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