Kentucky Clinical Management System: An Academic Center Lean Journey

Spring 2012 Pebble Partner Colloquium Agenda, April 16 th -18 th

Audrey Yates, MSIE, SSBB

UK Healthcare

Manager, Center for Enterprise Quality and Safety Performance Improvement

859.327.1657 ayate2@email.uky.edu

Kentucky Clinical Management System

TQM/CQI/FADE

1ST LEAN

PROJECT

2006-2007 DISCHARGE

PROCESS

KAIZEN EVENTS 2009

- 2011

NURSING

RECRUITMENT,

RN TIME @

BEDSIDE,

BEHAVIORAL

HEALTH GOOD

SAMARITAN, OR 5S,

CHILDREN’S ASTHMA

LEAN EDUCATION

EVENT

2008

TWO-DAY

EVENT

UK LEAN

MANUAL

MANY PROJECTS

2008 - 2010

CLINICAL OPERATIONS,

OR, ED, IT, PATIENT

SAFETY, DISCHARGE,

TEST RECONCILIATION,

EQUIPMENT/SUPPLIES,

LAB, RADIOLOGY

LEAN POCKET

GUIDE 2010

8 STEP PROBLEM SOLVING

2012:

CODE RESPONSE IN NICU

SAFE PATIENT HANDLING

PNEUMONIA CORE MEASURE

UHC HOSPITALIST

EFFICIENCY

SEPSIS

MORGUE MANAGEMENT

Quality Design Pocket Guide

by

Office of Enterprise

Quality and Safety,

Performance

Kentucky Clinical Management System

KENTUCKY CLINICAL

MANAGEMENT SYSTEM –

TRUE LEAN 2012

PARTNERSHIP WITH

COLLEGE OF ENGINEERING

AND UK HEALTHCARE

• the group by themselves

• using systematic problem solving

• to improve the work they do

• towards the achievement of the company’s targets and goals

• when and only when the existing culture is the reason the activity is occurring

Kentucky Clinical Management System – True Lean Definition

Kentucky Clinical Management System – Vision (DRAFT)

Manage UKHealthCare to become a top ten* Academic Medical Center by 2017 through the Guiding principles of:

• Patient centeredness

• Highest quality

• Safe

• Most cost-effective care

• In an environment of teamwork, service and mutual respect

* Graded by UHC Quality and Accountability Study Methodology

• Management System

• Jishuken Room

• Model Area

• Sequential Projects

• Education

Kentucky Clinical Management System – Strategy (DRAFT)

Kentucky Clinical Management System

Standardization

For the Patient

- Quality Care

- Safety

For the Employees

-Safe Environment

- Job satisfaction

For the Enterprise

- Quality Outcomes

- Profitability

For the Student

- Optimal Training Environment

J I D O K A

J I T

Continuous Improvement (Kaizen)

Just In Time

Stop The Line

Patient Centered Respect for People Elimination of

Waste Culture of Learning

Foundation

Goals/ Desired Outcomes

Philosophies

Most Essential Element

Motivated Employees

Maintenance of Standards

Critical Activities

Kentucky Clinical Management System – Kew Performance Indicators

The number of panel reviewed A3’s The number of roles clarified with job instruction training

The number of tasks written as standard work documents

Monthly evaluation of standard work compliance (# tasks monitored/# of times standard work followed correctly)

Patient satisfaction using Press-Ganey surveys

Employee Satisfaction

Possibly consider manager/leadership team satisfaction?

Employee turnover (nurses, advanced practice providers, physicians)

Inpatient mortality rates (raw) and UHC O:E

Vermont Oxford composite performance

Length of Stay (UHC O:E) CLBSI rates

VAP rates Cost per case

Variable supply cost per case Number of national presentations and publications on NICU care/management/education

Kentucky Clinical Management System – Detailer Modes

•Upper management not realizing they are responsible to change UK HealthCare’s culture •Management trying to delegate their responsibility •Rush to kaizen •Lack of focus on standardization •Lack of focus on building role thinking •Attempt to ‘PowerPoint’ the company to lean

QUESTIONS?