Presented by Cooper Linton Associate Vice President, Duke HomeCare & Hospice Hosted by Mark Graban of Value Capture Learning Objectives In this webinar, you will learn practical lessons that can be applied to any setting, not just home care: The fundamentals that guided the Lean journey at Duke HomeCare & Hospice Why committing to zero harm is such an important fundamental belief Why it's crucial for the organization to capture good catches, close calls, and near misses How safety huddles and tiered huddles provide a structured format Why "A3 thinking" must become the organizational culture Challenges to implementing Lean in home-based care Cooper Linton Associate Vice President, Duke HomeCare & Hospice Cooper Linton has worked in the healthcare industry for over 20 years with a passionate focus on home and community-based care. His professional background includes strategic planning, healthcare operations, certificate of need, marketing, business development, and healthcare construction. He currently serves as the associate vice president for Duke HomeCare, Duke Hospice, and Duke Home Infusion. Cooper also co-hosts a podcast, Edge of Aging, around healthcare and aging issues. He has a passion around healthcare access for the medically underserved as well as a desire to enhance access to services for caregivers. Mr. Linton holds a Masters in Healthcare Administration and a Masters in Business Administration from the University of Alabama at Birmingham where he also completed his Graduate Certificate in Gerontology. Cooper believes that his greatest “real world” education came through his role as a caregiver while he shared the care-journey of his parents. When not working, Cooper is happily busy as a husband, father, and an avid outdoorsman.

1. Profound change. Sustainable results. 3
Applications of Lean Leadership Methods
in Home-Based Care
Presenter:
Cooper Linton
Associate Vice-President
Duke HomeCare & Hospice
Host:
Mark Graban
Strategic Marketing
Value Capture

2. Profound change. Sustainable results.

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Our Presenter: Cooper Linton
• 20+ years healthcare experience
• Passionate focus on home and
community-based care
• University of Alabama at Birmingham
• Masters in Healthcare Administration
• Masters in Business Administration
• Graduate Certificate in Gerontology
• Co-hosts a podcast, “Edge of Aging”
• Husband, father, outdoorsman.
5

4. Applications for Lean Leadership
Methods in Home-Based Care
Home Health, Home Care, Hospice, Home Infusion
(Yes, you CAN do it!)

5. Introduction
• Cooper Linton: Assoc. VP, Duke Home Health, Hospice & Home Infusion
• Who we are… Duke HomeCare & Hospice
• ADC: Approximately 1850
• Geographic Service Area:
• Home Health and Hospice: 9 counties, 4400+ square miles
• Home Infusion: 3 states (NC, SC, VA), 128,000 square miles

6. Fundamentals That Guided Our Journey
• Respect for our staff, their time, and their expertise.
• “Commit to Zero”: Fundamental belief that no one should be
harmed by our care or in the provision of our care
• Eliminating waste, error, and rework.
• Not just “addressing” issues, resolving them!

7. Focus On “Zero Harm” and “Commit to Zero”
• Physical or emotional harm to…
• Patients
• Loved-ones/caregivers/family
• Staff
• Our business
• Risks are simply harms that haven’t materialized yet.
• Do we really want to wait for harms to occur?
• Do we capture “good catches,” “close calls,” and “near misses”?

8. Safety Huddles and Tiers
• Prioritizing front-line feedback, safety issues, and needs for
support each morning. Tiered huddles provide a structured
format.
• We capture celebrations of staff who are “caught being
awesome.”
• Clear your calendar and focus on supporting your people.
Right now!

9. The DHCH Lean Journey: Iterative Learning

10. Virtual Huddles and Shared Data
Excerpt of
a virtual
Tier 3
Huddle
Board

11. A3s and Just Do Its

12. A3 Thinking Must Become
Organizational Culture
“It is not only for what we do that we are held responsible,
but also for what we do not do.” --- Moliere
• Do we over-estimate the risk of taking action and under-
estimate the risk of the status quo?
• Our “executive” meeting time is 50+% reduced. More time
spent with front line staff.

13. Challenges to Implementing Lean in Home-Based Care
• Remote workforce
• Complications of lone-worker scheduling
• Time limitations related to visit volume and productivity
• Heterogeneity of care setting
• Higher incidence of injury in home-based care and concerns
over workplace safety

14. Impact on Covid Response
• Better prepared by our existing focus on Zero-harm
• Reduced weight of inefficiency allowing greater nimbleness
and speed of implementation
• Highly focused planning around patient and frontline staff
needs
• Greater confidence in our own abilities improved emotional
resilience.

15. Outcomes of Lean
• Billing Register Reduction of 60%
• Turnover reduced by over 50%
• Greater expressed staff satisfaction
• Cultural change:
• Frontline staff engagement
• Focus and responsiveness of leadership team
• Speed of operational decision making

16. The Lean Journey is Doable and Valuable
• Be full committed. This is not a “project”.
• Check what you knew at the door.
• Be prepared for a shift in work cadence and short-term
awkwardness.
• Do get humble. Be prepared for messiness.
• Do get a lean coach, not a “consultant.” You will benefit from
fresh eyes, perspective, and objectivity.

17. If you are interested, I am happy to share our
experience, connect you to my team members,
and discussion options.
Life is a team sport!
Cooper.Linton@duke.edu

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Announcements
(Then Q&A)

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Visit Us at www.ValueCaptureLLC.com
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• Blog
• Podcasts
• White Papers
• Case Studies

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Free eBooks – Wisdom from Paul O’Neill
ValueCaptureLLC.com/BothBooks

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Questions & Answers
Presenter:
Cooper Linton
Associate Vice-President
Duke HomeCare & Hospice
Host:
Mark Graban
Strategic Marketing
Value Capture