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Lean Six Sigma in Healthcare
August 2009
Greetings!

This newsletter will continue to analyze the improvements made in this Hospital Human Resource Department.  Specifically, we looked at streamlining the Nurse Recruiting process.  We began analyzing this HR department in last month's newsletter. (For prior e-newsletters, goto www.supplyvelocity.com and click on the archive newsletter link to review.)

PROBLEM
HR received the brunt of great frustration at this Hospital.  They were only able to fill critical Nurse and Medical Technician positions, within the 90 day goal, only 30% of the time.  This hurt the Medical Center's ability to serve their patients

LEAN SIX SIGMA TOOLS
Process Flow Mapping

IMPLEMENTATION DETAILS
1). See the attached link for the complete Process Flow Map.  As you can see it has hundreds of steps.  Different departments are represented with different colors. 
http://www.supplyvelocity.com/April_2009_HR_PFM.ppt
2) The HR Lean Team mapped the process, sorted it into:
Green - Value added to internal customers
Yellow - Non Value Added but required by government regulations
Red - Non Value Added and should be eliminated
3) There were 19 times that we had to type in a potential employee's name, SSN and contact info! 
4) They then brainstormed how to eliminate these non value added steps.  The complete list, with a quantification of time saved is shown on the attached link. 
http://www.supplyvelocity.com/April_2009_HR_Redtaglist.xls
5) We started with the green highlighted action items, which were the easiest (didn't require interacting with the government bureaucracy) and had the highest return.

When we initiated this process we focused on HR.  While internal customers can cause delays, we wanted to focus on what HR could do to improve performance before talking to other departments.  However, in retrospect, it would have been better to include representatives from internal customers, such as Nursing.  We did not make the team cross-functional.  As improvements were rolled out, we realized that we were too HR focused and should have included "internal customers" of the process on the team. 

All Lean Teams should be cross functional in departments and management levels (individual contributors to executives).


IMPACT ON PEOPLE
It was difficult for some of the HR staff to make the transition.  Many had been doing it the "old way" for decades.  For these people, it took more work for the HR Director to sell the improvements we made.  Her consistency, in applying these tools, eventually brought everyone on-board.

RESULTS
The "Recruiting completed within 90 days of application" measure increased from 33% to 56% within 6 months.  This is still below our minimum expectation of performance, but definitely better.  Work is currently happening to integrate Nurses into this process. 


Next month we will look at how this HR Department used 5S Visual Management to improve labor productivity and instill operational discipline.

Best Regards,

Mitch Millstein & Ray Davis