This document summarizes a webinar presented by Mark Graban of KaiNexus and Jason Coons of Kettering Health Network on their system-wide approach to continuous improvement. The webinar discusses how Kettering implemented a process excellence team using KaiNexus software, trained nearly 2,500 staff members, and completed projects that resulted in $2.6 million in financial impact in 2014. Key lessons from their journey include the importance of organizational alignment, clear metrics, governance, training models, and viewing continuous improvement as a management philosophy rather than just projects.

1. A System-Wide Approach to
Driving Process Improvement
Mark Graban
KaiNexus
@MarkGraban
Jason Coons
Kettering Health Network
@coonsja81
(Skip to slide #27 to watch this webinar)

2. • 10+ years in healthcare, medical device, and
consulting industry
• Education – Industrial Engineering, Health
Administration
• Various certifications – Lean, 6 Sigma,
PMP, ITIL
• Joined Kettering Health Network in 2010
About Jason Swartz
(Skip to slide #27 to watch this webinar)

3. Kettering Health Network
A System-wide Approach to Process
Improvement (Skip to slide #27 to watch this webinar)

4. Today’s Goals
• See how Kettering's system-wide approach to
projects, training, and daily problem solving led
to $2.6 million of financial impact last year
• Learn about KaiNexus, the continuous
improvement software platform that spread
continuous improvement by enabling change
management and accountability within the
system
• Get actionable advice from lessons learned in
Kettering Health Network's 5 year process
improvement journey
(Watch this webinar)

5. Kettering Health Network
Dayton, OH
Hamilton, OH
Cincinnati, OH
Xenia, OH
Columbus, OH
(Watch this webinar)

6. A Story...
• Information Systems
(Watch this webinar)

7. Process Excellence Purpose
To improve
People, Process, and Technology…
in that order
(Watch this webinar)

8. Department Balanced Measures
(Watch this webinar)

9. Our Journey
2010
2012
2013
2014
To the
future…
Expand resources to
meet increased
demand / support
A team of one…
Supporting two
hospitals (KMC/SMC)
Expand to support
all Network facilities
Integration of
analytics and
strategy
deployment
Year-long process to
hire team completed
Partnership with
KaiNexus
KMC/SMC achieves
great financial and
operational success
(Watch this webinar)

10. Support All of KHN?!?
• Network awareness
• No central or standard structure to
track and trend areas of opportunity
• No sustainable method to engage and empower
front-line staff
• Ability to find and hire talented people
• Network data management and governance
• No standard model to track actions required for
follow through (accountability)
(Watch this webinar)

11. Overcoming Our Challenges
• Leadership training and awareness
• KaiNexus as a platform, not just technology
– Creating improved awareness and heightened
accountability
– Standardized structure for tracking improvement within
projects
• Ability to move beyond the “project”
• Rigorous 6 step interview process
• Integration of Process Excellence and Business
Intelligence
(Watch this webinar)

12. A System-wide Approach
Training /
Development
Building internal
capabilities to identify
and eliminate waste.
Key Services
• Novice Training
• Advanced Training
• CPEL program
• Coaching / Mentoring
Process
Improvement
Identification,
resolution, and
sustainment of OFIs
across direct and
indirect patient care
Key Services
•Lean improvement
•Data Analysis
•Operational
Assessments
•Simulation
•Facility redesign
Change
Implementation
Management oversight
required to successfully
deliver or create a
unique, product,
service, or result.
Key Services
•Project Management
Services
•Strategy
deployment/oversight
(Watch this webinar)

13. Developing Our People
 Understand the
foundation of Lean
methodology and
key tools to
improvement
 Awareness of Lean
Management Model
and definitions
 Change Management
/ Culture shift
Novice Training Advanced Training CPEL Program
 Deeper
understanding of
Lean methodology
and problem solving
techniques
 Lean Management
Model review
 Understand key
attributes of a Lean
leader
 A3 Problem Solving
 Understand all
aspects of Lean
management system
 The ability to instill
lean thinking into
their area
 The ability to
facilitate rapid
improvement events
and process
improvement tools
 Ongoing CI
expectations
(Watch this webinar)

14. CPEL Projects (Sample)
• 100% reduction in Flash sterilization rates @ Soin OR
• 50% reduction in pre-admission testing time @ GV
• Improved pain management PG score from 42% to
89% @ Soin
• Abstraction training improvements result in 50%
decrease in hardware and zero build issues @ IS/KPN
• ED Navigator resulted in 25% increase in e-visits, 44%
increase in follow up charges, 15% increase e-visit
charges @ FHH
(Watch this webinar)

15. Staff Trained
0
100
200
300
400
500
600
700
800
900
1000
2011 2012 2013 2014 2015
Formal and Project Training
Training Projects
Nearly 2,500 leaders and staff trained
(Watch this webinar)

16. Project Governance
Strategic Alignment
• Utilize multi-
factor strategic
alignment
scoring model
Organizational Need
• Alignment to
OneBest
• Evaluation of
tactical need
• Campus level
needs
Change Readiness
• Assessment of
organization
cultural and
overall readiness
Project Business Case
(Watch this webinar)

17. Standard Project Approach
Business Case
Development:
Business Relationship
Manager and/or
assigned Project
Manager works with
requestor and
stakeholders to
develop or validate
business case
(problem statement,
metrics, etc.)
Sponsor Approval:
The project sponsor
signs off on the project
business case,
indicating it’s an
initiative that should
be facilitated by a
Project Manager.
Project Research:
Project will be
researched based
upon project type
Project Charter:
A draft project charter
will be developed,
which is a preliminary
high-level outline of
the project that helps
define scope and
financial impact.
Project Selection
The project will be
evaluated against
project portfolio by
appropriate approving
body. This determines
prioritization against
other initiatives.
Build Project Plan:
A detailed project plan
will be developed,
which includes:
Project Plan Approval:
The executive
summary will be
presented to the
appropriate
operational approving
body at which point
funding will be
released for projects
that require capital or
operating
expenditures.
Execute Project Plan:
Once approved, the
project will be worked
on by the Project
Manager and/or teams
assigned, based on the
timeline as outlined in
the project plan.
Transitioning Out:
Project Manager will
meet with Sponsor to
reviewall necessary
critical hand off items.
Deliverables
Accepted:
Upon completion of
project
implementation, final
deliverables will be
reviewed and
approved by Sponsor
and operational
approving body.
Initiation Planning Execution Closing
Build Executive
Summary:
Project Manager
develops an executive
summary of the
project plan
Project Closing:
Project Manager will
conduct final review of
project with sponsor,
key stakeholders, and/
or operational
approving body for final
acceptance.
Charter Sign off:
The project sponsor
must sign off on the
project charter to
move forward.
Risk Register
Project Schedule
Communication Plan
Resource Plan
Budget
Project Approvals: All
approvals are iterative and
will continue until approval
or project cancellation.
(Watch this webinar)

18. PROCESS
EXCELLENCE
Aligning Analytics to Drive Action
STRATEGY
BI GOVERNANCE DATA DELIVERY
BUSINESS
INTELLIGENCE
(Watch this webinar)

19. CONFIDENTIAL DATA,
NOT SHARED
Another Story…
• Length of Stay Initiative
– #1 Initiative across KHN
– Affects 7 facilities & 50+ units
(Watch this webinar)

20. 2014 Total Impact – $2.6M
(Watch this webinar)

21. Our Impact
$636,563
$2,054,498
$2,360,423
$4,058,034
$4,854,084
0.00
1.00
2.00
3.00
4.00
5.00
6.00
$0
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
2011 2012 2013 2014 2015
True Financial Impact & ROI
Cumlative $ Impact Annual Impact
*Financial impact validated and annualized one year. Does not account for cumulative impact.
(Watch this webinar)

22. Lessons Learned: Starting the Journey
• Organizational alignment
– Strategy linkage
– Relationships / Partnerships
• Agreed upon metrics of success and “runway
length”
• Governance of project selection
• Organizational data management
(Watch this webinar)

23. Lessons Learned: Starting the Journey
• Key project roles defined
• Process improvement approach
• Training model developed
• Hire the right people
(Watch this webinar)

24. Lessons Learned: For Lasting Success
• Integral part of strategic direction and future
• Resources match commitment and demand
• Clear understanding of data and goals (data
infa-structure)
• Viewed as a management philosophy
(Watch this webinar)

25. Lessons Learned: For Lasting Success
• President driven
• Everyone expected to participate
• Patient Centric
• Focus on the right things, ROI will follow
• Use of technology to better enable
improvement
(Watch this webinar)

26. Thanks!
Mark Graban
KaiNexus
@MarkGraban
mark@kainexus.com
Joe Swartz
Franciscan St. Francis
@JoeKaizeneer
joeswartz14@gmail.com
• Web:
– www.kainexus.com
– blog.kainexus.com
• Past Webinars:
– www.kainexus.com/webinars
• Social media:
– www.twitter.com/kainexus
– www.linkedin.com/company/kainexus
– www.facebook.com/kainexus

27. To learn using a
system-wide approach
to drive process
improvement, watch
the full webinar:
Watch Now
A System-Wide
Approach to Driving
Process Improvement

28. Other Resources
Upcoming Webinars
KaiNexus Blog
Continuous Improvement
eBooks