Practice Pro Newsletter Lean Project 2012Deb Kimball

Physician Liaison

Munson Medical Center

Practice Pro NewsletterPractice Pro Newsletter Lean Project 2012

• Practice Pro Newsletter: – Munson newsletter for affiliated physician practice managers

in 5 counties (Antrim, Benzie, Grand Traverse, Kalkaska, Leelanau)

– Produced monthly by Physician Liaison Program in coordination with Corporate Communications

• Challenges: – Lead time was 8+ weeks– Hard to provide timely, relevant information with long lead time– A lot of rework due to high priority news that needed to be

worked in

BackgroundPractice Pro Newsletter Lean Project 2012

• Team: – Deb Kimball, Physician Liaison/Editor (Value Stream Manager)– Deb Sielski, Corporate Communications/Production Specialist– Andrea Ludka, Physician Liaison/Manager– Kelly Niedzwiecki, Corporate Communications/Account Exec.

• Sponsorship Panel: – Andrea Ludka, Physician Liaison Manager (sponsor)– Dave McGreaham, VP of Medical Affairs (leadership panel)– Ian Jones, Corporate Comm. Director (leadership panel)

TeamPractice Pro Newsletter Lean Project 2012

• Project Purpose: Provide timely information to physician offices

• Metrics/Targets: Decrease lead time in newsletter production

Purpose/GoalsPractice Pro Newsletter Lean Project 2012

• Scope: Outline of articles through receipt of newsletter by physician offices

• Parameters: No new staff; no additional budget

• Deliverables: – A3– Current State Value Stream Map– Future State Value Stream Map– Implementation Plan

Scope/Parameters/DeliverablesPractice Pro Newsletter Lean Project 2012

• Timeline: – Complete current state mapping by May 2012– Have bi-weekly check-in meetings– See improvement in metrics by September 2012– Achieve target goal by January 2013

• Updates: • Sponsor will be updated at monthly goal meeting• Leadership panel will updated after initial future state

mapping and implementation planning, and at project completion

Timeline/UpdatesPractice Pro Newsletter Lean Project 2012

Kick-off Meeting 3.9.12Practice Pro Newsletter Lean Project 2012

Practice Pro Lean Project Kick-off LEAN PROJECT GOAL: Provide timely information to physician offices MEETING: Date: 3/9/12 Location: Physician Liaison – Andrea’s Office Start Time: 11:00 am End Time: 11:30 am TEAM MEMBERS: Deb Kimball Deb Sielski Andrea Ludka Kelly Niedzwiecki

AGENDA:

TOPIC LEAD LENGTH (minutes) 1. Review agenda DLK 11:00 – 11:02 am 2. Overview of Lean Project Requirements DLK 11:02 – 11:05 am 3. Review Practice Pro Project Charter/A4 DLK 11:05 – 11:15 am 4. Invite team to on-site Lean Office Champion Class and

discuss logistics (6/14 & 6/21, 8 am – 4:30 pm) DLK 11:15 – 11:25 am

5. Next Steps/Schedule Next Meeting DLK 11:25 – 11:30 am PARKING LOT: NEXT MEETING: Date: Location: Start Time: End Time:

Value Stream Map – Current StatePractice Pro Newsletter Lean Project 2012

Current State: In the layout part of the process, it would move from editor to production specialist to designer to production specialist to editor…and repeated 2 – 4 times until final layout approved. Lots of hand-offs creating long lead time.

Value Stream Map – Current StatePractice Pro Newsletter Lean Project 2012

Value Stream MappingPractice Pro Newsletter Lean Project 2012

Cycle Time: 1 week

Wait Time: 3 – 8 weeks

Lead Time: 4 – 9 weeks

5S – Practice Pro Main Folder (electronic)Practice Pro Newsletter Lean Project 2012

BEFORE

AFTER

• All files in a folder• Current issue folders at top• Archives for articles, graphics, and previous issues

LESSON LEARNED5S completed by editor and production specialist – who both use this folder

5S – Current Publication Folder (electronic)Practice Pro Newsletter Lean Project 2012

BEFORE

AFTER

• All files grouped into four folders• Makes it quick and easy to forward copy and

graphics to designer

AHA! MOMENTOne of the favorite process improvements for the production specialist – saved her a lot of time trying to pick out which articles and graphics needed to be sent to designer

5S – Yearly Publication Archive (electronic)Practice Pro Newsletter Lean Project 2012

BEFORE

AFTER

LESSON LEARNEDCan use Adobe Acrobat to search PDFs so don’t need to save original Word documents

• Articles are frequently edited in layout so Word files may not be final version. So deleted Word files as can pull articles from issue PDF.

5S – Project Folders (physical)Practice Pro Newsletter Lean Project 2012

Moved the Practice Pro file folders that I’m currently working on from a closed file drawer to a vertical & visual file organizer on my desk

LESSON LEARNEDSaves time and improves access to folders which I use daily

Standardized WorkPractice Pro Newsletter Lean Project 2012

PRACTICE PRO CALENDAR – ONGOING ARTICLES

January New Physicians

Recruited Prior Calendar Year

Rerun “Got PowerChart Access? Keep It Live by Logging On”

PRS: rerun “Here to Help”

February Heart Month Events

February Save the Date –

National Doctor’s Day February Heart Month

Events

March National Doctor’s Day Pharmacy Services/

Locations/Hours Rerun “Former

Employees and Computer Access”

Diabetes Alert Day/Diabetes Risk Test

April Physician Recruitment

Profile Diabetes Day Open

House (early April) National Prescription

Drug Take-Back Day (last Saturday in April)

May is Sleep Month?

May May is Sleep Month May is Stroke Month MMC Top 100, if

applicable

June Forms Reminder:

rerun “Updated Forms”

Office Manager Email List: rerun “Need Hot News Now? Email Us!”

PRS: Community Needs Survey/Office Profile Update – rerun “Updating Practice Information”

MMC Top 100, if applicable & wasn’t ran in May

July Rerun “Got

PowerChart Access? Keep It Live by Logging On”

Radiology Services/ Locations/Hours

August Save the Date – New

Physician Reception Rerun “CME” (8/10) Resources on “For

Physicians” Website

September Flu Season/

Mandatory Flu Shot New Physician

Reception Rerun “Former

Employees and Computer Access”

October Follow-up to New

Physician Reception Flu Shot Reminder Rerun “PHP Offers

Confidential Screening for Depression”

National Prescription Drug Take-Back Day (last Saturday in October)

November Flu Shot Reminder Lab Services/

Locations/Hours American Diabetes

Month/Diabetes Risk Test

Medical Staff Services Profile

December Flu Shot Reminder Munson Urgent Care

Holiday Hours National Handwashing

Awareness Week PRS: rerun “Updating

Office Information”

Created monthly calendar for recurring articles so that these are not missed

Visual Management – Practice Pro TrackingPractice Pro Newsletter Lean Project 2012

Created visual management board to track where each issue is in the process (macro level)

AHA! MOMENTManager was able to communicate copy due date to writer without asking editor

Visual Management – New PhysiciansPractice Pro Newsletter Lean Project 2012

• Created visual management board to track new physicians

• New physicians (max 3) are promoted on back page of Practice Pro

• Need orientation and photo prior to publication• Visual management board helps editor know

which physicians to promote in each issue• Also used by HealthLink and Corporate

Communications for marketing purposes

Pull Flow for Article Review/EditsPractice Pro Newsletter Lean Project 2012

• Added pull to article copy review process

• Manager wasn’t using top two boxes so repurposed as Review (manager) and Edit (editor) boxes

• Now articles are passed for manager review when EACH is written…NOT as a batch when ALL are written

• “Go” Post-it notes are used as an extra visual cue that there are articles to review

LESSON LEARNEDOne piece flow is great improvement over batch. Takes manager less time to review individual articles vs. batch and less likely for these to get lost on her desk.

Poka Yoke -- BeforePractice Pro Newsletter Lean Project 2012

PRACTICE PRO ARTICLES – MAY 2012

Andrea’s Column First-Ever Practice Pro Survey: We Need You! graphics: Andrea’s headshot; survey

Education Deb’s Column: One Year Later, HIPAA Education a Success graphic: Deb’s headshot HIPAA Red Alerts Down HIPAA FAQs graphic: HIPAA Hero

Scheduling section header: “Scheduling News”

o PWS Reminder o Update CAT Scan Forms graphic: CT Questionnaire o Prior Authorization Updates:

AIM Prairie States Aetna Molina

Articles

Recent Mailings to Your Office graphic: sepsis poster/badge card April Meaningful Use Presentation graphic: seminar photo

Information for Your Physicians section header: “Information for Your Physicians”

The Sotile Presentation – New Challenges, New Solutions: The Thriving Medical Family graphic: Save the Date

Cell Phones Can Be Used as Pagers for AT&T and Verizon Users graphic: cell and pager.jpg

Munson Happenings section header: “Munson Happenings”

A Healthy ‘Shh’: Silence Helps Healing graphic: Shh…screensaver The Restoration of Kid’s Creek graphic: Phase 2 Project Rendering

New Physicians/Moves/PRS (back panel)

Updating Physician Headshots graphic: Doogie Howser, MD? Education Insert insert header: “Health Education Events”

Munson Education Offerings Intro Seminars Coming Up

o Bariatrics o Neurosurgery o Orthopedics

Heart to Heart Screening for Women graphic: Heart to Heart May is National Stroke Awareness Month graphic: F.A.S.T.? Eight Hours. Are You Getting It? (May is Better Sleep Month)

• Previous article list format• No way of knowing how

many pages of copy this is• Issues must have an even

number of pages – if provide an odd number then production/designer don’t know if they should add or edit

Poka Yoke - AfterPractice Pro Newsletter Lean Project 2012

PRACTICE PRO ARTICLES – JUNE 2012 PAGE TITLE WORDS GRAPHIC NOTES

1 Deb’s column: 5Spring Cleaning Your Practice 267 kimball_deb_bw.jpg 1 A Recent Mailing to Your Office (SRI) 57 1 ICD-10 Update 234 Hgustine_heidi_bw.jpg 558

2 Medication Therapy Management’s Endgame: Compliant, Safe, Effective Use of Medications

626 Kathleen Brown, RPh.jpg

2 Know Your Medications Card 69 Know Your Medications Card (Form 2327).jpg

695 3 Munson Medical Center Discharge Pharmacy 167 Online RX Refill - Small.jpg OR

RX Refill - Large.jpg Select graphic depending on space

3 Munson Retail Pharmacies Online RX Refill 60 3 Munson Retail Pharmacy Hours 77 See notes pickup from March 2012

including images of all three pharmacies

304 4 What HIPAA Doesn’t Trump 160 header: “HIPAA” 4 What is a Fair Warning? 150 Rochelle Steimel.jpg header: “HIPAA” 4 HIPAA FAQs 304 HIPAA Hero (NEED) header: “HIPAA” 614

5 Scheduling CTs – Important to Know if Patient Has Acute Asthma 158 header: “Scheduling News” 5 Scheduling Back-to-Back Tests in PWS 119 header: “Scheduling News” 5 Are Your Forms Out of Date? 70 5 Need Hot News Now? 65 412

6 Bridget A. Green, MD 37 run without headshot 6 Updating Practice Information 66 103 TOTAL WORD COUNT 2,686

INSERT Know Your Medications Card (Form #2327) NA

• Revised article list format• Can now easily determine

amount of copy per issue• Can easily see if there are

sufficient graphics

AHA! MOMENTOne of my personal favorite improvements. This makes it SO much easier to plan issues.

Value Stream Map – Future StatePractice Pro Newsletter Lean Project 2012

Value Stream Map – Future StatePractice Pro Newsletter Lean Project 2012

Future State: In the layout part of the process, now the editor and production specialist meet to review articles and create thumbnail then the editor works directly with the designer…reducing hand offs and lead time.

Action PlanPractice Pro Newsletter Lean Project 2012

• Editor started working directly with designer in August. August Practice Pro went to the designer and ONLY TWO WEEKS later was mailed to practices – a reduction in lead time of two to four weeks.

• Starting with September issue…designer will grant FTP access to editor to transfer files via FTP instead of email

• It was VERY helpful to receive suggestions from neutral parties outside the process

• Overall…team is very happy with process improvements implemented so far

Final ThoughtsPractice Pro Newsletter Lean Project 2012

Questions?Practice Pro Newsletter Lean Project 2012