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Daily Continuous Improvement Program:Safety Culture at the Front Line
Trey CoffeyMedical Safety Officer
Associate Director, U of T C-QuIPS
2011: Lean-based ED Performance Improvement Program
We Finally Improved Door-to-
Floor times!
Reality sets in… Again.
• Early adopter of Lean in Appleton, Wisconsin.
• ThedaCare addresses sustainability by developing culture of DAILY continuous improvement FIRST
2012: Learning Partnership with ThedaCare
Different Levels of Process Improvement
Adapted from: “The Toyota Way Fieldbook” by Liker and Meier
Large issues
Medium issues
Small issues
LargeProjects
LeanEvent
Focus of Daily CIP
Six Sigma
Manager Daily Status Sheet
Unit Scorecard: Driver & Watch metrics
24% of unit scorecard
metrics related to
safety
Daily Improvement huddle: MWF 1:15-1:30
Daily Improvement Board
Just do its
More challenging
problem solving (PDSA3)
Collect Improvement
Cards
Prioritize Issues
Completed
Daily Improvement Huddle Board
Daily CIP’s Goal:Develop people to solve problems and improve
performance
Early success: hand hygiene compliance
Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar0.0
20.0
40.0
60.0
80.0
100.0
57.0
75.0
93.0
78.0
100.0
2011-2012 2012-2013 actual Target
Falls, Entrapment, Strangulation, Entanglement documentation
7B 7C 7D0%
20%
40%
60%
80%
100%
120%
24%
44%
23%
35%
43%
30%
51%
39%50%
57%50%
54%
0.670000000000002
0.680000000000001
52%48%
97%100%
72%
83%89%
77%
90%Aug
Sept
Oct
Nov
Dec
Jan-13
Feb
March
April
16% 20%
54%
71%
Sample performance gains realized by individual units
Perc
en
tag
e I
mp
rovem
en
t
Maturing the ProgramRelationship to Safety Culture
• Reporting Culture +• Just Culture ?• Informed Culture ?• Learning Culture ?
Acknowledgments
SickKids nursing and operational leaders: Kate Langrish, RN, Lynn Mack, RN, Linette Margallo, RN, Dinarte Viveiros, RN
SickKids Office of Process Improvement: Shiraz Bhajwa, MBA, Travis Beamish, MBA, Ali Shahzada, MBA
Executive sponsor: Jeff Mainland, EVP Strategy, Performance, Quality and Communication