© 2016 Rising Tide

The Human and Operations Balance:Leading a Lean Cultural Transformation to Achieve Sustainable Clinical and Business

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Presented on: Saturday, April 30th

Presented by: Nancy Hesse, Devree Molnar, and Sarah Beadling

CTCA Background

© 2016 Rising Tide

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Mission, Vision and Values

© 2014 Rising Tide

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Mission

CTCA is the home of

integrative and

compassionate cancer

care. We never stop

searching for and providing

powerful and innovative

therapies to heal the whole

person, improve quality of

life, and restore hope.

Vision

To be recognized and

trusted by people living with

cancer as the premier

center for healing and hope

Values

Hopeful

Compassionate

Empowering

Ethical

Responsive

Innovative

Team-Spirited

Our Promise and Our Stakeholder Bond

© 2014 Rising Tide

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Our Promise

You and your healing are at the center of

our hearts, minds, and actions, every day.

We rally our team around you, delivering

compassionate, integrative cancer care for

your body, mind, and spirit.

We offer clear information, powerful and

thorough treatment options, all based on

your needs.

We honor your courage, respect your

decisions, and offer to share your journey

of healing and hope.

Stakeholder Bond

As Stakeholders, we trust and value each other as

special members of the CTCA family. We appreciate

one another’s unique talents, optimism, and energy.

We are empowered to make a difference and we are

grateful for the dedication and devotion we share with

our patients and one another, every day.

We are the heart of the Mother Standard ®. We offer

compassion, trust, healing, and hope for those who

need it most. We recognize our exceptional

contributions and strive to make CTCA the best place to

work.

Together we celebrate our commitment to make a real

and lasting difference in the lives of one another, and

the people we serve.

Start with “Why?”

• Uncovering the need

– Meet challenges of changing healthcare industry

– Long-term hospital sustainability

– Survive and thrive

– Continuously improve

– Fulfill the mission, vision, and values

© 2014 Rising Tide

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Operational Excellence

Defined:

Achieving world-class performance and being recognized globally for the highest safety scores, the highest quality of care and service scores, the highest stakeholder engagement scores, delivering our services faster than anyone else can, and operating at the lowest cost

© 2014 Rising Tide

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Crafting the Plan

• We needed a system that:– Was sustainable

– Was unified and aligned

– Was all-encompassing and balanced

– Connected people with process by design

– Was organic to our culture and business

© 2016 Rising Tide

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Mutual Trust and

Respect

Problems are Blessings

Leadership and

Teamwork

Safety

Quality

Talent

Delivery

Finance

Alignment Towards True North

© 2016 Rising Tide

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Human Operations

Co

ntin

uo

us Im

pro

ve

me

nt

True North

Culture Transformation

Behaviors

Attitudes and Mindsets

Values and Beliefs

© 2016 Rising Tide

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Tra

nsfo

rmed

Form

ed

The Journey to Operational Excellence

© 2013 Rising Tide

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building | culture(1-2 years)

building | systems(1-2 years)

building | value(1-2 years)

Engaging the hearts and minds to build the foundational

operating framework

Creating standardized work processes to break down silos and

connect value streams

Systematically increasing the value added to the customer

1111

building | culture(1-2 years)

building | systems(1-2 years)

building | value(1-2 years)

Engaging the hearts and minds to build the foundational operating framework

Creating standardized work processes to break down silos and connect value streams

Systematically increasing the value added to the customer

Level 1 Level 2 Level 3 Level 4 Level 5

Operational Excellence OverviewSteering CommitteeChange Management

& Communication PlanRoles and ResponsibilitiesSuggestion SystemSIPOC / Value Stream MapVisual Management BoardDaily HuddleSafety SystemProblem Solving IPlan-Do-Check-Act Cycle

Leader Standard WorkExecutive RoundingMonthly MeetingMaster PlanningStandard Work IValue Stream Mapping IProcess MappingAudit IProblem Solving IIA3

One Page ReportJob InstructionTeam SuggestionsStandard Work IIValue Stream Mapping IIKanbanAndon5S+1Total Productive MaintenanceTeam Problem Solving IAnnual Planning

Meeting FacilitationEffective ListeningJob RotationOne-Piece-FlowPull SystemsTakt Time & Capacity PlanningAudit IITeam Problem Solving II

Organizational DesignInfrastructure StrategyManagement DevelopmentJust-in-Time ProductionSupply Chain Integration System Audit

Operational Excellence:

achieving world-class performance and being recognized globally for the highest safety scores,

the highest quality of care and service scores, the highest stakeholder engagement scores,

delivering our services faster than anyone else can, and operating at the lowest cost

Decreased stakeholder injuries

Improved quality outcomes

Decreased wait times

Decreased lead times

Decreased cycle times

Increased personnel utilization

Increased equipment utilization

Decreased downtimes

Increased stakeholder cross

training/flexibility

Increased process improvement

sustainability

Improved team synergy

Increased awareness and

communication

Increased problem solving

activity

Shift in focus to critical few:

metrics and problems

Increased stakeholder

suggestions

Process definition - %

processes standardized

Culture of Safety, Quality,

Talent, Delivery, and Finance

Increased

stakeholder

engagement

Decreased

turnover

Increased

purchasing power

Increased value-

added

percentage

Results / Evidence of Maturity

Human | Operations | Continuous Improvement

The Journey to Operational Excellence

Phase I Framework

© 2013 Rising Tide

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Suggestion System

Monthly Meeting

Leader Standard

Work

Problem Solving

Daily Huddle

PDCA

Visual Management

Board

SIPOC / VSM

Safety System

Standard Work

Visual Management Board

Laying the Culture-Changing Foundation

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Daily Huddle

Visual Management

Board

Problem Solving

Criteria for the Right Pilot Hall

© 2016 Rising Tide

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Stakeholder Engagement

Setup Logistics

Executive Support

Critical to Operations

Department Leadership

Implementing The OE System

© 2016 Rising Tide

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Select the right team

Share the what and why

Customize and create

their content

Communicate and adjust

Go-Live Coach

The ICU JourneyC

om

mit

to

Qu

alit

y Safe

ty Increased KBMA Rate from 75% to 99.5% sustained over 12 months

Reduced patient falls to 1.32 falls/1000 patient days

Qu

alit

y

Increased VTE Prophylaxis from 77% to 100%

Current Pressure Ulcer Rate is 0.6/1000 patient days (national benchmark is 2.65/1000

patient days)

Ventilator Associated Events: 1/1000 patient days (national benchmark is 6.46/1000 patient

days)

CLABSI: 0.3/1000 patient days (national benchmark is 1.84/1000 patient days)

CaUTI: 0.5/1000 patient days (national benchmark is 2.07/1000 patient days)

Enga

ge

Tale

nt Attended/Provided 215 professional education events (exceeding goal of 64)

Held 41 Journal Clubs (exceeding goal of 24)

Inn

ova

te

Del

iver

y

Progressive Upright Mobility A3 Project: Decreased ventilator days by 50% and decreased

length of stay from 12.8 days to 8.5 days, a positive financial impact of $752,055

Gro

w

Fin

ance Specialty Product Charge Capture: Increase from $0/month to $4272/month; $59,849 total

(Oct 2014-Oct 2015)

Perioperative Teamwork

Future Evolution and Implementation

© 2016 Rising Tide

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Growth and maturity

within our outlined journey

Cascading the OE System

throughout the

organization

Embedding within our culture as

the way we do business

Final Thoughts

© 2016 Rising Tide

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Balance the human and operations

Use fact-management

to solve problems and

make decisions

Be present and authentic

Visualize performance indicators to

create transparency

What Does it Take to be Successful?

© 2016 Rising Tide

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