TCIE’s Lean program changing the culture at People Inc.

BUFFALO, N.Y. — Rhonda Frederick has an abundant supply of “feel-good” stories to illustrate the impact of People Inc. Anecdotes often play a starring role when painting the narrative of Western New York’s largest nonprofit.

“But you need to have something to back them up as a whole. The data is going to show you that,” says Frederick, president and CEO of the human services agency based in Williamsville.

Collecting statistics is part of the agency’s DNA, per the distinct requirements of each funder and overarching regulatory body. Yet data traditionally received little attention outside of mandated reports.

That is, until a few years ago when UB’s Center for Industrial Effectiveness (TCIE) introduced tools of the Lean methodology of reducing waste and emphasized data’s relevance. A growing portion of People Inc.’s 4,000 employees are putting stock in data, using it to tighten operations in an era of diminishing funds and argue the case for heightened investment.

Beyond the efficiencies spurred by Lean efforts, Frederick and her leadership team notice a shift in culture. They see it in the development of employees. They witness office staff – typically removed from the front lines of serving individuals with disabilities and special needs, as well as seniors – connecting more deeply with the organization’s mission.

“It’s a whole different understanding,” Frederick says. “As a human services provider, we need that.”

Squeezing out waste

Like other non-profits, People Inc. is navigating a vastly different landscape than existed at its founding in 1970.

For decades, New York State operated a fee-for-service program. The reimbursement system was simple: agencies billed for their services.

The program is dismantling as the state transitions to a managed care model. Assessments determine the unique dollar figure of reimbursable care assigned to each individual with special needs.

The switch complicates budgeting and planning without removing burdensome regulations. Therefore, operating more economically and identifying exact costs is crucial – especially for an organization that tends an estimated 12,000 people.

People Inc. plunged into Lean in 2015, joining a TCIE non-profit training consortium with Baker Victory Services and Community Services for the Developmentally Disabled. The senior leadership team received an overview of the methodology. Six employees underwent in-depth training from TCIE facilitator Julie Stiles, learning and applying techniques to improve facets of the agency.

More People Inc. employees have enrolled in the intensive, 6-month Certified Lean Professional (CLP) program since then. They come from across the organization, forming the resource pool that leaders look to when continuous improvement ideas arise.  

“A lot of our projects have to do with squeezing the timeframes – squeezing waste out of the processes,” says People Inc. Senior Vice President Denise Bienko. “On a regular basis, people are now seeing the time lapses and questioning certain steps, whether you’re looking at the time between getting a phone call and delivering the service, or how long it takes to recruit an employee until the first day he or she starts working.”

While issues were visible well before Lean entered the picture, Frederick is not confident they would have been effectively resolved without a systematic approach.

She mentions, for instance, how the staff historically blamed New York State’s referral procedure for vacancies at housing units. A Lean project disproved the long-held belief.    

“I’m not sure we would have looked at the root cause,” she comments. “We all assumed we understood the problem.”

Other projects have led to a standardized billing process, a more measured focus on managing chronic diseases system wide, and numerous waste reductions.

Bienko credits Lean’s tactical approach for forcing individuals to slow down and address an issue step-by-step, avoiding the temptation to leap ahead prematurely.

“When you’ve got a million things on your plate, you try to act quickly and be decisive. And you work on assumptions a lot of times,” she explains. CLP “makes you say, ‘We’re not moving to the next step until we fully explore this and everyone’s on the same page.’ That’s a lot of discovery.”

The elevation of data

People Inc. touts itself as an innovator with a creative and experimental culture. Such a stance comes at a cost. Albany does not have the bandwidth to experiment with new ideas. Rather, the onus is on nonprofits to test their proposed solutions before requesting monies to sustain them.

Lean arms the organization with an advantage when scrutinizing propositions and appealing for an investment: proficiency in assembling pertinent data, in the right way, and analyzing trial outcomes.

For example, the nonprofit desires to utilize telehealth services, which are currently non-billable. It conducted a pilot aimed at proving the solution’s efficacy in eliminating unnecessary transportation of frail residents to physician’s offices or emergency rooms. Agency personnel contend that communicating with medical professionals via online avoids logistical difficulties, cuts staffing costs and alleviates the pressure on the community healthcare system.

Frederick attributes the pilot’s success to Lean – specifically a survey distributed immediately following telehealth sessions. The arsenal of resulting data is an integral part of the plea for long-term Department of Health funding.

This mindset of cultivating and making use of data is trickling throughout People Inc. Discussion of any new project involves contemplation of data collection from the get-go.

“When we’re articulating a project, we’re talking about the outcomes that are going to tell us whether we’re successful,” Bienko says. “It’s much more purposeful and intentional. It’s at the front end of the conversation.”

A new way of thinking

While only a few people undergo formal Lean training at a time, many more concurrently receive exposure to its principles. A team of co-workers, with representation spanning various levels and departments, assists each CLP candidate with project work.     

“It’s a diverse group that typically wouldn’t be looking at a problem together,” Frederick says.

The side effect is that employees gain insight into the nuances of others’ jobs and have a broader view of the organization. It helps tear down silos naturally intrinsic to large operations.  

Bienko says conversations sound a little different. Instead of judging the way things are done, employees want to understand the background before launching into questions.

“It improves communication. And it decreases the finger pointing,” Frederick says. “It’s no longer ‘they.’ It’s ‘us’ in this project together.”