Using Data to Turn the Tide of the Opioid Crisis
We’ve all seen the statistics: Drug overdoses, most of which are related to opioids, killed over 64,000 people in the United States last year — an increase of 21% over 2015, according to the Centers for Disease Control. The opioid crisis hit Indiana especially hard. In 2015, IV drug use in Indiana caused the nation’s worst HIV outbreak in 20 years, affecting rural Scott County. Let’s face it — the issue is complicated. There are challenges with both prescription and illicit drugs. Solutions must reduce the number of people who become addicts in the first place, as well as cure those who do. The underlying issue of pain management must be addressed. For all these reasons, the State of Indiana has recognized that understanding the data, and blending them with statistics from other agencies, is key to solving the complexities of the drug crisis in Indiana, and hopefully the nation. Issie Lapowsky described the state’s efforts to attack the problem in an enlightening articlethis fall in Wired magazine. Earlier this year, Indiana started an online opioid data center, where pharmacies, hospitals, mental health organizations, police departments and others can share data to help everyone see the big picture of what is really going on across the state. Working with the analytics-software provider SAP, the State of Indiana constructed a database that includes information on drug arrests, drug seizures, death records, pharmacy robberies, overdose-related ambulance calls, and the use of naloxone, an overdose-reversal drug. State officials also incorporated the data-visualization tools from Tableau, so agencies providing the data can log in and observe trends over time. This far-reaching data-sharing effort—including some 16 government agencies—is amazing in a country still struggling to keep up with the recent explosion of opioid abuse. The state’s efforts are beginning to pay off. To decide where to locate five new opioid treatment facilities, the team took a map of state’s existing treatment facilities and meshed it with a map of overdose cases and instances where paramedics administered naloxone. Then, they measured the distance from the areas with the most overdoses to the nearest treatment location to identify gaps where new facilities might be most helpful. They’ve also been able to monitor drug seizures real time, to monitor new drugs that are hitting the black market. This can help the state spot new drug outbreaks before they reach crisis levels. If you’d like to hear more about how big data is transforming public health and learn what’s next in the battle against the opioid scourge, check out the INconversation with Dr. Jennifer Walthall, Secretary of the Indiana Family and Social Services Administration on Jan. 24 from 4-5:30 p.m. at Indiana Humanities, 1500 N. Delaware. Dr. Walthall is leading the charge to use data to target the areas of the state most in need of treatment programs. Kudos to the team for their efforts to foster collaboration and data sharing to help agencies collectively address the opioid issue real...
Read MoreUsing Process Improvement to End Homelessness
Homelessness is an issue that pervades many societies around the world, but it seems to be an exceptional struggle for the United States. It’s a complex problem that leads many to conclude that the homeless will always be a part of today’s urban environment. However, an organization called Community Solutions believes that homelessness is truly a solvable problem. It’s just an issue that’s lost its sense of urgency. By utilizing data, Community Solutions is helping communities combat homelessness real time, by tracking progress against monthly goals, and accelerating the spread of proven strategies. Through an initiative called Built for Zero, they’re creating systems that are built for learning, allowing organizers to change and improve as they go, prioritize resources, identify gaps and match people to the best housing opportunities to fit their needs. And, it seems to be working. In January, The City of Rockford, Illinois Department of Human Services announced that the City has been recognized as the first community participating in Built for Zero to effectively end homelessness among local veterans. Using data for improvement isn’t only about having the correct numbers and facts – it’s about using them for decision-making – to make adjustments, refine systems and track progress in real time. This isn’t a new or revolutionary approach. In fact, most operations and business excellence problem solvers across industries already make daily improvements and adjustments that are centered on data analysis. It is unusual, though, to see it applied to improving the well-being of a community. In the case of Built for Zero, data analysis has enabled evaluation, troubleshooting and process improvement across a community’s entire housing placement system, helping communities prioritize resources, identify gaps and ensure that individuals and families experiencing homelessness are referred to housing opportunities that best fit their needs. In the past, cities have not kept track of housing placement data on a community level. Individual agencies may collect data on the number of clients it houses in a week or a month, but odds are that data isn’t relayed across the system. Without this data, community leaders have know way of knowing if progress is being made. In theory, fixing the problem is simple. In order for a community to end homelessness, the total number of people it places into housing each month should be greater than or equal to the number of people it needs to house that month to achieve a path to zero. If those numbers are out of whack, then it’s easy to tell that a community needs to adjust its strategy. That’s where an openness for data collaboration comes in. Participating communities are publicly sharing their monthly housing placement measurements, allowing community leaders, partners and stakeholders to track progress in real time. This transparent feedback loop not only allows a community to constantly evaluate and enhance its system, it also creates shared accountability and buy-in across the entire housing placement system and encourages learning and communication across communities within the initiative. It is this type of transparent, real-time, person-specific data that will help communities optimize resources, improve multi-agency coordination and accelerate housing placements, ultimately bringing the goal of ending veteran and chronic homelessness nationwide over the next few years within reach. What other societal issues do you think could be helped by process improvement? Please share your ideas! How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreA Ringing Endorsement: Using Six Sigma to Improve Call Center Operations
When was the last time you called a company and got connected to their call center? Were you stuck on hold for what seemed like an eternity? Or was the service representative less than helpful? Let’s face it. Call center performance can make or break any service provider’s customer loyalty ratings. Customer service representatives need to be able to answer the phone. They need to resolve questions quickly. Hold time needs to be minimal and at or under the customer’s expectation. Yet these important metrics, taken alone, with little or no regard to other client-affecting service level indicators, can lead to a loss of business. I read an interesting case study recently about a call center in that predicament. At first, call center leadership didn’t realize that the center’s performance was a problem – until there were rumblings that the organization’s contract was about to be cancelled because of poor service. When faced with this issue, many call centers just lay off staff in an attempt to increase productivity of the remaining group, or try to improve results by forcing people to be on the phone even more. This call center took a difference approach. They enlisted the help of a Lean Six Sigma (LSS) expert to improve their performance. The call center began collecting data around its operations and what customers wanted. The results were eye-opening: Most calls that could not be resolved on the first call required some research by the service representatives. The service representatives were primarily judged on whether they were available to answer calls. This limited the time they could devote to research open issues. As a result, many calls that could not be resolved right away were often never resolved. Customers whose inquiries were not answered within a few days would call back. This increased the call volume, increasing the numbers of calls that could not be resolved on the first call, and led to multiple entries in the computer system for the same problem. Baseline data showed that the call center was achieving only a 50 percent first-call resolution rate and 62 percent five-day resolution rate. Furthermore, service representatives with the highest available-to-answer rates had the lowest resolution rate. Interestingly, there was no correlation between available-to-answer and first-call resolution – so just increasing the time that people were available to answer calls would not necessarily drive up the first-call resolution rate. The call center decided to implement several improvements: They divided employees into two groups. Part of the staff would only take calls and the rest would do the research to resolve the issues. Representatives rotated through the two groups, with daily metrics designed for success, collected individually and reported in a central location. Significant drops in first-call resolution now immediately trigger follow-up action. The call center’s IT department tweaked the computer system to utilize an unused field in the screens to capture issues needing research and the age of those issues. After four days, calls that were not resolved were forwarded to the leadership team for action. Within weeks, the first-call resolution rate dramatically increased from 50% to 90% and the five-day resolution rate rose from 62% to 98%. LSS can be a great tool for getting call center performance back on track. By focusing on what the client needs, developing a process around those needs and tracking key performance metrics, a call center can become a true asset to the organization as a whole. How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes...
Read MoreHelping the Boy Scouts to “Be Prepared”
A few years ago I had an opportunity to facilitate a Lean Six Sigma (LSS) project with the local Boy Scouts of America (BSA) council. As an Eagle Scout, I was honored to help an organization that has given so much to me. The project had a relatively simple goal: provide a reliable way for young men and their parents throughout Central Indiana to enter their contact information so that they could receive more information about scouting. Due to the limited time commitments available for the participants, we decided to conduct the project as a two-day Kaizen (sometimes referred to as a rapid improvement event or REI). I was fortunate to have a Green Belt assist me with facilitation on the second day. Over these two days, we took input from our team members, either parents or BSA Council members. This was used to develop the Voice of the Customer, Voice of the Business, and Critical Customer requirements. We evaluated data from previous years as to how many young men had joined BSA annually and developed an estimate of the number of potential Scouts that would be accessing the system. Since this project occurred right before BSA’s 100th anniversary year and many special events were planned, the group anticipated an even larger response than normal. The team also discussed probable issues that could prevent young men and/or their parents from signing up. The team divided into two groups to develop new ways to collect contact information from young men interested in learning more about scouting, or their parents. Team members then compared the two plans. The best aspects of each were selected and combined into the final process involving a new web-based user interface. The team also developed a multi-level approach of assigning BSA volunteers to follow up on the requests, to ensure that all requests were acted upon in a timely manner by the appropriate representative. We then developed an implementation plan and a Failure Mode Effects Analysis (FMEA) to make sure that nothing fell through the cracks. I followed up with the BSA council a few times to check on the project implementation status. Everything was implemented without serious impediments. Overall the team was very happy with the outcome of the project. I was very proud to a part of a team that had a wonderful result even though they had never been exposed to LSS. LSS can be a powerful tool in helping non-profits like BSA do more of the good they were founded to do! How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreSix Sigma Approach Improves ICU Bed Turnaround Time
These days it seems every organization is being told to work smarter, due to unprecedented pressures in funding, staffing and supply costs. No place can this be seen more clearly than in the hospital setting. With all the changes in the American health care system, every hospital is struggling to maximize the use of whatever it has, be it equipment, staffing, or patient rooms. In the May 2017 issue of ISE Magazine, Patrice Batamack, PhD and Christine A.N. Ndjee, MD discuss an effort by a Los Angeles academic acute care medical center to improve bed turnaround time in its 32-bed Intensive Care Unit (ICU), to better meet patient needs and control costs. The hospital noticed that bottlenecks occurred when staff discharged or transitioned patients to lower acuity units. Leaders assembled a team to evaluate the situation using Six Sigma methodology. The team focused on both the voice of the customer, i.e. patients desiring less wait time between transfers into and out of the ICU, and the voice of the business, i.e. the hospital, needing a faster turnover rate for these rooms. The team went through the DMAIIC process (define, measure, analyze, improve, implement, control). Instead of jumping to the conclusion that the hospital needed more ICU rooms, the team collected data about the cause of delays surrounding the turnover of these rooms, such as cleaning and preparing the room for the next patient. The cleaning process was owned by the Environmental Services Department. The team established turnover rates for these rooms. After collecting data for 6 months, they discovered that the process was out of statistical control. The main causes for the delays centered on the availability of managers; their trust in the hospital information system; the availability of the nursing floor staff; their ability to use the hospital info system consistently; availability of supplies; and staffing levels. The team recommended several improvements, not the least of which was to promote and reinforce better teamwork, emphasizing collaboration, cooperation and staff flexibility. The team developed a detailed implementation plan and a Visual Basic tool to monitor the process. By decreasing the median cleaning turnaround time from 67 minutes to 60 minutes, the project team anticipated an annual savings of at least $24,000 in the ICU alone! Too often a problem such as this is addressed by trying to increase staffing, and/or facilities. Six Sigma tools helped this team use data to identify the root causes of delays, make informed decisions and implement solutions. This team proved that by improving the cleaning process, they could achieve better ICU room utilization, meeting the needs of both the customer (patients) and the business (hospital administration). Kudos to the team on a job well done! How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreGaining Financial Credibility for Your CI Initiative
Earlier this month I attended a meeting for health care-focused Lean practitioners in the Indianapolis area. While we discussed several subjects, one topic was at the top of everyone’s list: how to financially justify employing continuous improvement (CI) in an organization, especially with senior staff members. As part of the presentation that day, a CI team from a local hospital explained their journey from a limited and obscure function within the organization to one that holds a key role in the eyes of the business. An important part of this transformation came about by changing how project savings were calculated. Early in the program, the CI team determined the value and/or savings associated with a project. This led to several discussions about the validity of the savings calculations. It did not take long for the CI team and management to agree that monetary valuations should be determined in conjunction with members of the Finance Department. This gave the financial validation needed for data presented by the CI team to the management team. The CI program went from an unknown entity to an important part of the organization. This was done, in part, by a joint effort of the CI team working with the Finance Department. Every CI program needs to establish credibility within the business. How has that been done in your organization? How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
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