This document describes ThedaCare, a community-owned healthcare system focused on achieving better value for customers. It provides an overview of ThedaCare's facilities and services. Key accomplishments highlighted include creating an internship program to develop leaders in continuous improvement, achieving significant reductions in defects and wait times through rapid improvement events, and establishing standard work practices. Challenges noted include managing change with professional staff by addressing fears of lost autonomy and building trust with data showing standard work improves outcomes.
Évoluer ou disparaitre. L'avènement de l'intelligence artificielle dans nos outils du quotidien vient à nouveau de frapper à notre porte en tant qu'accompagnateur des transformations agiles. ChatGPT offre de nombreuses opportunités pour faciliter et accélérer notre travail d'accompagnateur. Découvrez quelques cas pratiques d'utilisation pour augmenter la qualité et la productivité dans vos interventions terrain.
Comment gérer l’humain dans un monde VUCA - HR Square 14 - Jan-Fév 2017Philippe Vallat
« On entend beaucoup parler d’un monde ‘VUCA’ dans
lequel nous évoluerions. Comment adapter nos activités et processus RH à ce mode de fonctionnement pour en tirer le meilleur plutôt que d’en être ‘victime’ ? ».
Article avec interview de Philippe Vallat
State of the Global Workplace - Gallup Report (2017)Adrian Boucek
Only 15% of employees worldwide are engaged at work. This represents a major barrier to productivity for organizations everywhere – and suggests a staggering waste of human potential. Why is this engagement number so low?
A huddle is a brief meeting held each shift/day to enable teams to be informed, review work, make plans, and move ahead rapidly with the daily work. Conducted standing up, preferably around the data dashboard/patient board, the whole team meet for just 10 minutes to make plans for the day and ‘quick fire’ ideas to trouble shoot any potential issues.
Évoluer ou disparaitre. L'avènement de l'intelligence artificielle dans nos outils du quotidien vient à nouveau de frapper à notre porte en tant qu'accompagnateur des transformations agiles. ChatGPT offre de nombreuses opportunités pour faciliter et accélérer notre travail d'accompagnateur. Découvrez quelques cas pratiques d'utilisation pour augmenter la qualité et la productivité dans vos interventions terrain.
Comment gérer l’humain dans un monde VUCA - HR Square 14 - Jan-Fév 2017Philippe Vallat
« On entend beaucoup parler d’un monde ‘VUCA’ dans
lequel nous évoluerions. Comment adapter nos activités et processus RH à ce mode de fonctionnement pour en tirer le meilleur plutôt que d’en être ‘victime’ ? ».
Article avec interview de Philippe Vallat
State of the Global Workplace - Gallup Report (2017)Adrian Boucek
Only 15% of employees worldwide are engaged at work. This represents a major barrier to productivity for organizations everywhere – and suggests a staggering waste of human potential. Why is this engagement number so low?
A huddle is a brief meeting held each shift/day to enable teams to be informed, review work, make plans, and move ahead rapidly with the daily work. Conducted standing up, preferably around the data dashboard/patient board, the whole team meet for just 10 minutes to make plans for the day and ‘quick fire’ ideas to trouble shoot any potential issues.
Healthcare Management for Change
Lecture By Ravi kumudesh,
President, College of Medical Laboratory Science
for Allied Health Science Graduates
On December 09, 2016
at National Institute of Health Science, Sri Lanka
“Management is the art of “knowing what you want to do” and then seeing that it is done in the best and cheapest way. ……F.W.Taylor
Strategist Management
"The Art and Science of Formulating, Implementing, and Evaluating Cross-Functional Decisions That Enable an Organization to Achieve It’s Objectives"
Management as a process “consisting of planning, organizing, actuating and controlling, performed to determine and accomplish the objective by the use of people and resources.”
……George R. Terry
Recorded webinar: http://slidesha.re/1tGIZaH
Subscribe: http://www.ksmartin.com/subscribe
Purchase the book: http://bit.ly/TOObk
Effective problem solving is not an innate skill that most people are born with.
Even for those few few lucky ones who are born with natural problem-solving talent, it is often drummed out of them by parents, teachers, and bosses. And those whose academic preparation would lead you to believe that they're highly skilled in this area (such as engineers and physicians) regularly fall prey to sloppy problem solving.
The good news is that effective problem solving is a skill that can be developed. Everyone can learn to solve problems effectively given the will and ample practice with a skilled coach/teacher.
This webinar focuses on the P (plan) phase of the PDSA/PDCA cycle (plan-do-study-adjust), which is the most difficult phase of scientific problem solving for people to master. Topics include:
• Setting a target condition
• Problem clarification
• Scoping and qualifying the problem
• Root cause analysis
Watch this lively discussion and learn the important first steps for closing the gap between where you are and where you'd like or need to be.
As preparation for the webinar, you may want to read the Discipline chapter in Karen's Shingo Award-winning book, The Outstanding Organization. www.ksmartin.com/TOO
Value stream mapping is a practical and highly effective way to learn to see and resolve disconnects, redundancies, and gaps in how work gets done.
This VSM project template helps you and your project team to put together a "storyboard" for effective presentation to your key stakeholders. It includes four key phases:
1) Define and pick product/service family
2) Create a current state map
3) Develop a future state map
4) Develop an implementation plan
This document consists of a VSM project template in Powerpoint format and a set of Excel templates comprising VSM charter, Results table, Implementation Plan and common VSM icons.
ATMTL23 - Dépasser les frontières : Réinterpréter les Principes ISTQB avec un...Agile Montréal
Cette session propose une réinterprétation des principes de l'ISTQB à travers un prisme Agile, défiant l'idée reçue que les grands principes de tests présentés par l'ISTQB sont uniquement centré sur des modèles séquentiels. En plongeant dans les fondamentaux de l'ISTQB, l'objectif est de démontrer leur intégration harmonieuse avec les méthodologies Agile, mettant en lumière leur adaptabilité intrinsèque. En combinant ISTQB et l'agilité, un nouveau cadre dynamique pour les pratiques d'assurance qualité se dessine, encourageant à défier le statu quo et à explorer le potentiel agile des techniques de tests modernes.
Measures of Success: React Less, Lead Better, Improve MoreMark Graban
In this webinar, Mark Graban shares key insights from his new book that will help you be more effective with your Lean management system. He will share the practical methods and mindsets of “Process Behavior Charts” that apply at the boardroom strategy deployment level and for frontline unit huddle boards. Every metric shows variation over time, but if we react to every change in every metric, then nothing is a priority. This approach can help us waste less time, which means we can improve more effectively and sustainably.
In this webinar, participants will:
Know the three questions people should ask about their metrics and the system that leads to those results
Learn how to interpret their metrics with “Process Behavior Charts”
Determine when to react to a change in a metric, based on three simple rules for determining that we have found a “signal” in the noise
Understand how Process Behavior Charts are more effective than “Bowling Charts” or “red/green” analysis
Metrics at Every (Flight) Level [2020 Agile Kanban Istanbul FlowConf]Matthew Philip
Slides as presented on Dec 8, 2020 at FlowConf organized by Agile Kanban Istanbul. https://www.flowconf.com/
Organizational change often stalls out at departmental boundaries, whether that is IT or another division. How do we help organizations connect vertically and horizontally to realize the outcomes that they have when undertaking large-scale change efforts?
Join this session to learn from a case study of a bank that combined flight levels and metrics to bridge their departmental boundaries and recognize gains not only in software delivery effectiveness but unifying higher-level strategy.
Insights e lições aprendidas em projetos de transformação de processosEloGroup
Apresentação sobre as principais lições aprendidas que tivemos em mais de 2000 projetos de transformação de processos que fizemos. Essa apresentação ocorreu no Café com BPM, evento realizado em outubro e novembro em várias cidades do Brasil, tendo como pauta principal "Como as organizações podem resolver os desafios de Produtividade & Custos da sua organização"
These are the slides for the webinar https://vimeo.com/507636848
Since releasing her book, Clarity First, Karen has continued to analyze, experiment, and reflect on the strong connection between operating with clarity and successfully deploying Lean management—or any improvement-centric management philosophy. She’s learned that addressing the need for clarity head-on is an accelerant.
In this webinar, Karen discusses:
• The personal and organizational benefits of operating with clarity
• The three ways people approach clarity
• How to use Lean Management practices—the 5 P’s—to cultivate clarity
With a strong appetite for and courage to operate with clarity, there's no limit to individual and organizational performance!
To supplement the webinar, visit www.tkmg.com/books/clarity-first -- take our free quiz to assess how you and your organization currently rate, download the first chapter of the book or the CLEAR Problem Solving card mentioned in the webinar, and more.
If you’re interested in learning more about the clarity practices Karen discussed in the webinar, check out www.tkmgacademy.com, our online learning arm.
Lean Thinking is a philosophy of Aligning People to Process to Purpose to Prosper. A Lean leader has to be a mentor, coach and guide for his team. The focus is to minimize daily fire fighting and graduating towards an organization focusing on continuous improvement and innovation.
Objectives and Key Results (OKR) is a collaborative goal-setting framework. They are used by teams and individuals to set challenging, ambitious goals with measurable outcomes.
Employee Onboarding : Statistics you need to knowElodie A.
Learn everything you need to know about employee onboarding and how to ensure that each new hire is successful with this complete guide.
Content by Officevibe, the simplest tool for a greater workplace.
Read more on our website:
https://www.officevibe.com/employee-engagement-solution/employee-onboarding
Download your free checklist of the perfect onboarding:
http://bit.ly/2jVcIzO
Chek our product!
https://www.officevibe.com/
Introduction to OKR - Objectives and Key ResultsWeekdone.com
Do you know what’s the one thing in common in Google, Linkedin, Intel, Zynga, Oracle, Twitter and Sears?
What’s behind the success of aligning their people and teams to work as one towards set goals?
It’s the magical acronym OKR – Objectives and Key Results. All of them use it and love it. Today we’re introducing OKR support also in Weekdone team collaboration software.
Healthcare Management for Change
Lecture By Ravi kumudesh,
President, College of Medical Laboratory Science
for Allied Health Science Graduates
On December 09, 2016
at National Institute of Health Science, Sri Lanka
“Management is the art of “knowing what you want to do” and then seeing that it is done in the best and cheapest way. ……F.W.Taylor
Strategist Management
"The Art and Science of Formulating, Implementing, and Evaluating Cross-Functional Decisions That Enable an Organization to Achieve It’s Objectives"
Management as a process “consisting of planning, organizing, actuating and controlling, performed to determine and accomplish the objective by the use of people and resources.”
……George R. Terry
Recorded webinar: http://slidesha.re/1tGIZaH
Subscribe: http://www.ksmartin.com/subscribe
Purchase the book: http://bit.ly/TOObk
Effective problem solving is not an innate skill that most people are born with.
Even for those few few lucky ones who are born with natural problem-solving talent, it is often drummed out of them by parents, teachers, and bosses. And those whose academic preparation would lead you to believe that they're highly skilled in this area (such as engineers and physicians) regularly fall prey to sloppy problem solving.
The good news is that effective problem solving is a skill that can be developed. Everyone can learn to solve problems effectively given the will and ample practice with a skilled coach/teacher.
This webinar focuses on the P (plan) phase of the PDSA/PDCA cycle (plan-do-study-adjust), which is the most difficult phase of scientific problem solving for people to master. Topics include:
• Setting a target condition
• Problem clarification
• Scoping and qualifying the problem
• Root cause analysis
Watch this lively discussion and learn the important first steps for closing the gap between where you are and where you'd like or need to be.
As preparation for the webinar, you may want to read the Discipline chapter in Karen's Shingo Award-winning book, The Outstanding Organization. www.ksmartin.com/TOO
Value stream mapping is a practical and highly effective way to learn to see and resolve disconnects, redundancies, and gaps in how work gets done.
This VSM project template helps you and your project team to put together a "storyboard" for effective presentation to your key stakeholders. It includes four key phases:
1) Define and pick product/service family
2) Create a current state map
3) Develop a future state map
4) Develop an implementation plan
This document consists of a VSM project template in Powerpoint format and a set of Excel templates comprising VSM charter, Results table, Implementation Plan and common VSM icons.
ATMTL23 - Dépasser les frontières : Réinterpréter les Principes ISTQB avec un...Agile Montréal
Cette session propose une réinterprétation des principes de l'ISTQB à travers un prisme Agile, défiant l'idée reçue que les grands principes de tests présentés par l'ISTQB sont uniquement centré sur des modèles séquentiels. En plongeant dans les fondamentaux de l'ISTQB, l'objectif est de démontrer leur intégration harmonieuse avec les méthodologies Agile, mettant en lumière leur adaptabilité intrinsèque. En combinant ISTQB et l'agilité, un nouveau cadre dynamique pour les pratiques d'assurance qualité se dessine, encourageant à défier le statu quo et à explorer le potentiel agile des techniques de tests modernes.
Measures of Success: React Less, Lead Better, Improve MoreMark Graban
In this webinar, Mark Graban shares key insights from his new book that will help you be more effective with your Lean management system. He will share the practical methods and mindsets of “Process Behavior Charts” that apply at the boardroom strategy deployment level and for frontline unit huddle boards. Every metric shows variation over time, but if we react to every change in every metric, then nothing is a priority. This approach can help us waste less time, which means we can improve more effectively and sustainably.
In this webinar, participants will:
Know the three questions people should ask about their metrics and the system that leads to those results
Learn how to interpret their metrics with “Process Behavior Charts”
Determine when to react to a change in a metric, based on three simple rules for determining that we have found a “signal” in the noise
Understand how Process Behavior Charts are more effective than “Bowling Charts” or “red/green” analysis
Metrics at Every (Flight) Level [2020 Agile Kanban Istanbul FlowConf]Matthew Philip
Slides as presented on Dec 8, 2020 at FlowConf organized by Agile Kanban Istanbul. https://www.flowconf.com/
Organizational change often stalls out at departmental boundaries, whether that is IT or another division. How do we help organizations connect vertically and horizontally to realize the outcomes that they have when undertaking large-scale change efforts?
Join this session to learn from a case study of a bank that combined flight levels and metrics to bridge their departmental boundaries and recognize gains not only in software delivery effectiveness but unifying higher-level strategy.
Insights e lições aprendidas em projetos de transformação de processosEloGroup
Apresentação sobre as principais lições aprendidas que tivemos em mais de 2000 projetos de transformação de processos que fizemos. Essa apresentação ocorreu no Café com BPM, evento realizado em outubro e novembro em várias cidades do Brasil, tendo como pauta principal "Como as organizações podem resolver os desafios de Produtividade & Custos da sua organização"
These are the slides for the webinar https://vimeo.com/507636848
Since releasing her book, Clarity First, Karen has continued to analyze, experiment, and reflect on the strong connection between operating with clarity and successfully deploying Lean management—or any improvement-centric management philosophy. She’s learned that addressing the need for clarity head-on is an accelerant.
In this webinar, Karen discusses:
• The personal and organizational benefits of operating with clarity
• The three ways people approach clarity
• How to use Lean Management practices—the 5 P’s—to cultivate clarity
With a strong appetite for and courage to operate with clarity, there's no limit to individual and organizational performance!
To supplement the webinar, visit www.tkmg.com/books/clarity-first -- take our free quiz to assess how you and your organization currently rate, download the first chapter of the book or the CLEAR Problem Solving card mentioned in the webinar, and more.
If you’re interested in learning more about the clarity practices Karen discussed in the webinar, check out www.tkmgacademy.com, our online learning arm.
Lean Thinking is a philosophy of Aligning People to Process to Purpose to Prosper. A Lean leader has to be a mentor, coach and guide for his team. The focus is to minimize daily fire fighting and graduating towards an organization focusing on continuous improvement and innovation.
Objectives and Key Results (OKR) is a collaborative goal-setting framework. They are used by teams and individuals to set challenging, ambitious goals with measurable outcomes.
Employee Onboarding : Statistics you need to knowElodie A.
Learn everything you need to know about employee onboarding and how to ensure that each new hire is successful with this complete guide.
Content by Officevibe, the simplest tool for a greater workplace.
Read more on our website:
https://www.officevibe.com/employee-engagement-solution/employee-onboarding
Download your free checklist of the perfect onboarding:
http://bit.ly/2jVcIzO
Chek our product!
https://www.officevibe.com/
Introduction to OKR - Objectives and Key ResultsWeekdone.com
Do you know what’s the one thing in common in Google, Linkedin, Intel, Zynga, Oracle, Twitter and Sears?
What’s behind the success of aligning their people and teams to work as one towards set goals?
It’s the magical acronym OKR – Objectives and Key Results. All of them use it and love it. Today we’re introducing OKR support also in Weekdone team collaboration software.
3 Strategies for Maximizing Service Line Efficiency, Quality and ProfitabilityWellbe
Maximizing service line efficiency, quality and profitability is a hot topic, particularly with rising patient care demands, changing reimbursement models, and estimated physician shortfalls. This webinar takes a look at three solutions beginning in the operating room and expanding to the entire patient care journey.
1st solution: A unique clinical and operational service model focused on the specialization of qualified, reimbursable clinical labor to optimize surgeon involvement and reduce OR costs.
2nd solution: Taking a holistic view of the service line through the patient care journey to produce a value stream map to understand the current state. Assisting staff with comparing this current state to the ideal future state, comparing national benchmarks and clinical best practices helps your staff innovate and co-create an individualized plan to get your service line to a higher level.
3rd solution: Utilizing dashboard metrics of the critical to success factors, to sustain and improve your service line.
As a participant, you will be able to:
• Identify key operational and clinical indicators of orthopedic service line efficiency
• Describe how Surgical First Assists can add value in the OR
• List the steps in developing and/or evaluating or building an orthopedic service line
• Describe how metrics/dashboards assist in sustaining change and improvement of orthopedic service line
About the Speaker:
Miki Patterson, PHD ONP, Senior Director of Orthopedics in Intelligent CareDesign at Intralign
Dr. Patterson is a certified orthopedic nurse practitioner and brings over 25 years of clinical experience in healthcare, consulting, direct advanced orthopedic patient care, teaching, NIH level, qualitative and quantitative research and publishing. She is a past president of the National Association of Orthopedic Nurses (NAON) and continues to be nationally recognized for leadership and advancing orthopedic care.
An opportunity to hear how service redesign positively impacts on the patient experience and improves outcomes for both the patient and NHSScotland. Showcasing examples of changes to pathways of care in orthopaedics and community support for people with complex and chronic conditions.
Purpose of the Call:
Change is challenging and getting staff clinicians and physicians to participate in quality improvement initiatives is often a struggle. Understanding the clinical perspective and developing effective change strategies can help.
By the end of this session participants will:
•understand why it is often difficult to engage with clinicians and physicians
•learn how to assess their change strategies for adoptability
•gain experience with the Highly Adoptable Improvement Model and Toolkit
Watch the webinar http://bit.ly/1A0mxOR
Acute hospitals end of life care best practiceNHSRobBenson
Delivering reliable best practice in an acute hospital setting for patients whose recovery is uncertain. Including details of the AMBER care bundle. Presentation from Anita Hayes and colleagues from England's National End of Life Care Programme as part of the Department of Health's QIPP end of life care workstream seminar series at Healthcare Innovation Expo 2011
In this presentation for Digital Health Institute Summit 2020 I will explain how we overcame barriers for patient engagement and achieved very high response rates using our ePRO ZEDOC Platform. I'll give real-world insights from a project we ran at the Rheumatology service at NUH in Singapore.
I wear two hats - this talk is with the first one!
by Wolfgang Krips, Senior Vice President of Global Infrastructure Operations of SAP at the Lean Summit 2010, New Horizons for Lean Thinking on 2/3 November 2010
Lean Leadership for Executives: Initial findings from LGN Research by David Brunt shown at the Lean Summit 2012 - Learning - Educating - Sharing on 27/28 November
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
2. Is a comprehensive, community-owned healthcare system focused on
achieving measurable, better value for our customers. Our mission is to
improve the health of our communities.
Appleton
Medical Center
160-Bed Acute Care
Medical Center
Theda Clark
Medical Center
260-Bed Acute Care
Medical Center
New London Family
Medical Center
25-Bed Acute Care
Medical Center
Riverside
Medical Center
25-Bed Acute Care
Medical Center
Orthopedics Plus
The New Standard for
Quick, High Quality
Orthopedic Services
In The Fox Cities
ThedaCare
Physicians
Employing Over
118 Physicians
At 20 Locations
ThedaCare at Home
Home Health, Hospice,
DME, Respiratory
Therapy, Infusion,
Pharmacy Services
ThedaCare at Work
Occupational and
Employee Health
Services, Employee
Assistance Program
Ingenuity First
Offers Innovative
Solutions to Employers
For Health Care Costs
Fox Cities
Community Clinic
A Free Clinic Jointly
Owned With
St. Elizabeth Hospital
The Heritage/
Peabody Manor
Continuing Care
Campus for Older
Adults
ThedaCare
Behavioral Health
Inpt and Outpt Mental
Health, Substance
Abuse Services
Gold Cross
Ambulance Service
Jointly Owned With
Affinity Health
Systems
July 2006
3. Mission
the reason we are together
“ThedaCare’s mission is to improve the
health of our communities”
4. Vision
a picture of the ideal state to be achieved
“To always set and deliver the highest standard
of health care performance in measurable and visible
ways so our customers are confident they are
making the right decision in choosing us.”
5. Shared Values
the internal compasses that guide our day-to-day
decisions; the glue that holds the organization together
Compassion
Courage
Honesty
Innovation
Integrity
Respect
Teamwork
6. ThedaCare Goals
6/30/06
Decrease Defects and Waiting
Time by 50% each year
Business Engagement
Quality
Customer
Increase Productivity 10%
each year
All staff and physicians
participate in 2 or more RIE’s
7. Defects per Million Opportunities
(DPMO) Performance
Industry/Process Defect DPMO
Commercial large jet travel Crash 3.4
Nuclear industry Reactor malfunction 3.4
Chemical industry Spill 6,210
Road safety Death 6,210
Microlight aircraft or
helicopter
Crash 66,807
Himalayan mountaineering Death 388,537
8. RESULTS:
Collaborative Care
A vision of hospital care with nursing at its center
A new model of inpatient care delivery based on:
• Change in team roles and responsibilities (people)
• Innovative processes
• Principles of poka-yoke; pull production and visual
management
Provided in environment designed specifically for
the model, to reduce waste, to ensure safety and to
promote healing.
9. RESULTS:
KEY ATTRIBUTE CURRENT FUTURE
Physician Role Hierarchical Partner in care team
Medical Record/Plan of Care Multiple Care Plans, developed
separately by clinicians at different
times.
One plan, developed by team in room
with patient.
Patient Experience Disjointed. May be confusing, even
contradictory.
Single plan of care developed with
patient – is visible, continuously
updated with patient driven schedule
and goals.
Clinical Quality Admirable, but not 100% reliable.
Manage errors. Dependent on heroic
effort.
Reliable, standard work, using
evidence-based quality and real time
problem solving to prevent errors.
Toll gates.
Nursing Role Task oriented. Care manager. Expanded and
empowered role in decision making
and patient care progression. Bedside
management of quality measures.
Environment Semi-private, dated. Private. Designed for patient/staff
safety, and to support collaborative
processes.
Collaborative Care is the Model Which Will Transform Us
From Current to Future State
10. RESULTS:
~ Collaborative Care ~
Initial* Results
Measure Pre Desired Collaborative Care Unit
Defect Free Medication 1.5/pt .1/pt
Quality Bundle Pneumonia 38%
CHF
93%
86%
Patient Satisfaction 68% Top Box 84%
Length of Stay 4.35 days 2.86
Case Mix Index 1.09 1.12
Cost Per Case $9,640 $6,000
* First 12 Weeks of R&D Unit
12. Collaborative Care Patient Progression
Tollgate
2
Tollgate
4
Tollgate
5
Tollgate
1
Tollgate
3
PatientDischarge
Are we
progressing
care?
Problem
Solve
NO
PT
Care
Are we
progressing
care?
Problem
Solve
NO
PatientAdmission
PT
Care
Are we
progressing
care?
Problem
Solve
NO
PT
Care
Are we
progressing
care?
Problem
Solve
NO
PT
Care
Are we
progressing
care?
Problem
Solve
NO
PT
Care
PT
Care
Collaborative Care Value Stream Metrics
13. ThedaCare Orthopedics Plus
MSC Care – January 2006
RESULTS:
PCPs -Growth (increased providers, locations)
-Enhanced quality
-Standard work
LATs
-more
schools
ED
SA
-more
athletes
Tier 1
Tier 2 “Mayo-like”
Sports Med PT Occ Med
Rheum LAT Behavioral Med
Physiatry Imaging
Tier 3
Orthopedic Surgery
1 surg case/10 patients,
More focused referrals
from larger referral base
Hand
Delays minimized
Delays minimized
EMR doc
--------
Service
& Clinical
Quality
14. •1/27 – Injured (R) knee pivoting on it getting into the shower.
Musculoskeletal Care Journey
RESULTS:
•1/31 – 0827 Called to make an appointment.
•1/31 – 1415 Seen by Sports Medicine Physician, evaluated,
X-rays done, MRI ordered.
•1/31 – 1451 Initial note completed , encounter closed,
charges dropped.
•2/1 – 0630 MRI knee completed.
•2/1 – 0847 Radiologist report transcribed, report available
in EMR.
15. Musculoskeletal Care Journey
RESULTS:
•2/1 – 0905 Patient called by Sports Medicine
Physician, informed of positive MRI results.
•2/1 – 1200 Orthopedic Surgeon sees patient,
surgery scheduled for 1530.
•2/1 – 1655 Anesthesia start in OR.
•2/1 – 1746 Out of OR.
•2/1 – 1915 Patient returns home.
16. RESULTS:
Door to Balloon
Cardiologists benchmarked in a
collaborative in Wisconsin
2 week long RIEs involving ER and Cath
lab
Physician champion emerging to drive
competition
Kim/PPT/John/HealthForumSF0706
17. Mean Time to PCI – AMC
(Door to Balloon)
0
20
40
60
80
100
120
140
Jan
M
ar
M
ay
Jul
Sept
Nov
Jan
M
ar
M
ay
Jan 05-Jun 06 Goal
Key Events:
2-6-06 Door to Balloon RIE
2-15-06 Standing orders AMI
2-27-06 Code STEMI initiated
RESULTS:
18. “CODE STEMI”
Date: 6-4-07
Arrival Time: 1613 Via walk-in/EMS
EKG Time: 1618
ASA: 1622
Beta Blocker: 1627
Time to CVL: 1634
Xylocaine: 1642
1st Balloon Time: 34 Minutes
DOOR TO BALLOON TIME: 34 MINUTES
RESULTS:
21. The 7-Week Cycle of an R.I. Event
3 weeks before – Value Stream review, Event
Selection, Select Team Leader/Co-Leader and team
members estimated financial, quality and staff impact
1-2 weeks before – RI Checklist, preparation .. Cell
Communication, aim statement, measures
day 1 - current conditions
day 2 – create the future
day 3 - run the new process
day 4 - standard work
day 5 - presentation
1st week after - Capture the savings
2nd week after – Update Standard
Work
3rd week after – CFO validation
•Step 1 “Identify” waste
•Step 2 “Eliminate” waste
Accomplishments:
22. “6S”
GET RID OF WHAT'S
NOT NEEDED
R.I. EVENT GOALS: IMPROVE AUDIT SCORE BY 20 POINTS
1: SORT OUT
2: STRAIGHTEN
3: SCRUB
4: SAFETY
6: SUSTAIN
5: STANDARDIZE
6-S APPLIES
TO ALL AREAS
AUDIT AND IMPROVE
ORGANIZE WHAT IS NEEDED
(VISUAL MANAGEMENT)
CLEAN UP
(SEE AND SOLVE)
ADDRESS UNSAFE
ACTS, CONDITIONS, MOTIONS
ESTABLISH
WHO / WHAT / WHEN
FOR UPKEEP
SELF-DISCIPLINE
AND CARE
Accomplishments:
6S is a Productivity tool not a workplace clean up campaign
25. Accomplishments:
Created the TIS Internship
1% of workforce have full-time jobs in
improvement
We can effectively manage 3 week-long
events each weeks
Standard work for executive GEMBA done
weekly
6S in all units
27. Logistics & Design
Accomplishments:
8 weeks, 50% of work time (160 hrs)
Weekly schedule/focus
Reading/pre-work
Coaching with Manager
Learning methodologies
• Fieldwork
• Application to department work
Linking with PDP
Operational managers of participants involved in the learning process
Evaluation-show and tell
PDSA Framework
O: ThedaCare Improvement System/TIS Internship for Leaders
28. Accomplishments:
Outcomes
1. Lead successful improvement activities relevant to
scope of responsibility.
2. Evaluate the impact of improvement strategies on the
people and processes in your work area and formulate an
action plan to support continuous improvement efforts.
3. Demonstrate communication and facilitation skills to
build and lead effective teams.
4. Apply Plan-Do-Study-Act methodology using clinical
data to facilitate continuous process improvement and
daily problem solving.
5. Demonstrate behaviors appropriate to the role of leader
within our TIS culture.
30. Accomplishments:
Manager Assessment of Participant2.0
3.3
2.3
3.3
1.6
3.3
2.3
3.6
1.9
3.9
1.0
2.0
3.0
4.0
5.0
Pre- Post- Pre- Post- Pre- Post- Pre- Post- Pre- Post-
Lead Improvement Leading Effective Teams PDSA Leader in TIS Culture People, Processes &
Action
31. 1
Establish a sense of
urgency for Change
Form a powerful
guiding coalition
Create the new
vision
Communicate
the VisionEmpower others to
act on the Vision
Plan for and create
short-term wins
Consolidate
Improvements
ThedaCare Change Model – Draft 2
Endings
Chaos
New
Beginnings
Collective/Group Cycle
(Intellectual Change)
Individual Cycle
(Emotional Change)
Fundamental
Supporting Processes:
•Leadership Development
•Rigorous Assessment
•Development of Core Processes
•Capacity for Intervention
•Communication/Indoctrination
We are getting exactly
the results we are
designed to achieve! To
get something different,
we must change our
approach!
Sources: “Leading Change” – John Kotter
“Managing Transitions” – William Bridges
“Making Sense of Change Management” Cameron & Green
Institutionalize
new
approaches
Lessons Learned:
32. RIE Participant Survey
Lessons Learned:
I would recommend this organization to a friend as a good place
to work
Overall, I think this is a great place to work
My manager or someone at work seems to care about me as a
person
My manager shows appreciation for the work I do
At work, my opinion seems to count
People here are willing to give extra to get the job done
My manager provides me with sufficient opportunities to
improve myself
I am satisfied with my job security
People are encouraged to balance their work and personal life
Management has kept promises made to us
35. Habits
Safety
• Does the staff member understand and know the safety concerns of his
or her business unit?
• Is work being stopped and remedied if a safety issue is identified?
Taking responsibility for results
• Does the staff member know what is expected?
• Does he/she follow standard work?
• Does he/she effectively communicate the need to change to the
manager/supervisor?
• Does the staff member seek help from colleagues, managers and
supervisors in implementing desired change?
We improve something every day
• Does the staff member use and support PDSA in the workplace?
• Does the staff member measure and share results with the team?
36. We work as one
• Does the staff member know the system measures?
• Does the staff member ask for help?
• Does the staff member anticipate patient/customer needs across the
continuum?
• Does the staff member anticipate the impact of actions on team members ?
Our customers come first
• Does the staff member ask our customers if we are meeting their
expectations?
• Is the staff member designing business models to meet our customer/patient
demand?
We capture learning
• Does the staff member celebrate successes and failures in big ways and in
small?
• Does the staff member recognize changes within people that drives changes?
• Is the staff member coaching/willing to be coached?
• Is the staff member helping people to be successful?
• Does the staff member forgive people if they make a mistake
37. We are candid and respectful
• Is the staff member open to new information?
• Does the staff member have regular, open, honest communication with
others?
• Does the staff member put all issues on the table right away?
• Does the staff member use the 5 whys?
• Does the staff member get data that clarifies?
• Does the staff member work to develop common understanding with the
right people?
38. Lessons Learned:
Create Pull for Physicians
Radiology transcription data
Outpatient surgery center/under arrangement
partnership (partnership with physicians)
40. Future Plans
TIS Leadership Education (Learning to See)
Cell lead & training visit to Ariens
3% of work force full-time on improvement
through re-deployment
41. Issues With Suggestion
Managing change related to professional
staff
• Fear of loss of autonomy of decision making in
our professional staff will only be mitigated
with the data that standard work works
• Lack of trust of administration will only be
improved by getting wins in the departments