on our path to excellenceon our path to excellence kim hollon gagan rajpal signature healthcare....
TRANSCRIPT
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On Our Path to Excellence
Kim Hollon
Gagan Rajpal
Signature Healthcare
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• Good but missed Lean and Safety Studer BSC
• Top Heavy Bright Ideas
• Management heavy / silo focused 90 Day Plans
• Previous focus on cost Value Stream
Problem Solving
• Sustaining gains a problem Kaizen Events
Prior Experience with Quality Improvement
Left Hospital with high performance. When returning after
2 years, systems were gone and performance was low
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2010 - SHC’s Position
• Minimal cash reserves
• Prior top down leadership
– Middle manager arrested development
– Lacked transparency to problems
• Weak improvement goals
• Physician group not aligned to system goals
• Losing money in Managed Medicare
• Measured quality very good
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Purpose-driven Excellence
• Organizational purpose
Signature Healthcare, while remaining independent, will provide our patient and business communities with coordinated care of highest quality and value in the region
• Purpose driving us
Improving the safety how our health system and transforming our health system to one that fully engages our team in improving quality cost and the patient experience
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My Motivation
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Why Lean
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What I learned from other
organizations
OR
Go a Mile Wide AND a Mile Deep | Kris Hallan | LinkedIn
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What I chose to do - Our Model
Go a Mile Wide AND a Mile Deep | Kris Hallan | LinkedIn
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Why Cultural Implementation?
• Safety
• High reliability
• Patients cross our value stream
• Sustain gains over time
• Facilitate seeing defects
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Our Path
© 2016 All Rights Reserved | Adams Strategy Group | http://AdamsStrategy.com
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Implementation
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Implementation
• Year One:
– Injury review
– One FTE
– Leadership and physician education
– System-wide implementation of core
management system
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Implementation
• Year Two:
– Benchmarking
– Kaizen Event
– Pilot Hall development
– LSW and Gemba time
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Implementation cont.
• Year Three:
– Stabilization across system
– Audits and Talent management
– Add Lean staff
• ROI and Coaching
– Focused Improvement
– Coaching/education
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Implementation
• Year Four:
– Enhance Physician engagement in RCA’s
– Additional Lean staff
– Culture of Safety
• Education; error prevention behavior tools; great
catch; coaches; safety huddle
– New manager on-boarding
– Lean 0.5 education
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Implementation
• Year Five:
– Finance Pilot Hall
– Standardize LSW
– Value stream for medical diagnosis
– Employee selection tool
– New Skills – Andon, Pull, Team PS, OPR, 3P
• Year Six: Quality Circles
– Transfer Lean to Key Partner (Home Health)
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Sample of Improvements
75% reduction in reportable employee injury rates
85% reduction in pressure ulcer (skin care harm) rate in CCU
100% reduction in infection of central line catheters in CCU
75% reduction in 30-day COPD readmissions from Oct 14 – Sep 15
24% reduction in 30-day all cause readmissions
43% reduction in time to make level of care decision for behavioral health patients
70% reduction in “Door to doctor” time in ED
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Lessons Learned
• Start with change mgt. roadmap
• Leader turnover is necessary but costly
• Early Sr. Team alignment
• Human/Operational balance
• Timing
• More time designing goal cascade
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Lessons Learned
• Design for span of control
• Physicians need support
• Fewer pillars to start
• FI earlier and with support
• Internal and external lean expert
• Master Plans
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Takeaways
• Use external Lean Advisor
• Anticipate management’s bell curve
• Audits: teaching and alignment
• Coaching resources needed
• Pilots – Early Adopter and EA Senior Leader
• LSW is critical for a LMS
• Manage manager turnover
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Session No: TP/04
On Our Path to Excellence
Kim Hollon, CEO
Signature Healthcare