Sustaining a Quality Improvement Program
A question I get quite often is, “How do you sustain your Continuous Improvement (CI) program?” Generally, this question comes from people who have been involved in a CI program for awhile and it has started to lose its luster. Let’s face it. CI is hard work. And sustaining that hard work is very difficult, especially in a business world where more and more is demanded of each individual. In an insightful article in the Jan/Feb 2018 issue of ACHE’s Healthcare Executive, CatalystPresident Kim Barnas recommends that sustaining a CI effort begins with an organization’s leadership, particularly the CEO and executive committee. She then lists a dozen principles that are critical for CI leaders to model: Use personal A3 (similar to plan, do, check, act or PDCA) and self-assessment Have a constancy of purpose Establish “true north” metrics Demonstrate transparency through visual management Respect for standards (standard work) Show respect for every individual Focus on the process Utilize scientific thinking and Lean tools Lead with humility Seek perfection Ensure quality at the source Think systemically While these principles should be emphasized by all leaders, it is important that those leading organizations through a CI program demonstrate these qualities, not only to their executive committee, but also throughout the organization. Continuous improvement is not a program that only works in one area or in one level of a company. It must be utilized and be pervasive throughout the organization. Employees must feel they are empowered to make changes, and those changes must be recognized and encouraged by senior management. While sustaining a CI program can take significant effort, that effort can provide great rewards, not only for the CI team members, but for employees throughout the organization (via time and cost savings and improved employee satisfaction) and eventually customers. How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreForensic Labs Use Lean Six Sigma to Reduce Backlogs, Bring Justice
Across the U.S., police department forensic lab teams painstakingly perform tests in hundreds of thousands of cases each year in an effort to bring about justice. When evidence is brought into the lab, it must be screened, sampled, extracted, measured and quantified to create a profile. Unlike the TV crime shows (where everything is solved in 20 minutes plus commercials), the time from collecting evidence to having a completed scientific report to continue the legal process can takes weeks and sometimes months or even years. As a result, it’s really easy for the process to get backed up. Particularly with city budgets and staffing getting tighter and tighter, forensic lab leaders can be at a loss for how to make a dent in the backlog of cases. But the Tulsa Police Department’s Forensic Lab in Tulsa, OK has done just that. In two years, they successfully whittled down the number of backlogged cases (cases more than 30 days old) by over 60%, from 800 to less than 500! It’s all a matter of learning to do more with less, noted Operations Manager Jon Wilson. They did it by implementing Lean Six Sigma training (LSS) and techniques. The team improved performance by removing extra steps from the process while still maintaining accuracy. The Louisiana State Police Crime Lab implemented a similar LSS initiative a few years ago. The team successfully shrunk the lab’s backlog from nearly 2,000 cases to less than 340. But the departments weren’t satisfied. Both teams set the lofty goal of eventually eliminating their backlogs entirely. Why? Because of the impact it can have on victims and their families. “A rape kit sitting on a shelf for more than a day, one day is too many,” shared Louisiana State Police Colonel Mike Edmondson. Although numerous police departments have made headway in reducing backlogs with Lean Six Sigma, others are challenged to find funding for the initial staff training in LSS techniques. That’s why it’s encouraging that last month Congress introduced legislation to continue the Debbie Smith DNA Backlog Grant Program, which provides funding to support public crime laboratories’ work to build capacity and process DNA evidence, including evidence collected in rape kits. Since its enactment in 2004, the Debbie Smith Act has been renewed twice with overwhelming bipartisan support. The Act’s namesake, Debbie Smith, has a courageous story to share that should keep us all working toward helping crime labs have the tools they need to do their jobs more efficiently. If you’d like to follow the bill’s progress, check out this bill tracker. How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreCancer Center Saves Lives With Six Sigma
Many health care leaders are beginning to see the benefits that Six Sigma tools can bring to not only solving current operational problems, but also creating long-term solutions. One example comes from the Sylvester Comprehensive Cancer Center at the University of Miami’s Miller School of Medicine. The cancer center’s Director of Clinical Operations Lauren Giolai, MBA, BSN, RN shared with Oncology Nursing News that “if you don’t set up the process so that it’s a sustainable win, people get tired and suffer from change fatigue. Creating collaborative solutions that make it better for everyone are the keys to success.” Giolai is an oncology nurse, a job that can be incredibly rewarding as well as challenging. Cancer care nurses develop close relationships with patients, as well as their families and caregivers, over months and years of treatment. In addition to providing treatment, they also teach them how to manage their symptoms and conditions. They get to be an advocate, cheerleader, supporter and encourager for patients facing one of the toughest times in their lives. They also keep tabs on a patient’s changing condition and coordinate needed therapies. They frequently are the liaison between patients and doctors, conveying important updates. Because of their compromised immune systems, cancer patients often encounter sudden, potentially life-threatening changes in their condition. Getting them to prompt medical care often can mean the difference between life and death. One area Giolai and her team found opportunities for improvement was in reducing wait times for cancer patients who come to the hospital’s emergency department with neutropenic fever, caused by low levels of infection-fighting white blood cells. Using Six Sigma tools, a multi-disciplinary team focused on cutting down the time it took from the time patients with neutropenic fever entered the emergency department to when they received intravenous antibiotics. It took input from many departments within the hospital, but eventually a systematic, data-driven approach paid off. The cancer center started giving patients a neutropenic fever alert card that they could share with ambulance personnel and emergency department staff when they entered the hospital. They also added a field on the emergency department’s sign-in form to allow patients an opportunity to indicate neutropenic fever. They then developed a neutropenic fever alert system that emergency department staff could use to trigger a team that would quickly respond to the bedside when such a patient was identified. Giolai credits these simple improvements with saving hundreds of lives. The task force won 2 awards, Overall Showcase and Greatest Customer Impact, at the 2017 Florida Sterling Conference Team Showcase competition. They then used a similar approach to reduce the wait time for lab results by 53% and overall wait time by 26% The results? Patient satisfaction scores went through the roof. Giolai said that breaking down silos and bringing together different departments that don’t normally interact to solve a problem is one of the key benefits of Six Sigma. She offered tips on how to go about lasting process improvement in health care, including: Picking a change that will impact patients Mapping out the process Getting input from the customers and stakeholders Forming teams with a variety of backgrounds and perspectives Defining clearly what you want to improve Defining clearly the steps you need to take Completing the steps and track the results, making changes as needed Kudos to the Sylvester Comprehensive Cancer Center team on a job well done. What tools have been helpful to create sustainable improvement at your workplace? How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting...
Read MoreThere’s Always Room for Improvement
A few months ago I met with a group that wanted to learn about Lean Six Sigma. As we began our discussion, they assured me everything was going well. They just wanted to get more information on how we might consider a continuous improvement process. As we talked, it became apparent that there were several potential areas that could be evaluated. These included a very complicated production process, a multi-stage transportation process from factory to warehouse, and a lot of variation in the intermediate and final products that they were producing. I asked them about bottlenecks -areas where things are not going as smoothly as one would hope or expect. As we delved into the processes that they were using, they began to realize that there were multiple areas that, while not broken, could certainly use a tweak here or there to help improve productivity. Our discussion led into several areas of Lean, talking about transportation, over-engineering, and loss of time. We decided however to focus on a bigger issue dealing with defects, and that a Six Sigma project would be very appropriate for what they needed to evaluate. It’s often interesting to talk to individuals or groups to understand how things are done at their company. At first, everything is fine. But the more you talk, the more anecdotal information you get about what is really happening — problems that have bubbled up or excess resources devoted to working around issues. One of the first steps in any continuous improvement program is admitting that there is room for improvement. A “perfect” system doesn’t need any help, because the people using it won’t admit they need help. It’s important as one considers either a new cip or one that’s been well established for some time to keep an open mind about what could be changed and what could be gained by those changes. How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreThe Power of Checklists
My wife and I recently went on a trip for business and pleasure. As we were preparing to go, she put together a packing list. I, being a non-list person, began filling up my suitcase and finished much sooner than she did. Needless to say, I discovered a few key items that I had forgotten to pack once we reached our destination, necessitating a stop at the local drug store. In looking back on this incident, I can see the advantage that my wife had in creating a checklist of items she wanted to take with her. We’ve traveled enough that she has a standard list that she works from each time. Although she may add or subtract a few items based on our destination or time of year that we’re traveling, it seems that she never forgets any of the items that she wants to bring for the trip. Lists such as this are very useful in a variety of settings. While discussing airplanes with a pilot friend, he told me that he uses a checklist each time he goes flying. And while he’s been flying more than 30 years (currently in a two-seater instead of a 747), he still uses a checklist for each flight. Checklists have also been utilized in medicine, particularly in hospital settings. In his book The Checklist Manifesto, surgeon and researcher Atul Gawande, MD, MPH, argues that today’s workplaces have become so incredibly complicated that mistakes of one kind or another are virtually inevitable. He illustrates how a simple, low-tech checklist can make all the difference in reducing errors and ensuring patient safety. When designing a new continuous improvement process, checklists can be extremely handy in ensuring that everyone knows what the process is, and follows the process the same way. This helps to ensure uniformity and completeness of the new process. It also prevents the tendency to relapse into old methodologies, thus negating the gains from the new process. Most organizations have standard operating procedures of some nature. Within those, how many actually have a checklist of the steps involved within that process? Does your organization use checklists, and, are there ways to incorporate checklists in the work that you are doing? I look forward to hearing your thoughts! How are you helping your employees to work smarter by reducing the amount of time they spend on non-productive activities and correcting errors? If your business processes need a “check-up,” please email me at michael@leadingchangeforgood.com! I’d love to help you get back to a healthy, productive...
Read MoreUsing Data to Turn the Tide of the Opioid Crisis
We’ve all seen the statistics: Drug overdoses, most of which are related to opioids, killed over 64,000 people in the United States last year — an increase of 21% over 2015, according to the Centers for Disease Control. The opioid crisis hit Indiana especially hard. In 2015, IV drug use in Indiana caused the nation’s worst HIV outbreak in 20 years, affecting rural Scott County. Let’s face it — the issue is complicated. There are challenges with both prescription and illicit drugs. Solutions must reduce the number of people who become addicts in the first place, as well as cure those who do. The underlying issue of pain management must be addressed. For all these reasons, the State of Indiana has recognized that understanding the data, and blending them with statistics from other agencies, is key to solving the complexities of the drug crisis in Indiana, and hopefully the nation. Issie Lapowsky described the state’s efforts to attack the problem in an enlightening articlethis fall in Wired magazine. Earlier this year, Indiana started an online opioid data center, where pharmacies, hospitals, mental health organizations, police departments and others can share data to help everyone see the big picture of what is really going on across the state. Working with the analytics-software provider SAP, the State of Indiana constructed a database that includes information on drug arrests, drug seizures, death records, pharmacy robberies, overdose-related ambulance calls, and the use of naloxone, an overdose-reversal drug. State officials also incorporated the data-visualization tools from Tableau, so agencies providing the data can log in and observe trends over time. This far-reaching data-sharing effort—including some 16 government agencies—is amazing in a country still struggling to keep up with the recent explosion of opioid abuse. The state’s efforts are beginning to pay off. To decide where to locate five new opioid treatment facilities, the team took a map of state’s existing treatment facilities and meshed it with a map of overdose cases and instances where paramedics administered naloxone. Then, they measured the distance from the areas with the most overdoses to the nearest treatment location to identify gaps where new facilities might be most helpful. They’ve also been able to monitor drug seizures real time, to monitor new drugs that are hitting the black market. This can help the state spot new drug outbreaks before they reach crisis levels. If you’d like to hear more about how big data is transforming public health and learn what’s next in the battle against the opioid scourge, check out the INconversation with Dr. Jennifer Walthall, Secretary of the Indiana Family and Social Services Administration on Jan. 24 from 4-5:30 p.m. at Indiana Humanities, 1500 N. Delaware. Dr. Walthall is leading the charge to use data to target the areas of the state most in need of treatment programs. Kudos to the team for their efforts to foster collaboration and data sharing to help agencies collectively address the opioid issue real...
Read More
Recent Comments