Wendi Middleton, Director of Continual Quality Improvement, Aging Adult Services Agency within the State of Michigan’s Department of Health and Human Services, and Dennis Sergent, President, Sergent Results Group

In our 3rd interview podcast of 2019, Wendi Middleton, Director of Continual Quality Improvement, from the Aging Adult Services Agency within the State of Michigan’s Department of Health and Human Services, and Dennis Sergent, President, Sergent Results Group, share reflections on the "Challenges and Opportunities in Applying the Deming Philosophy in Government."

(This is Tripp's first interview with Wendi and Dennis)

Highlights include:

• A 5-year history of applying the Deming Philosophy within the State of Michigan's Department of Health and Human Services (HHS)
• The development of Aging and Disability Resource Centers
• Learning "Who are our partners?"
• Where to start? / Who does what to whom?
• Family services and a cat
• First exposure to the Deming Red Bead Experiment
• Getting to know each other better within Michigan's HHS
• Creation of the BOLD ("Building Options for Long Term Decision-Making") Council
• Acronyms as an art-form
• Detailing the processes - Where to start and where to integrate?
• Exposure to control charts within the Bell Telephone System
• Education and steps to move forward
• Creation of the BOLD ("Be OLD") Councils
• Acronyms as an art-form
• Grant funding provided consulting help
• Process steps, including road blocks and issues
• Subject Matter Experts (SME) and Design Teams
• A focus on quality improvement, not change
• Policy changes, with improvements
• Living at home, using improvements in non-emergency transportation services
• Weekly Stand-and-Deliver meetings to review ongoing PDSA efforts
• Continual Improvement efforts are not always “linear,” with forward improvement (sometimes they go backwards)
• State government is a culture all by itself
• People sometimes become their job (position)
• Getting people on board with improvement; not always happy fits, some move on to other positions
• Managing “Level-of-Care Determinations”
• When facing system obstacles, take inspiration from Eleanor Roosevelt, Don’t take a “No” (answer) from someone without the authority to say “Yes”
• Setting new standards for working with state vendors
• New skills by Design Team members
• “Everything is designed around getting money from the federal government”
• Design Team roles are about improving access to state services, not finding sources of funding
• Effectiveness (doing the right thing), before efficiency (faster, better, cheaper)
• Cost savings have been measured, yet the bigger impact is serving more people for a given budget allocation
• Reducing the waiting list for services
• Instead of asking for more money, ask if the existing process can be improved to provide better service
• Discovering a mindset that if some don’t have a problem with a given process, others won't as well (meaning, the process is deemed to be OK as is, while it may well need improvement) 
• Impact on Design Teams after attending The Deming Institute’s “Me vs We workshop” 
• Getting over self-interest issues
• T-Shirt idea, “The Status Quo is Not an Option”
• Avoiding doing better what needs not be done
• Design Teams need ongoing support, including starting with on-boarding and ground rules
• Emergence of self-respect and respect for others