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Healthcare Performance Improvement Mistakes, Part 6: Searching for the Golden Ticket

Submitted By: Brian MacClaren

I’m not sure exactly how many Wonka Bars that Veruca Salt’s army of workers opened up to find her golden ticket to Willy Wonka’s chocolate factory, but she certainly had many more opportunities than Charlie, whose family only had enough extra money to spare for one just one shot at his dream. When it comes to improvement projects, I don’t believe that any of us want to be exactly like either of these two polar opposites. However, regardless of how many that we start, too many are never completed. It seems we go off after a fresher, more exciting opportunities—will the next one be a golden ticket? What percent of projects are completed in your organization: 75%, 50%, fewer?

If you’re Veruca, your organization starts too many projects and finishes too few—aggressively pursuing as many chances at finding that last golden ticket. If your organization is like Charlie, you bank on just a few projects and hope for a big winner. Programs that use an integrated approach of Lean Six Sigma for healthcare might be likely to utilize both improvement workshops and projects to close performance gaps.

Depending on how your program is set up, the number of projects or workshops that can be finished each year varies. Some organizations choose to have trained resources work part-time on healthcare process improvement projects, others have set aside full-time positions for this function. There are some baseline expectations of how many an experienced practitioner can complete in a given year.There are other elements of a program’s leadership and infrastructure that play an important role in project completion as well. In order to truly achieve the ROI from the program, the impetus to close projects or complete all actions from an improvement workshop should be wired into the organization.

Part-Time Full -Time Benefits
Lean Expert / Green Belt 2-3 N/A $100,000
Operational improvements
Black Belt 2 6-8 $250,000+
Operational improvements
Master Black Belt N/A 3-4
(Critical /Enterprise-wide
Operational improvements

How to Prevent the Golden Ticket Syndrome

  • Make finishing projects part of the reward structure. No project, no bonus!
  • Demand results by selecting projects with executive sponsorship and strategy alignment.
  • Nurture and grow project management skills to ensure your change agents have the necessary discipline. It’s not all about control charts and data analysis!
  • Participants of training courses must arrive with a project in hand. Candidates for training must be certified by applying the tools to important projects and producing an ROI.
  • Leadership must commit to a set of strategic priorities for the organization and stick to them.
  • Always maintain a portfolio of strategically important projects.
  • Complete improvement projects with urgency. Long term initiatives are okay—long term projects are not. If a project takes longer than three months, it probably was not important enough or it was too big. No projects longer than six months unless absolutely necessary.
  • Require specific thresholds for project benefits—operational improvements, quality/safety improvements, financial improvements. Where there exists a solid business case, there exists better chances for a closed project.
  • Create a structure that requires individuals to complete a certain number of projects. Certification should not be granted for attending training only.

In summary, create specific expectations for the completion of projects in your organization and actually make it more difficult NOT to finish them. As a result, expect to see a higher number of projects being completed, better benefits, and maybe even a shot at riding the glass elevator with Mr. Wonka.

If you are interested in learning more about lean six sigma for healthcare and performance improvement programs, download the white paper “10 Common Mistakes in Healthcare Performance Improvements.”

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