Renewing Your Quality Process

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  • Renewing Your Quality Process

    1. 1. Through the Looking Glass: Reviewing, Renewing Your Organization’s Commitment to Quality HCW: 11 ASQ World Congress Management Consulting in Healthcare & Katherine Reller Consulting
    2. 2. Through the Looking Glass: Surviving and Reviving Your Organization’s Commitment to Quality Management Consulting in Healthcare & Katherine Reller Consulting
    3. 3. SESSION OBJECTIVES <ul><li>Identify the importance of recognizing ‘cornerstones’ of organizational quality </li></ul><ul><li>Conduct a reflective review of your organization’s quality direction and /or programs </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    4. 4. SESSION OBJECTIVES <ul><li>Identify commonly missed “danger signs” that a focus on quality is lost </li></ul><ul><li>Discover how past lessons can renew hospital wide quality efforts </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    5. 5. Today’s work <ul><li>Conduct a reflective assessment of your own organization </li></ul><ul><li>Review the ‘real life’ case study </li></ul><ul><li>Discuss lessons to apply to your own organizations </li></ul><ul><li>Identify real strategies and tools to take home to apply </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    6. 6. Your expectations of the morning? <ul><li>What are 1-2 major questions you would like answered, as a part of today's workshop? </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    7. 7. Healthcare 25 Years Ago Continuous reimbursement dance Recruitment issues High cost High regulatory& patient expectations Transparency & disclosure expectations High public scrutiny High Leadership turnover Management Consulting in Healthcare & Katherine Reller Consulting
    8. 8. Healthcare Today Continuous reimbursement dance Recruitment issues High cost High regulatory& patient expectations Transparency & disclosure expectations High public scrutiny High Leadership turnover Management Consulting in Healthcare & Katherine Reller Consulting
    9. 9. The “Hidden Costs”? <ul><li>What can be the result, if organizations don’t focus on internal quality? </li></ul><ul><li>What are some signs and symptoms that you may be getting off track? </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    10. 10. The “Hidden Costs”? <ul><li>What are some things that can distract organizations? </li></ul><ul><li>If you are off track how do you recognize it, gather support, and get going in the right direction? </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    11. 11. The Self Assessment <ul><li>EXERCISE ONE </li></ul><ul><li>DO YOU??? </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    12. 12. The Case Study Caring Medical Center Management Consulting in Healthcare & Katherine Reller Consulting
    13. 13. The Case Study <ul><li>Caring Medical Center (C.M.C.) </li></ul><ul><ul><li>501(c)3, 150 bed hospital </li></ul></ul><ul><ul><li>Located in a Midwestern city /population 125,000 (500,000 county) serving 3 counties </li></ul></ul><ul><ul><li>Today, part of a four hospital system </li></ul></ul><ul><ul><li>1200 employees </li></ul></ul><ul><ul><li>Several major hospital competitors in a 3 county area </li></ul></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    14. 14. A Bit’o History <ul><li>What was happening in healthcare in 1995? </li></ul><ul><li>Approaches to quality? </li></ul><ul><li>Approaches to cost </li></ul><ul><li>Approaches to staff empowerment? </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    15. 15. What Happened Next? <ul><li>Front line employees were trained in multiple improvement techniques selected by the training department </li></ul><ul><ul><li>Leaders sent to seminars </li></ul></ul><ul><ul><li>Team members received in-house training </li></ul></ul><ul><li>Employee led teams select quality projects generated via idea box – teams meeting weekly </li></ul><ul><li>Some projects selected by management </li></ul><ul><li>Employees encouraged to solve problems </li></ul><ul><li>Many projects with many employees underway </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    16. 16. 1 Year Later Quality Improvement “Lite” <ul><li>Less work – Less filling </li></ul><ul><li>Fewer employees working on fewer projects </li></ul><ul><li>No oversight, each department goes it’s own way </li></ul><ul><li>New silos established (some continue strong) </li></ul><ul><li>Fewer improvement ideas generated – no tracking </li></ul><ul><li>Quality newsletter established (plus, slogans, posters, etc.) </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    17. 17. Results – 2 years later <ul><li>G roups took on a series of small to medium issues </li></ul><ul><li>Little evidence of measurable results </li></ul><ul><li>Support dried up and projects stopped being chartered </li></ul><ul><li>Sponsors focused on financial issues </li></ul><ul><li>Quality newsletter still published </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    18. 18. A New Perspective…. <ul><li>A new CEO came in and brought with him a new perspective on organizational systems and customer service </li></ul><ul><li>Many service departments faced cutbacks </li></ul><ul><li>Clinical areas were immune to review </li></ul><ul><li>A new wave of change was in the air </li></ul><ul><li>The season of “reengineering & redesign began” </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    19. 19. Re-engineer the System! <ul><li>The new CEO brought with him consultants to “re-engineer” organizational systems </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    20. 20. Two Years Later….. <ul><li>No evidence of re-engineering could be found </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    21. 21. Attack Customer Service! <ul><li>A new VP Ops. The introduction of a packaged program successful at “my previous hospital” </li></ul><ul><li>Everyone trained… and trained </li></ul><ul><li>Customers and families were surveyed </li></ul><ul><li>Rewards were distributed depending on manager’s level of buy in </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    22. 22. Then what happened? <ul><li>Area hospital competition increased and revenue stagnated. Several area hospitals added new clinical service programs </li></ul><ul><li>CMC implemented a hiring freeze, stopped all travel to seminars and meetings and started planning a new medical office building </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    23. 23. Then …. <ul><li>A nearby larger facility brought CMC into their system of 3 hospitals </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    24. 24. Progress… <ul><li>A new wing was added to the hospital with new OR’s as a major part of the construction project </li></ul><ul><li>CMC builds ambulatory surgical center on the edge of town </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    25. 25. Devastating News… <ul><li>CMC receives its worst JCAHO review ever. </li></ul><ul><ul><li>A very public discussion of the level of hospital quality takes place in the area’s largest newspaper </li></ul></ul><ul><li>A significant group of surgeons leaves CMC to open own ambulatory surgery center </li></ul><ul><li>The board of directors holds a retreat to discuss their role in quality improvement – brings in Don Berwick </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    26. 26. Devastating News… <ul><li>NOW, what do you think happens? </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    27. 27. Who’s at Fault? <ul><li>The board of directors asks for and receives resignations of: </li></ul><ul><ul><ul><ul><ul><li>CEO </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>COO </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>CFO </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>VP Nursing </li></ul></ul></ul></ul></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    28. 28. And then there were none… Management Consulting in Healthcare & Katherine Reller Consulting
    29. 29. Massive Layoffs in the Community <ul><li>The area’s largest employer lays off 1,000 people for an unknown period of time </li></ul><ul><ul><li>Service volumes increase for a short period, then decline by 10% </li></ul></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    30. 30. Transition <ul><li>CMC looking for new leadership </li></ul><ul><li>High unemployment in community </li></ul><ul><li>High public scrutiny from poor JCAHO review </li></ul><ul><li>What should CMC do now? </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    31. 31. Lessons Learned <ul><li>EXERCISE #2 </li></ul><ul><li>Where did CMC go wrong? </li></ul><ul><li>What were the danger signals? </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    32. 32. Current State <ul><li>EXERCISE #3 </li></ul><ul><li>CMC next steps? </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    33. 33. Your Organization <ul><li>EXERCISE #4 </li></ul><ul><li>Charting your hospital’s condition </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting
    34. 34. Through the Looking Glass- Reviewing, Renewing ASQ World Congress <ul><li>Kenneth G. Bast </li></ul><ul><li>Management Consulting in Healthcare </li></ul><ul><li>1505 Rushmore Drive </li></ul><ul><li>Burnsville, MN 55306 </li></ul><ul><li>www.MgtConsultinginHealthcare.com </li></ul><ul><li>[email_address] </li></ul><ul><li>Cell: (612) 817-3548 </li></ul><ul><li>M. Katherine Reller RN MS, CPHQ </li></ul><ul><li>Reller Consulting </li></ul><ul><li>3936 HWY 52 North Suite 285 </li></ul><ul><li>Rochester MN 55901 </li></ul><ul><li>[email_address] </li></ul><ul><li>Office: 507-206-3023 </li></ul><ul><li>Cell: 507-261-4873 </li></ul>Management Consulting in Healthcare & Katherine Reller Consulting

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