Achieving excellence, a step at a time.


World-class organizations talk about improvement outcomes based on “True North Measures”. In the perfect process, all activities are considered value-creating activities, and these activities are lined up for continuous flow. In this environment, the lead-time for products and services equals the cycle times for the value-creating activities. The process, products and services are created without any defects. Without any waste, the products and services can be generated at the lowest possible cost.

True North Measures are based on delivery of goods and services that can be created with perfect quality, at the shortest lead-time and at the lowest cost. Since improvement is not possible without the engagement of people, a measure of staff engagement or staff morale is often added to the True North Measures.

True North CategoryTrue North Measure
People  Staff morale or staff engagement 
Quality  Defects per unit of service or process outcomes related to meeting the customers requirements
Delivery / Access Lead time for goods and services from customer need identified to customer need met expressed in time (minutes/hours/days)
Cost Hours or $ consumed per unit of service. Typically a measure of productivity
Growth Increases in revenues or volumes

The following details some results from our clients.

  • Reduced Acute Length of Stay by 15% across all programs (LOS reduction of 1.5 days per patient)
  • Reduced discharge-planning resources by 17% by creating a new patient navigator role which combined discharge planning, clinical coordination, and resource utilization functions (reduction of 5 FTE)

  • Reduced average emergency department length-of-stay from 3.1 hours to 2.1 hours per patient for lower acuity patients with 9% higher patient volumes. (32% reduction)
  • Reduced average emergency department length-of-stay from 5.1 hours to 3.3 hours for non-admitted medium acuity patients. (35% reduction)
  • Reduced the left-without-being-seen percentage from 6.1% to 0.78% (allowing ~2000 more patients to be seen each year)

  • Increase in number of clients seen per clinician per day from 8 to 12 (50% increase)
  • Increase in patient satisfaction (overall rating of care) from 90 to 96 (7% improvement)
  • Reduction in time from approval to initial visit from 12.3 days to 4 (67% reduction)

  • Lead-time reduced for medical record preparation from two weeks to 2-3 days (75% reduction)
  • Patient total visit time reduced from 80-90 minutes to 40 minutes (50% reduction)
  • Provider capacity increased by 3 patients per day
  • Provider work day decreased from an 11-hour day to an 8-hour day with transcription, e-mail and voice mails completed by the end of each day. (27% reduction)

  • Reduced MRI Pt LOS by 24% while reducing staff MCT by 42%
  • Increased a 2 x-ray unit capacity by over 100% negating the need for 2 techs and an additional machine
  • Value stream improvement in MRI resulted in a 18% increase in daily throughput with 25% less technologist manpower yielding annualized savings of $100K
  • Optimized Imaging schedule utilization with a net result of additional 15% capacity

  • Rejected referrals received per month reduced from 47 per month to 23 per month (50% Reduction)
  • Reduced the referral processing time from 30 days to 6 days. (80% reduction)
  • Reduced the cost of travel in support of referral process by $800/month (20% Reduction)

  • Reduced the cost per case from $1290 to $1150 over nine months during value stream improvement (10.8% reduction)
  • Reduced overall budget variance by a favorable 14%
  • Increased same day surgical volume by 10%

  • Reduced turnaround time for month end close from 23 calendar days to 10 calendar days (56% reduction)
  • Added a complete day for variance analysis within the 10 calendar days improving the quality of the reports
  • Standardize templates and reporting to simpify user readability

  • Using lean principles, two in-patient units changed their organizational structure with a blend of regulated and non-regulated healthcare professionals using evidence based care guidelines
  • Mix change resulted in $200,000 in annual labor costs per unit
  • New processes, managed visually, resulted in significant levels on increased patient satisfaction