier Better Faster Cheaper Facilitators in Each Key Value Stream Aligned Planning Process “Tortoise, Not Hare”

Lean Improvement Work at BIDMC Research Jan 2005 Planning May 2005 Aug- Sept 2005 Pilot Program Formalized Dec 2005 Value Stream Lean Diffusion Work Planning Jul Oct 2008 2006 Lean Diffusion Implementation Apr 2009 Tru e. N ort h A few examples of Lean improvement work: Early Efforts Orthopaedic Clinic • Creating flow & improving capacity After More Learning Fix the workflow before building the system • Pharmacy: Model work flow for Inpatient Units • • Improving communication, reducing searching, mistake-proofing tasks & aligning workflow best practice Electronic Med Admin Design End to End flow • Supply chain • Patient flow

5 Block Lean Diffusion Plan Training/ Development Spread of Lean (Post-Graduate Work ) 140 Graduates to date Graduates diffuse Lean Thinking in their spheres of influence Intensive events supported by Business Transformation End to end process flow through multiple departments Steering Committee: Comprised of Lean Study Group graduates Advisory Board: External Lean Experts & BIDMC Board Members Project Work System Work Governance Structure Executive & Director 8 Week Lean Leadership Study Group Leading in a Lean Environment Training Lean awareness training for all staff External peer-to-peer networking – Healthcare Value Leaders Network

Alignment: Cascading Strategy from the C Suite 3 -4 Year Goals from Senior Management Annual Operating Plan Divisional Plans (Clinical and Non-Clinical) Department Plans

FY 12 AOP

People, Culture and Communication Goals • Multi-Year: Keep BIDMC a desirable and supportive place to work for all staff • From the 2012 AOP – Develop best practices for management and leadership behaviors to ensure consistency across BIDMC – Prepare workforce for operating in a rapidly changing environment by introducing manager training support and employee communication tools that encourage and sustain a Lean culture

Building Lean Capacity in the Workforce • Competencies for employees and managers that support a Lean environment and BIDMC culture and values • Using competencies for: – Screening Applicants – Measuring Performance – Development and Coaching

Building Core Competencies in Lean • 8 Week Lean Leadership Study Group – Over 140 senior administrative and clinical leaders in 8 week lean program • How to Lead in a Lean Environment Course – follow up course to extend the lean management components to intact management teams – 450 Managers and Directors learn how to lead in a Lean environment in a 12 hour course over the next 18 months

8 Week Lean Leadership Study Group Learn to See Commitment: Class (6 hrs/wk over 8 consecutive weeks) + time for homework Alignment True North Hierarchy of Improvement Favorable Environment Difference between “Being there vs. Getting there” See Waste Foundations Know Why 2 weeks Idea Systems Practice Problem Solving Develop more Problem Solvers Management Leaders’ Role 3 weeks Countermeasures Know How 3 weeks Go to Gemba Post. Graduation Lean Study Group Graduate Requirements: ü Lead efforts to create an improvement environment ü Teach & coach others ü Lead project work to continuously improve local processes

How to Lead in a Lean Environment

Becoming a Lean Organization 10% Tools 90% People

Traditional Leader Quick Results Proud Results at all Costs Lean Leader Patient Humble The Right Process Will Lead to the Right Results Accomplish Objectives through People Develop People Overcome Barriers Take Time to Deeply Understand Problems and Root Causes Before Acting Manage by the Numbers Deeply Understand the Process

New Role as Leaders at BIDMC Team Members Supervisors Managers Directors VPs / Chiefs COO CEO

Five Key Leadership Practices (Adapted from Servant Leadership, a concept developed by Robert Greenleaf) • Developing People through Teaching and Coaching • Leading from Behind • Listening with an Open Mind • Influencing without Authority • Promoting Change and Innovation

Why Coach and Develop Others in Continuous Improvement & Problem Solving? • Front line employees are closest to the work and the patients…. add the most direct value • Staff feel valued and engaged when they are involved • Frees you up to do work appropriate to your role

Builders, Cutters and Maintainers Kevin Klinvex Select International Executive Vice President & Co-Founder

Hiring Builders Everywhere with Multi-level Assessment • Multi-level Assessment Approach (MLA) • Better people at all levels and across all geographic locations • Starts in one or more locations and spreads • Applicable to all industries: – Manufacturing & Distribution, Healthcare, Energy & Utilities, Transportation & Logistics, Retail & Front. Line Service, Food Services/Grocery Operations, Engineering & Technical

Multi-level Assessment Competencies Testing & Interviewing Hiring Process At every level: • Step 1: Competencies • Step 2: Testing & Interviewing • Step 3: Hiring Process

Multi-level Competencies Keep It Simple! Competencies • Competencies: The behavioral DNA of your successful people • Format: Short definition followed by positive and negative indicators • Build from level to level: Competencies build from level to level • Number of suggested competency levels: 6 – 12 • Number of competencies per level: 8 – 15 • Timeframe to have competencies: Weeks, not months/years

Step 1: Multi-level Competencies Competency Levels Competencies Succession Promotion Competencies By Level Compensation Production, Service, Admin II Supervisor III Professional IV Sales V Director, Manager VI Senior Manger and Executive Selection On-boarding Career Planning I Performance Management Training & Development

Organization Competency Snapshot Click to View Larger From a large Energy Company with many drilling operations

Step 2: Testing & Interviewing Recruiting and Sourcing Web-based Application & Prescreening Applicant Tracking Automated Scheduling Web-based Testing and Assessment Structured Behavioral Interview Background Review/ Drug and Alcohol Screen Each step in the hiring funnel has evaluation content that should be checked for accuracy and consistency

Step 2: Testing & Interviewing Screening Tests, interviews and other tools used to evaluate applicants Select Screening Interview Safety. Mirror. SM Service. Fit® Secure. Fit® Pro. Fit® Nurse. Fit. SM Physician. Fit In Depth Assessments Select In-depth Behavioral Interview Select Assessment® for Executives Select Assessment® for Leader Development Safety. Mirror. SM for Leaders Select Assessment® for Professionals Select Assessment® for Physicians/Nurses

Testing & Interviewing

Testing & Interviewing

Testing & Interviewing

Behavioral Interview Testing & Interviewing • Behavioral interviewing identifies the three main types of employee behaviors: – Builder – Proactive, high energy, positive attitude, committed – Cutter – Cynical, negative attitude, does the minimum required to get by, gossiper, makes excuses, takes credit for others’ work – Maintainer – Steadfast, dependable, very task focused, comfortable with status quo, not looking for promotion

Step 3: Hiring Process Hiring and promotion at each level should follow a consistent process that is accurate, efficient and legally defensible • Hiring & Promotion Across Departments • Start-ups and Expansions • Mergers and Acquisitions

MLA in Action: Pittsburgh Pirates vs. Toyota vs. ? ? Less than 5% makes all the difference

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