Welcome ORHLCP

Agenda for Today

Context Gemba Exec Q&A Lunch ReflectionLikes & Please

ConsidersDeparture

Gemba Notes: • Eight groups, each visiting two areas in hospital or clinic• Use your cards to record questions for Exec Q&A • See name tag for group assignment

PeaceHealth – Who we are OUR CORE VALUESRespectWe respect the dignity and appreciate the worth of each person as demonstrated by our compassion, caring and acceptance of individual differences.

StewardshipWe choose to serve the community and hold ourselves accountable to exercise ethical and responsible stewardship in the allocation andutilization of human, financial, and environmental resources.

CollaborationWe value the involvement, cooperation and creativity of all who work together to promote the health of the community.

Social JusticeWe build and evaluate the structures of our organization and those of society to promote the just distribution of health care resources.

Founded in 1890 by the Sisters of St. Joseph of Peace

OUR MISSIONWe carry on the healing mission of Jesus Christ by promoting personal and community health, relieving pain and suffering, and treating each person in a loving and caring way.

OUR VISIONEvery person receives safe, compassionate care: every time, every touch.

OUR PATHEnabling the well-being of our neighbors in times of health and times of need.

PeaceHealth –Stats at a Glance

Our PeaceHealth JourneyW i t h L e a n & D a i l y M a n a g e m e n t S y s t e m

Harold Peters, P.Eng.System Director, Performance Improvement

Mid 1990s

•SHMC pioneers Lean in healthcare

•John Black Assoc. (JBA) supporting

•Execs to Japan•Management and methods approach

Early 2000s

•SHMC transitions Lean from management to methods

•Bellinghamadoption

Late 2000s

•Bellingham, Southwest Florence implement own versions of Lean

•SHMC RiverBend built on Lean principles

FY14 New approach selected

•Exec approves Lean as system improvement standard

•Joan Wellman & Assoc. (JWA) selected as coach and training partner

FY15

•Lean rebranded as CareOptimization

•Two-pronged strategy:•Operations•Projects

•Columbiaimplements first two modules of DMS

FY16

•Columbiacontinues implementation post-CareConnect (Epic)

•Spread to Oregonand all of PH Medical Group

PeaceHealth – History of Lean

Prior Approach (1995-2013) Current Approach (2014-2015)Project / kaizen / RPI focus Mindset, management, methods focus

Community System

Teach Lean tools to front-line Teach Lean management to leaders

Engage front-line in projects Engage front-line in daily improvements

Improvement owns the initiative Operations owns the initiative

Many projects Few projects

Spread = do more projects Spread = use more DMS

Dramatic changes, immediate ROI Engagement, culture change, delayed ROI

PeaceHealth’s Lean Journey

Cross-Functional Management

StrategyDeployment

Daily Management System (DMS)

CareOptimization Objectives

New mindset and management system– Culture of learning and continuous

improvement, with sustained improvements

Leaders with new capabilities– Lead improvement; coach caregivers

Engaged caregivers– Solving problems; improving the work

Standard methods and tools– The “how” for sustained improvement

Goal(True North

CareTogether Objectives(True North Metrics)

Caregiver & ProviderRequirements

Mission with a Business Purpose

Extraordinary Patient Care

Meaningful work

Consistent “good” income/benefits

Feel supported by management

Reasonable workload (no overburden)

Culture of respect/Safe work environment

PeaceHealth Vision

PeaceHealth Mission©2014 Joan Wellman & Associates, Inc.

CareOptimization Value Proposition

Lean as a Daily Management System (DMS)

The Lean Daily Management System

©2014 Joan Wellman & Associates, Inc.

Success Metrics Strategy Deployment – Ensure everyone is pulling in the same

direction at the same time.

Performance Boards – System goals, local target(s) outcomes, front-line-selected process improvement initiatives. Daily or weekly huddles to review status and progress.

Readiness Readiness Boards – status (red/green) of Safety, Workload, Staffing,

Methods, Equipment, Supplies

Units huddle for 10 minutes by shift or daily at their Readiness Board

Daily tiered huddles from unit, to local leadership to executive leadership

Standard Work

Units choose a specific process to standardize, track for abnormalities, and audit

Problem Solving

Front-line problem solving tools (STP, Everyday Kaizen) to apply to Performance and Readiness Boards

Schedule/Takt (Tempo)

Match capacity to demand; stay on schedule

PeaceHealth’s Lean Journey

2014 – Present Passing the Tipping Point Southwest – organic unit-level

implementation; now restarting with structured approach

St. John – structured start; leadership led

CareConnect (Epic) implementation – caused pause & momentum loss

Sacred Heart (Oregon) –structured implementation; leadership led; all modules scheduled

Medical Group – structured implementation; leadership led; all clinics implementing concurrently

Tipping Point

©2014 Joan Wellman & Associates, Inc.

PeaceHealth’s Lean Journey DMS Experiences

First six months: >90% of escalated patient care barriers solved by leadership (nearly 400 in each Columbia hospital)

Caregivers using words like “responsive” and “agile”

Leadership AssessmentNancy Steiger, FACHE, RN

President, Columbia and SVP, Ambulatory Services

Gemba visits No photographs of patients or patient information Check your nametag for your group number Join your group in the atrium (okay to leave belongings; room will be

occupied) Please ask questions ! Use your cards to record

questions for Exec Panel Q&A

Please return by 11:30

Group # Tour Guide Locations1 Elvin Surgery clinic and OB clinic2 Amy Eye Care clinic and Surgery clinic3 Monica Periop and Eye Care clinic4 Jennifer P. OB clinic and Neurology clinic5 Matt Diagnostic Imaging and 3N (Med/Surg)6 Liz and Molly 3N (Med/Surg) and Diagnostic Imaging7 Cindy Neurology Clinic and Surgery (hosp.)8 Vanessa Surgery (hosp.) and Periop

Plus Delta

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