Lawrence Rosier & Associates
Management Consultants Government Reform
LETTER of TRANSMITTAL: May 7, 2013
To: Assistant Secretary for Health Howard Koh, M.D., M.P.H.
From: Lawrence Rosier Principal Management Consultant representing Lawrence Rosier & Associates
Subject: Proposal for the implementation of a Pilot Demonstration for the Reform of the US Department of Health and Human Services.
The approach recommends the use Lean six Sigma to make high Level health decisions in health management and in health diagnostics supplemented by Enterprise Lean to get the highest efficiency with the most effectiveness in the DOHHS and in health care delivery systems nation wide.
The objective of this Proposal is for a pilot demonstration of how health care can be made efficient and affordable through the implementation of Lawrence Rosier’s General Reform Model, a unique method of using Enterprise Lean to obtain the highest efficiency and effectiveness possible; followed by right sizing the organization (making sure there is balanced work load), the development of a Bottoms-up budget and finally the conversion to a Team Management organization.
The method builds upon the implementation of Toyota’s Enterprise Lean with both high level Management Lean Teams studying agency systems and document flows and work place Functional Lean Teams studying all of the agencies functions involving all agency employees. The Lean Training of employees is done by agency training staff after a train-the-trainer program provided by a certified Lean trainer. The primary purpose of the Lean Teams is find the best way to perform the agencies functions getting the highest efficiency possible while improving the agencies effectiveness. An added benefit of Lean training is to empower employees for innovation and continuous improvement of their functions.
Please Review the following Proposal of a demo for DOHHS reform. This document is intended to be used to promote understanding and to start discussion on consulting activities and may be altered to fit required situations. The Federal Government may modify the attached Proposal to fit its specific needs.
Kindest Regards Lawrence Rosier Principal Management Consultant
Please Review the articles on my website for or details.
Lawrence Rosier & Associates
Management Consultants Government Reform
12143 Cedar Grove Rd. Rolla, Missouri
Phone 573-364-8789 Cell 573-578-4716
http://managementconsultant.blogsome.com
PROPOSAL May 7, 2013
By Lawrence Rosier & Associates
This Proposal for a Pilot demonstration of Federal Agency Reform is presented to Assistant Secretary for Health Howard Koh, M.D., M.P.H. By Lawrence Rosier Principal Management Consultant
This proposal is for the implementation of a pilot reform using the General Reform Model developed by Lawrence Rosier Principal Management Consultant to be implemented by The DOHHS. The Method implements Functional Lean Teams throughout the Agency. The Lean concept was developed by Toyota to involve employees in increasing the efficiency and the continuous improvement of their jobs. The benefits to the Government are from efficient and effective operations but also the change in the way government employees view their jobs empowering them to innovate and make continuous improvements to their jobs. The General Reform Model uses the data developed by the Lean Teams for Work Measurement and from that staffing and budgeting is determined. The objective of the General reform model is to get the highest efficiency possible and improve the effectiveness of the agency and turn a difficult major reform into a relatively smooth operation.
Goals:
The main goal is to maintain the serves of the agency while getting the highest productivity possible and improve the effectiveness of the agency by empowering its employees through Lean training to innovate and make continuous improvement to the systems in their jobs. This is followed by Right-sizing the agency‘s staffing, the development of a bottoms-up budget and the change to a Team Management organization
The developed Lean Team data is used for right-sizing and the development of a bottoms-up budget the result is to increase the efficiency and effectiveness of the agency which may result in the reduction of agency staffing. A major benefit is the transparency to the Federal Reform Commission of the Agency’s staffing budget. The “General Reform Model” is a approach designed Lawrence Rosier to accomplish these Goals.
Proposal Details:
I suggest a meeting to allow DOD leaders and staff members to become fully familiar with the logic of the method I am proposing using my General Reform Model.
The first step is the formation of a Departmental Reform Commission with broad powers to lead and implement reforms. This can be followed by the selection of the Agency to be reformed.
I suggest that the day to day activities of the implementation be co-chaired by the Management Consultant and a high level Department representative. The Department representative will be tasked with providing those employees who will participate in the implementation and their expenses such as equipment offices and meeting rooms. The Department representative shall be given the authority to remove any employee who attempts to block this reform implementation and refer them to the Departmental Reform Commission for disciplinary action.
The Management Consultant will form an Implementation Team with Budget Analysts and or Auditors on loan from the GAO and or the Department’s Audit Division. The required number is entirely dependent on those who can be made available and the size of the Agency. I do not bring any of my own staff to the job but chose to train current employees as Budget Analysts and Lean Facilitators to fill key jobs during the implementation . The advantage is that the knowledge they acquire in managing the new methods will stay within the Department and will be used for other continuing implementations.
The first act of the Departmental Reform Commission and the Principal Consultant is in planning for the implementation of Lean Teams within the selected Agency. The purpose is to resolve issues related to Lean training, Facilitators, Budget Analysts and specifically what the Lean Teams must do to meet the requirements for determining staffing and budgets. I suggest that a Certified Lean trainer be brought in to train the agency’s training staff. Lean training should begin immediately by the Agency’s training staff. I also suggest that the Agency’s normal training curriculum be suspended and an all out effort be made for Lean Training of all personnel. Training should be made for staff members first followed by management and then Lean Facilitators. Lean facilitators organize and train each employee Lean Team work group which usually meets for one hour on a weekly basis. There are three major Lean Team endeavors, a high-level Steering Lean Team, a mid-level Lean team made up of mid-level managers to make document flows efficient and at-the-work-place Functional Lean Teams those who do the basic work of the Agency. The Steering Lean Team will report to the Principal Consultant and will assist in the management of the implementation.
The Steering Team also has an alternate task when required to consolidate the Agency’s internal Services as described in Lawrence Rosier’s Consolidation Model. Mid level Lean Teams are tasked to study inter-department and agency document flows.
After a period of about three to six months most Functional Lean Teams, those that were organized and trained by Facilitators, should have their Value Stream Analyses completed. I have had success with doing the flow of the current method on long butcher or brown wrapping paper taped around a conference room on the walls. The proposed improved method is done directly under the current method to highlight the differences between the methods. I would now allow the Lean Team to present the improved method to management. After the presentation the Lean study data is given to a Budget Analyst to determine the savings from the proposal.
Activities of the Principal Consultant:
The Principal Consultant will play a key role in being sure that the Lean teams are properly trained and in the selection and approach of the high-level Lean teams. The Principal consultant will insure that the activities of Analysts currently employed by the GAO and Department Auditors can determine the correct staffing level through Work Measurement and any expenses needed during the process. Some Analysts may find the proper staffing for variable processes difficult to determine. If so the Analyst should wait for the Management Consultant to make this determination. This data combined with the number of occurrences of the Function over time, obtained from a daily log kept by each Lean Team, provides the basis for an accurate Functional budget. The data from the Lean study should be Transferred to a spread sheet by the Budget Analysts and summarized in a database where all of the Agency’s Functional Data is stored. The activities of Budget Analysts are important and will be followed closely by the Principal Consultant.
The Principal Consultant will make a final review of the data to determine the actual staffing required. Note that in most cases this is not a simple calculation due to variations in the times required to do some processes. Consolidation of Agency employees is required meaning most employees who currently do not have a full time job will have to be trained to also do a second job while other employees will become redundant. A Special skill is required in balancing the work load to give the remaining employees a full time job. This may be further complicated by jobs which continually change which will require the training of a Work Planner to balance the work load assignments for each employee on a weekly basis using six sigma as a management tool. This is also the period of time for Right-sizing the entire Agency once it is known where staffing can be reduced. Layoffs should be completed within three months.
Current knowledge about Bureaucratic staffing has shown that nearly all bureaucracies are overstaffed by at least 10% and most are overstaffed by as much as 20%. Savings to the Federal Government for this implementation is largely from the salaries and benefits of redundant employees. Long term benefits continue from employee empowerment to innovate and make continuous improvement to their jobs. Other benefits are from the simplification of government processes. The Return On Investment is expected to be significant and may reach as much as $100 for every $1 invested. After three months with the Pilot Demo projections for actual savings can be made.
The Federal Government Agrees to Pay Lawrence Rosier & Associates a Fee per week for services rendered. This agreement can be canceled by either party with a one week notice. All expenses such as travel, lodging, rental car, per diem are the sole responsibility of Lawrence Rosier & Associates.
The following Client signatures of the representatives for the Federal Government represents a general agreement that the Federal Government will follow the proposal’s outline of Lawrence Rosier’s General Reform Model as presented. The proposal contains suggestions for the implementation of the General Reform Model which may be modified by mutual agreement. By the following signatures the Client also agrees to the weekly fee required by Lawrence Rosier and Associates.
_____________________ ___________________
Signatures of Federal Government Representatives
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Signature of Lawrence Rosier Principal Management Consultant
Lawrence Rosier & Associates 12143 Cedar Grove Rd. Rolla, Missouri 65401
573 364 8789, cell 573 578 4716, fax: 573 368 2907
Email: Lawrencerosier4@gmail.com
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