W O R K P R O C E S S F O C U S !Let’s Achieve Your Excel lence!

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BETTER PROCESSES, BETTER RESULTS!

DAWN GARCIA, MS, RN, CMQ-OE!

PURSUIT OF EXCELLENCE LLC

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Pursuit of Excellence LLC! ! ! ! ! ! ! ! ! January 2014

Better Processes, Better Results!Processes All Around Us!

Most of the things that we do during our day are connected by, and largely formed by work processes. In the simplest terms a “process” is a series of actions or activities that combine to achieve an end or out-come. When processes are consistent or systematic, the characteristics of the “end” can be forecast and controlled, resulting in the ability to improve results. Better results mean a better business margin and the resources to support ongoing business growth and sustainability. The focus of this paper is to provide key insights into the creation of those systematic and streamlined processes, to support consistent, high performing results. !

Why Map our Work Processes?!

In order to create systematic and controlled processes, we first need to “map” them, to determine exactly what they contain and affect. Process mapping can benefit a number of business activities, including: !

• An understanding of an entire process flow, if no one has the full picture!

• New employees need to be trained, and there is not clear understanding of the process!

• An organization needs to identify improvements in response to external or environmental threats!

• A targeted improvement project has been identified; a project team needs to improve outcomes!

• Strategic planning needs to understand stakeholder, market share or supply chain impacts!

• A design of a new space or function requires an understanding of how the work is done!

• Quality control issues have identified a need to better understand and improve a process!

• Mergers and acquisitions require process mapping of both organization’s functions and processes!

Types of Process Maps!

This paper will focus upon a basic flowchart process map, as this is the most commonly used tool for process improvement initiatives. A basic flowchart can be created on Microsoft Office or Mac software to illustrate process flow, once the information is gathered and validated. !

Other fairly common process maps include stakeholder maps (derived from a stakeholder analysis), high-level process overview maps, cross-functional flowcharts, and bottleneck maps. The stakeholder maps and high-level maps are often used at the organizational level as part of strategy or operational planning. Cross-functional and bottleneck maps address workforce tasks, accountability and load capacity. !

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Begin at the Organizational Level!

The starting point to evaluate and improve your processes, is to begin your review at an organizational process level. While every business is comprised of thousands of processes, the key to successful opti-mization is to limit this to a workable number, typically less than five. These five processes will be the major services in your business, from which the bulk of your subprocesses are derived. At the level of the subprocess, and below, is where the opportunity for standardization and improvement are realized. !

Identifying your key work processes can be the hardest task, so an example may be helpful. Let’s say, for instance, that you work in the banking industry. As you are evaluating your work processes, you can group them into a few key categories: managing accounts, investment services, loan services, and busi-ness operations. Within each of these broad process categories, the bulk of the work of the organization is accomplished. Take a few moments now, and consider the process categories in your organization. !

Understand your Key Work Processes!

From your broad categories, your key work processes and subprocesses can be identified, as required to fulfill your business operations. In the banking industry example, under managing accounts, would be processes for opening different types of accounts, accessing these accounts through in-person and online activities, making deposits, withdrawals and transfers, as well as applying fees, and closing accounts. Each of these processes has steps for the successful operation to be performed, which may be referred to as “standard work processes.” If you have not yet defined standard work for each of these activities, a review of how each of your processes work is in order. The time invested in this activity will be well worth the investment as you come to understand the variation that exists with different technology tools, and different members of your workforce, as they carry out the same functions. The main benefits to be realized from this process work are: 1) an opportunity to identify variation in your processes, that may appear as unfavorable service to your customers; 2) a mechanism to improve the efficiency of your pro-cesses, eliminating extra steps that do not add customer value, and 3) a standard means of performing a task, for training and development of your workforce. !

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In business settings!!C o p y r i g h t e d , A l l R i g h t s R e s e r v e d , P u r s u i t o f E x c e l l e n c e , L L C ! B e t t e r P r o c e s s e s , B e t t e r R e s u l t s ! !

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Define your Key Work Processes!

So, you have identified your key work processes, and you are motivated to optimize them. The next step is to define the specific steps of the process, removing steps that have variability, or fail to add value to the customer, while clarifying the consistent steps required to achieve the desired outcomes. The best way to achieve this is to observe the process in action, going to the “Gemba” or place that the activity occurs. It may be tempting to capture the process from recall or the report of a senior employee’s reflection, howev-er there are always steps missed or identified by an actual observation of the process in action. There is no substitution for the value of observing the actual process, and learning from the findings identified. One additional note, in order to accurately define the process steps, multiple observations of the same process are needed, in order to identify and normalize process variations.!

Let’s return to our banking example of a key work process; managing a checking account. We’ve picked managing a checking account because it is one of the high volume services performed at most banking institutions. Likewise, every organization will want to prioritize processes for improvement that either are the highest volume, highest risk, or highest known variation to desired outcomes. Using a simple pri-ority matrix can help to discern these areas of priority, if resources are limited to only a few areas.!

By the nature of the service, a checking account provides a tracking of expenses and credits, reflects cur-rent available funds, and check or debit transactions. This service includes processes for receiving de-posits (multiple sources), processing checks and debits (multiple means), maintaining an ongoing account balance statement (online versus paper), and managing operations for security, privacy, fund overdrafts, ATM cards, and associated fees. !

Once we’ve identified the discreet processes, we can now observe how we are currently providing these activities into a basic flowchart “process map.” The process map reflects a series of activities, and vari-ables of a process, so that they can be refined or optimized. This is the step where the improvement op-portunities are identified, and redesigned for greater consistency and value. In most organizations, a re-view and optimization of key work processes can result in cost savings of 30-40% while improving quali-ty performance! In addition, process optimization also benefits employee engagement and productivity, as a result of role clarity, consistency, training and accountability. The combination of these outcomes cre-ate a huge return on the process mapping investment! !

Executing Key Work Process Improvements!

A work team is needed to manage the change process, if not already engaged in the data gathering and planning phase. The team should have a leader skilled in process improvement practices. Team members should reflect the varied roles involved in the process of focus. Team members should be given work time to participate in the project, to best support engagement and outcomes. The team is then commissioned for the project scope and purpose, within a specified timeframe, and with essential team resources.!

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Basic Flowchart Maps!

The team’s first outcome is flowcharting the process. Creating a basic flowchart can be as simple as get-ting a large sheet of paper, (think wall banner size) and sticky notes. Each part of the observed process becomes a unique sticky note, placed in order of occurrence. If there are variations, the team can help to clarify the rationale for these, and identify a relative frequency of occurrence. Starting and ending points for the process map should be predetermined, based upon the project plan. For the benefit of efficiency of the team, the team leader typically prepares the initial flowchart based upon real observations. When the team meets, they review step by step the event flow, and affirm, clarify, modify and remove steps from the sequence to move from the current process to the desired future state. This is the core work of process mapping. As teams build experience with the process, the speed and effectiveness of review and modifi-cation builds considerably, as does the application of skills for future state process mapping. !

By applying Lean principles of waste elimination, a team can be coached to eliminate non-value added steps from most workflow processes that may not have been evident without the clarity of the process map. The team leader guides the team’s review of key steps to determine if the step was really needed, and if so, why. As the team generates questions, insights, and potential efficiency changes, a ‘lean’ cus-tomer-focused process emerges. If the team is composed of each of the involved functions in the process, improvement opportunities can often be readily identified. !

Once the future state is developed, and the team agrees with the new process flow, it’s time to verify that the changes work well through a pilot phase. Pilot testing ensures that the design considers all facets of the process, that assumptions made are valid, and that the skills and abilities of the workforce support the new practice. If modifications are needed, this is the time to design these, and then standardize the work to the new process map. The standard work as defined for each process provides an excellent foundation for training of the workforce who will be carrying out the revised process. !

As we are making process changes, it is important to recognize that changes involving behavior or habit changes require multiple repetitions to reinforce and establish the new practice, until a new pattern or habit is secured. For this reason, establishing job aids and technology supports to ensure process consis-tency provide great value in effecting multiple process changes within similar roles. !

Complex Process Maps!

Simple process maps of single processes are fairly easy for process teams and quality leaders to develop and align for improvements, but how does one approach complex processes, such as a patient receiving care in a hospital setting? With hundreds of processes happening almost simultaneously, how does one control the variation, and deliver process consistency? The same process of mapping the flow of the pa-tient through the system occurs, however there are many more areas of variation depending on the spe-cific circumstances of the patient and their needs. Scoping the project is an essential first step.!

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Scoping the project involves identifying a clear beginning point of the desired process map, as a measur-able or observable event. An example would be a patient’s entry into a health care setting at the registra-tion desk. It is also essential to have a clear process end point, to avoid “scope creep,” which may engage the team in more work than was originally intended when the team was commissioned. From the starting point, the process map is developed, similar to a basic one, however there are often simultaneous pro-cesses that occur and interact. Two tactics work best for this situation: 1) use a swim lane map with an expert process facilitator, or 2) limit the project focus to a single process at a time, using the basic plan as outlined above. In the second option, additional processes are later addressed individually, in priority.!

Two very important factors in complex process maps are the membership and function of the project team, and the development of a clear project plan. The team needs to have a facilitator with strong skills in project management and performance improvement, and who has an understanding of how to address communication and decision-making within the organization. The project plan captures the essence of the project purpose, beginning and end points, metrics for performance improvement, executive sponsor, connection of the project team’s work to any existing teams, and a listing of the team members. Once drafted, the plan is reviewed and approved by the executive sponsor before the team is commissioned. Ideally, the team includes a representation of the key roles involved in the process, yet is limited to mem-bership of less than 25 people, in order to be able to reach consensus on process changes. Including repre-sentative roles of the process also ensures an accurate capture of the findings, allows an understanding of factors that would not be immediately recognized by observers, and supports employee awareness and engagement. When the time for implementation occurs, the involved team member can translate the ra-tionale for the decided changes, and can reinforce the importance of the changes in response to normal change resistance forces.!

The greatest challenges for interdisciplinary process teams usually fall into the categories of role clarity, scope creep, team engagement, communication, and decision-making. Each of these areas can be effec-tively addressed by a skilled facilitator, and should be considered in the construct of the team’s rules of engagement. Particularly in complex process maps, the importance of communicating the purpose of the team, and progress made over time, is essential to maintain support of others who will be involved in the implementation of changes, as the project proceeds to goal completion. !

Importance of Measurements!

One area of critical importance to effective work process improvement is the evaluation of measurable impact to the project goals, over the course of the project, at completion, and into the future. Project mea-sures can be “in-process” measures, or outcome measures, depending upon the type of project involved. In-process measures typically reflect completion of defined process steps, while outcome measures often describe error reduction, or process efficiency improvements. While both are important, relevant mea-sures should be established as part of the project plan, as evidence of project success. !

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Defining a specific measure(s) is important to illustrate the benefit of the project to the team and the orga-nization, as well as to build momentum and buy-in from the involved workforce members. It’s especially helpful if the metric is directly tied to the organization’s mission, vision and values, as a motivating factor for the entire workforce. Once established, accomplishment of the measure targets provides an opportuni-ty for celebration and reinforcement of the project’s benefit and results over time!!

Importance of a Control Plan!

Reaping the benefits of a project team’s work include controlling the new process as standard work. A control plan is needed to achieve this. The control plan consists of several components: 1) education and training of new employees to the standard work defined in the new process map; 2) leadership aware-ness, engagement and accountability to coach employees and teams in change management to the new process map elements; and 3) monitoring the performance measures over at least six months to a year, to ensure that results (and therefore consistent processes) are in place. The executive sponsor should have oversight accountability for this control plan, and should identify individuals to support specific aspects as indicated.!

Resources - Getting Started!

Getting started with process mapping of work processes can be challenging and time-consuming work if improvement expertise is not readily available within an organization. Since all organizations can benefit substantially from process mapping, this is an area of great opportunity for enhancement of current and future organizational performance by building this internal knowledge resource. While this takes time to develop, engaging potential future team leaders in successful project teams provides the initial founda-tion of awareness and process knowledge for future benefit. !

To begin the process, a template for project scoping is attached, that includes areas of initial consideration. If there are gaps in knowledge or expertise identified, external support may be needed to achieve the goals, and build credibility for organizational change management and performance improvement. If ex-ternal resources are needed, consider a consulting relationship that will not only achieve the desired project goals, but that will impart the knowledge needed to help your team be able to manage future projects internally, as an additional value. Pursuit of Excellence LLC is highly skilled in these aspects, and can create the foundation for improvement in your organization. !

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Process Map Template!

Process Element Items Needed Organization’s Plan

Define Process Describe the process to be improved.

Executive Sponsor Define the individual on the senior leadership team that supports and has oversight accountability for the project.

End Point Define the project end point as a noun and a verb, using two to five words.

Starting Point Define the project starting point, as a noun and a verb, in two to five words.

In-Process measures Define the observable and measurable steps of the process that will be most affected by the improvement.

Outcome measures Define specific measures and targets as affected by the process, in support of organizational performance goals.

Parallel Teams/Processes Define any other groups, teams or processes that may overlap work done by this process team.

Customer Define who will benefit the most from the project work, by role, as well as externally.

Team Leader Define an individual who will be accountable to develop, and lead the project plan with a defined team.

Team Participants List the process team participants, reflecting the key roles that are involved in the process.

Stakeholders List any party who affects or is affected by the process or outcomes.

Suppliers/Contributors List anyone contributing to the process.

Timeline Define the project start and end dates.

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