Monthly Archives: October 2015

Quality month: sharing improvement stories

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Root Cause wideRecently I wrote that October was Quality Month and I highlighted Dr. Richard Shannon’s excellent talk, part of our Lean Thinker’s Series. I “teased” that I would comment on the Quality Month poster sessions in an upcoming post.

For two days, 48 quality improvement teams displayed their stories as posters. I spent about an hour checking out the posters and talking with people from the teams. I targeted the ones with potential scalability or an IT connection.

Jennet Malone, a manager at The Briarwood Center for Women, Children and Young Adults, explained how they increased use of the portal.

Here are a few worth noting:

Got Portal? –The Briarwood Center for Women, Children and Young Adults

We rolled out our patient portal more than 3 years ago. Patient enrollment has been fairly successful  with over 200,000 active users but this is still not at the level we need. This health center established specific goals for making portal functionality part of everyday clinic workflow and used by patients and families. They increased their marketing efforts and established staff incentives for meeting short term goals. They purchased iPads to help staff sign up patients. They added the portal metric to their daily huddle. The result: Briarwood Center for Women, Children and Young Adults has the highest percentage of patients on the portal when compared to other clinics! Continue reading →

Power of Collaboration

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It was a long but productive 24 hours. A team of us from the health system flew to Durham, NC, on Tuesday evening, spent a 10 hour day on Wednesday at Duke Medicine, and then flew home. It was a site visit aimed toward learning from each other and determining opportunities for collaboration.

UMHS and Duke have similar profiles: our overall size, IT infrastructure and core applications. We are in similar places on our EHR journey with Epic. And we are both very focused on analytics – the impetus for our visit.

Duke’s CIO, Dr. Jeff Ferranti, and I know each other; we thought the proposal for a visit was a great idea. Our Chief Medical Information Officer, Dr. Andrew Rosenberg, and Duke’s Chief Health Information Officer, Dr. Eric Poon, planned and organized the day’s agenda.  We let Andrew and Eric run with it and they did a terrific job!

Two important clinical leaders joined our Michigan team of several senior IT leaders — Dr. Jeff Desmond, our Chief Medical Officer, and Dr. Steve Bernstein, Associate Dean for Clinical Affairs. We needed them there as we talked broadly about analytics and support for population health. Continue reading →

October is Quality Month!

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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.

Continue reading →

Are we ready for the business of the day?

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“Huddles, not just another meeting;” I wrote that when we started our twice a week IT leadership huddle in April. How true! And as of three weeks ago, we have another leadership huddle experiment in progress – the daily hospital leadership huddle. It is part of our developing lean Daily Management System.

Our Acting CEO and COO for the University of Michigan Hospitals and Health Centers, Tony Denton, runs the daily huddle. As Tony said in his initial communication, “The purpose of the leadership huddle is for senior leaders to have daily awareness of issues that may impede our ability to provide service. The leadership huddle is the “top tier” of a daily management system designed to surface issues and problems, assign leads for pro-active problem-solving efforts, examine trends and track progress. It is a key aspect of developing a more effective Michigan Operating System. If successful, we expect to see continuous improvement in our safety, quality, timeliness and financial results, and enhanced ability to deliver ideal patient and family care experiences through the engagement of our people.”

The value of these leadership huddles was clear the first week. Continue reading →

Providing care, no matter where

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Against all odds and in spite of personal risk – doctors and nurses provide health care, especially emergency responders. We’ve all seen the stories and images from recent disasters and war zones.

The Hospital in the Rock Museum in Budapest, Hungary is one of the most vivid examples of providing care under adverse conditions. Hospital in the RockOn a recent trip to Europe, I toured the museum; it’s an actual underground hospital built in a cave system inside Budapest’s Castle Hill.

We walked along long and twisting corridors into a series of irregularly shaped rooms. I could see that the rooms were, in fact, caves; the walls were painted rock. The ceilings curved domes. Now, the passageways and rooms are brightly lit, but I could imagine them lit more dimly in the past. The walls and ceilings were lined with pipes for water, air and electricity. Our guides told us that they turn off the ventilation systems during the tours because it would be too noisy for anyone to hear the narrations.

The Hungarians built the underground hospital in the 1930’s for about 60-70 patients. During WWII, and especially in the 1944-45 Siege of Budapest, it cared for 600 wounded soldiers. During the Cold War, it was converted to be a shelter in case of a nuclear war.

During WWII, the focus was on broken limbs and wound care and of course preventing infection. We saw small, narrow wards with bunk beds pushed next to each other; three patients could be fit into two beds if needed. We saw an operating theater that accommodated two patients.  Talk about major infection prevention challenges! Continue reading →