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NIATx and Process Improvement at SAMHSA 09 15 08
 

NIATx and Process Improvement at SAMHSA 09 15 08

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My presentation to the Delaware State Conference of the American Society for Quality, September 2008. Process Improvement integrating the NIATx method.

My presentation to the Delaware State Conference of the American Society for Quality, September 2008. Process Improvement integrating the NIATx method.

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    NIATx and Process Improvement at SAMHSA 09 15 08 NIATx and Process Improvement at SAMHSA 09 15 08 Presentation Transcript

    • The NIATx MethodThe NIATx MethodProcess Improvement atProcess Improvement atThe Substance Abuse and Mental HealthThe Substance Abuse and Mental HealthServices AdministrationServices AdministrationWhat is this stuff?What is this stuff?Why should I care?Why should I care?OK, how do I do it?OK, how do I do it?A bird’s eye view of process improvementBruce Waltuck, M.A., CC&CSenior Advisor for Process Improvement, SAMHSAChair, Government Division, ASQ240-276-2005 bruce.waltuck@samhsa.hhs.gov
    • SAMHSA – A Life in the Community for EveryoneSAMHSA – A Life in the Community for Everyone
    • NIATx – a Three-Way PartnershipNIATx – a Three-Way PartnershipSAMHSA’s Center for Substance AbuseSAMHSA’s Center for Substance AbuseTreatmentTreatment– Strengthening Treatment, Access, and RecoveryStrengthening Treatment, Access, and Recovery(STAR)(STAR)The Robert Wood Johnson FoundationThe Robert Wood Johnson Foundation– Paths to RecoveryPaths to RecoveryCHESS – University of WisconsinCHESS – University of Wisconsin– Center for Health Enhancement System StudiesCenter for Health Enhancement System Studies– Led by Dr. David GustafsonLed by Dr. David Gustafson
    • ProcessProcessWhy did the chicken cross the road?Why did the chicken cross the road?How will the chicken cross the road?How will the chicken cross the road?– For the greater good.For the greater good. PlatoPlato– The confluence of events in the cultural gestaltThe confluence of events in the cultural gestaltnecessitated that individual chickens cross roads at this historicalnecessitated that individual chickens cross roads at this historicaljuncture.juncture. Carl JungCarl Jung– The problem we have here is that this chicken wont realize thatThe problem we have here is that this chicken wont realize thathe must first deal with the problem on THIS side of the roadhe must first deal with the problem on THIS side of the roadbefore it goes after the problem on the OTHER SIDE of thebefore it goes after the problem on the OTHER SIDE of theroad. What we need to do is help him realize how stupid hesroad. What we need to do is help him realize how stupid hesacting by not taking on his CURRENT problems before addingacting by not taking on his CURRENT problems before addingNEW problems.NEW problems. Dr. PhilDr. Phil– it is a core part of the chicken’s business.it is a core part of the chicken’s business.
    • Process ImprovementProcess ImprovementWhat happens when the chicken crossesWhat happens when the chicken crossesthe road?the road?What would we like to happen when theWhat would we like to happen when thechicken crosses the road?chicken crosses the road?What are the options?What are the options?How will we know what to do?How will we know what to do?How will we know how we did?How will we know how we did?
    • Common elements of successCommon elements of successProcess focusProcess focusCollaborative problem-solvingCollaborative problem-solvingAnalysis and decisions based on data, notAnalysis and decisions based on data, notopinionopinionDecisions by consensusDecisions by consensusRespectful dialogueRespectful dialogueIntention of seeking continuousIntention of seeking continuousimprovementimprovement
    • The basic NIATX principlesThe basic NIATX principlesUnderstand and involve the customersUnderstand and involve the customersof the process (internal and external)of the process (internal and external)Find opportunities for improvement thatFind opportunities for improvement thatare “key problems,” important to theare “key problems,” important to theCEO.CEO.Get ideas both in and out of yourGet ideas both in and out of yourorganization and fieldorganization and fieldConduct short test cycles to checkConduct short test cycles to checkpromising improvement ideaspromising improvement ideas
    • The Five QuestionsThe Five Questions(from the NIATx method)(from the NIATx method)Base your process improvement efforts onBase your process improvement efforts onthe answers to these questions:the answers to these questions:– What are we trying to accomplish?What are we trying to accomplish?– What is like to be a customer of this process?What is like to be a customer of this process?– How will we know if a change is actually anHow will we know if a change is actually animprovement?improvement?– What changes can we test, to see if aWhat changes can we test, to see if apromising idea is really an improvement?promising idea is really an improvement?– How can we sustain the improvement weHow can we sustain the improvement weimplement?implement?
    • Data. . .uhh… what is it good for?Data. . .uhh… what is it good for?(Absolutely(Absolutely Everything)Everything)Any path will get youAny path will get youthere, if you don’t knowthere, if you don’t knowwhere you’re going.where you’re going.Known knowns; knownKnown knowns; knownunknowns; unknownunknowns; unknownunknowns.unknowns.It isnt what we dont knowIt isnt what we dont knowthat gives us trouble, itsthat gives us trouble, itswhat we know that aintwhat we know that aintso. –so. – Will RogersWill RogersWe do it that way becauseWe do it that way becauseit’s the way we haveit’s the way we havealways done italways done it
    • What are we AIMing at?What are we AIMing at?Any path will get you there if you don’tAny path will get you there if you don’tknow where you’re goingknow where you’re goingWhat should be the 3-4 main aims forWhat should be the 3-4 main aims forSAMHSA in improving our processes ofSAMHSA in improving our processes ofwork?work?Alignment with Strategic ObjectivesAlignment with Strategic ObjectivesSimple Conversation Café methodSimple Conversation Café methodExecutive Leadership makes the finalExecutive Leadership makes the finaldecision on key aimsdecision on key aims
    • Four words, plus oneFour words, plus onePlanPlan– What are we aiming to achieve?What are we aiming to achieve?– What results would really be improvement?What results would really be improvement?DoDo– Test and assess promising ideas.Test and assess promising ideas.StudyStudy– Analyze your data. Reach conclusions. Decide.Analyze your data. Reach conclusions. Decide.ActAct– Make the improvement the new process standard.Make the improvement the new process standard.– Measure results. Listen to process customers.Measure results. Listen to process customers.RepeatRepeat
    • Why should I care?Why should I care?How do you want to feel at the end of the day?How do you want to feel at the end of the day?
    • What do you think,What do you think,when we ask you to do this?when we ask you to do this?WIIFM is not a Nintendo radio station.WIIFM is not a Nintendo radio station.WIIFY is not wireless internet service.WIIFY is not wireless internet service.WIIFU is the win-win state we seek.WIIFU is the win-win state we seek.
    • OK, you convinced me to try.OK, you convinced me to try.Now, how do I do this work?Now, how do I do this work?
    • It isn’t rocket science.It isn’t rocket science.It is simple, but not always easy.It is simple, but not always easy.
    • ““How’m I Doin’ ?”How’m I Doin’ ?”Ed Koch, former Mayor of New York CityEd Koch, former Mayor of New York CitySAMHSASAMHSA– 12 current process improvement teams12 current process improvement teams– Approximately 15% of the workforce involvedApproximately 15% of the workforce involved– More than 10 new process improvement teams chartered and beginningMore than 10 new process improvement teams chartered and beginningtheir worktheir work– Significant improvements inSignificant improvements inCycle time to answer constituent correspondence (avg. 30+ days to under 6)Cycle time to answer constituent correspondence (avg. 30+ days to under 6)Cycle time to issue new hire ID (21+ days to under 7)Cycle time to issue new hire ID (21+ days to under 7)Design of purchase waiver form- new template; successive improvements;Design of purchase waiver form- new template; successive improvements;extensive trainingextensive trainingResponse to callers seeking substance abuse or mental health treatmentResponse to callers seeking substance abuse or mental health treatment(treatment locator system)(treatment locator system)NIATxNIATx– 39 treatment organizations provided with collaborative learning and39 treatment organizations provided with collaborative learning andtechnical assistance for process improvement aimed at four definedtechnical assistance for process improvement aimed at four definedgoalsgoals– Over 200 local service providers in the nationwide network, using theOver 200 local service providers in the nationwide network, using theprocess improvement methodprocess improvement method
    • Two wordsTwo wordsAttentionAttention– Observe the processObserve the process– Understand the processUnderstand the process– REALLY understand the processREALLY understand the processIntentionIntention– What do we want?What do we want?– Why?Why?– What can we do to get there?What can we do to get there?
    • Additional ResourcesAdditional ResourcesA Leader’s Framework for Change – Snowden and Boone, HBRA Leader’s Framework for Change – Snowden and Boone, HBR(available from Bruce in pdf)(available from Bruce in pdf)Evidence-Based Management, Pfeffer and Sutton, HBR (availableEvidence-Based Management, Pfeffer and Sutton, HBR (availablefrom Bruce as pdf)from Bruce as pdf)A Quantum Change for Public Health, Resnicow and Page, Am JrA Quantum Change for Public Health, Resnicow and Page, Am JrPub Health (available from Bruce in pdf)Pub Health (available from Bruce in pdf)Jazz Improvisation as Metaphor for Change in Organizations, FrankJazz Improvisation as Metaphor for Change in Organizations, FrankBarrett (available from Bruce as pdf)Barrett (available from Bruce as pdf)Facilitating Organization Change, Eoyang and Olson (available soonFacilitating Organization Change, Eoyang and Olson (available soonin SAMHSA library)in SAMHSA library)A Simpler Way, Margaret Wheatley (available soon in SAMHSAA Simpler Way, Margaret Wheatley (available soon in SAMHSAlibrary)library)Navy Benchmarking Handbook (available from Bruce in pdf)Navy Benchmarking Handbook (available from Bruce in pdf)See also-See also-– www.niatx.netwww.niatx.net– www.margaretwheatley.comwww.margaretwheatley.com– www.conversationcafe.orgwww.conversationcafe.org