Process Excellence

James Ramos, Director of Process Excellence

For School of Medicine leaders, both formal and informal, who are passionate about driving change and interested in challenging the status quo, the Process Excellence team fosters a culture of Continuous Improvement and serves as coaching partners, empowering our clients to collaborate and achieve spectacular results. While we see value in the deployment of tools and lean methodologies, we know the real power to change lies with the people who do the work. So we focus on people.

Our mission is to empower innovation in every person, every day. 

Fiscal Affairs- Year of Improvements

A not so well-kept process excellence secret: there can always be an improvement gap.  If, by definition, a gap is simply the distance between where we are now and where we seek to be, we immediately see the primacy of our own expectations in that equation.  Seek a higher target and the gap widens.  Lower your expectations and the gap can disappear.  What’s more, the wider the improvement gap the more a team or individual is forced to look deeply at their existing processes and demand wholesale changes.  Wide gaps are an urgent call for us to be creative, purposeful, and to take risks.  For the Fiscal Affairs teams--Budget and Financial Planning, the Controllers group, and Faculty Compensation--FY19 was just that, a year of wide improvement gaps--a year to reinvent. 

By September 2019, the Budget and Financial Planning team (“BFP”) received the results of  More its annual budget survey, sent out to the community of DFA’s, department heads, and other budget users.  The upshot: the budget process--and, in particular, the budget template--was too manual, too complicated, and took far too long to complete.  The team struggled with a pressing question: How do you dramatically simplify the budget process for the DFAs and department heads while at the same meet the requirements of the senior administration and the University?  

To begin with, the old template had to go.  A new template, in order to truly meet the needs of the customer, would have pre-populated historical actuals, simple tools to create forecasts, visual dashboards, and audit tools to check for common mistakes.  Moreover, to complement the template, BFP decided to create a Budget 101 course that quickly and efficiently summarized budgeting best practices.  It took six months of preparation, including multiple pilot programs, but the results of their re-invented budget process speak for themselves.  They were able to cut the number of departments that spent 20+ hours filling in the budget process by 50%, and they doubled the number of departments that completed the template in under two hours. 

The Controllers Group found themselves similarly trying to reinvent one of their critical documents.  The creation of the quarterly Dean’s Statement took over three weeks--or 12 weeks on a yearly basis--to generate, validate, and publish.  To create this report was an enormous investment in time and energy that could, if saved, be redeployed to other strategic uses.  In the prior years the team tried to automate this report, but quickly found itself ensnared in technical complications and ultimately failed to complete the project.  Crestfallen but nevertheless still hopeful, the team decided in FY18 to re-attempt the Dean’s Statement automation, with a different approach and with the collaboration of FMS.  They succeeded spectacularly.    

With the click of a button the Controller’s Group can now generate and publish the quarterly Dean’s Statement, which allows them to provide more timely analysis to the senior leadership and, in fact, also allows them to find and fix incorrect or missing journals before critical dates.  They made good on their promise to redirect this time savings into other projects.  One of their key objectives, while still in development, is to redesign all of their reports to make them more visual, and to host them on one central platform for the senior leadership and potentially for departments.  They started with the Clinical Operations report, which visually depicts the movement in financial performance for clinical departments.


Faculty Compensation’s improvement story arch goes back to 2017 with their salary scale program, an initiative designed to radically simplify the way faculty salaries are set and to increase pay equity amongst faculty in the departments.  Over the years, as an ongoing part of this improvement project, the team has increased the participation of departments in the program.  For the FY20 annual Faculty Setting process the number of participating departments went from 85% to 93%, and the group is confident in their long-term goal of 100% of participating departments. 

In prior years, the team only worked with the departments that had already adopted the scale approach to refine and update salary scales annually in response to the market movement.  This year, knowing their goal was within reach, they decided to work with all departments and proposed a possible scale structure tailored to address external competitiveness and internal equity while considering each department’s unique recruitment and retention challenge as well as financial feasibility.  And they didn’t want to stop there.  They wanted to expand the depth of information provided to the departments.  They recognized that setting fixed compensation is only one part of the total compensation story.  There is also incentive to consider.  For the first time, the team provided departments with analysis during their annual meetings regarding the incentive ratio comparison and, in part, launched a hybrid chart to convey both fixed and total compensation comparison in their BI dashboard.  Thanks to this improvement, departments now have a richer context for understanding the total compensation picture for their faculty members.   



Upcoming Workshops

Workshops coming soon!

share with us

Do you have an improvement story or an idea that you or your team implemented? What are some of the big wins? Who did this impact? We want to feature your story here- email us

coming up

  • November 11, 2019
    1-2:00 pm: SNP workload mgmt 60-day report out (2490 Hospital Dr Ste. 205) 
  • November 12, 2019
    10-11 am: DoS onboarding 90-day report out (Alway M121) 
  • November 21, 2019
    TBD: EPS Financial Aid/ Med Scholars 30-day report out (Zoom) 
  • November 22, 2019
    9-9:30am: Ortho-research 90-day report out (Zoom) 

Interested in a Launch?

I’m interested in using the launch process to help my team solve a problem.

Step 1: Are you a member of the Stanford School of Medicine?

Step 2: Start with a problem facing your team. Typically, this would be an area in where there is a gap between expectations and results.

Step 3: Discuss with your manager or leader, and contact us to determine if this would be a fit for a launch—usually a three-day event that focuses your team and customers on targeted improvements.

Step 4: We will work with your Team Leads/Managers to produce a scope document that sets goals aimed at significantly reducing your gap. The launch would then be scheduled, team members would be named, and facilitators and resources would be secured.

Step 5: The launch itself is attended by your team and a team leader; all participants collaboratively map the current and desired/future processes, along with issues and ideas for improvement. The final day includes a report out to your sponsors.

Step 6: After the launch, there are 30, 60, and 90-day report outs.