Open Your Heart and Mind to Process DesignCategory 6

Sandy Churchill

Vice President – Quality and Safety

Marty Dietrich

Manager – Quality Improvement

World-class Criteria

6.1

How do you design your key work systems and

determine your key work processes to deliver

value to patients?

En

ab

l e

VO

C

Achieve

Vision

And

Mission

Enterprise Model

Risk/Patient Safety/Quality

Support Services

Human Resources

Information Systems

Revenue Cycle

Supply Chain Management

Learning and Innovation

Key Work Systems

Organizational Systems that Guide

Building Loyal Relationships

Emergency Care

Inpatient Care

Out Patient Care

• Patient Access•Assessment/Diagnostic•Care Delivery/Treatment•Discharge

Key Work Processes

Input Output

Key

Support

Work

Systems

Clinical Support Services

©

GSAM Leadership System

Understand

Stakeholder Requirements

1

Accountability

for Results

PatientCommunity

Suppliers

Partners

Physicians

Volunteers

Associates

Families

Mission

Values

Philosophy

Integrity

Passion

Caring

Organize,

Plan & Align

Perform to

Plan

Develop, Reward

& Recognize

Learn, Improve

& Innovate

Set Direction

Establish Goals

Leaders initiate/implement meaningful

changes to services/processes to

create new value

PDSA

Determine

Need: New

System or

Service

Gate 1

Justify

Proposal

Gate 2

Secure

Approval

Gate 3

Initiate

Project

Gate 4

Work

Process

Design

Gate 5

Implement

Deploy

Gate 6

Work System Design

1Design

Work

Processes

Gate 5

3 4

PLAN

DO

STUDY

ACT

Determine

Process

Requirements

Benchmark

Best Practices

Identify

Regulatory

Requirements

Determine

If Process Will

Be External or

Internal

5

Map

Processes

6

Evaluate

Technology

8Develop

Education /

Roll-out Plan

Implement

Deploy

Gate 6

Improve

Utilizing

PDSA

2

Design, Manage, & Improve Work Processes

7 Select

In-Process

& Outcome

Measures

Possible

Heart Attack

recognized

Balloon

Inserted

Vessel

Opened

Process: Cardiac Alert

1%

3.7% 4%

6%

14%

0%

2%

4%

6%

8%

10%

12%

14%

16%

< 60 61-75 76-90 >91 No Balloon

30

-D

ay M

ort

alit

y (%

)

Door to Balloon Time in Minutes

Survival by the Minute

Reference - Gusto IIb - Berger, Circulation 1999, 100:10-14

Good

Designing & Managing Cardiac Alert Process

Timeliness, high

quality/safe care

Partner with EMS

Determine

Process

Requirements

Determine If

Process Will Be

External or

Internal

1

4

Benchmark Best

Practices

2

Identify

Regulatory

Requirements

3

Designing & Managing Cardiac Alert Process

12-lead EKG

7 Select

In-Process &

Outcome

Measures

5

Map Processes

6

Evaluate

Technology

8Develop

Education / Roll-

out Plan

Arrival EKG ED

MD

Cardiac

MD

Cath

Lab

Balloon

Inserted

Minutes

In Cardiac Alert Process: Time Is Muscle

20

14

9

8

5 4

Min

ute

s

Time to EKG

Years

32

21

1113

107

2

Min

ute

s

Time to Cardiologist

Years

21

10

97

5

5

Min

ute

s

Time to ED Physician

15

108

75

0

Min

ute

s

Time to Alert

Years

Cardiac Alert – In Process Measures

Years

76%

81%

90%

95%

97%98% 98%

2004 2005 2006 2007 2008 2009 2010

Pe

rce

nt

% Door To BalloonWithin 90 Minutes

Good

73

67

63

60

5455

52

2004 2005 2006 2007 2008 2009 2010

Min

ute

sCardiac Alert Process

Average Door To Balloon TimeOutcome Measure

Lives

saved!

Good

Where would YOU go if you were having a heart attack?

Centers for Medicare and Medicaid Services –

CMS Website

http://www.hospitalcompare.hhs.gov

This Information Is Available to You…

89%

90% 90%

98%

84%

86%

88%

90%

92%

94%

96%

98%

100%

National State Closest Competitor GSAM

Door to Balloon Time within 90 Minutes(Data source: www.hospitalcompare.hhs.gov)

Good

Thank you fromAdvocate Good Samaritan Hospital

A Thomson Reuters’ Top 50 Cardio Hospital in 2011

Questions

Panelists:

Kathy Bretz, Director – Clinical Excellence

Chuck Derus, MD-Vice President – Medical

Management

Peggy Norton-Rosko, Director – Critical Care/

CV Services