Sanford Improvement Making Lean Work in Healthcare

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1 Sanford Improvement Making Lean Work in Healthcare David Peterson Enterprise Director of Continuous Improvement Outline/Agenda Office of Continuous Improvement Who are we and what do we do? History/Journey of Improvement at Sanford Sanford Improvement Improvement Elements Project Examples How can you do this on your own? Questions 1

2 Office of Continuous Improvement Who are we? Engineers and Health Care Professionals Trained in Process Improvement and Project Management methodologies What do we do? Act as internal consultants/experts Workflow analysis and efficiency improvements Project Management Office of Continuous Improvement What is our Role? Outside eyes on existing processes Challenge the status quo Drive the improvement process Bring together cross functional groups Be the voice of the patient We love metrics Help manage spread across regions 2

3 Improvement Journey Interest in engineers in our organization in the early 2000 s Leadership engaging in the LEAN philosophy Small group of engineers doing informal improvement efforts Established a following and some in operations bought into the process (Internal Medicine and CSPD) Improvement Journey Formed OCI as a formal department Engaged Virginia Mason for rigorous LEAN training which brought more structure to our improvement efforts Developed our own internal LEAN certification Today we are an enterprise group of 12 reporting to the VP of Quality, Safety and Continuous Improvement 3

4 Sanford Improvement Various improvement methodologies utilized throughout the organization Standardize and formalize our improvement process encompassing all various models Common Language Common Tools Sanford Improvement is 4

5 Sanford Improvement is Patient Centered All about the patient Patients define value Satisfaction is key Sanford Improvement is Patient Centered All about the patient Patients define value Satisfaction is key Data Driven Utilize the data Must have Metrics Leading vs. Lagging 5

6 Sanford Improvement is Patient Centered All about the patient Patients define value Satisfaction is key Data Driven Utilize the data Must have Metrics Leading vs. Lagging Leadership Directed Set the vision Engaged Allocate Resources Remove Barriers Sanford Improvement Calls us to.. LEAN, PDSA, Six Sigma Build people and their capacity Eliminate waste Error proof processes Evidence based practices 6

7 Sanford Improvement Calls us to.. Selection and prioritization process Aligned to strategic goals Defined responsibilities Project Charters Report Out Process Sanford Improvement Calls us to.. Value Stream Mapping Spaghetti Charts Rapid Improvement Events LEAN tools 7

8 Sanford Improvement Calls us to.. Visibility Boards Standardized Report Outs Integrating improvement work into daily work Enterprise Standards and goals Improvement Elements Current State Mapping Ideal State Mapping Gaps Brainstorming Create Standard Work Communication Plan Implementation Plan Accountability from leaders Public display of data Report out to Leadership 8

9 Inpatient Project Examples Care Rounding Asset Tracking Transport Process Supply Cart Standardization Family Birth Center Readmissions and Day of Discharge Bed Supply and Storage Project Examples Emergency Department Nurse Arriving Patients Quick Registration Immediate Rooming 30 Minute Rounding Track Board Inpatient Handoff Process 9

10 Project Examples Procedural Case Standardization and Picking Process Room Turnover Inventory Management Endo Suite Processes Interventional Radiology Day Unit Project Examples Facility Design and Layout Sanford Medical Center Fargo Sanford Heart Hospital in Sioux Falls Lab Pharmacy Moorhead Clinic 10

11 Project Examples Patient Prep 2 bin Supplies Room Turnover (Clinic, IR, OR, ED) Set up Reduction (OR, IR) Morning Huddles Bed Ahead Process Mobile Specialty Carts (ED) Clinic Project Examples Physician Templates Reduced Rules for Scheduling Acute add on Process Indirect Work Management In Room Outbooking Team Based Care Top of Scope Real Time Location System (RTLS) 11

12 How can you do this? Preparation Leader or Physician Champion Manageable Scope Metrics for Success Baseline Proper Team Structure Cross Functional, Front Line Staff and Physicians Block Schedules Reserve Time Go and See the Process How can you do this? Event Describe the Current State Decide what you want to fix Ideal State Open discussion Brainstorm Keep within scope Parking Lot other Ideas Overall Goal Guides Decisions Develop Standard Work 12

13 How can you do this? Implementation Pilot or Trial vs. Full Rollout Educate staff on Standard Work Give it time Be present during rollout to see issues Don t scrap new ideas offer suggestions Process Metrics real time measurements How can you do this? Sustainability Display metrics in department Discuss at team meetings and huddles Make adjustments as needed you can t foresee every scenario during event Report out to leadership Keep staff accountable Celebrate success 13

14 How can you do this? Benefits Improved Process Patient and Staff Satisfaction Outcomes Quality, Wait Times, Access Staff Engagement and Culture of Change Tools 14

15 Tools Tools 15

16 Tools Questions? 16

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