Archive for category: Our Stories

TeamTech helps a state rethink resource allocation 

The Challenge

Maximizing resources while improving services is the greatest challenge faced by state and local governments alike. Among the myriad of services provided by local government in Kansas, incarceration of juvenile and adult offenders is arguably one of the costliest.  Healthcare costs for prisoners, particularly costs of prescription drugs, have had a crippling effect on county budgets. Because the federal government requires county government to provide healthcare to inmates – counties have little choice but to absorb the growing costs.

The Solutions

TeamTech partnered with the Kansas Association of Counties (KAC) and the Kansas Governor’s Health and Human Services (HHS) Cabinet Team to identify and bring together decision makers from county government and state agencies to determine the best way to save money on medical care costs for incarcerated populations. TeamTech set up and led the process which included gathering the initial data on who was spending what on healthcare costs. Prescription drugs and hospital costs were the two largest contributors to cost and many counties also discovered that they had been spending way too much on prescription drugs.

TeamTech helped participants identify ways in which governmental entities, including county and state detention facilities can save money and improve efficiency.

As a result of the project, county officials soon discovered that they can save administrative costs in two ways:

1. By contracting with companies that specialize in providing correctional healthcare to inmates, counties not only save money on prescription drugs but also on legal expenses and administrative costs. These private companies assist correctional agencies by providing correctional healthcare and carefully screening and managing billing for off-site health care services. Through these contracts, local physicians still provide medical care to inmates, but the local providers now must adhere to policies and procedures that work elsewhere to contain costs.
2. By gathering and examining data on their prescription purchases, counties were able to either renegotiate with their current pharmaceutical drug companies for better prices – or take advantage of large volume pricing by combining purchases with other counties. In some cases, counties obtained better prices by contracting through the Department of Corrections for prescription drugs.  And in a few counties, local pharmacists adjusted their rates to match the lower rates that large pharmaceutical companies were offering.

The Payoff

1. More efficient delivery of services: This program has resulted in significant savings to the tax payer. Greater cooperation between state and local government has tangible benefits: The Kansas Department of Corrections projects an annual savings of at least $1.4 million and Sedgwick County alone predicts an annual recurring savings of $1 million.
2. Counties see value in working together: This successful effort has laid the groundwork for other local government collaborations and enables increased compliance with state and federal regulations. (Link here to The Kansas Collaborative)

“TeamTech brought the groups together, facilitated the conversation and steered the teams in a positive direction.  They had the tools necessary to take the information state-wide.”

“The key to our success was that we had the right people at the table and the data we needed to analyze our current situation and make necessary changes.  TeamTech didn’t just facilitate the meetings, they worked tirelessly to make sure that assignments were completed between meetings and prodded during meetings to get the best results.”

Elizabeth Gillespie
Director of the Shawnee County Department of Corrections

Click here to read more about the The Kansas Collaborative.

Process and protocol help turn an organization around

The Challenge

A not-for-profit agency, with more than $50 million in annual revenue, had grown exponentially overnight with the receipt of a state contract to provide adoption services for the children in state custody. Managing the many systems that needed to efficiently coordinate at this rate of growth reached a state of crisis. By June 2001, the organization was struggling to meet key operational and financial goals. The Board asked management to seek outside help to assist with process improvement. By early 2002, the organization’s ability to continue to operate beyond June 30, 2002 was questionable.

The Solution

TeamTech was hired in April 2002 as a key partner to the Chief Operating Officer, the Executive Vice President of Human Resources and their respective teams. Our approach encompassed six key strategies:

1. Assess and Understand. This initial assessment took two days to complete. A financial analysis was the first step. We quickly determined that our process improvement efforts needed to be expanded to a turnaround effort. Next, we focused on resources within the organization – which key processes were adding to net assets and which processes were draining net assets. We identified key values that would guide decision-making and potential process improvements, including adhering to best practices. Finally, we assessed internal leadership to tap strengths as well as supplement and address weaknesses.
2. Identify, Link and Translate. Together with leadership, we identified the key organizational processes that linked to the critical performance indicators identified by the Board so we could closely monitor the impact of changes. Then, we translated these indicators into front-line language. For example, social workers became involved in calculating the number of children they needed to place each month to reach certain adoption placement percentage goals while maintaining best practices. As a result, associates beyond finance and top leadership became aware of the impact they had on the organization’s performance.
3. Involve Those Impacted. We formed Process Improvement Teams, which included front-line staff members and supervisors, to focus on improving the operational processes that drain net assets. Leadership set goals for each team. Teams received process improvement tools “as needed” rather than through formal classroom training, and the core operating values became: data-driven, customer-focused, process- (not people) focused, and time- and budget-conscious. These teams were essential for four reasons:
   • staff members needed some sense of control in the midst of the turnaround,
   • the associates doing the work were the ones that knew how to improve it,
   • individuals were encouraged to develop their analytical and decision-making skills so the improvement process could remain intact beyond our engagement, and
   • we were able to increase our ability to assess morale and concerns. TeamTech initially facilitated all of the Process Improvement Teams.
4. Focus, Focus, Focus. Due to the short time frame and crisis situation, actions were prioritized into three categories: immediate, mid-range and long-range. Actions that would positively impact the key performance indicators on or before June 2002 received immediate attention.
5. Partner with, Mentor and Coach Key Leadership. We had to make tough decisions quickly. We met or talked daily with the Chief Operating Officer in our role as a sounding board, mentor and coach. We sat down regularly with the operations leadership team to help facilitate decisions pertaining to the redesign of the service delivery model. We suggested and validated strategies as well as raised questions to ensure thinking was as comprehensive as possible.
6. Close the Accountability Loop. With the COO as the leader, we were fierce about deadlines and accountability. We created an action plan of who was to do what by when at the end of every meeting and used it as the agenda for the next meeting. We hammered away at the need to “close the feedback loop” so we would know if the changes made to improve processes had the intended results. We facilitated regular meetings with operations and finance staff members to study weekly cash flow statements, monthly financials and key performance charts to ensure understanding. We shared and celebrated the accomplishments of each Process Improvement Team.

The ability to move quickly and effectively was accomplished through the collaborative efforts of many departments and teams. Individual efforts were critical and surpassed expectations. Buy-in was built among the staff members by the leadership and participation of Operations and Human Resources.

The Payoff

• Within 60 days of the beginning of the engagement, the negative drain on net assets stopped, with surpluses in the following months;
• More than 450 people kept their jobs;
• Process Improvement Teams remain intact, and are now a regular part of the way the organization “gets things done;” and
• Children in state custody have continued quality and continuity of care.

Top-to-bottom audit – and creativity – help state save millions

The Challenge

The primary responsibility of the governor is to manage the public’s resources wisely. This is a challenge even in the best of times, but in the face of a serious budget shortfall, only the most innovative thinking will lead to a state government that is not only more efficient but more accessible to the citizens.

Shortly after her election in 2002, Kansas Governor Kathleen Sebelius made good on her campaign promise to conduct a top to bottom performance review of state government. She assembled more than 60 volunteers – from business leaders to citizens – to come up with suggestions for streamlining state government and making it more accountable to its people. The Governor and her transition team turned to TeamTech for help in managing the process and in assuring a successful outcome for participants and the citizens of Kansas

The Solutions

These first Budget Efficiency Savings Teams (BEST) identified potential dollar savings by conducting a top to bottom performance review of state government. More than just an audit, the BEST teams were also charged with coming up with innovative solutions and identifying new ways of doing state business. TeamTech was called on to design a process and establish a plan and framework for identifying solutions. TeamTech worked with private industry, citizens and policymakers to identify key values for improved decision making. Participants agreed that in order to bring about effective change, decisions on the future direction of state government must meet the following criteria:

• Data-driven
• Customer focused
• Continuous improvement
• Cross-agency perspective
• Enterprise-wide thinking
• Decentralized decision-making with accountability
• Centralized accessible information

In addition to working directly with the Best Teams, TeamTech also designed a process to gather input from the public. In a matter of eight weeks (mid-November of 2002 to mid-January 2003) these five initial public BEST Teams received over 2000 e-mails, faxes and phone communication from Kansans about ways the state could improve efficiency.

The Payoff

This initial BEST process as led and facilitated by TeamTech produced cost and operating efficiencies by:

1. Identifying dollar savings through streamlining and removing redundancies: These initial five BEST Teams identified $60 million in potential savings. Governor Sebelius used these savings ideas in her state fiscal year (FY) 2004 Budget presented to the Kansas Legislature. One year later those dollars had been saved.
2. Institutionalizing dollar savings by creating a management culture that encourages collaboration and resources sharing: The work of these initial BEST Teams spurred a more comprehensive internal process. We know that change from the inside out is the only effective way to sustain systemic change. TeamTech continues to facilitate dozens of internal cross-government BEST Teams charged with streamlining and finding savings. Thanks to cross-government purchasing efforts, nearly $27 million in purchased goods and services were realized in FY2005. The County/State Offender Population Prescription Drug Team has realized over $2.4 million in recurring annual savings for both county and state government (both FY05 and FY06).

Governor Sebelius and other state agency leaders consider the first phase efforts of BEST a success.

“Oftentimes, people in organizations have good ideas, but institutional barriers prevent them from being heard. At TeamTech our role is to establish venues in which people at all levels can share ideas and be heard.”

Moving a mental health team from sinking to soaring

When Tim DeWeese took over as director of a large county mental health department, he inherited an organization in shambles.

“Broken,” he said. “That’s the one word I’d use to describe us.”

The department was operating without a common mission, which, no surprise, lead to a disengaged workforce. What’s more, the department’s balance sheet was bleeding so badly the county had to bail them out.

To turn the department around, DeWeese knew he would have to align teams around a common vision – a clear and purposeful direction. He’d have to do it quickly. He’d need everyone to have buy-in. And he’d have to be practical about changes.

“I didn’t want some big strategic plan weighted down with theory,” he said. “I wanted a plan that was actionable. And I wanted someone to help me see it through through to the end. It was such a mess, I knew I needed someone to hold us accountable.”

A colleague recommended TeamTech because of the group’s bias for action, its practical approach to strategy – and its relentless emphasis on accountability.

Now, after two years of working with TeamTech, the department is hardly recognizable. For the first time in a decade, its revenue stream is in the black – and there’s a growing reserve. They’re recording the highest levels of productivity they’ve ever had. And, according to the recent county-wide employee engagement survey, their employees are among the most passionate and happy with their work.

“I couldn’t have done it without TeamTech,” he says. “None of us could have.”

The key? Empower everyone

Kathleen Harnish McKune, CEO of TeamTech, knew that to move the mental health department forward, buy-in would need to be widespread. The solution: TeamTech’s “Everyone A Leader” workshops. The workshops pivot on the idea that leadership is a decision not a title. The hands-on sessions are driven by the idea that if an organization isn’t empowering everyone to lead from where they sit, they’re not using their resources wisely.

For DeWeese, the real turnaround came after adopting the Everyone A Leader mindset. From the front lines to the board room, employees felt empowered to lead from their positions.

“We had engaged staff and so we then had engaged clients,” he said. “In fact, our client ‘no show’ rate dropped from 35 percent to 12 percent. That’s unheard of.”

The department now works with a unified clinical philosophy and approach. The entire organization knows the strategic direction they’re headed. And everyone comes to work ready to lead.

“I figured it would take us five or six years to turn the place around,” DeWeese said. “But we’re in an incredible place in half that time.

“The most important part of this though is that we’re better serving our clients. And that’s the reason we’re all in this field in the first place.”

A different approach to winning

DeWeese had worked with consultants in the past. Government agencies are no stranger to seeking guidance from outside sources. But, honestly, he’d never had much luck.

“We’d build a plan—a good plan—and it would sit on a shelf. It was never built to be acted on,” he says.

Out of the gate, DeWeese saw differences between TeamTech and previous consultants he’d hired. For one, TeamTech outlined expectations up front. They wouldn’t just build a strategic plan. They’d build it and launch it. Second, they helped the group identify – and remove – the barriers preventing them from succeeding.

“It was a huge difference,” he says. “It forced us to think strategically about how we remove, mitigate or work around barriers.”

The most impactful by-product of that approach, says DeWeese, is that it forced them to identify their strengths. Most outside consultants start with “What’s wrong?” and assume goals haven’t been met because of a deficiency – or two or three. Instead, TeamTech helped them focus on their strong points – and then harness that energy to break down barriers.

“It was very ‘meta’ for us,” says DeWeese. “We’re in the business of helping people with mental illnesses remove barriers. That’s what we do.”