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Department of Public HealthHuman Resources ‐ presentation Value Stream Mapping – RN Hiring

SFGH JCC

September 17, 2014Department of Public Health

Value Stream Map

Sequence of activities describing a process including waits in between the process steps.

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Value Stream Mapping

• Cycle time = CT– The time it actually takes to complete one step in the process.

• Lead time = LT– The total time from the beginning to the end of a process, including all cycle times and wait times.

• Value added ratio (or percent) =The value added time in the process (from the patient’s perspective)  divided by the total lead time.

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What are our “buckets” of work?

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Hiring Manager triggers need for

hire

Employee’s 1st

day of work

“Gemba” = Shop floor

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What were our gembas?

…. Some required field trips!

• SFGH – HR Operations• DHR (Dept of Human Resources)• Mayor’s Office• DPH HR Merit• SFGH Finance• SF DPH Finance• DET – Orientation• Occupational / Employee Health

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Going to Gemba

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Going to Gemba

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HR Operations – Request to Hire

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Going to Gemba

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HR Operations - Appointment Processing

Going to Gemba

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HR Merit – Reviewing and Posting

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Going to Gemba

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DHR Client Services

Conviction HistoryRequest to Fill

Going to Gemba

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Going to Gemba

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SFGH Finance

Going to Gemba

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DET - Orientation

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Going to Gemba

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Hundreds of forms throughout process –paper and electronic

Amended 3/1/11

BACKGROUND VERIFICATION

CERTIFICATION BY APPLICANT (read carefully): I hereby authorize all my employers and schools (unless otherwise noted) to release any and all information concerning me, including information of a confidential or privileged nature. I hereby release any and all employers from any liability or damage that may result from furnishing the information requested. Applicant’s Signature _____________________________ Date ___________________

(TO BE COMPLETED BY HIRING MANAGER)

APPLICANT’S NAME (please print) __________________________________________ POSITION CONSIDERED FOR: ___________________________________ F/T or P/T NAME OF REFERENCE: _______________________________ PHONE # ______________ COMPANY NAME: ______________________________ FAX #_____________ DATES OF EMPLOYMENT: __________________________ WAS APPLICANT’S RELEASE FAXED TO REFERENCE? YES ____ 1. Reference refused to give any information: ______ 2. What was ________ (applicant’s name) overall performance when he worked for you? _____________________________________________________________________ 3. Were there any problems, on the job, that we should know about? ________________________________________________________________________ 4. Are you aware of any allegations involving patient abuse or abusive behavior? ________________________________________________________________________ 5. Would you rehire? Y N 6. Other Comments: __________________________________________________ ____

_____________________________________________________________________

SFGH Manager’s Signature _________________________ D ate: _______________ Printed Name ______________________________________

RETURN TO HR WITH COMPLETED REQUEST TO HIRE FORM (OVER)

Amended 3/1/11

BACKGROUND VERIFICATION

CERTIFICATION BY APPLICANT (read carefully): I hereby authorize all my employers and schools (unless otherwise noted) to release any and all information concerning me, including information of a confidential or privileged nature. I hereby release any and all employers from any liability or damage that may result from furnishing the information requested. Applicant’s Signature _____________________________ Date ___________________

(TO BE COMPLETED BY HIRING MANAGER)

APPLICANT’S NAME (please print) __________________________________________ POSITION CONSIDERED FOR: ___________________________________ F/T or P/T NAME OF REFERENCE: _______________________________ PHONE # ______________ COMPANY NAME: ______________________________ FAX #_____________ DATES OF EMPLOYMENT: __________________________ WAS APPLICANT’S RELEASE FAXED TO REFERENCE? YES ____ 1. Reference refused to give any information: ______ 2. What was ________ (applicant’s name) overall performance when he worked for you? _____________________________________________________________________ 3. Were there any problems, on the job, that we should know about? ________________________________________________________________________ 4. Are you aware of any allegations involving patient abuse or abusive behavior? ________________________________________________________________________ 5. Would you rehire? Y N 6. Other Comments: __________________________________________________ ____

_____________________________________________________________________

SFGH Manager’s Signature _________________________ D ate: _______________ Printed Name ______________________________________

RETURN TO HR WITH COMPLETED REQUEST TO HIRE FORM (OVER)

RTH packet – 29 pages

ORAL AUTHORIZATION REQUEST FORM REQUEST FOR EEO SELECTION APPROVAL

Date of Request: Oral authorization classification/title: Status of eligible list/examination for classification: Department: DPH/GH Unit: Name of Manager: Phone Number: Position work schedule full time/part time/as needed/ and hours per week: Special condition on position (language waiver, children's waiver etc.): RECRUITMENT PROCESS: Length of recruitment time: (please attach the job announcement) Recruitment activities (e.g. newspaper and network bulletin board agency mailings etc.) APPLICANT POOL Total number of applicants: Race and sex: White African Amer. Hispanic Asian Filipino Am. Ind. M F M F M F M F M F M F ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) APPLICANT POOL Total number of qualified applicants: Race and sex: White African Amer. Hispanic Asian Filipino Am. Ind. M F M F M F M F M F M F ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) INTERVIEW PROCESS Interview dates: INTERVIEW PANEL Number of interview panelists:

ORAL AUTHORIZATION REQUEST FORM REQUEST FOR EEO SELECTION APPROVAL

Date of Request: Oral authorization classification/title: Status of eligible list/examination for classification: Department: DPH/GH Unit: Name of Manager: Phone Number: Position work schedule full time/part time/as needed/ and hours per week: Special condition on position (language waiver, children's waiver etc.): RECRUITMENT PROCESS: Length of recruitment time: (please attach the job announcement) Recruitment activities (e.g. newspaper and network bulletin board agency mailings etc.) APPLICANT POOL Total number of applicants: Race and sex: White African Amer. Hispanic Asian Filipino Am. Ind. M F M F M F M F M F M F ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) APPLICANT POOL Total number of qualified applicants: Race and sex: White African Amer. Hispanic Asian Filipino Am. Ind. M F M F M F M F M F M F ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) INTERVIEW PROCESS Interview dates: INTERVIEW PANEL Number of interview panelists:

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Observing and understanding the work

elapsed time for one observationquality check safety precaution standard WIP # pieces of WIP takt time

standard work sheet date of observation:operation sequence:

from:to:

end time:

observer:process:

area/location:subject observed(pt, nurse, etc):

start time:

elapsed time for one observationquality check safety precaution standard WIP # pieces of WIP takt time

standard work sheet date of observation:operation sequence:

from:to:

end time:

observer:process:

area/location:subject observed(pt, nurse, etc):

start time:

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Staff Observation –

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Request to Fill Process

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Observing and understanding the work

City & SFGH Departments -

Org Chart

The path an open position takes to get filled

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Observing and understanding the work

IT Systems

Staff Observation

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DHR – Referral

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Staff Observation ‐

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HR Operations HR Operations

1 2 3 4 5

time observation form

observation time

date of observation:

start time:observer:

area/location:

subject observed:

process:

step no.

description of operationMode (most freq. occurring) task

timeremarks

observations

total time for one observation

1 2 3 4 5

time observation form

observation time

date of observation:

start time:observer:

area/location:

subject observed:

process:

step no.

description of operationMode (most freq. occurring) task

timeremarks

observations

total time for one observation

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Observing and understanding the work

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Time Observation

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Finance Review and ApprovalRequest to Fill

Time Observation

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Direct Observation System Data

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Time Observation Calculations(“doing the math”)

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Creating Current State VSM

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Current State VSM

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Current State VSM

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Current State VSM

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= 190 days= 40 days

= 150 days

= 26 days= 164 days

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Problems, Issues, Defects & Waste(Yellow Post‐Its)

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Problems, Issues, Defects & Waste(Yellow Post‐Its)

Scheduling

Duplication of WorkPaper forms Multiple Approvals

Variation in Process (No Standard Work)Incomplete

Information

Lack of Training

Multiple issues with Form III

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Idea Generation(Blue Post‐Its)

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Idea Generation(Blue Post‐Its)

Summary of Improvement Opportunities

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Leverage IT• Hard stops in HR IMS• Hiring manager access/direct entry into HRIMS• Eliminate Form III• Linkage of HRIMS and eMerge• Eliminate paper

External Setup• New hire packet and medical history complete prior to appt

Improve Orientation Process• Flex availability to demand

Communication• Transparency for hiring managers and applicants• Conditional employment notification

eMerge cups for everyone!

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Summary of Improvement Opportunities

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Eliminate Overprocessing• Repeated budget quality

checks• Duplicate layers of handling

Streamline/Clarify or Restructure HR Ops / Merit• Roles & responsibilities

Improve Medical Exam Process• Group visits• Flex availability to demand

Master Staffing Plan• Preempts mayor’s review

Standard Work/Checklists• Hiring managers• HR/Finance staff• Applicants

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Creativity ExerciseF‐E‐C‐R‐S

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Creativity ExerciseF‐E‐C‐R‐S

Creativity ExerciseBe Someone Else

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Future State VSM

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Future State VSM2-5 year vision

= 63 days

= 39 days= 7 days

= 24 days

= 56 days

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A3

Kaizen Projects – Plan, Do, Check, Act

• October 6 – 10 New Hire processing• November 17 – 21 5S (sort, straighten, scrub, systematize, standardize)

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The Team

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