on our path to excellenceon our path to excellence kim hollon gagan rajpal signature healthcare....

On Our Path to Excellence

Kim Hollon

Gagan Rajpal

Signature Healthcare

• 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

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

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

My Motivation

Why Lean

What I learned from other

organizations

OR

Go a Mile Wide AND a Mile Deep | Kris Hallan | LinkedIn

What I chose to do - Our Model

Go a Mile Wide AND a Mile Deep | Kris Hallan | LinkedIn

Why Cultural Implementation?

• Safety

• High reliability

• Patients cross our value stream

• Sustain gains over time

• Facilitate seeing defects

Our Path

© 2016 All Rights Reserved | Adams Strategy Group | http://AdamsStrategy.com

Implementation

Implementation

• Year One:

– Injury review

– One FTE

– Leadership and physician education

– System-wide implementation of core

management system

Implementation

• Year Two:

– Benchmarking

– Kaizen Event

– Pilot Hall development

– LSW and Gemba time

Implementation cont.

• Year Three:

– Stabilization across system

– Audits and Talent management

– Add Lean staff

• ROI and Coaching

– Focused Improvement

– Coaching/education

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

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)

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

Re-communicating

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

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

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

Thank You!

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Session No: TP/04

On Our Path to Excellence

Kim Hollon, CEO

Signature Healthcare

khollon@signature-healthcare.org