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Center for Leadership and Transformation to Transform County Operations

Rapid Transformation Tactics Employed by Private Sector under Development in Santa Clara County

SANTA CLARA COUNTY, CALIF.— Married couples in the U.S. accrue certain tangible and intangible benefits – tax breaks, lower insurance rates, longevity. In return they give up a degree of autonomy and make joint decisions. At least that was the premise advanced by Darlene Gardner, leader of one of five project teams tasked with identifying challenges and strategies to make immediate and long-term improvements in the way the County of Santa Clara government operates. She went on to say that her team, which examined Information Technology (IT), concluded although County IT departments are a part of a marriage, by acting independently they are not reaping the comparable benefits.

Gardner’s remarks were made at a recent presentation to the heads of County departments where the five teams reported on their work over the past six weeks. The inaugural group of mid-managers is the first to complete training in the County’s new Center for Leadership and Transformation (CLT) launched by County Executive Jeffrey V. Smith during the spring. Smith’s mantra since he took the helm is that the County of Santa Clara has the capacity to become a leader among counties in the nation.

“We are sufficiently large, yet nimble enough to make the kind of changes that are necessary,” Smith has told employees at all levels of the organization. “The County is facing very difficult fiscal challenges. This means we have to make decisions based on new models, find ways to become a leaner, more efficient organization and we have to innovate.”

The strategic direction articulated by Smith is one of the reasons the County of Santa Clara Board of Supervisors selected him to fill the post of County Executive nine months ago. At meetings of Executive Managers and Department Heads, Smith shares stories from visionary leaders of award winning companies. But he is just as likely to hand a manager a Buddhist parable or koan and pose the question of how it applies to the management of his or her organization.

Guiding Principles

The Center for Leadership and Transformation is founded on the principles that lasting, organizational transformation can be achieved when Santa Clara County: encourages employees and equips them with methods and processes to lead change from any part of the organization; empowers employees to suggest and participate in innovative, actionable solutions and breakthrough ideas; cultivates the power and expertise of cross-functional collaboration; develops metrics that establish the findings and best practices from change efforts; and fosters an environment that honors the relentless energy, creativity, and commitment necessary to transform business policies and practices.

The Center for Leadership and Transformation philosophy is that the most effective way to accomplish one’s mission is to lead from the middle, where employees are ideally situated to understand what it takes to accomplish their unit’s goals as well as how to advocate with senior management for their employees. For this reason, the first group to be trained is comprised of middle managers.

“Line managers and supervisors often have their finger on the pulse of their operation,” said Smith. “They understand what is needed to deliver the services for which they have responsibility and ideally they have the confidence of senior management as well. So they are uniquely positioned to be change agents. Our goal is to empower them to identify and make changes needed for the organization to be effective.”

Ideas for Change

The first five project teams in the County’s Center for Leadership and Transformation took the message to heart and came back with a series of recommendations that promise several million dollars in savings.

A great example is the IT project team. Its mission was to determine how the County could create efficiencies and cost savings in information technology and systems. At the suggestion of the Chief Information Officer, the IT group began its work by surveying all County departments to analyze non-core software. The group found that many County agencies acquired software and implemented systems over time, on a department-by-department basis, resulting in an information technology system that resembles a patchwork quilt. The cost each pays for software licenses varies significantly, depending on the number of users and rates in effect when purchases were made. An example cited was the disparate cost for similar antivirus licensing software. One office paid as little as $8 per user, another $17, and still another $21. Countywide, the annual maintenance cost for software is estimated at more than $13 million. By consolidating and negotiating the purchases, when contracts such as the anti-virus contracts expire, the group projects that just a 10 percent improvement in cost of software maintenance could yield savings of at least $1 million.

During a brainstorming session, Team 2 decided to tackle the issue of bureaucracy. They identified a fundamental underlying problem that many large organizations face: The need to address barriers to getting things done. Whether it is a function of too many decision makers, the long planning horizon required to recruit and hire, rules and regulations governing how goods and services are to be purchased, or micro-management, a number of barriers slow down the process and reduce productivity.

“Our goal is to establish an ongoing process to break through barriers,” said Rapid Action Force (RAF) Project Team Leader Amando Cablas. “We can create a culture of change and innovation by implementing a program to fast-track approval of new ideas.”

The group determined that some ideas fail to gain support because they are impractical. Others fail to gain traction because it’s simpler to continue with business as usual. The team recommended creating a Rapid Action Force in the County Executive’s Office of Budget and Analysis to solicit and evaluate new ideas, and quickly implement those that meet certain criteria. For instance, they must be cost-effective, budget neutral, create lean workflow, and be able to be implemented in 90 days or less. The placement of the RAF in the County Executive’s Office would give it the clout needed to overcome any organizational opposition or inertia.

The third project team examined the cost in the County’s policies that restrict how temporary (Extra Help) employees can be retained. Extra Help employees are hired for a specific task and specified duration of time such as tax collection season, elections; or to temporarily fill an existing position due to illness, disability, or transfer of the employee; or to fill an unanticipated need such as epidemics, disasters, or an influx of specific populations, perhaps with language assistance needs.

The team made its case by assessing the cost to the County when it loses employees who are trained and understand the current operating environment. Extra Help employees are usually identified through informal sources, including employee referrals. To ensure a competitive process for permanent County jobs, limits are placed on the length of time Extra Help employees may work and their ability to apply for other county jobs.

The group estimated the average cost to train a new employee to be about $27,500. When those temporary employees are let go, that investment is lost, plus an additional $27,500 is spent to train someone new, if the position is needed on a longer term basis. The related projected cost savings for retaining Extra Help employees would range from $1.4 million to $4.1 million for 50 to 150 new hires.

The Employee Services Agency will follow up on the team’s recommendation to centralize recruitment for certain types of extra help hiring across County Departments thereby shortening the recruitment period with qualified candidates. In addition, ESA will follow up on the recommendation to examine providing extra credit for relevant County service in civil service examinations. This will allow those extra help employees with relevant experience to gain better access to permanent jobs and result in less training and orientation and generate cost savings for hiring departments.

Two teams address issues pertaining to Valley Medical Center (VMC): 1) The first team conducted an assessment of the use of Electronic Medical Records (ELMR). ELMR is the electronic medical record system for outpatients. It is in place at regional VMC care sites and ideally would facilitate better coordination, information sharing, and patient care between the hospital and the clinic system. Today, 500 providers and 1,500 users are a part of the system. During the next phase of implementation, ELMR will be expanded to include medical specialties. When complete, the system is expected to streamline the patient clinic visit process.

The ELMR team examined the current status of the system and made a series of recommendations – some technical and some process improvements, including the possibility of sending text messages to patients to remind them of appointments, and eliminating duplicative data entry.

The final group is the Patient Registry Team, lead by Dr. Angela Suarez. Currently patient information is maintained in 31 disparate systems. The group recommended that the County implement a patient registry to provide a single view of patient information by linking fragmented data, and use aggregated patient information for pro-active population and chronic disease management. The proposed patient registry would link the four critical areas: Decision Support; Lab; Diagnostic Imaging; and the Emergency Department. A patient registry would allow providers to monitor and intervene in the care of all of their patients, not just those who seek care in the physician’s office. Full implementation of the system would require a financial investment, in hardware, software, interfaces and system maintenance. However, the group outlined the intangible benefit as improved patient care.

Next Steps

The County’s Executive Management Team will undergo training in Rapid Transformation Principles and Processes at Stanford University next month. The Office of Budget and Analysis is creating a website where the results of the projects will be monitored and tracked. Its Director Leslie Crowell brought the Rapid Transformation concept to the County Executive after having read a newspaper article about the concept last year and follow up discussions with Behnam Tabrizi, a consulting professor at Stanford University and the author of Rapid Transformation: A 90-Day Plan for Fast and Effective Change.

“This is a very exciting project for the County,” said Crowell. “It is not a theoretical exercise. We’re bringing together cross-functional teams to look at current county issues and produce actionable results.”

The CLT web page will be designed to be interactive, informative, and inspirational,” Crowell continued. “It will feature stories about people and programs which are innovative, and recognize employee and program contributions to the County and the community.”

“I want to challenge us to tell ourselves a different story; not that something will never work,” a beaming Smith told the assembled executive managers recently. “Employees of large organizations often think they can’t change things in bureaucracy. I want our story to be: Yes we can. We can change things.”

Media Contact: Gwendolyn Mitchell/Laurel Anderson, Office of Public Affairs, (408) 299-5119
Posted: July 15, 2010