Can research help bridge the knowledge gaps of the Lean...
13
6/20/2018 1 John S. Toussaint, MD CLEAR Research Symposium June 13 th 2018 Can research help bridge the knowledge gaps of the Lean Healthcare Transformation?
Transcript of Can research help bridge the knowledge gaps of the Lean...
6/20/2018
1
John S. Toussaint, MDCLEAR Research Symposium
June 13th 2018
Can research help bridge the knowledge gaps of the Lean Healthcare Transformation?
6/20/2018
2
WHICH, IF ANY, OF THE FOLLOWING TRANSFORMATIONAL PERFORMANCE IMPROVEMENTAPPROACHES IS THE PRIMARY APPROACH USED IN YOUR HOSPITAL TO IMPROVE QUALITY,
SAFETY, EFFICIENCY, AND PATIENT SATISFACTION?
6/20/2018
3
“Can’t you make this easier”
Arnie Milstein-Stanford
Everyone in the organization has learning needs for lean transformationBoardSenior executive teamKpo membersModel cell managersFront line teamsSupport teams
6/20/2018
4
Research Question 1
“Where do we start”?
6/20/2018
5
Senior Leadership and Board Learning
Model
Cell
Redesign
Management
System
Change
Management
© 2018 Catalysis, Inc.
Model Cell at Harbor UCLA
6/20/2018
6
Research Question 2
What do executives need to know?
6/20/2018
7
Executive Leader Coaching Session Modules
Coaching Session #1- Personal A3 and Self-AssessmentCoaching Session #2 – Constancy of PurposeCoaching Session #3 – True NorthCoaching Session #4 – Transparency through visual managementCoaching Session #5 – Respect for StandardsCoaching Session #6 – Respect for every individualCoaching Session #7 – Focus on the ProcessCoaching Session #8 – Scientific ThinkingCoaching Session #9 – Lead with HumilityCoaching Session #10 – Seek PerfectionCoaching Session #11 – Ensure Quality at the SourceCoaching Session #12 – Think Systemically
6/20/2018
8
Executive Leader Management System Modules1. The Status Sheet2. The Scorecard3. Introduction to Performance Review 4. Performance Review5. Visual Management and Huddles6. Process Observation/Kamishibai7. Leader Standard Work
Research Question 3
What’s the optimal learning process for executives on the lean journey?
6/20/2018
9
www.createvalue.org
Senior Leader Self-Assessment on Fundamental Behaviors
Levels of frequency, duration & intensityLevel 1: Rare, Undeveloped, IndifferentLevel 2: Irregular, Experimental, ApparentLevel 3: Frequent, Predictable, ModerateLevel 4: Consistent, Stable, PersistentLevel 5: Uniform, Mature Tenacious
Source : Karl Hoover and John Toussaint, “A Management, Leadership, and Board Road Map to Transforming Care for Patients” Frontiers of Health Services Management, Spring 2014
6/20/2018
10
Reflection
0
1
2
3
4
5
Willingness
Humility
Curiosity
Perseverance
Self-Discipline
Go See, Listen & Learn
Asking Questions
Effective ListeningA3 Thinking
Partner, Buddy System
Coach
Leader Standard Work
Senior Leader Behavioral Self-Assessment
Research Question 4
What are the critical behaviors required of executives for success?
6/20/2018
11
Western Sussex Hospitals NHS FTStarting point• Product of 2 organizations merging across 2 main
sites. • Stable leadership team and good performance• Achieved Foundation Trust but recognized
needed to do more to continue to improve
• Year of research into different approaches and ‘tilling the soil’ with senior team
Outcomes
7%Increase in staff engagement
30%Reduction in falls
77%Reduction in ‘ward fit’ patients delayed in ICU
26%Agency spend reduction
Approach• Appointed Catalysis and KPMG on 2 year
programme to support ‘Patient First’ improvement journey.
• Catalysis provided Executive coaching support and learning from dozens of similar improvement journeys
• KPMG provided lean and coaching support on the ground to implement the management system and building, training and handing over to the internal Kaizen Office.
What happens when you do this?
32
47
83 82
Staff are asked for improvementsuggestions
Staff are involved in departmentalchange
Before % After %
Empowering staff to ‘remove the rocks from their shoes’
6/20/2018
12
Best HSMR in Canada 2 out of the last 6 years
50% Reduction in falls
60% Reduction in Hospital Acquired Infections
35% Reduction in Staff Injuries (BBF)
17% Reduction in Average Length of Stay
7,000+ Improvements implemented in past 3 years
Achieving Success
Research Question 5
How do we measure success (or lack thereof) along the way ?
6/20/2018
13
