How To Change Culture With Data Driven Process Improvement

Transcription

1 Changing Culture with Data Driven Process Improvement

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3 A Brief Introduction: MedStar Georgetown University Hospital Non-Profit Academic Hospital Located in Washington, DC 1 of 10 Hospitals in the MedStar Health system Ali Anderson Data Analyst Process Improvement Dept BS, Industrial Engineering Michael Molineux, MD Division Chief, Hospitalist Medicine Asst Professor, Internal Medicine at Georgetown University

4 Latest Project: Length of Stay (LOS) Problem: Longer than Expected Length of Stay Goal: Reduce LOS by 1.0 days Impacts of problem: Overcrowding in the ED with patients waiting to be admitted Regularly above capacity on adult inpatient units Physician and Staff dissatisfaction New Approach: Lean Six Sigma Process Improvement Project

5 Lean Six Sigma is a data-driven methodology used to solve problems with a multi-disciplinary team Define Measure Analyze Improve Control Define problem & goal Define scope Establish a team Assess current state Refine problem & goal Identify and test root causes Develop & rank solutions Conduct pilot Continuously monitor & report performance Calculate ROI

6 Start by understanding current culture Someone else is looking at it. If I need it, I can get it. Data The data I need is unavailable. I don t trust the data I do get. Decisions are made using experience and limited data Performance Improvement This is yet another initiative. It will come and go. Limited confidence that momentum or improvements will last Change This is the way that we do it here. Organization and culture are steeped in tradition

7 Define Measure Analyze Improve Control Teach about the Lean Six Sigma method Explain the reasons behind each phase and activity Use data to define foundational project elements Problem statement Goal statement Scope Outliers

8 Define Measure Analyze Improve Control Understand data sources and establish data integrity Cite sources, inclusion/exclusion criteria, time period, sample size Ask questions in the right order Ask how often does it happen before how long does it take? Present data in understandable, memorable, and consistent way Use graphs to fit audience: Bar chart vs. Box plot Clinicians are visual people Narrow focus of investigation based on findings

9 Define Measure Analyze Improve Control Prove connection between root cause and problem with statistical tests Confirm or refute previously held beliefs about what causes the problem Narrow focus for solution development

10 Define Measure Analyze Improve Control Rank solutions based on key criteria developed by the team Test solutions in a pilot Create metrics with the team Share metrics on regular basis Example Dashboard Coach leaders to be independent What key metrics mean How to read dashboards What level requires actions

11 Define Measure Analyze Improve Control Develop sustainment plans Metrics to be tracked Plans for audits to be conducted Provide metrics regularly on key process inputs and outputs Send to executive sponsors keep visibility Send to nursing leaders watch performance and take action Send to physician leaders evaluate trends among individuals

12 Project Completion How did this project change attitudes about data? Project Team XYZ happens all the time. I m sure data could confirm this, but XYZ happens all the time. Can you look up how often XYZ happens let s see the data! Executive Sponsors How does Lean Six Sigma really work? We ve had a general sense of performance, but we ve never had such detail. We ll use Lean Six Sigma and data to achieve FY16 operating plan.

13 Key Takeaways: Teach about your methods 1. Define problem and goal with data 2. Explain data sources and inclusion/exclusion criteria 3. Present data in simple ways to tell the story 4. Make decisions using data: Where to focus What to change How to change How to monitor and maintain

14 Ali Anderson Dr. Michael Molineux MedStar Georgetown University Hospital