Our clients include diverse industries around the world:
Our clients know that, to thrive in the future, their organization must be different in fundamental ways. Typically they already know what kind of difference is needed: implementation of a new vision or strategic direction, re-engineered work processes, restructuring jobs and/or teams, creating a new era of cooperation between labor and management, "walking the talk" of quality or service or diversity.
What they do not know – which DTA provides – is how to put the difference in place rapidly and effectively.
Click
below to checkout a partial client list from each industry:
Uniformed Services University of the Health Sciences
Service
Industry
Marriott Corporation
McDonald’s Corporation
Sheraton Hotel Boston
United Airlines
Unions
American Federation of Government Employees
(AFGE)
American Federation of State, County and Municipal Employees
(AFSCME)
Association of Flight Attendants
Communication Workers of America
(CWA)
Federation of Nurses and Health Professionals
(FNHP)
Florida Education Association
United Auto Workers (UAW)
References available on request.
EDUCATION
Florida Education Association (FEA) Trust & Transformation
How do you bridge a 30-year chasm of conflict between two competing organizations that merged in order to survive? In 2000, two Florida education unions affiliated with rival national unions (American Federation of Teachers and National Education Association) agreed to merge. The new merged organization represented more than 250,000 teachers and education staff professionals in Florida’s 67 school districts and over 100 union locals. The hope was that, as a single entity, FEA could represent its members and the children of Florida better. A six year transition agreement was established. Four years after the official merger, the integration process was not working. The promise and opportunities of the new organization were not being realized.
In 2004, the FEA president called us in. He was convinced that, unless something was done, the merger would collapse because of the unresolved conflicts between the two rival factions. He told us “We did not deal with the practicalities of integrating it.” He asked us to help bring together two distinctly different cultures and heal old conflicts, wounds, history, and polarized philosophies of doing business.
Over a period of 11 months, we worked with a newly-chartered FEA Futures Committee (65 key leaders representing both former unions) to address both underlying conflicts and fundamental organizational and strategic issues that had proved intractable in the past. The challenge was how to accomplish this in the course of one year with only four Friday evening-Saturday sessions, and one 2.5 day session with a cross-section of 65 people who had other full-time jobs and assignments and were geographically dispersed.
The results:
Merger process completed with integration into a single union. Behavior changed who’s side are you on and who has more influence in the organization to everyone consolidated and working together. People felt they had co-created the new organization.
1000 delegates at the annual FEA Delegate Assembly approved changes to the union constitution by an 80% margin including strategic goals, budget, governance structure, and dues.
Agreement on a shared process to sustain organizational learning, including how to have difficult/important discussion and a way to come to resolution.
Today, five years out/later…
The union continues to be successful, working together, as a strong single voice, together with school districts to be an advocate for public education and ensure the forces that would weaken public education would not prevail.
The work we did together created a firm foundation for the union to go ahead in a unified manner, giving an internal focus vs. external focus.
When the Futures Committee members were asked, “On a scale of 1-10, how comfortable are you that your opinions were considered in shaping the committee’s recommendation?” the average response was 9.3! This was a tremendous leap from an average response of 6.9, eleven months earlier to “How confident are you that we will carry out our commitments to each other.”
Designing a Culture of Multidisciplinary Collaborative Medication Management
(CMM)
At Banner Good Samaritan Medical Center (BGSMC) in Phoenix AZ, the Director of Pharmacy had a vision of pharmacy directly involved in
t herapy decisions from patient admission to discharge, as a collaborative effort and partnership between all health care professionals to improve patient health outcomes. The early involvement of physicians, nurses, and executives was critical in gaining support for the practice model.
Our Work
Sylvia James and Paul Tolchinsky worked with BGSMC from June to December 2008 to create a multi-diciplinary, high engagement approach, launch the project, and redesign structures and processes for a March 2009 implementation. In August 2010 BGSMC was selected as the spotlight pharmacy of the month by The American Society of Health System Pharmacies
http://www.ashp.org/PPMI/Spotlight.aspx
The CMM project purpose was: “Together, design a culture of multidisciplinary collaborative medication practice that will deliver the highest level of patient care, optimize medication safety and improve satisfaction across all disciplines.” The first step to achieve this purpose was a two-day CMM meeting of 250 health care professionals to discover the most effective way to manage a patient’s entire medication experience. The next steps coming out of this meeting were to prioritize the logical order of redesign work to be done, establish a temporary lateral structure of a multidisciplinary Coordinating Council and chartered eight design teams. In three one-day work sessions structure and roles were clearly designed and critical work processes including staff development were redesigned.
Results
Eighty-three percent (83%) improvement in medication reconciliation accuracy, patient admissions process streamlined by more than 30 minutes, decrease in duplicate and inappropriate dosing and administration, and a 50% decrease in nursing calls to the pharmacy regarding drug orders. Pharmacist involvement from administration to discharge, use of well-developed protocols support provided by technicians, as well as a highly-integrated information system resulted in a dramatic decrease in medication errors in the emergency department and the general medical surgical units.
“The strongest metric we have is the physician and nursing support for the model and the success of pharmacy-led medication reconciliation.” By the third month, support was so positive that physicians and nurses outside of the demonstration area began clamoring for their areas to be next.
If you would like to hear more about this work or explore ways we could support the challenges your organization is facing, contact
Sylvia James.
Covenant HomeCare
Covenant HomeCare
provides home healthcare to 16 counties in eastern Tennessee and is part of a regional not-for-profit healthcare system. The agency provided approximately 250,000 home health visits annually and was faced with a dramatic decline in patient admissions and a steep decline in Medicare reimbursement. HomeCare’s core business processes were inefficient and often inaccurate, relying heavily on many rounds of inspections. In addition, while clinical management of the patient was competent and of high quality, it was neither as efficient nor appropriately focused on measurable patient outcomes. With losses projected to be $1.5M, they had one year to bring down cost or be closed. The goal was to do this without cutting staff or jeopardizing the quality of patient care.
Over a period of six months Dannemiller Tyson Associates worked with them to design and facilitate a process to mobilize the staff to identify and redesign seven most critical business processes. Seven facilitated microcosm teams from all levels and disciplines within HomeCare then redesigned these processes to cut waste and increase efficiency.
Results of the work were:
• Within four months all seven of the core business processes were redesigned and ready to be implemented. This ensured the achievement of their “break-even” goal.
• Improved employee satisfaction due to high levels of involvement in decisions that affect their lives,
• A change in the culture to one of employee involvement, empowerment and alignment with strategic goals, and
• Customer satisfaction improvements in all categories measured with some categories moving from 60th-70th percentile rankings to 90th percentile rankings.
DTA consultant Mary Eggers who worked on this engagement will be happy to tell you more about what we did at HomeCare and how it was done.
Process redesign
- Covenant HomeCare
HomeCare a home health agency providing 250,000 home health visits annually in 1999 was faced with closure due to operating in the red for several years. With a new president and a commitment from corporate, Covenant Healthcare, had one year to turn things around. The new president asked Dannemiller Tyson Associates to help her cut $1.5M out of the HomeCare budget by redesigning core and support business processes. Between January and May of 2000 they created an organization where all 350 employees were aligned around a new strategic plan and the action to achieve the plan and had identified, redesigned and implemented seven critical business processes. During a period when four out of five home health agencies in the US were closing HomeCare is still, in 2005, operating and thriving.
To learn more, click here
The EDICT Story
When a major pharmaceutical company, medical researchers from the Baylor College of Medicine and patient advocates from the Intercultural Cancer Council wanted to get more representation for underserved populations in clinical trials, they created the EDICT Project
(Eliminating Disparities In Clinical Trials). EDICT’s purpose was to engage representatives from research institutions, the pharmaceutical industry, the insurance industry, medical schools, government agencies and patient groups to create policies that would increase diversity in clinical trials. Al Blixt and Sylvia James from Dannemiller Tyson were engaged to help.
Over a two-year period, Al and Sylvia designed and facilitated dozens of meetings that involved more than 100 national leaders and experts from across all of these sectors. Nine “Opportunity Teams” were created to look at specific policy areas such as insurance, professional education and community involvement. Web meetings of these small virtual teams were combined with periodic large face-to-face meetings to share information and plan next steps. A new policy context model was created to illustrate the complex interactions that influence how more women, children, ethnic and racial minorities, persons with disabilities, the elderly and other underserved groups can be included in trials of new medicines that affect them.
The result was a set of more than 30 policy recommendations designed to make changes in different parts of the medical research system. These were rolled out at a national conference, at capitol hill briefings and in a series of regional meetings to engage local leaders in adopting or advocating for these policies.
Whole-Scale® Change principles were used to get people talking and working together across organizational and sector boundaries. The result was a set of recommendations that had broad input and support. Many have already been implemented. To learn more about the EDICT story, contact
Al Blixt.
The New C.S. Mott Children's Hospital and Von Voigtlander Women's Hospital
How do we move everyone (and everything) into a brand new hospital with the confidence that
EVERY THING in the building will work flawlessly the first time – because lives depend on it? This was the question facing 65 leaders at the University of Michigan in February of 2010 when they came together for three days to understand and apply the Whole-Scale® systems approach to the answer.
Those in the room were made up of the various teams responsible for all aspects of the opening the new
C.S. Mott Children's Hospital and Von Voigtlander Women's Hospital – planned for November 2011.
As Loree Collett, Administrative Director of the Children’s and Women’s Hospital Project put it: “We call this planning process ‘activation’ and it basically consists of asking and answering hundreds of questions.
How will we move the patients on move day and in what order? What departments have to be in the building before we move? What about staffing? How many people do we need on move-day and on every day in the new hospital? What about equipment – who moves it and when? Telephones – they need to work in the old unit
and the new unit – how do we make this happen? And what about our patients’ families – how will we include them in this day? How can they be helpful? How can we minimize stress for them?”
The purpose of the three day meeting was to charter what was to become the Activation Team using the tools of the Whole-Scale® methodology. This team was made up of leaders/members of sub-teams responsible for various aspects of the move. While these teams need to stay focused on their particular area, they also needed to keep in mind that their actions were part of and would impact the whole. During the meeting, the participants agreed on roles and responsibilities and crafted processes to make sure that all necessary activities would be coordinated in the months ahead.
If you would like to hear more about this work or explore ways we could support the challenges your organization is facing, contact
Al Blixt or Mary Eggers
New Zealand Safe Staffing / Healthy Workplace Initiative
So how DO you ensure that an appropriate number of staff with the right mix of skills is always available to meet patient needs in a safe and healthy environment? This was the question the New Zealand Ministry of Health was seeking to answer.
The Director, District Health Boards (DHBs), and the New Zealand Nurses Organization determined that Whole-Scale® Change was the approach that would help them with the answer and requested a two-day workshop on theory and practice. During our conversations with them they realized that, more importantly, they needed to do real work on this initiative during the two days.
Results: Participants walked away with the basic principles of the Whole Scale approach, a vision of success in their specific location, identification of what realistic progress would look like in the next six to nine months, and an action plan that would guide their work for the next several months. One of the Director’s of Nursing said “three days ago all I could think was that I need to spend these two days out of the office like I need a hole in my head; now I can’t imagine how we would succeed without me having been here.”
Next Steps: Bev Seiford worked with one of the participating DHBs to design and facilitate a 50 person retreat. The goal was to get a cross section of employees and physicians to take ownership of the challenges and be part of the solutions. During the day, participants identified process improvements, determined actions, created communication channels, and declared how they would hold themselves and each other accountable. They also celebrated their success in unlocking their potential to mobilize themselves in new ways to solve their own problems. A follow-up email said “I am confident this work activity will be extremely important as we collaborate to meet the challenges of the health care demand in the Bay of Plenty.”
If you would like to hear more about this work or explore ways we could support the challenges your organization is facing, contact
Bev Seiford or Mary Eggers.
MANUFACTURING
The Rockford Adams Story – A Ten Year Change Journey
The Adams Confectionary plant in Rockford, Illinois faced multiple challenges. The plant’s world-wide division had recently been acquired in a hostile takeover. The competition was coming at its products “with all guns blazing”. Half of the 600 highly skilled workers would be retiring in the next five years. The plant manager knew that the plant needed to transition to higher levels of quality and productivity or see its products moved to sister plants in Canada and Mexico. He asked Dannemiller Tyson to help him engage his leadership team and then the entire plant to create and commit to an action plan for the future.
Over the next six months, DTA consultants helped to engage everyone in learning about the challenges, imagining the possible future and designing a strategy to get there. We worked first with the manager’s team of direct reports in a series of planning meetings. Then we helped expand the circle to include all the managers, supervisors and team leaders. Finally, we facilitated a two-day meeting where the entire plant of 600 colleagues were actively engaged in learning, sharing ideas and committing to actions based on four common goals. After the big meeting we helped see that tasks teams were chartered and launched. Then it was up to the people of the plant to take the future into their own hands.
Over the next year, everyone pitched in to create new processes, take costs out and train many new workers while keeping the plant running at a very high standard. Dannemiller Tyson consultants facilitated a “reunion” meeting after twelve months that brought all the workers back together to share their success stories and decide on what needed to be done next. Over the next five years, the plant survived and thrived while the division was sold again to new corporate management. Today, ten years later, few of the original workers remain but the banner committing to the strategy signed by every worker a decade before still hangs in the entry to the plant. The vision of creating a plant that could compete in a demanding world economy and ensure jobs for hundreds of Rockford families has been realized.
When we first met them, the founders of Best Friends Animal Society based in Kanab, Utah were struggling with how to manage their phenomenal growth and transition to a new generation of leadership. Best Friends had begun in 1984 when a group of 18 dedicated “founders” purchased land in southern Utah to build an animal sanctuary and carry out their mission of creating a better world through kindness to animals. By 2004 their “No More Homeless Pets” movement had changed the world of animal welfare and Best Friends had frown to be a 300-person organization with a quarter-million members. The founders knew they needed help to create an effective organizational structure suited to the unique culture of Best Friends as well as a vision of the future to carry on the mission when they were gone.
Our work began with a planning retreat with the Best Friends “transition leadership team” that included the founders’ board and two younger managers. We helped them create a new draft organizational design, a new draft strategy and, eventually, a new governance structure with outside board members. We took the draft strategy and draft organization design to a meeting of 50 managers and team leaders for their input. Then, in early 2005, we worked with a staff event planning team to design a two-day meeting to engage all 300 employees in listening, giving feedback and planning actions for a new and ambitious plan to reach more people and save more animals. We actually had to repeat that meeting twice because half the group was needed to run the sanctuary and care for its 1600 animals.
When Hurricane Katrina struck New Orleans in the fall of 2005, the Best Friends strategy was put to the test. A “rapid response team” of more than 100 workers was deployed to set up shelters, care for animals and make the case to emergency response agencies that it was essential to include animals in rescue activities. More than 9000 animals were saved as a result. In the years since, Best Friends has advanced its mission both by supporting local animal welfare groups and by example. Best Friends hosts 35,000 visitors a year at its Utah facility and provides education to other animal welfare groups around the country. Best Friends took on the task of rehabilitating many of the Michael Vick fighting dogs. The Best Friends sanctuary is now featured on the Animal Planet cable channel.
Many of the founders are retired now or soon will be. They do so, confident in the knowledge that the mission is in good hands. DTA consultants Al Blixt, Sylvia James and Mary Egger have been asked back at critical moments over the years since to support the building of leadership teams and to facilitate agreement on how to “pass the torch”. They will be happy to talk to you about their experience and how we can help your organization.
PUBLIC
SECTOR
Process redesign - The City of New York
Client Situation: In the first quarter of 1991, with 3 percent of the country's population, New York City accounted for a remarkable 61 percent of cases of multidrug-resistant tuberculosis in the United States. The City of New York was confronted with a potential tuberculosis (TB) epidemic involving a new strain of TB resistant to conventional treatment. The Center for Disease Control had identified a danger that if not interrupted, the disease might spread to the rest of the nation. Involving several agencies, controlling tuberculosis was emerging as a problem in one of the largest cities in the United
States….click here for more information.
Organization Design - Central Intelligence Agency
A division of the CIA consisting of 150 employees was experiencing customer dissatisfaction at an all time high and facing the possibility of being outsourced. A new leader was brought in to (1) reengineer the processes to make them faster, better and cheaper; and (2) to change the culture from a craftsperson, individual focus to a team based, customer sensitive organization. Dannemiller Tyson Associates worked with organization – the effort began in February with a leadership retreat. In March everyone was brought together; processes were redesigned in April and May; a new organization structure (with new roles and responsibilities) was created in June; and the new organization went “live” in October. The outcomes were 1) Cycle times were down 40 percent, 2) The organization was completing the same volume of work with 20% fewer people (mostly gone through attrition), 3) Five new teams were started up (including a brand new leadership team), and 4) Customer satisfaction was up 80% from pre-Launch measures.
To
learn more, click here
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Reserved
Designing a Culture of Multidisciplinary Collaborative Medication Management
(CMM)
When a major pharmaceutical company, medical researchers from the Baylor College of Medicine and patient advocates from the Intercultural Cancer Council wanted to get more representation for underserved populations in clinical trials, they created the EDICT Project
(Eliminating Disparities In Clinical Trials). EDICT’s purpose was to engage representatives from research institutions, the pharmaceutical industry, the insurance industry, medical schools, government agencies and patient groups to create policies that would increase diversity in clinical trials. Al Blixt and Sylvia James from Dannemiller Tyson were engaged to help. 
How do we move everyone (and everything) into a brand new hospital with the confidence that
EVERY THING in the building will work flawlessly the first time – because lives depend on it? This was the question facing 65 leaders at the University of Michigan in February of 2010 when they came together for three days to understand and apply the Whole-Scale® systems approach to the answer.
So how DO you ensure that an appropriate number of staff with the right mix of skills is always available to meet patient needs in a safe and healthy environment? This was the question the New Zealand Ministry of Health was seeking to answer.