Interested in a Free Case Study on Reducing Academic Attrition Through Strategic Performance Management, by David “Scott” Hencshel, Director, Lean Six Sigma Training & Deployment

1. Strategic Performance & Change Management Conference
November 13-15, 2012 in New Orleans, LA
Reducing Academic Attrition
Through Strategic
Performance Management
David “Scott” Hencshel
Director, Lean Six Sigma Training & Deployment
Office of Strategy and Innovation
Army Medical Department Center and School
Fort Sam Houston, Texas

2. Trivia: Who is this?
• Saved the lives of thousands of British Soldiers in the
Crimea.
• Wrote “Notes on Matters Affecting the Health, Efficiency
and Hospital Administration of the British Army”.
• Introduced a system of recording sickness and mortality
data at military hospitals—pled the case with data.
• Was a pioneer in the uses of social statistics and their
graphical representation (invented the polar-area charts).
• Elected to a fellowship in the Royal Statistical Society.
• Honorary member of the American Statistical Association.
• Most effective weapon was the presentation of sound
statistical data.

3. Polar Area Chart
The death rate at
Scutari, calculated here
on an annual basis as a
fraction of the patient
population, reached 415
percent in February.
Sanitary reforms began
in March. This diagram
is taken from the report
of a Royal Commission
set up after the war to
investigate sanitary
conditions in the army.

4. LINE DIAGRAMS
from the Royal
Commission’s report
compare conditions
in the Army to those
in civilian life.
Mortality in the
peacetime army in
Britain was nearly
twice as high as it
was among civilians
(top).
In the Crimean War
“zymotic” diseases
were the main causes
of death and were far
more prevalent than
they were in England
(bottom).

5. Who is it?
Florence Nightingale

6. TSG Guidance for Balanced Scorecard
20 Dec 07—Army Surgeon
General, LTG Schoomaker
memo to Major Subordinate
Commands.
“Use the BSC as a
guide in all command
and management
functions with
conscious disciplined
application, it truly
works!”

7. What is a Balanced Scorecard?
• Strategic planning and management system
• Decision-making and communication tool
• Provides disciplined framework for planning and
measuring strategy
• Uses performance measures to monitor strategy
execution and make better strategic decisions

8. BSC is comprised of
• Strategy Map
• Visual/graphic representation of our strategy
• Quick look at our strategic priorities in the form of
strategic objectives (“bubbles” on the map)
• Scorecard
• Developed from the strategy map
• Translates our strategic objectives into a comprehensive
set of performance measures and targets
• Provides the framework for our strategic measurement
and management system

9. Cascaded Objectives
MEDCOM (our higher headquarters)
- Promote, Sustain and Enhance Soldier Health
- Train, Develop and Equip a Medical Force that Supports Full Spectrum Operations
- Deliver Leading Edge Health Services to Our Warriors and Military Family to Optimize Outcomes
America’s Premier Medical Team Saving Lives and Fostering Healthy and Resilient People
Army Medicine…Army Strong!
Maximize Value in Provide Global Balance Innovation Optimize Communication and
Build the Team
Health Services Operational Forces with Standardization Knowledge Management
Patient/Customer/
Stakeholder
CS 1.0 Improved CS 2.0 Optimized CS 3.0 Improved CS 4.0 CS 5.0 Improved CS 6.0
ENDS
Healthy and Protected Care and Transition Healthy and Responsive Patient and Inspire Trust
Protected Battlefield in Army
Feedback Adjusts Resourcing Decisions
Families, Beneficiaries of Wounded, Ill, and Customer
and Army Civilians Injured Warriors Warriors Medical Force Satisfaction Medicine
IP 12.0
Implement
IP 13.0 Build
Relationships and
IP 15.0 Leverage
Research,
AMEDDC&S (us)
Internal Process
Best Enhance Development and
IP 10.0 Practices Acquisition
Optimize Partnerships
IP 7.0 Maximize IP 8.0 Improve
WAYS
Medical Physical and Quality, IP 9.0 Improve
Readiness Psychological Health Outcome- Access and IP 16.0
Promotion and Focused Care Continuity of Synchronize
Care IP 14.0 Improve
IP 11.0 Improve
Information
Prevention and Services
Internal and
External
Army Medicine to
Support Army AMEDD Center and School: As of 26 Jun 08
Stationing &
Systems Communication BRAC
Stewardship Stakeholders
Customers/
Inspire Trust in
and Growth
Learning
Products and
LG 17.0 Improve LG 19.0 Promote
LG 18.0 Improve LG 20.0 Improve Services
Recruiting and and Foster a
Training and Knowledge
Retention of Culture of
Development Management
AMEDD Personnel Innovation Improve
Improve Customer
Employee
MEANS
Satisfaction
Satisfaction
Resource
R 21.0 R 22.0 Optimize
Optimize Lifecycle Management of R 23.0 Maximize
Resources and Facilities and Human Capital
Financial/
Value Infrastructure
Optimize and Reward
This is a dynamic, living document For more information go to: https://ke2.army.mil/bsc Diversify Stewardship
Resources
Improve Access
Improve
to Products and Enhance
Improve Joint Change
Services Communication Optimize
Integration Management
Employee
Processes
Recognition
Internal
Increase
Organizational
Efficiency and
Enhance Medical Standardization
Training and
Force Improve
Development Knowledge
Management
Encourage
Innovation
Organizational
Capacity
Improve Increase Optimize
Improve Training
Organizational Understanding of Employee
and Working
Alignment Duties/Responsibilities Education and
Environment
Training
Slide 9 of 30

10. Stakeholders CS 1.0
Customers/
Inspire
Trust in
CS 2.0 Products and CS 3.0
Improve Services Improve
Customer Employee
Satisfaction Satisfaction
Stewardship
Financial/
FS 4.0 FS 5.0
Optimize Reward
and Diversify Stewardship
Resources
IP 6.0
IP 9.0
Improve IP 8.0
IP 7.0 Improve IP 10.0
Access to Enhance
Improve Joint Change Optimize Civilian
Products and Communication
Integration Management Employee
Processes
Services
Recognition
Internal
IP 12.0
Increase
IP 11.0 Organizational IP 13.0
Enhance Efficiency and Improve
Medical Training Standardization Knowledge
and Force Management
Development IP 14.0
Encourage
Innovation
Organizational
Capacity
OC 17.0 OC 18.0
OC 15.0 OC 16.0
Increase Optimize
Improve Improve Training
Understanding of Employee
Organizational and Working
Duties / Education and
Alignment Environment
Responsibilities Training 10

11. Scorecard
(Initial)
Attrition rates TBD /
by class. baseline
Objective Objective Statement Measure Targets Initiatives
Financial Stewardship
Quarterly review of projected
Recognize efficient use of resources.
budget execution versus TBD Baseline
Reward innovation that improves Budget return from
Reward Stewardship actual execution
operations and/or increases customer Credit Card
satisfaction % compliance with credit card Rebate.
Objective Objective Statement Measure
rebate policy Target
< 5 days Initiative
Attrition rates (%) of all MOS Charter attrition
TBD Baseline
Ensure health services assets of all three courses work group .
Enhance Medical
Processes
components are trained and modular and % deploying BCT receiving
Internal
Training and Force
cutting edge to support full spectrum predeployment training across AC 100%
Development TBD
operation and joint force requirements. all COMPOS NG TBD
TBD TBD TBD
11

12. 68W Attrition rate
Attrition rate = (1- (grads/starts))*100
# of Graduates
1- X 100 = Attrition
# of Starts
356
1- X 100 = Attrition
400
1- 0.89 X 100 = 11%

13. The BSC forced us to find the best
tool to “measure” and “see”
attrition?
We decided on using a Control Chart. Why?
1. See trending and monitor the process over time.
2. Detect special cause variation. Special cause variation is
data/events that occur outside the Control Limits (approx +/– 3
std dev from the mean = 99.73%) seen as the red lines above
and below the mean.
3. Help us establish the current performance level (baseline) and
then allow us to compare/monitor current performance to the
baseline.

14. What is the right Control Chart to use?
This depends on the type of data that you have:
Continuous Data-----Speed, Time, Distance
Discrete/Attribute Data-----Attrit, non-attrit = (P Chart)
Charts the proportion of
defectives in each
subgroup.

15. Special Cause Variation 68W Combat Medic

16. Scorecard
(Current)
68W Attrition Attrition %
between UCL
and LCL
Strategic Objective
Objective Commentary Measure Target
Ensure health services assets 68W Attrition rate Attrition Rate stay
IP 11.0 Enhance of all three components are between Upper and
trained and modular and Attrition rate = Lower Control Limit
Medical Training
and Force cutting edge to support full (1- (grads/starts))*100
spectrum operation and joint
Development
force requirements.

17. First Time Pass = Rolled Throughput Yield
• What is the final yield (First Time Pass %) after passing
through 5 steps (modules) in a course?
– Each step (module) has a yield of “Y”.
• Y = 95%
• Y = 99%
– Assume a class size of 400 for this example
Step 1 Step 2 Step 3 Step 4 Step 5 Output
Y = 95% 380 361 343 326 310 77%
Y = 99% 396 392 388 384 380 95%
Moral of the story--A comparatively small improvement in yield results in an
enormous improvement in output productivity and a dramatic reduction in cost!

18. Last Thoughts
We were . . . . . . . Now we . . . . . . . .
Not measuring correctly (rolling Have a proper definition of Attrition (to
quarterly average? Really?) include mathematically) and use the P
Chart to “see” performance and trending
Paying homage to a “false target” Have meaningful targets based on
(cookie cutter 10%) historical data and baselines by course
Dealing with Attrition on the 2nd Deal with Attrition throughout our
floor of building 2840 organization

19. Strategic Performance & Change Management Conference
November 13-15, 2012 in New Orleans, LA
View the Strategic Performance
& Change Management program
here: http://tinyurl.com/8wxywgc
If you would like to receive the free IQPC brochure
directly email taryn.soltysiak@iqpc.com