Barnes-Jewish Hospital implemented an organization-wide lean curriculum to teach lean methodology to all employees. This was done to address the issue of improving processes across the entire hospital rather than just in isolated areas or departments. The curriculum combines an education program for all employees with focused process improvements in specific value streams. As a result of the hospital's lean transformation, it has seen improved operating margins, lower employee turnover rates, and higher patient satisfaction scores. Barnes-Jewish Hospital was also named a finalist for the 2009-2010 International Team Excellence Award for its lean process improvements.
The document discusses interprofessional team collaboration (IPTC) in hospitals. It covers several topics including the context of changing healthcare needs, definitions of occupation and profession, models of interprofessional care and collaboration, theoretical constructs of IPTC, issues and challenges of IPTC, and the focus and objectives of the author's study on the impact of IPTC on healthcare professionals' job satisfaction, retention, and professional growth. The study will use mixed qualitative and quantitative methods including surveys, interviews, and document analysis with healthcare professionals in several hospitals in Nepal.
Michael heffer interprofessional collaborationLornestar
This document discusses interprofessional collaboration (IPC) and provides examples from St. Joseph's Health Centre of how IPC has been implemented. Some key points:
1) IPC involves intentional learning with, from, and about other professions to improve individual and team capacity and patient outcomes.
2) Government support through initiatives like funding academic health science centres has helped establish IPC. Hospitals also need senior leadership buy-in and dedicated roles to promote IPC.
3) St. Joseph's has implemented structures like an interprofessional advisory committee and point of care teams to facilitate IPC. Change leaders and competency frameworks also support its adoption.
4) Evaluating initiatives like St. Joseph
Ahec interprofessional collaboration presentationDeanna B. Hiott
This document describes the Outpatient Quality Improvement Network (OQUIN) initiative in South Carolina to improve cardiovascular health through interprofessional collaboration. OQUIN provided medical summary data to practices to monitor patient outcomes and drive quality improvements. This led to South Carolina improving from 33rd to 17th in cardiovascular health. The Center of Pediatric Medicine used Lean Six Sigma methodology in an initiative to increase measurement of patient heights and weights to calculate BMI for obesity identification. Through defining the problem, measuring baseline performance, analyzing causes, improving processes, and controlling gains, rates of missing BMI data decreased from 22.45% to 1.46%. The project highlighted the benefits of interprofessional teams bringing different perspectives to problem solving and mutual goal setting.
Future of Healthcare - Interprofessional Teamsusffw
This document discusses the importance of interprofessional healthcare teams and education. It describes challenges in the current healthcare system like lack of care coordination. National organizations recommend nurses be educated with other professions to improve collaboration. Effective teams require mutual respect, shared values, and good communication. The appreciative inquiry model focuses on an organization's strengths rather than its problems. Interprofessional education aims to develop competencies like values/ethics, roles, communication, and teamwork to bridge the gap between education and practice.
Using Performance Management to Improve Employee EngagementTony Wiggins
The document discusses a case study on identifying different levels of performance management within an organizational framework presented by Tony Wiggins at the Tonkin Performance Management in Healthcare Conference in Melbourne. Wiggins discusses the Growing Performance Project that aimed to develop staff performance culture as an employee engagement tool to deliver better health outcomes through strategies to integrate performance management across the organization with leadership playing a key role.
This document provides information on interprofessional education (IPE), including definitions, core competencies, rationale, implementation strategies, and tools. It defines IPE as occurring when two or more professions learn about, from and with each other to improve collaboration and quality of care. The document outlines the core IPE competencies of roles/responsibilities, values/ethics, communication, and teamwork. It emphasizes that change is difficult but can be achieved through forming inclusive coalitions, attaining clear goals, and building on small successes. A variety of teaching methods are presented, including case conferences, shadowing, and interprofessional research.
Crandall Ross is a highly skilled nurse educator and manager with extensive experience in leadership, management, nursing care, and education. She excels in constructing engaging curriculum and implementing changes that improve efficiencies and reduce costs. Ross seeks to provide compassionate care and an unparalleled learning experience for students, staff, and patients. She is an effective communicator and leader with expertise in managing projects, people, and delivering superior patient services.
The document discusses interprofessional team collaboration (IPTC) in hospitals. It covers several topics including the context of changing healthcare needs, definitions of occupation and profession, models of interprofessional care and collaboration, theoretical constructs of IPTC, issues and challenges of IPTC, and the focus and objectives of the author's study on the impact of IPTC on healthcare professionals' job satisfaction, retention, and professional growth. The study will use mixed qualitative and quantitative methods including surveys, interviews, and document analysis with healthcare professionals in several hospitals in Nepal.
Michael heffer interprofessional collaborationLornestar
This document discusses interprofessional collaboration (IPC) and provides examples from St. Joseph's Health Centre of how IPC has been implemented. Some key points:
1) IPC involves intentional learning with, from, and about other professions to improve individual and team capacity and patient outcomes.
2) Government support through initiatives like funding academic health science centres has helped establish IPC. Hospitals also need senior leadership buy-in and dedicated roles to promote IPC.
3) St. Joseph's has implemented structures like an interprofessional advisory committee and point of care teams to facilitate IPC. Change leaders and competency frameworks also support its adoption.
4) Evaluating initiatives like St. Joseph
Ahec interprofessional collaboration presentationDeanna B. Hiott
This document describes the Outpatient Quality Improvement Network (OQUIN) initiative in South Carolina to improve cardiovascular health through interprofessional collaboration. OQUIN provided medical summary data to practices to monitor patient outcomes and drive quality improvements. This led to South Carolina improving from 33rd to 17th in cardiovascular health. The Center of Pediatric Medicine used Lean Six Sigma methodology in an initiative to increase measurement of patient heights and weights to calculate BMI for obesity identification. Through defining the problem, measuring baseline performance, analyzing causes, improving processes, and controlling gains, rates of missing BMI data decreased from 22.45% to 1.46%. The project highlighted the benefits of interprofessional teams bringing different perspectives to problem solving and mutual goal setting.
Future of Healthcare - Interprofessional Teamsusffw
This document discusses the importance of interprofessional healthcare teams and education. It describes challenges in the current healthcare system like lack of care coordination. National organizations recommend nurses be educated with other professions to improve collaboration. Effective teams require mutual respect, shared values, and good communication. The appreciative inquiry model focuses on an organization's strengths rather than its problems. Interprofessional education aims to develop competencies like values/ethics, roles, communication, and teamwork to bridge the gap between education and practice.
Using Performance Management to Improve Employee EngagementTony Wiggins
The document discusses a case study on identifying different levels of performance management within an organizational framework presented by Tony Wiggins at the Tonkin Performance Management in Healthcare Conference in Melbourne. Wiggins discusses the Growing Performance Project that aimed to develop staff performance culture as an employee engagement tool to deliver better health outcomes through strategies to integrate performance management across the organization with leadership playing a key role.
This document provides information on interprofessional education (IPE), including definitions, core competencies, rationale, implementation strategies, and tools. It defines IPE as occurring when two or more professions learn about, from and with each other to improve collaboration and quality of care. The document outlines the core IPE competencies of roles/responsibilities, values/ethics, communication, and teamwork. It emphasizes that change is difficult but can be achieved through forming inclusive coalitions, attaining clear goals, and building on small successes. A variety of teaching methods are presented, including case conferences, shadowing, and interprofessional research.
Crandall Ross is a highly skilled nurse educator and manager with extensive experience in leadership, management, nursing care, and education. She excels in constructing engaging curriculum and implementing changes that improve efficiencies and reduce costs. Ross seeks to provide compassionate care and an unparalleled learning experience for students, staff, and patients. She is an effective communicator and leader with expertise in managing projects, people, and delivering superior patient services.
This document contains summaries of several individuals' work experiences and accomplishments in various positions. It highlights skills and achievements in areas like community outreach, patient services, training, organizational leadership, program development, and administrative management. The positions covered include patient care associate, medical clinic aide, communication specialist, and office automation assistant.
This document discusses collaborative practice in healthcare. It defines collaborative practice as developing effective working relationships between practitioners, patients, and communities to improve health outcomes. The benefits of collaborative practice include better patient care and health outcomes, increased job satisfaction and productivity, and a more sustainable and cost-effective healthcare system. Studies show collaborative practices between physicians and other healthcare providers can decrease hospitalizations, lower health metrics like blood pressure, and improve patient symptoms. The document outlines steps to implement collaborative practice through clarifying roles, improving communication, and assessing practices using tools like the Queen's University Collaborative Practice Assessment Tool. It stresses the importance of clear roles and accountability to reduce liability risks.
This document discusses the Transforming Care at the Bedside (TCAB) initiative launched by the Institute for Healthcare Improvement to redesign care on medical/surgical units. TCAB aims to improve safety, patient-centeredness, team vitality, and value through engaging frontline staff in testing changes. The framework focuses on high leverage changes like leadership, teamwork, patient-centered care, value-added processes, and safety. Metrics include adverse events, falls, pressure ulcers, satisfaction, and time spent on direct care.
Clinical Governance: As Drive for Patient Safety in Clinical Dentistry Ruby Med Plus
The focus on patient safety is an international phenomenon. Patient safety is an integral component of the quality of care. The governance of patient safety ‘encompasses panoply of regulatory processes that directly or indirectly intend to manage, prevent or limit iatrogenic events in oral health care services’.
Jill Fulkerson is a registered nurse with over 20 years of clinical leadership and healthcare administration experience. She currently serves as the Director of Inpatient Services at West Valley Medical Center in Idaho, overseeing multiple clinical departments and 160 employees. Previously, she was the Clinical Director of the Emergency Department at Tacoma General Hospital in Washington, managing a staff of 112 employees and an annual budget of $123 million. Her experience demonstrates success in improving clinical quality, patient satisfaction, and financial performance through process improvement initiatives and staff development.
Wellness Initiative For Nurses Under Stress PosterStarwindow
The Wellness Initiative for Nurses Under Stress (WINUS) aims to provide nurses at a local Nevada hospital with an on-site health promotion program to help them make healthy lifestyle choices and better cope with work-related stress. The 6-month pilot program includes workshops, nutrition counseling, stress management programs, and discounted gym memberships. Program evaluation will assess changes in health risks, stress levels, and job satisfaction before and after the program. The goal is for WINUS participants to report 20% improved health risks and 30% greater job satisfaction after 6 months. The program's theoretical framework draws from the PRECEDE-PROCEED model of health promotion planning and evaluation.
Future of Healthcare - Crown Point - Interprofessional Teamsusffw
This document provides an introduction to interprofessional education and practice. It describes recommendations from organizations like the IOM to improve collaboration between healthcare professionals through interprofessional education and teams. The goals of interprofessional collaboration include providing better, higher quality care at a lower cost. It also identifies the need to prepare students with the skills to work effectively on interprofessional teams after graduation.
3 denton-ifa task shifting quality of careifa2012_2
This document discusses task shifting in home and social care in Ontario, Canada. It defines task shifting as delegating tasks from regulated professionals like nurses to less specialized workers like Personal Support Workers (PSWs). The study explored how task shifting impacts quality of care. Interviews found task shifting can improve care through continuity but may risk safety if PSWs lack medical knowledge. Key issues are unequal PSW training and assessing changes in client conditions. Proper education and supervision are needed to address potential risks to client health and safety from task shifting.
The document provides an overview of the newly formed Team Health program at the Clinical Education and Training Institute (CETI), which aims to improve teamwork, communication and collaboration for safer patient-centered care. It summarizes outcomes from two statewide consultation forums, which identified priorities for preparing new clinical graduates and enhancing team-based care. The consultations generated consensus that the Team Health program is evidence-based and can be implemented in coordination with Local Health Districts and other related programs.
Trillium Health Centre implemented Positive Deviance methodology to reduce antibiotic resistant organisms acquired in the hospital. Key aspects of implementation included engaging frontline staff through improvisation activities to shift culture and encourage open communication. The "Nurse Jackson" concept was created to non-threateningly address infection control issues and led to staff becoming more aware of practices and collaborative in improving them. Surveys found high rates of staff knowing and using the term with positive ratings of its impact on practices. Successes are being shared more broadly and sustainability measures include ongoing audits and reporting.
The document discusses the South Eastern Sydney Recovery College (SESRC), an educational initiative in Australia focused on mental health recovery. It operates using a co-production framework where people with lived experience of mental health issues and professionals jointly plan and deliver courses. Staff interviews found co-production within the Recovery College setting was transformational. Since opening in July 2014, the Recovery College has held courses for over 100 students, including consumers, carers, clinicians, and staff. Feedback has been positive about the inclusion of lived experience perspectives.
The document discusses the purpose and elements of nursing codes of ethics. It defines a code of ethics as a formal set of moral rules that governs a nurse's relationships with patients, staff, and the profession. Codes of ethics are intended to establish and maintain high practice standards, provide ethical guidelines, and regulate conduct. The International Council of Nurses' code has four responsibilities for nurses: promote health, prevent illness, restore health, and alleviate suffering. The code addresses nurses' duties to patients, co-workers, society, and their practice. National nursing associations also implement codes of ethics and professional conduct.
This document summarizes a presentation given by CDC experts on CDC resources, tools, and programs for health promotion in worksites. It provides an overview of various CDC initiatives to support worksite health promotion such as the Healthier Worksite Initiative, National Healthy Worksite Program, and Work@Health program. A major focus is on the CDC Worksite Health ScoreCard, a tool to help employers assess evidence-based health promotion interventions. The presentation reviews the development, validation, scoring methodology and uses of the ScoreCard tool. It also discusses the Total Worker Health approach which integrates occupational safety and health protection with health promotion.
This document provides information and recommendations for creating a culture of physical activity in the workplace. It discusses why employers should support physical activity, including increased productivity and lower healthcare costs. It recommends developing infrastructure, policies, and programs to promote activity, including mapped walking routes, bike racks, showers, activity rooms, flexible schedules, and active commuting programs. The document also provides tips for measuring outcomes, developing communication plans, and implementing step-by-step changes to increase physical activity among employees.
The document discusses the roles and skills of hospital managers. It describes managers as coordinating work activities to accomplish organizational goals efficiently and effectively through people. Some key roles of hospital managers include being a figurehead, leader, liaison, monitor of information, disseminator of information, and spokesperson. Effective management skills include technical, human, analytical, decision-making, computer, communication, and conceptual skills. The document outlines several functions and roles of hospital administrators in managing resources, staff, costs, technology, and negotiating.
This document discusses different methods of patient assignment in nursing. It defines patient assignment as how the total work of a nursing unit is divided among personnel. The main methods discussed are: case method (one nurse cares for assigned patients per shift), functional method (work divided into tasks), team nursing (group of nurses care for patients led by team leader), primary nursing (one nurse cares for 4-6 patients 24/7 during hospitalization), and modular method (combines primary and team nursing). The document outlines advantages and disadvantages of each approach and factors to consider in patient assignment.
The Akron Children's Hospital radiology department was facing long wait times for MRI exams of up to 8 weeks. A Lean Six Sigma project was conducted using a multidisciplinary team in a 2-day kaizen event. They identified issues with the scheduling process and insurance authorization delays. Countermeasures included modifying the scheduling to better meet demand and allowing authorization during scheduling. This reduced wait times significantly to same-day for many exams. It also increased exam volumes and generated over $1 million in additional annual revenue while improving patient access.
1) Mercy Medical Center implemented lean process improvements in their emergency department to address slipping patient satisfaction scores.
2) A cross-functional team conducted a value stream map of the emergency department which identified non-value added steps. This led to a series of lean initiatives including fast track service to treat less acute patients within one hour.
3) The results were dramatic - patient satisfaction scores rose to the 95th percentile, length of stay decreased, and the department saw a 6% increase in patient volume while maintaining quality of care.
The document outlines Lean Six Sigma training courses for various roles, including:
- Executive Introduction to Lean Six Sigma for senior leaders
- Lean Six Sigma Champion training for those selecting and tracking projects
- Lean Six Sigma Black Belt training, a comprehensive 25-day course teaching the DMAIC methodology
- Lean Six Sigma Green Belt training, a shorter 6-day course also covering DMAIC
It provides details on the objectives, contents, and duration of each course. The goal is to equip individuals across an organization with the skills needed to successfully implement continuous improvement through Lean Six Sigma.
This document contains summaries of several individuals' work experiences and accomplishments in various positions. It highlights skills and achievements in areas like community outreach, patient services, training, organizational leadership, program development, and administrative management. The positions covered include patient care associate, medical clinic aide, communication specialist, and office automation assistant.
This document discusses collaborative practice in healthcare. It defines collaborative practice as developing effective working relationships between practitioners, patients, and communities to improve health outcomes. The benefits of collaborative practice include better patient care and health outcomes, increased job satisfaction and productivity, and a more sustainable and cost-effective healthcare system. Studies show collaborative practices between physicians and other healthcare providers can decrease hospitalizations, lower health metrics like blood pressure, and improve patient symptoms. The document outlines steps to implement collaborative practice through clarifying roles, improving communication, and assessing practices using tools like the Queen's University Collaborative Practice Assessment Tool. It stresses the importance of clear roles and accountability to reduce liability risks.
This document discusses the Transforming Care at the Bedside (TCAB) initiative launched by the Institute for Healthcare Improvement to redesign care on medical/surgical units. TCAB aims to improve safety, patient-centeredness, team vitality, and value through engaging frontline staff in testing changes. The framework focuses on high leverage changes like leadership, teamwork, patient-centered care, value-added processes, and safety. Metrics include adverse events, falls, pressure ulcers, satisfaction, and time spent on direct care.
Clinical Governance: As Drive for Patient Safety in Clinical Dentistry Ruby Med Plus
The focus on patient safety is an international phenomenon. Patient safety is an integral component of the quality of care. The governance of patient safety ‘encompasses panoply of regulatory processes that directly or indirectly intend to manage, prevent or limit iatrogenic events in oral health care services’.
Jill Fulkerson is a registered nurse with over 20 years of clinical leadership and healthcare administration experience. She currently serves as the Director of Inpatient Services at West Valley Medical Center in Idaho, overseeing multiple clinical departments and 160 employees. Previously, she was the Clinical Director of the Emergency Department at Tacoma General Hospital in Washington, managing a staff of 112 employees and an annual budget of $123 million. Her experience demonstrates success in improving clinical quality, patient satisfaction, and financial performance through process improvement initiatives and staff development.
Wellness Initiative For Nurses Under Stress PosterStarwindow
The Wellness Initiative for Nurses Under Stress (WINUS) aims to provide nurses at a local Nevada hospital with an on-site health promotion program to help them make healthy lifestyle choices and better cope with work-related stress. The 6-month pilot program includes workshops, nutrition counseling, stress management programs, and discounted gym memberships. Program evaluation will assess changes in health risks, stress levels, and job satisfaction before and after the program. The goal is for WINUS participants to report 20% improved health risks and 30% greater job satisfaction after 6 months. The program's theoretical framework draws from the PRECEDE-PROCEED model of health promotion planning and evaluation.
Future of Healthcare - Crown Point - Interprofessional Teamsusffw
This document provides an introduction to interprofessional education and practice. It describes recommendations from organizations like the IOM to improve collaboration between healthcare professionals through interprofessional education and teams. The goals of interprofessional collaboration include providing better, higher quality care at a lower cost. It also identifies the need to prepare students with the skills to work effectively on interprofessional teams after graduation.
3 denton-ifa task shifting quality of careifa2012_2
This document discusses task shifting in home and social care in Ontario, Canada. It defines task shifting as delegating tasks from regulated professionals like nurses to less specialized workers like Personal Support Workers (PSWs). The study explored how task shifting impacts quality of care. Interviews found task shifting can improve care through continuity but may risk safety if PSWs lack medical knowledge. Key issues are unequal PSW training and assessing changes in client conditions. Proper education and supervision are needed to address potential risks to client health and safety from task shifting.
The document provides an overview of the newly formed Team Health program at the Clinical Education and Training Institute (CETI), which aims to improve teamwork, communication and collaboration for safer patient-centered care. It summarizes outcomes from two statewide consultation forums, which identified priorities for preparing new clinical graduates and enhancing team-based care. The consultations generated consensus that the Team Health program is evidence-based and can be implemented in coordination with Local Health Districts and other related programs.
Trillium Health Centre implemented Positive Deviance methodology to reduce antibiotic resistant organisms acquired in the hospital. Key aspects of implementation included engaging frontline staff through improvisation activities to shift culture and encourage open communication. The "Nurse Jackson" concept was created to non-threateningly address infection control issues and led to staff becoming more aware of practices and collaborative in improving them. Surveys found high rates of staff knowing and using the term with positive ratings of its impact on practices. Successes are being shared more broadly and sustainability measures include ongoing audits and reporting.
The document discusses the South Eastern Sydney Recovery College (SESRC), an educational initiative in Australia focused on mental health recovery. It operates using a co-production framework where people with lived experience of mental health issues and professionals jointly plan and deliver courses. Staff interviews found co-production within the Recovery College setting was transformational. Since opening in July 2014, the Recovery College has held courses for over 100 students, including consumers, carers, clinicians, and staff. Feedback has been positive about the inclusion of lived experience perspectives.
The document discusses the purpose and elements of nursing codes of ethics. It defines a code of ethics as a formal set of moral rules that governs a nurse's relationships with patients, staff, and the profession. Codes of ethics are intended to establish and maintain high practice standards, provide ethical guidelines, and regulate conduct. The International Council of Nurses' code has four responsibilities for nurses: promote health, prevent illness, restore health, and alleviate suffering. The code addresses nurses' duties to patients, co-workers, society, and their practice. National nursing associations also implement codes of ethics and professional conduct.
This document summarizes a presentation given by CDC experts on CDC resources, tools, and programs for health promotion in worksites. It provides an overview of various CDC initiatives to support worksite health promotion such as the Healthier Worksite Initiative, National Healthy Worksite Program, and Work@Health program. A major focus is on the CDC Worksite Health ScoreCard, a tool to help employers assess evidence-based health promotion interventions. The presentation reviews the development, validation, scoring methodology and uses of the ScoreCard tool. It also discusses the Total Worker Health approach which integrates occupational safety and health protection with health promotion.
This document provides information and recommendations for creating a culture of physical activity in the workplace. It discusses why employers should support physical activity, including increased productivity and lower healthcare costs. It recommends developing infrastructure, policies, and programs to promote activity, including mapped walking routes, bike racks, showers, activity rooms, flexible schedules, and active commuting programs. The document also provides tips for measuring outcomes, developing communication plans, and implementing step-by-step changes to increase physical activity among employees.
The document discusses the roles and skills of hospital managers. It describes managers as coordinating work activities to accomplish organizational goals efficiently and effectively through people. Some key roles of hospital managers include being a figurehead, leader, liaison, monitor of information, disseminator of information, and spokesperson. Effective management skills include technical, human, analytical, decision-making, computer, communication, and conceptual skills. The document outlines several functions and roles of hospital administrators in managing resources, staff, costs, technology, and negotiating.
This document discusses different methods of patient assignment in nursing. It defines patient assignment as how the total work of a nursing unit is divided among personnel. The main methods discussed are: case method (one nurse cares for assigned patients per shift), functional method (work divided into tasks), team nursing (group of nurses care for patients led by team leader), primary nursing (one nurse cares for 4-6 patients 24/7 during hospitalization), and modular method (combines primary and team nursing). The document outlines advantages and disadvantages of each approach and factors to consider in patient assignment.
The Akron Children's Hospital radiology department was facing long wait times for MRI exams of up to 8 weeks. A Lean Six Sigma project was conducted using a multidisciplinary team in a 2-day kaizen event. They identified issues with the scheduling process and insurance authorization delays. Countermeasures included modifying the scheduling to better meet demand and allowing authorization during scheduling. This reduced wait times significantly to same-day for many exams. It also increased exam volumes and generated over $1 million in additional annual revenue while improving patient access.
1) Mercy Medical Center implemented lean process improvements in their emergency department to address slipping patient satisfaction scores.
2) A cross-functional team conducted a value stream map of the emergency department which identified non-value added steps. This led to a series of lean initiatives including fast track service to treat less acute patients within one hour.
3) The results were dramatic - patient satisfaction scores rose to the 95th percentile, length of stay decreased, and the department saw a 6% increase in patient volume while maintaining quality of care.
The document outlines Lean Six Sigma training courses for various roles, including:
- Executive Introduction to Lean Six Sigma for senior leaders
- Lean Six Sigma Champion training for those selecting and tracking projects
- Lean Six Sigma Black Belt training, a comprehensive 25-day course teaching the DMAIC methodology
- Lean Six Sigma Green Belt training, a shorter 6-day course also covering DMAIC
It provides details on the objectives, contents, and duration of each course. The goal is to equip individuals across an organization with the skills needed to successfully implement continuous improvement through Lean Six Sigma.
Seven core factors are key to counteracting the frequently encountered pitfalls to change management. These include: clarity of purpose and direction; engagement of stakeholders; allocation of necessary resources; alignment of systems and processes; leadership commitment at all levels; effective two-way communication; and tracking of goals and progress. Addressing these factors helps ensure change initiatives stay on track.
Great Ormond Street Hospital Ferrari Formula One Handoversciaranmay
1) Great Ormond Street Hospital for Children (GOSH) benchmarked its handoff process from cardiac surgery to intensive care against the pit stop techniques of Formula One racing teams.
2) Process improvements resulting from this benchmarking included increased standardization, role definition, coordination, and checklists, which led to increased patient safety and decreased error rates.
3) While some aspects like teamwork and choreography were directly transferable, other Formula One techniques like extensive rehearsal and contingency planning were not feasible for GOSH due to limitations of resources, flexibility needs, and the complexity of living patients compared to race cars.
Dennis J. Frankos is an industrial engineer and Lean Six Sigma professional with experience applying operations research techniques in various industries. He has over 20 years of experience leading process improvement projects using Lean Six Sigma methodologies. His background includes roles as a Lean Six Sigma Master Black Belt, Black Belt, and engineering leadership positions at companies including Wyndham Vacation Ownership and United Space Alliance. He has a Master's degree in Industrial Engineering and is skilled in areas such as simulation modeling, decision analysis, and statistical process control.
Implementing Fixed Patient For Nurse RatiosTanya Williams
This document proposes implementing hourly rounding at a hospital to improve patient safety and satisfaction. A task force would be established to use research evidence to propose, implement, and evaluate the change. The Johns Hopkins Nursing Evidence-Based Practice model would be used as a guideline, consisting of three phases - identifying the issue, searching for evidence, and translating evidence into practice. Implementing hourly rounding would help meet patients' needs, reduce call lights and falls, and improve HCAHPS scores.
Peg and georgies scientific poster for pneg final9 10-14Emily Sermersheim
This document describes a student nurse internship program in a neonatal intensive care unit (NICU) that aimed to ease the transition from student to clinician. The 8-week summer program provided opportunities for student nurses to gain clinical experience in the NICU and bridge the gap between theory and practice. Survey results found that the program increased participants' baseline knowledge, confidence, and socialization with patients' families and staff. The program resulted in higher staff satisfaction, increased retention of nurses in the NICU, and better support for new nurses as they transitioned into the clinical role.
Using Deming’s principles to create the next generation of healthcare leadersgperez12
This document describes a partnership between a university's healthcare administration master's program and a Veterans Affairs hospital to improve the curriculum and provide students with real-world experience in process improvement. The program introduced Deming's quality principles and lean methodology into the operations management course. Students worked on ongoing process improvement projects at the VA hospital in small groups, receiving mentorship from hospital staff. This immersive experience allowed students to apply their classroom learning and develop skills in areas like process analysis, problem-solving, and quality improvement that are crucial for future healthcare leaders. Feedback from both the university and hospital indicated the partnership successfully prepared students while benefiting the hospital.
Here is a draft essay applying Peplau's nursing theory to the implementation of electronic health records:
Introduction:
Hildegard Peplau developed the interpersonal relations theory, one of the early nursing theories focused on the nurse-patient relationship. Peplau's theory outlines four phases of the nurse-patient relationship: orientation, identification, exploitation, and resolution. This theory provides a useful framework for examining how nurses can support patients through the transition to electronic health records (EHRs).
Orientation Phase:
When EHRs are first implemented, both nurses and patients will be in the orientation phase. Nurses will need training on the new system while patients may feel confused or anxious about the changes in documentation. It
This document summarizes the October 2016 edition of "Good News You Should Know", a newsletter from the LBJ campus of UTHealth. The newsletter highlights recent progress and achievements in quality care at LBJ Hospital and affiliated clinics. It discusses the hospital receiving re-designation as a Pathway to Excellence facility for nursing care. It also summarizes several quality improvement projects from LBJ faculty that were recognized in a quality competition.
Copyright @ Lippincott Williams & Wilkins. Unauthorized reprod.docxdickonsondorris
Copyright @ Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Copyright @ Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
JONA
Volume 37, Number 12, pp 552-557
Copyright B 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins
T H E J O U R N A L O F N U R S I N G A D M I N I S T R A T I O N
Organizational Change Strategies for
Evidence-Based Practice
Robin P. Newhouse, PhD, RN, CNA, CNOR
Sandi Dearholt, MS, RN
Stephanie Poe, MScN, RN
Linda C. Pugh, PhD, RNC, FAAN
Kathleen M. White, PhD, RN, CNAA,BC
Evidence-based practice, a crucial competency for
healthcare providers and a basic force in Magnet
hospitals, results in better patient outcomes. The
authors describe the strategic approach to support
the maturation of The Johns Hopkins Nursing
evidence-based practice model through providing
leadership, setting expectations, establishing struc-
ture, building skills, and allocating human and
material resources as well as incorporating the
model and tools into undergraduate and graduate
education at the affiliated university.
Evidence-based practice (EBP) is an essential com-
ponent of professional nursing,1,2 a crucial compe-
tency for healthcare providers,3 and a basic force in
Magnet hospitals4 and results in better patient out-
comes and higher levels of nursing autonomy.5
Fostering EBP within organizations requires strong
infrastructure, including nursing leadership and hu-
man and material resources.6-10 Several organizations
have reported on the use of EBP change models to
assist and mentor individual EBP project teams.11-14
One recent publication discusses the use of a change
model in the context of organizational change,
highlighting the establishment of an EBP committee
that is positioned within the nursing department’s
administrative structure.15 Approaching the imple-
mentation of EBP as an organizational transforma-
tional change frames the approach strategically.16
After the creation and testing of a conceptual
model for EBP,17 a strategic plan was developed to
implement the Johns Hopkins Nursing EBP model
and guidelines (JHN EBP) throughout the organi-
zation. The team knew that the implementation of
EBP would require a substantial change in nursing
culture. The goal was to infuse the use of JHN EBP
into routine practice within each department. This
goal required a number of strategic objectives that
included developing EBP education programs and
Web-based resources, modifying job description cri-
teria to include behavioral outcomes for EBP, defin-
ing the origin of potential question generation, and
building nurse EBP skills and expertise (Table 1).
The EBP program was built through providing lead-
ership, setting expectations, establishing structure,
building skills, and allocating human and mate-
rial resources. The JHN EBP model and tools were
then incorporated into undergraduate and graduate
education at the affiliated university. T.
Copyright @ Lippincott Williams & Wilkins. Unauthorized reprod.docxbobbywlane695641
Copyright @ Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Copyright @ Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
JONA
Volume 37, Number 12, pp 552-557
Copyright B 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins
T H E J O U R N A L O F N U R S I N G A D M I N I S T R A T I O N
Organizational Change Strategies for
Evidence-Based Practice
Robin P. Newhouse, PhD, RN, CNA, CNOR
Sandi Dearholt, MS, RN
Stephanie Poe, MScN, RN
Linda C. Pugh, PhD, RNC, FAAN
Kathleen M. White, PhD, RN, CNAA,BC
Evidence-based practice, a crucial competency for
healthcare providers and a basic force in Magnet
hospitals, results in better patient outcomes. The
authors describe the strategic approach to support
the maturation of The Johns Hopkins Nursing
evidence-based practice model through providing
leadership, setting expectations, establishing struc-
ture, building skills, and allocating human and
material resources as well as incorporating the
model and tools into undergraduate and graduate
education at the affiliated university.
Evidence-based practice (EBP) is an essential com-
ponent of professional nursing,1,2 a crucial compe-
tency for healthcare providers,3 and a basic force in
Magnet hospitals4 and results in better patient out-
comes and higher levels of nursing autonomy.5
Fostering EBP within organizations requires strong
infrastructure, including nursing leadership and hu-
man and material resources.6-10 Several organizations
have reported on the use of EBP change models to
assist and mentor individual EBP project teams.11-14
One recent publication discusses the use of a change
model in the context of organizational change,
highlighting the establishment of an EBP committee
that is positioned within the nursing department’s
administrative structure.15 Approaching the imple-
mentation of EBP as an organizational transforma-
tional change frames the approach strategically.16
After the creation and testing of a conceptual
model for EBP,17 a strategic plan was developed to
implement the Johns Hopkins Nursing EBP model
and guidelines (JHN EBP) throughout the organi-
zation. The team knew that the implementation of
EBP would require a substantial change in nursing
culture. The goal was to infuse the use of JHN EBP
into routine practice within each department. This
goal required a number of strategic objectives that
included developing EBP education programs and
Web-based resources, modifying job description cri-
teria to include behavioral outcomes for EBP, defin-
ing the origin of potential question generation, and
building nurse EBP skills and expertise (Table 1).
The EBP program was built through providing lead-
ership, setting expectations, establishing structure,
building skills, and allocating human and mate-
rial resources. The JHN EBP model and tools were
then incorporated into undergraduate and graduate
education at the affiliated university. T.
The document discusses innovation in nursing. It defines innovation as the introduction of new ideas or processes to benefit individuals or organizations. It then discusses different types of innovation like product and process innovation. It also outlines characteristics of innovation and the steps involved in the innovation process. Finally, it discusses factors driving innovation in nursing like addressing workforce shortages and technological advances in healthcare.
Standardized Clinical Placement
Amanda Swenty
MSN-Learner
Walden University
NURS 6600
April 30, 2016
Introduction
Summary of Practicum Project Topic
Project Goals
Project Objectives
Rationale for Goals
Practicum Project Methodology
Practicum Project Findings
Conclusion
I would like to welcome the faculty and course members to this presentation of a topic that I am passionate about as a current faculty member. This project will explain in detail the need for a standardized placement tool for academic settings and hospitals to use.
2
Current difficulty placing students in the clinical setting
Limited sites for faculty led/preceptor led clinical
Disorganized Process of placement of students
Current placement is done individually by each site and it time intensive
Current process shows favoritism
Summary of Practicum Project Topic
As a former student I have felt the pains of placement for students in the clinical setting. As a faculty member I have been exposed to the difficulties that placing students has placed on the colleges and faculty, and the hospitals that host students. The difficulties are in the following areas:
Lack of qualified faculty willing to be flexible in unique clinical times (weekends/nights)
Poor communication between the school/hospital
Time extensive placement for current process ( School sends a request, hospitals wait for requests from all colleges before approving, placement approvals/denial sent back to college). This process can take up to months for a response.
Due to the poor communication sites are limited as managers don’t respond timely so sites go without students on site
The faculty from each college and placement coordinators from each hospital all meet monthly to discuss process. At this meeting it was discovered that one hospital places favoritism to the college associated with them and also the technical college as they have tenure with them. This makes fair placement an issue.
In the Greater Green Bay Healthcare Alliance meeting I presented the proposed topic for approval on April 8, 2016. The above listed issues were discussed and all members agreed to provide data to make placement a standardized process. All faculty and placement coordinators agree to provide all data available to create a useful tool that can be used by all members for student clinical placement.
3
Project Goals
Gather all necessary information to create an effective standardized placement tool
Create a standardized student placement tool
Presentation approved by the Greater Green Bay Health Care Alliance
Successful completion of this course to better prepare me for this advanced degree in nursing
The project goals that I have set for this project are related to the creation of a standardized tool that can be useful for academic setting and healthcare facilities to use to place students in the clinical setting. As listed in the introduction the current process lacks organization, standardiz.
Different models of collaboration between nursing service andTHANUJA MATHEW
This document discusses different models of collaboration between nursing education and service. It describes several models including:
1) The clinical school of nursing model which brings academic staff into hospitals to foster exchange between clinical and academic nursing.
2) The dedicated education unit which uses staff nurses as clinical instructors for students on designated hospital units.
3) Research joint appointments where researchers have roles in both educational and clinical settings to improve nursing practice through research.
The document provides details on several other models and discusses the benefits of collaborative partnerships between nursing education and healthcare services.
This document discusses the importance of evidence-based practice in nursing. It begins by explaining how evidence-based practices have reverberated across nursing practice, education, and science. The need for improved healthcare calls for evidence-based practices to be incorporated into health systems to increase effectiveness, safety, and efficiency. New practice approaches should be evidence-based to help move healthcare in the desired direction. The document also provides an example of how one facility successfully reduced hospital-acquired pressure ulcers through implementing evidence-based skin assessment and wound care protocols. It concludes by stating the importance of evidence-based practices in tackling issues like hospital-acquired pressure ulcers.
This document is a resume for Lizabeth A. Stetz, who is pursuing a career as a registered nurse. She has over 15 years of experience as an EMT-I and patient care associate at Ohio State University Wexner Medical Center. She is passionate about delivering excellent patient care. She received her Associate's Degree in Nursing from Chamberlain College of Nursing in 2014. She has received several commendations and awards for her work.
The WATCH Project has expanded its service area and career pathways to help over 225 low-income individuals obtain healthcare certifications and jobs through the provision of educational and support services, several project staff have been hired to better serve participants, and two participants received awards for their academic and work achievements.
The University of Kansas Department of Health Information Management is featured in the Journal of the American Health Information Management Association.
collaboration and its model (including new model 2019 Integration model)NehaRana89
This document discusses various models of collaboration in nursing. It defines collaboration and describes types such as interdisciplinary, multidisciplinary, and transdisciplinary collaboration. Several models of nursing collaboration are outlined, including the Clinical School of Nursing model, Dedicated Education Unit model, Research Joint Appointment model, Practice Research model, Collaboration Clinical Education Epworth Dakin model, Collaborative Learning Unit model, and Collaborative Approach to Nursing Care model. The key aspects and objectives of each collaborative model are summarized.
Clinical Workforce Development NCA Informational WebinarCHC Connecticut
Learn more about training and technical assistance offered through Community Health Center Inc.'s National Cooperative Agreement (NCA) on Clinical Workforce Development. Hear more about FREE Learning Collaboratives opportunities to enhance or implement a model of Team-Based Care at your Health Center, and how to implement a Post-Graduate Residency program for Nurse Practitioners and Post-Doc Clinical Psychologists.
This 3-page document summarizes the findings of a review of the Nurse Unit Manager (NUM) role in Queensland, Australia. Key issues identified through NUM consultation groups were an unclear and inequitable workload, a desire to refocus on clinical leadership and patient outcomes, and barriers like administrative burdens and a lack of decision-making power or development opportunities. The review aims to strengthen support for NUMs by providing clarity around responsibilities, enhancing capabilities, and improving work-life balance. Recommendations are made to NIBBIG to address issues and refocus the NUM role on sustainable clinical leadership.
The document describes 4 projects that received Challenge Grants from 2008-2009 focused on improving patient-centered care:
1) The TAP project at UCSF developed a transition program for adolescents with chronic conditions moving to adult care including resident training, a transition handbook for patients, and found a need for improved transition preparedness.
2) The IPR project at Medical College of Georgia implemented and measured patient-centered rounds on medicine units, identifying strategies to overcome obstacles and a blueprint for wider adoption.
3) The Resident Performance project at Carillion Clinic adapted an evaluation tool for patients to assess residents' competencies, finding it reliable for comprehensive feedback.
4) The Patient-Centered
Diane Babicz is a learning and development consultant with over 20 years of experience in designing and implementing global training programs. She has led cross-functional teams and managed multi-million dollar budgets. Her background includes positions at Novartis Pharmaceuticals, where she created training initiatives and improved processes, and the University of Medicine and Dentistry of New Jersey, where she managed an education program and increased grant funding. She now works independently, providing consulting services to various clients.
Supporting and developing patient safety collaboratives - Phil Duncan and Fiona Thow, Patient safety collaborative delivery leads, NHS Improving Quality
Presentation from the Patient Safety Collaborative launch event held in London on 14 October 2014
More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx
1. Making the Case for Quality
November 2010
Barnes-Jewish Hospital Enhances Quality Patient Care by
Embracing Lean
by Sarah Kinkade and Laurie Wolf
A large organization can have its advan-
At a Glance . . . tages, but a seamless learning curve to
embrace lean methodology, unfortu-
• The organization-wide nately, is not one of them. Faced with a
lean curriculum at Barnes- hospital of staff with varying education
Jewish Hospital combines levels, the Barnes-Jewish Hospital oper-
an education program
ational excellence team was challenged
for all employees with
focused improvements with ensuring that all employees under-
in value streams. stand lean and how to integrate lean into The operational excellence department from Barnes-Jewish Hospital gathered
• Improved operating their daily work. for a photo with its award for being a finalist in the ITEA process.
margins, employee Pictured from left to right are Sarah Kinkade, Luis Baja,
turnover rate, and patient About Barnes-Jewish Hospital Gordon Philips, Karen Cleveland, Kent Rubach, Laurie Wolf,
Pat Matt, John Lynch, Mike Lee, and Brian Hoff.
satisfaction scores are
linked to the hospital’s Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri
lean transformation. and the largest private employer in the St. Louis region. An affiliated teaching hospital of Washington
• Barnes-Jewish entered University School of Medicine, it has a 1,800-member medical staff with many who are recognized as
this project in ASQ’s “best doctors in America.” Barnes-Jewish Hospital is a member of BJC HealthCare, one of the nation’s
International Team
largest healthcare organizations. In 2009, the 9,400 employees at Barnes-Jewish staffed more than
Excellence Award
competition and 1,100 beds and treated 54,700 inpatient admissions.
was named a finalist
for 2009-10. The hospital is consistently named on the honor roll of America’s Best Hospitals by U.S. News &
World Report. The only Missouri hospital to make the publication’s honor roll, Barnes-Jewish has been
listed on the honor roll annually since 1993. In addition, Barnes-Jewish was the first adult hospital in
Missouri designated as a Magnet hospital by the American Nurses Credentialing Center in 2003. This
is the highest national recognition for excellent nursing practice in hospitals. Barnes-Jewish received
re-designation as a Magnet hospital in 2008.
Transforming Performance Through Lean
Beginning with traditional performance improvement efforts in 2003, the hospital experimented with
consultants and internal leadership, but generally achieved the same result each time: pockets of success
that were rarely sustained. Then in 2007, the hospital leadership pulled together a team of management
engineers, known as the operational excellence department. By combining clinical and manufactur-
ing backgrounds, all with a foundation in lean or Six Sigma techniques, the team made improvements
by implementing value streams. The major difference in a value-stream improvement was the ability
to sustain that success over time. In 2009, a team from the Barnes-Jewish women and infants depart-
ment presented results of value-stream process improvements as a finalist in ASQ’s International Team
Excellence Award (ITEA) process. The team’s sustained improvements in admitting and discharging
patients won an award for the best safety project.
ASQ www.asq.org Page 1 of 5
2. Unfortunately, these successful interventions were not wide- leaders experienced the education with their employees, they
spread to other areas. The shortfall to this process occurred when seemed to embrace the concept much better than if they sent
a patient came to the hospital and was treated in more than one their employees to participate without understanding the lean
area. For example, if a patient arrived in the emergency depart- process themselves.
ment, where lean activities have made processes very efficient,
then traveled to radiology for an x-ray and waited for three John Lynch, MD, chief medical officer at Barnes-Jewish, says
hours, the hospital as a whole was not functioning efficiently. the hospital has created a great model for other healthcare
Knowing these silos would never produce an entire lean orga- organizations to follow. “Lean management techniques have
nization where the patient could flow easily throughout, the been around manufacturing industries for many years, but their
operational excellence team implemented a lean curriculum to application to healthcare is relatively new,” he says. “At Barnes-
educate every employee. Jewish, we have found a way that works well in our healthcare
environment to teach every employee about lean and how it can
As the hospital began to use lean tools such as value-stream improve their daily work.”
analyses and kaizen events, it saw change occur more quickly
than with traditional performance improvement approaches. The implementation of lean curriculum aligns with the orga-
Although individual value streams were realizing impressive nizational strategy in every area. The six strategic focus areas
results, this success was not widespread. Cultural change was of the hospital are safety, quality, service, people, innovation,
slow, partly due to the small number of employees involved in and financial health. The various lean tools can be applied to
events, and the even smaller number of employees who truly multiple strategies and improve each metric the hospital tracks.
understood lean. The hospital needed a variety of tools that As a result, lean is literally shown as the hospital’s foundation
would enable wide diffusion and adoption of lean principles to on the strategic map and called “the way we work,” as shown
achieve true cultural change within the organization. By focus- in Figure 1.
ing on educating all employees, the team chose to develop a
lean curriculum. During the curriculum rollout, employees from many depart-
ments were eager to attend the course and immediately began
Developing a Lean Culture improvement projects as soon as they completed the train-
ing. This initial enthusiasm made the rollout time intensive for
Throughout 2008, the operational excellence team developed the operational excellence team, but after six to nine months,
the curriculum with help from the organizational development subject-matter experts were comfortable running events on their
team and hospital leadership to ensure every employee, regard- own and new requests decreased. The next challenge was decid-
less of job title or education level, would have “enough” and the ing how to engage the remaining directors that did not respond
same knowledge of lean. The operational excellence department to the “pull” request.
teaches each lean curriculum course, ensuring that each course
is taught in the same way. Though this method is a strain on the Through partnering with the organizational development depart-
department’s time, team members felt it was the only way to ment, lean curriculum was added to every employee’s required
accomplish the goal. annual competency list. This ensures that every employee
attends the basic lean course, and it also provides a tracking
Each member of the leadership team was asked not only to mechanism. Though implementation is still in process, the
participate in the lean curriculum, but to help lead the educa- culture has shifted at the hospital already. The administration
tional session for his or her employees. In essence, the leaders has complete buy-in to lean methodology and hundreds more
were pulling the lean strategy through each department. As employees are participating in lean events. Figure 2 depicts the
Figure 1—Lean as the foundation for Barnes-Jewish Hospital’s current strategic map
Our Mission Our Vision Our Values and
Service Behaviors
Barnes-Jewish Hospital takes Barnes-Jewish Hospital, along with our
exceptional care of people. partner, Washington University School • Integrity
of Medicine, will be national leaders in • Compassion
medicine and the patient experience. • Accountability
• Respect
• Excellence
Our Goals
People Innovation Finance
Safety Quality Service
Attract, retain, and Build clinical Generate earnings
Avoid all Provide the best Develop superb
develop a high-quality, programs that are to sustain mission
preventable harm possible care customer experiences
diverse workforce national leaders and pursue vision
The Way We Work
Lean Thinking
Add value, eliminate waste
ASQ www.asq.org Page 2 of 5
3. progression of lean over the years as various strategies (such as importance of lean methodology. Without that, culture change
traditional performance improvement, Six Sigma, and lean) were cannot be achieved. Change management techniques taken from
implemented at Barnes-Jewish Hospital. a Destra Consulting program called Accelerating Change and
TransitionsTM (ACT) were also useful. ACT tools provide a road
The operational excellence department established a solid map to establish shared goals methodically and then assemble
foundation of lean by focusing on a lean training program with the components to ensure acceptance and commitment. ACT
modules in 5S, standard work, problem solving, and managing includes familiar tools such as threat-opportunity analysis, stake-
for daily improvement. This lean training initiative, combined holder analysis, and the elevator speech.
with traditional process improvement, Six Sigma, and other
culture-changing tools, is achieving enhanced quality in patient To keep an eye on lean progress, the operational excellence
care and a safer environment for employees, patients, and department tracks metrics, such as how many employees par-
visitors. Every department that participates in a focused lean ticipate in lean events, how many events happen each month,
module is required to designate a local subject-matter expert the number of employees who are exposed to lean through lean
to serve as the resource for others to turn to after the module curriculum, and how often an event team gives an outbrief pre-
is in place, as shown in Figure 3. This subject-matter expert is sentation to hospital leadership.
an employee of the local department, usually a unit secretary
or project coordinator, who can handle the additional workload The operational excellence team also tracks which value streams
and is eager to expand his or her skills. By training an expert, are currently working to improve patient flow throughout the
the operational excellence department can focus on the overall hospital. Each value stream’s information is posted for all
strategies of the hospital instead of becoming over-involved employees to see. Many departments keep a strategy wall for
with 5S in every area. employees to keep up with what is happening.
In addition to education of the seasoned staff, every new Improving the Patient Experience
employee is now introduced to lean methodology as part of the and Increasing Efficiency
two-day new employee orientation. The major lesson learned
for the hospital was to make sure every employee knows the Results of the program include a high-quality patient experience
and improved efficiency throughout the hospital. The tangible
Figure 2—Progression of lean throughout results from the lean curriculum process were seen through the
Barnes-Jewish Hospital progress of lean education in the organization. As of January
2010, approximately 9 percent of all staff has participated in lean
activities, compared to only 2 percent involved in prior perfor-
Lean Diffusion – 2009 mance improvement activities, as shown in Figure 4.
Lean Curriculum
Other benefits of the educational program include a standard
Lean/Sigma – 2007
Value Stream Focus Midyear 2006 education for all employees designed to level-set the entire orga-
nization. A subject-matter expert is available when needed at the
Six Sigma – 2005 gemba (the place where value is created for customers through
Black Belt/Yellow Belt daily work) in each department. Subject-matter experts also help
with sustaining and handling new projects to allow management
Traditional PI – 2003 engineers to manage a greater number of projects at the same
• PDCA • Team Problem Solving
time. Hospital leaders expect lean principles to be evident in
every decision.
The trust and teambuilding created between multi-disciplin-
ary departments is the most valued result. This is validated
Figure 3—Key roles in the lean transformation process
Standard
Work
Culture
Lean PULL Change
Curriculum Transformation
Journey
Strategic Problem
5S Lean
Planning Solving
Transformation
Teach and Plan and
Coach Direct
Participation
Manage for Daily
Improvement
Management
Director Subject Matter Expert All Staff
Engineer
ASQ www.asq.org Page 3 of 5
4. continually at every outbrief session to hospital leadership. The Continuing the Lean Transformation
teams presenting are becoming more and more interdisciplinary,
showing a true teamwork mentality. In addition to improved metrics, the hospital successfully imple-
mented 13 software system changes, including a provider order
Although each enterprise goal is influenced by multiple factors, entry system.
progress can be linked to the organization’s efforts in lean trans-
The method of team management is changing as the transforma-
formation. As depicted in Figure 5, comparing metrics achieved tion journey matures. The hospital is now viewed by service
in 2009 to 2008 shows that improvement occurred in the hos- lines—similar to a product family. Figure 6 illustrates this in a
pital’s operating margin, employee turnover rate, patient safety matrix that lists service lines in the horizontal rows and support
scorecard, oncology growth, patient satisfaction scores, and aver- services in columns. For example, the matrix can be used to
age length of stay for patients. show that inpatient medicine must rely on radiology, pharmacy,
and labs to provide high-quality patient care. Viewing the enter-
Figure 4—Percentage of employees involved with lean prise at this high level helps reveal where to deploy resources.
activities
Number of Participants Performance boards that relate directly to the strategic goals are
2% Traditional Performance Improvement posted throughout the hospital. Service line and ancillary support
9% Lean Transformation
1900 1850
departments are beginning to manage performance accordingly.
Traditional PI
1800 +500 Status updates are published hospital-wide through e-mail, hos-
Value Streams
pital publications, and Friday outbriefs.
1600 Lean Curriculum
Sharing Results
1400
+1100
1200 The operational excellence team presented the lean transformation
1125
+900 project at the ITEA process during the World Conference on Quality
Participants
1000 and Improvement in May 2010. The presentation focused on how
900
800
+700 implementing a lean curriculum program in a large organization of
9,400 employees can instill and sustain a culture change in a diverse
600 environment. This team project earned a people’s choice award for
best innovative idea for internal customers.
400
325
+150 For Barnes-Jewish Hospital, lean is a balancing act of diffusing lean
200
thinking to all employees while guiding project work with a stra-
125 150 175 200 225 250
0 tegic focus through value-stream activities. The team’s journey is
2004 2005 2006 2007 2008 2009
establishing the foundation necessary for Barnes-Jewish Hospital to
(50% are repeat participants)
lead healthcare reform and remain a national leader in medicine.
Figure 5—Improvements linked to the lean Figure 6—Barnes-Jewish Hospital’s enterprise
transformation service matrix
Percent Improvement 2008-2009
30% Neuroscience
Transplant
Service Lines, i.e.,
26%
“Product Families”
Heart & Vascular
25
Oncology
23%
Medicine
Patient Flow
Surgical Service door-to-door
20
Women & Infants
Emergent Care
Other Out Patient
15
Imaging: Radiology, CT, MRI, etc.
Social Work Discharge Planning
12%
Phys/Occ/Speech Therapies
Registration Admission
10
PeriOperative Svc
Operating Rooms
Food/Nutrition
GI/Endoscopy
Laboratories
Room Care
Pharmacy
Transport
6%
5
1.4% 1%
0
Operating Turnover Best in Oncology Patient Length of
Margin Rate Class Growth Satisfaction Stay
Score Shared Service Functions
ASQ www.asq.org Page 4 of 5
5. For More Information About the Authors
• To learn more about Barnes-Jewish Hospital, visit the Laurie Wolf is a Certified Professional
organization online at www.barnesjewish.org. Ergonomist with a master’s degree in human
• For further details on this team project, contact Kent factors engineering. She is an ASQ Certified
Rubach, operational excellence director, at krubach@bjc.org Six Sigma Black Belt. Her recent Lean Six
or 314-747-1840. Sigma work at Barnes-Jewish Hospital involves
• Details on the ASQ International Team Excellence Award physician services on 13 medicine units for
process are available at http://wcqi.asq.org/team-competition/. patients from admission to discharge, resulting
in a safer environment for both patients and employees.
Sarah Kinkade works in the public relations/
marketing department at Barnes-Jewish
Hospital, focusing on internal communications.
She is dedicated to communicating the improve-
ment initiatives, such as lean, at the hospital to
employees and externally to the public. She has
a bachelor’s degree in communications and a
master’s degree in business administration.
ASQ www.asq.org Page 5 of 5