William Considine embraces Lean Six Sigma to improve Akron Children’s Hospital

The price tag was $3.5 million. For a renovation that would allow for an additional 3,000 surgeries a year and for a leading hospital with gross patient services revenue of $709.5 million, $3.5 million wasn’t going to break the bank.

But it was still $3.5 million. And, in the end, it was $3.5 million that Akron Children’s Hospital didn’t have to spend.

The renovation was proposed for the sterile processing department, the place where surgical instruments are sterilized. The department just couldn’t support the increased demand that was asked of them. Naturally, when that happens, the first thoughts turn to either more employees or maybe more space. Akron Children’s had the same thought.

But before it brought out the hammers, it asked members of the department and of the hospital’s Lean Six Sigma team to review the problem. Turns out, a simple redesign of the processes and space solved the problem. No space added, no employees added, and $3.5 million saved. Think about it, that’s only one problem. Imagine if you had all of your employees thinking that way.

Now, Akron Children’s President and CEO William Considine does.

“We’re going to them and saying, ‘You know your work better than anybody. We want to empower you and give you the resources to look at ways to improve your efficiencies,’” Considine says. “And they love being a part of it.”

Akron Children’s has always had a commitment of continuous improvement in services and efficiency. That commitment led the pediatric hospital to start implementing Lean Six Sigma two and a half years ago.

Along with the processes and methodologies, Considine realized Lean Six Sigma is also about enhancing your culture, engaging employees and empowering them to improve.

“We all know that culture eats strategy every day,” he says. “You can have the best strategy in the world, but if you don’t have a good culture, you’re going to have a hard time implementing that strategy. Lean Six Sigma is a real investment in culture. It communicates to your people that you really value them and what they do.”

Here’s how Considine equates Lean Six Sigma and employee empowerment to produce efficiency.

Present employees the idea

As the CEO, you have to set the stage.

First, you need to make sure your management team and board will back your idea. Even though Akron Children’s has a philosophy of continuous improvement, the hospital still discussed whether Lean Six Sigma was a worthy way to spend time and money. A few raised concerns, but Considine says sometimes getting buy-in from skeptics centers on how you present the idea and listen to opinions.

“One thing you need to do is respect everybody’s opinions and I do,” he says. “At the same time, advance positive energy in what we’re doing. I find people want to be around positive energy.

“You know how you feel when you’re in a room with a bunch of naysayers. Quite honestly, people don’t want to be around negative energy. I don’t give it a lot of credibility. If people want to voice it fine, I don’t hover around it though. I move on to that positive energy and, ‘OK, we’ll take that input. We’ll process it, and we’re going forward.’ The large majority of people go forward.”

For Considine, Lean Six Sigma wasn’t a hard sell. Members of his leadership team actually recommended discussing the strategy. But not having leadership on board is one of the pitfalls you can face when implementing new processes and procedures.

“Not having genuine commitment from your management team, the people on the front line will figure out real quick and they’ll say, ‘Well, no one really cares about this,’” Considine says.

With management on board, you need to again set the stage for your entire employee base. Akron Children’s used a gamut of communication tools to get the message out — internal publications and departmental meetings, Considine spoke — but it’s how the message is phrased from the top that’s important. You have to explain the plan and set your expectations.

Considine gave Lean Six Sigma credibility by explaining it as a proven technique used in industry, business and recently hospitals to identify ways to improve processes. He outlined what he would expect from employees by telling them the best way to find efficiency is asking those on the front line how to improve what they do every day and that management would be asking for them to present ideas.

“You have to talk about how proud you are of the organization and the service,” Considine says. “When you talk to people, you just say, ‘There’s been a lot of change. You know your job as well as anybody. Are there ways that it can be structured? Are there processes that have been put into place (that can be) made more efficient?’ People respond to that. They really respond. All you have to do is have the courage to ask the questions. Ask them for help and they will help.”

Along with explaining Lean Six Sigma and employee expectations, the hospital identified people within the company who were held in high regard by their peers to be resources for the effort. The idea is to make employees comfortable with changes coming down the pipeline and empower them to take ownership in helping. If employees see trusted colleagues involved, the sell might be easier.

“We identified some of our own people that people in the hospital knew and respected, and said, ‘Here’s the team that can help you, will work with you,’” Considine says. “You have to set the table the right way, but it surely can be done.”

Provide resources

Considine wanted his 4,000-plus employees to have a chance to contribute to the Lean Six Sigma principles, so he knew he needed a support system that would allow employees to share ideas and have access to resources to turn them into reality. So Akron Children’s formed the Center for Operations Excellence. It’s staffed with the seven people the hospital recognized as having an influence on their colleagues. They’re now Lean Six Sigma trained and serve as project leaders.

Considine says an entire center dedicated to implementing strategy isn’t necessary. You might take a different approach based on how you internally structure resources and your company culture. Truly, how to support Lean Six Sigma activity could become a project of its own.

No matter how you structure your support, there is one thing to remember.

“The key is you want to empower the people,” Considine says. “You don’t want to have so much structure there that it’s bureaucratic. Keep it simple.

“The thing is you want the people on the front line to say, ‘Hey I got this idea. I do this job every day and I think I can make this job, these processes, a little simpler, more efficient.’”

Basically you want to make the process easy for employees to recommend ideas, and you want them to feel comfortable that they can suggest those ideas. Remember, this is about empowering them. You want your system to be one where they reach out to you.

At Akron Children’s, projects are broken into two categories: A3 and Kaizen, with the latter being more cross-departmentally focused. Employees interested in finding efficiency fill out a sheet suggesting their idea, and then they’re contacted by the Center for Operations Excellence who will assign the employee a coach and a project leader to walk that person through the steps. More than 500 employees have completed an eight-week, A3 project. And there’s currently a waiting list.

That momentum is not going to happen overnight. You’re not going to come in the next day with a list full of ideas.

“The reason I think we’re at that level now is people know we’re serious about this,” Considine says. “People have seen the reward that others that have done this have gained in terms of personal satisfaction, and they want to be part of it. You have to build that.”

Considine recommends picking a couple early projects that you know will see good results. Is there a process within your organization you know you can make more efficient by cutting steps? At the same time, identify and involve the more innovative people in your company. As you ramp up the important communication process, you will have a win-win scenario and a personal story to inspire employees and build energy.

Communication is critical in every aspect of every organization, but it becomes especially important as you’re trying to gain and maintain energy around new processes. But just because you’ve outlined your idea, you’ve set expectations, you’ve given employees resources, doesn’t mean communication stops. Even when the idea is finally embedded in your culture, it’s still important to share what has been accomplished throughout the organization.

Akron Children’s maintains constant conversation around Lean Six Sigma through monthly and weekly employee publications, departmental meetings and CEO round tables.

At Considine’s monthly leadership meetings, a story is shared with his executives about a Lean Six Sigma initiative and they’re asked to repeat it to their staff.

“If you’re in a department that starts sharing about what another department is doing with this, you start thinking, ‘Oh, there’s something that we can do,’” he says.

You need to use multiple communication vehicles to get your message out. But once again, it’s how you craft your message that is important, especially when you have the attention of a small group.

“What we try to do when we use that vehicle is instead of talking about Lean Six Sigma as a program, we put a face on it,” Considine says. “We talk about a Lean Six Sigma project that one of the people these people know has done. Communicating what it is is endless; you have to keep doing that, and you have to keep celebrating what you do.”

Celebrate success

If your child needed an MRI two years ago, the waiting list at Akron Children’s was about 25 to 28 days. Through discussion with department employees and dissection of the workload, the hospital was able to add 35 MRI tests a week, dropping the wait time to three days or less.

Considine has heard hundreds of similar stories since implementing Lean Six Sigma. Many of those stories come from A3 project graduations. Once employees finish their eight-week project they share their findings in terms of patient wait time savings, financial savings and hours saved in the workday. Considine, members of his management team and his board attend those graduations.

You need to find an outlet for employees to share their solutions, one that allows them to feel pride in what they’ve accomplished and gives them a sense that their voice has been heard. At the same time, you need to find a way to keep a pulse on what your employees have been able to achieve and document that success.

Considine takes what he hears at the graduation and ties it into his communication with other employees to show and celebrate employee and company achievement.

“It gives you the chance to tell a story,” he says. “When you celebrate, you put a face on it, a face of a fellow worker, a face of a family. It’s genuine. It’s not something that is phony.”

Even though the hospital has a resource center, even though you might have certain employees leading projects, you as the CEO must take full ownership of processes such as Lean Six Sigma. That means you must communicate, motivate and celebrate.

“You’ve got to believe in your people, you’ve got to trust your people, empower them, and you’re going to be blown away when you see what they come back with,” he says. “They’re going to show you improvements that you would never have thought about. They’re going to show you ways to be efficient that the high-stake consultants you could bring in wouldn’t be able to find. You just have to keep celebrating that.”

HOW TO REACH: Akron Children’s Hospital, (800) 262-0333 or www.akronchildrens.org