Each year UMHS celebrates Quality Month and this year is no exception. Last week as part of our Lean Thinker’s Series, Dr. Richard Shannon, EVP Health Affairs, University of Virginia Health System, gave an excellent talk titled “Patient Safety and Quality: The New Currency in Academic Health Centers”.
It was good to hear how another academic medical center is approaching similar challenges and applying lean. Some of my takeaways from his talk and the lunch discussion that followed:
- Dr. Shannon described their Be Safe initiative – “Our Be Safe initiative is advancing our status as a high performing organization by systematically applying the scientific method (Lean Principles) to improve the safety of our patients and workforce through real time problem solving.” He shared examples of how they have reduced the incidence of hospital acquired infections, a problem for all hospitals.
- Senior executives hold a “situation room” and digital report out each morning. They spend 15 minutes reviewing critical problems that have been reported and then spend the next 45 minutes actually going to the units to understand the specific problems more deeply. And they do it on Saturdays as well.
- Their IT team plays a central role in providing data and reporting in support of their daily management system. They have developed the “Be Safe” reporting system. It is a common platform that supports daily manual entry from any employee and takes automated updates from other feeder systems. He emphasized the importance of having actionable data. All of their A3s are done online and uploaded to a library that can be queried. Patient safety events are documented with an online form as part of the system. I plan to reach out to their CIO, Rick Skinner, who has shared some of their lean stories with me in the past. Having heard Dr. Shannon’s talk, it’s time to get a much better understanding of their system.
- They have what they refer to as a “90 day coalition” or “kaizen”, the Japanese term for continuous improvement. Over the 90 day period, they focus on 6 key metrics to improve. One senior leader is assigned to each metric. The CIO is not one of the 6 assigned but everyone wants him involved because IT support is critical to get at data they need for their analysis. Each senior leader finds 6 hours a week to work on this – they find one hour per day, plus some time on the weekend.
- How do executives find this time? Have they taken steps to reduce time in other meetings? Dr. Shannon described his approach. He now holds 90 minute monthly meetings with his direct reports instead of weekly meetings. He has reduced his external commitments and travel to stay close to home and make this work. He focuses only on the top priorities. He has pushed down signing authority and flattened the organization.
- You have to ask the right questions and solve the right problem. He told the story of a capital request for a new parking garage to address the problem of running out of parking during peak clinic times each day. But as they dug deeper, they identified the true problem was the wait time of patients in clinic once they parked. Instead of investing in a new parking garage, they invested in process changes and technology to reduce the patient wait time in clinics.
- In line with our own Dr. Jack Billi’s view that we have to create 25,000 problems solvers at UMHS by engaging every employee in lean thinking, Dr. Shannon talked about engaging the wisdom and skills of every worker.
Dr. Shannon’s entire talk can be viewed here.
Another important part of Quality Month is the poster session that included 48 unique displays covering a range of quality improvement and lean projects. Watch for a future post on some of the teams I talked with at the poster session.
While October may be officially “Quality Month” and a time to showcase the great work being done throughout our organization, we have to ask the right questions, identify the right problems and find solutions every single day.