Choosing the Right Metrics for Lean Six Sigma
In Marcus Buckingham's new book, The One Thing You Need to Know, there's a section on knowing your "core score." What's the one thing you need to know about your business?"
Core Score for Prisons
Buckingham interviewed General Sir David Ramsbotham who was in charge of Her Majesty's prisons. He says that he knew he couldn't make wardens change. In order to make things happen, he had to change the way they measured success.
- Old metric: number of escapees
- New metric: number of repeat offenders
The old goal was to keep prisoners in, but the General started thinking: Who is a prison designed to serve? Answer: the prisoner!
"The main purpose of a prison should be to serve the prisoner. By which I mean that we must do something for the prisoner while he is in prison so that when he is released back into society he is less likely to commit another crime." Armed with this new score, he turned the prison world upside-down.
Core Score for Health Care
In the old world of health care, the measure was based on "outcomes"--did the patient get better no matter how long it took. I am coming to believe that the new world of health care is measured on speed.
- Door-to-Doctor time in the Emergency Room of under 30 minutes
- ED Length of Stay (under 2 hours)
- ED-to-Nursing Floor for admitted patients of under 30 minutes
- Length of stay (2-3 days based on diagnosis)
- Discharge-to-Disposition (patient transferred) of under 60 minutes
Most of these times can run two-to-four times longer at present. Patients are used to being served in minutes everywhere else, why not in health care? Of course, health care will need a few metrics of patient safety as well:
- ED returns within seven days
- Hospital returns
- Poor outcomes (infection, death, etc.)
Education's Core Score
I recently worked with a school district. The school district gets money based on attendance.
Who do school systems serve? The student! So I'm wondering if a school's core score shouldn't be the dropout rate. Dropouts are more likely to struggle with finding work and resorting to crime. It's an indicator that we've failed to prepare that student for life. Attendance is a predictor of dropout rates; it's what I call a process indicator. The dropout rate is a quality indicator that measures the end result.
What's Your Core Score?
Who do you serve? What do they want?
How can you measure that you deliver what they want?
Here's my point:
Measurements drive behavior. Bad measures will drive bad behavior. Good measures will drive good behavior. If you aren't getting what you want from your business, adjust what you measure and how you reward it. The system will change!
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