Lean Healthcare Research Symposium 2018 Chicago Marriott Downtown Magnificent Mile

Fourth Floor Armitage/Belmont Conference Rooms

June 13, Chicago, Illinois Program

8:00am Registration Begins 8:30am Welcome and Overview of the Day Thomas Rundall, PhD, Henry J. Kaiser Professor of Organized Health Systems,

Emeritus, and Co-director, Center for Lean Engagement and Research in Healthcare (CLEAR), University of California, Berkeley

8:45am Keynote Presentation Can Research Help Bridge the Knowledge Gaps in the Lean Transformation? John Toussaint, MD, Executive Chairman, Catalysis, Inc. 9:30am Refreshment Break (State Foyer) 9:45am Recent Research on Lean from CLEAR Stephen Shortell, PhD, MPH, MBA, Blue Cross of California Distinguished

Professor of Health Policy and Management, Emeritus; Professor of Organizational Behavior, Emeritus, and Co-director, Center for Lean Engagement and Research in Healthcare (CLEAR), University of California, Berkeley Thomas Rundall, PhD, Henry J. Kaiser Professor of Organized Health Systems, Emeritus, and Co-director, Center for Lean Engagement and Research in Healthcare (CLEAR), University of California, Berkeley

Results from two research projects will be presented: (1) findings from a national survey on the extent of lean implementation in US acute-care hospitals and the effects of lean on hospital performance, and (2) the development of a principles-

based lean implementation assessment instrument for use in healthcare organizations

10:30am Recent Research on Performance Improvement from HRET Jay Bhatt, DO, Chief Medical Officer, American Hospital Association, and

President and CEO, Health Research and Educational Trust The prevalence of performance improvement (PI) programs and methodologies

In hospitals and health systems will be presented, as well as trends in PI implementation. Implications for the next generation of performance improvement will be discussed.

11:00 Stretch/Poster Break (State Foyer) 11:15am What Does It All Mean? Understanding Lean Quality Improvement Data in the

Real World Craig Blackmore, MD, Director, Center for Healthcare Improvement Science, Virginia Mason Medical Center Quality improvement research occurs in the real world, with a myriad of potential confounding factors. In this presentation examples from Virginia Mason Medical Center are used to explore how data from lean quality improvement interventions can lead to correct or incorrect understanding of the effects of interventions and confounders. 11:45am Drivers of Lean Enterprise Transformation Martin Charns, DBA, MBA, Professor, Boston University, and

Director Emeritus, VA Center for Healthcare Organization and Implementation Research

Building on earlier research of organizational transformation focused on quality improvement, our current research in ten VA medical centers identified five key drivers of transformation that vary in importance at different stages of maturity in the implementation of lean management systems throughout a healthcare

organization. 12:15pm Lunch (Halsted Room) 1:00pm Harnessing the Power of Lean to Advance Behavioral Health Crisis Care Margaret Balfour, MD, PhD, Chief of Quality and Clinical Innovation,

Connections Healthcare Solutions, and Assistant Professor of Psychiatry, University of Arizona The story of the transformation of our struggling behavioral health crisis center will illustrate how lean strategies improve safety, throughput, and culture in a psychiatric emergency setting. Also described is a collaborative partnership with our payer in which crisis utilization data was leveraged to drive system-wide improvements. 1:30pm Can We Sustain Process Improvement Initiatives in Healthcare? Evidence from

Randomized Control Experiments Aravind Chandrasekaran, PhD, Associate Professor and Associate Director, Center for Operational Excellence, Fisher College of Business, The Ohio State

University In this study, randomized control field experiments conducted at Mayo Clinic and the Ohio State Wexner Medical Center are examined to assess how to

implement and sustain process improvement initiatives (PI) in healthcare. Through these experiments, we find that sustaining PI initiatives in these complex environments depend on several contextual factors that are less researched. We offer initial insights on these factors.

2:00pm Lean Practice Transformation and Burnout in Academic Primary Care Jonathan Lee, MD, MAS Assistant Clinical Professor of Medicine, UCSF School of

Medicine A brief overview of the national state of burnout amongst healthcare providers

will be presented, followed by descriptions of lean-driven practice transformation efforts and burnout and satisfaction data from providers and staff in an academic general internal medicine clinic.

2:30pm Refreshment Break (State Foyer) 3:00pm Panel Discussion Lean Implementation and Burnout Among Healthcare Professionals George McClendon, PhD (Moderator), Vice President, Therapeutic Research and

Development, Atrium Health (formerly the Carolinas Healthcare System) Dael Waxman, MD, Vice Chair and Professor, Department of Family Medicine, Atrium Health Lee McHenry, MD, Professor of Medicine, and Medical Director of IU Springmill Medical Clinics, Indiana University School of Medicine Jonathan Lee, MD, Assistant Professor of Medicine, UCSF School of Medicine

Evidence from multiple surveys and other data sources indicate that many health care professionals are burned out: a syndrome characterized by a high degree of emotional exhaustion, a high degree of depersonalization, and a low sense of personal accomplishment at work. The purpose this panel is to explore the topic of lean implementation and burnout among physicians and nurses. Some of the questions that will be addressed include:

• Is clinician burnout a significant problem in your healthcare organization? • What are the consequences of clinician burnout in your organization?

(quality and safety? turnover and reduction of work effort? healthcare costs? personal consequences?)

• What is the relationship between lean implementation and clinician burnout in your organization?

• What research on clinician burnout is your organization currently engaged in? What kind of research on lean implementation and clinician burnout would help your organization’s leaders and staff understand and reduce clinician burnout?

4:00pm Final Comments and Adjournment 6:30pm Lean Transformation Summit Welcome Reception (Grand Ballroom Foyer)