VRTAC-QM Manager Minute: Get in and Get er' Done! How Ohio Makes VR Work for Customers!

Welcome to the Manager Minute. Joining Carol Pankow in the studio today is Susan Pugh, Deputy Director of the Bureau of Vocational Rehabilitation with the Opportunities for Ohioans with Disabilities. Susan has worked within the agency in a variety of capacities including, VR Counselor, Assistant Area Manager, and Assistant Deputy Director.

In this episode, Susan discusses Ohio's rapid engagement process and the Lean approach that has reduced onboarding time and ushered in more customers. Susan and Carol cover a lot of the initiatives that Ohio has implemented to enable them to speed up the process so that customers are trained and employed as soon as possible.

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VRTAC-QM Manager Minute: Get in and Get er' Done! How Ohio Makes VR Work for Customers!

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Speaker1: Manager Minute brought to you by the VRTAC for Quality Management, Conversations powered by VR, one manager at a time, one minute at a time. Here is your host Carol Pankow.

Carol: Welcome to the Manager, Minute. Joining me in the studio today is Susan Pugh, Deputy Director of the Bureau of Vocational Rehabilitation in the agency called Opportunities for Ohioans with Disabilities. Now that's a mouthful. Susan has worked within the agency in a variety of capacities, including VR counselor. She's been an assistant area manager and assistant deputy director. Susan, it's so great to have you here today. How are things going in Ohio?

Susan: Things are great. I appreciate the opportunity to talk with you today.

Carol: All right. Well, today's topic is covering this idea of rapid engagement and the idea behind that is getting customers in and moving as quickly as possible. So they are successful in your agency has been using that lean process to completely revamp many of your processes and procedures. And I know that private industry has successfully used Lean for many years to improve manufacturing processes. But I know sometimes it doesn't always translate over to VR because we don't make widgets, after all. But we do work with people, and I know VR often creates really complicated processes to help individuals move through the VR system. So when I was in Minnesota, our governor had brought forward the idea of using lean throughout state government with some pretty successful results. I remember our license bureau for when undergoing a huge overhaul and where it would take weeks and months to get license plates and get your license. They were able to get that down to a matter of days, and so that was excellent. I know we also had to have a lean coordinator in each of our agencies that would report up to the governor on a quarterly basis, and we really put a lot of effort into that and you were able to get exposed to this same concept through your agency director Kevin Miller. And I remember talking with you a little bit ago that you really done a lot to examine your agency's processes and practices so you can do more for individuals with disabilities. So let's chat about this. Can you talk to me a little bit about your introduction to Lean and how it works in your agency?

Susan: Yes. Our director, Kevin Miller, joined O.D. back in January of 2011, and one of the first things that he did was establish a division of performance and innovation for the agency, and now that that division is called our Division of Employer and Innovation Services, and that deputy director was tasked with bringing lean into the organization. And like you mentioned in Minnesota, we have a lean Ohio office that provides all kinds of resources and support for state agencies who want to do this. So the way we kind of started out was members of executive team went to something that was called at the time, a champion training and where we learned and we were briefly exposed to all the different aspects of lean and learned how to champion lean processes within the organization. And after that, we started sending staff because within lean, there are belts like within karate. And so we've had people that have become green belts and black belts in lean processes. Now all of our supervisors and managers and some of our program specialists also receive yellow belt training, which is comparable to the to the champion training that I was mentioning. So now it's really kind of ingrained into all of the aspects of what we're doing. We've done tons of different lean events, which I'm going to talk about here and a little bit, and it's just more ingrained into our culture 10 years later.

Carol: Well, I like the word that you used in grain because you really do have to make it become part of the agency's culture. Otherwise it ends up being this thing that sits over here on a shelf, you know, and employees are like, Well, whatever, you know, here's the latest and greatest. I wondered, though, did you have some skepticism about the process in the beginning? And was there any kind of pivotal moment when staff went, Oh, you know what? I kind of do get this. I see where we're going.

Susan: Yes, One hundred percent at first it was really and I think you mentioned this earlier. It's kind of hard for our staff to think about our processes in these way. We've been trained that our processes all individualized and that's a good thing to meet the needs of the people that we serve. And it was really hard for them to think about standardizing that process as really a good thing. It was really counterintuitive to how we've always operated the program. Know, I think one of the other things that was kind of pivotal was looking at informed choice and how we could look at that differently. That informed choice isn't really free choice to where everybody has to have their path. We can kind of have some lanes. So to speak, that people are going into that will really help them meet their individualized objectives. So staff started participating in these lean events and despite that skepticism, once they really got involved, they were all in. For example, in these events are staff are empowered to make decisions. So it really uses frontline staff and also customers to help redesign these processes. And that really helped staff with buy in and then that team rolls it out to their peers. And so that in really helped, first of all. And then I would say the second thing was once we really started experiencing success and seeing these processes really result in the desired effects that we were looking for, then people were totally in, you know, they saw that it worked and then they wanted to do more of it because it makes things easier for our customers, but it also makes things easier for our staff. That's super

Carol: Cool. I like that about Lean. You know how it involves all these different layers of folks in the process. So it isn't just like some group over here is deciding a thing again, and then they're telling us what we're going to do. You know, I like that. I always remember all the little sticky notes up on the wall, churning out the whole process. And when you start moving sticky notes around and you go, Oh my gosh, great. We have like forty two steps to do this one thing, it is completely eye opening. Now I know when you and I had chatted, there were so many terrific projects that you had done and I'd like to break those down so our listeners can get a sense of what each is about. So can we start with the front door your process for getting rid of the waiting list? Can you tell me about that?

Susan: Yes. So this was back way in 2012, our first Kaizen event. So Kaizen means, I think, roughly break for the better or something like that. And it's really about process, like uncovering what is your process and fixing it. So at that time, as an agency, we averaged 127 days to eligibility from the start of the process to eligibility. And that was really the first piece of this was we didn't really know that that was our number before this happened because it is very data driven kind of activity. And I think we all would agree that 127 days is just unacceptable. And so staff really were like, Wow, no, this can't be we have to do better for the people that we serve. And so then our director said, I know that the federal standard is 60, but we're going to do 30 and our staff, myself included, I will freely admit we all looked at him like he had two heads. This was not possible. There were all the reasons, good reasons that we were at 127 days. We all knew we could do better, but to do 30 days was mind blowing. It just felt like an impossibility. So this team came together and they made all kinds of recommendations. The first thing was they realized we didn't have a process for doing intake and eligibility. We had like 88. So we have 88 counties in Ohio. Every county had their own process, and so this group was tasked with creating something new. And so some of the main things that they did was, first of all, they eliminated a whole pre-application process. We used to have a referral form that was even before the application. They were like, Get rid of that. And that already took off like 20 something days just right off the bat. Like that easy. We also had designated counselors at the time to determine eligibility, which had helped us get more consistent with our eligibility decisions. But they said we have a 4 lane highway and we need an 8 lane highway. We can't do it this way anymore. And so we moved away from that designated eligibility counselor model. And then they developed a process and they put time frames for each step like you have to do this within certain days and this within certain days. And it just helped reframe the pace at which we were taking all of these steps. And there were a whole bunch of other thi