On Leadership

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.

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Fall, football and fleece

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Last Saturday was a wake-up call that Fall is fast approaching. With morning temps under 50, it was fleece time. It was also the first home football game for the University of Michigan under new coach Jim Harbaugh. Blue and maize was everywhere I went in Ann Arbor. Our new coach and football team delivered a resounding victory in the first home game to everyone’s delight. But this isn’t about football or fleece, it’s about adapting to change – something we are expected to do often.

Yes, I donned a fleece when I ran errands and walked the dogs but I didn’t fully adapt – I still wore my sandals. I will only make that adaptation when I have to. I figure I can hold out for a few more weeks at least.

Season changes are to be expected and there’s no use fighting them. For us Northerners, yes, that means cold and snow as well in another few months. But there are many changes that we can’t anticipate, even some that seem to smack us upside the head. There are changes we choose, often after much thought and deliberation. And there are the ones we don’t choose or have no control over. But we eventually learn to embrace or at least live with them.

In our work lives there are always new processes and tools to learn and adjust to. Continue reading →

Reducing costs while increasing value

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Except for maybe start-up technology companies, there isn’t an IT department anywhere that has an open checkbook. In health care, we know all too well the need to manage costs while answering what seems to be an insatiable demand for technology solutions. CIOs need to understand the technical debt of a large application portfolio and the total cost of ownership (TCO) for systems. They need to find ways to reduce the cost of commodity services, and to create capacity for new work.

At UMHS, we have an initiative called Value and Margin Improvement, or VMI.  The VMI program is a multi-year effort across the health system.  UMHS leadership launched VMI to help achieve our financial stewardship goals by empowering collaborative teams to design and implement sustainable improvements that enhance value and financial results.

VMI aims at reducing duplication, inefficiencies and non-value added work in order to more effectively manage our costs, improve the value we provide and increase our margin.  A positive operating margin allows us to invest in the future and better serve our patients, referring physicians, students, the research community, and other key stakeholders.

VMI projects take a balanced approach to improve and sustain overall value while still maintaining the desired safety, quality, service delivery, and employee engagement metrics. The program promotes the use of lean methodologies and collaborates with our central lean team, the Michigan Quality System (MQS).

We are systematically moving through Continue reading →

Commit to a healthy workforce

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Last week I joined the second “Summer Walk” that the MHealthy champions in our IT department organized. It was a 1.5 mile round trip between our two main office facilities during the lunch hour. We had about 60 participants for each walk. What a great way to get some exercise, connect with colleagues and show our shared commitment to healthy living!

I wasn’t planning to do the walk when I first saw the announcements and flyers around our office. I expected that I had meetings during that time. But when one of the MHealthy champions reached out directly and asked me to show my commitment to healthy living, how could I say no?  It turned out that I could join them if I left a meeting 15 minutes early. I’m glad I did; literally “walking the talk”.

Our department is so committed that we were recently recognized as being one of the top performing areas, with 58% of employees participating in the University’s MHealthy Rewards program. More than 21,000 people throughout the University took advantage of the annual opportunity to review their health status, develop an action plan for improvement, and participate in helpful programs and services such as Active U, Weight Watchers, tobacco treatment, or stress-management programs. This is the program’s seventh year.

Our department’s MHealthy workgroup is developing new plans for activities and events to promote physical activity, healthy eating, and other positive health behaviors. The Summer Walks on the last Friday of each month are just the beginning.

They have also started a FitBit community for the department. Continue reading →

So what’s the problem – A3 thinking

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If you don’t know what an “A3” is, don’t worry. When I started at University of Michigan Health System, I didn’t either.  When I first saw an A3 meeting on my calendar, I asked “What group is that?”

Plan, do, check, act. PDCA on white isolated background. 3d

There were so many groups with different acronyms!  Turned out it was a meeting with a few colleagues to update our status report on major UMHS IT initiatives. We were using an A3 format for our report.

So what is an A3? It is a tool used as part of Plan-Do-Check-Act (PDCA).  The A3 name actually comes from the paper size (11 x 17 sheet) that tells a story laid out from the upper left-hand side to the lower right.

Telling the story of a problem on an A3 includes looking at the background (why and what), describing its current condition (where things stand), and doing a root cause analysis. And then, establishing goals and targets, proposing countermeasures, making an action plan and determining success metrics.   Continue reading →

Investing in the success of others

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What do @TheWomenRising, @digitaldivas3, and #HITchicks have in common? They are some of the Twitter handles and hashtags that young women professionals in technology are using on social media to encourage Women around CR tablemore women to go into the field. I recently did a fireside chat with Kate Catlin, the organizer of Women Rising, and about 30 young women in downtown Detroit. It was the first in a new UpRising series where they invite in “high-powered women in technology” they want to learn from.

The questions covered a broad range of concerns, and not just about working in technology. We were scheduled for an hour but could easily have continued for several more. I answered their questions with advice and lessons from my own experience.

Some of their questions:

How did you get started in technology?  Continue reading →

At work and at play: IT leaders connect with patients

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Monday was the 42nd annual  C.S. Mott Children’s Hospital Golf Classic. While the golfers have a lot of fun, it is a significant annual fundraising event that makes an important difference in the lives of children and their families at Mott Children’s Hospital. Over the years, individual and organizational sponsors have provided support for computers at patient bedsides, medically safe camps for children with serious health issues, assistive devices for children with special needs, and many more important projects and services.

The Mott Golf Classic is committed to advancing pediatric medicine and enhancing the care experience for patients and their families. It supports unique initiatives that distinguish Mott Children’s Hospital which is ranked as one of the best children’s hospitals in the country by U.S. News & World Report.

Reminding all of us in health care why we do what we do, each year a child and their family are recognized as an honored guest and we hear their story.  This year Larry Prout Jr. and his parents, Larry and Kathy, along with his five older siblings and other family members were the guests of honor.  Larry Jr. was born with three birth defects – Spina Bifida, Cloacal Exstrophy, and a massive Omphalocele. His parents didn’t know if he would make it through the first 24 hours after birth and there were many times during his first six months that he had to fight for survival. With their love and the specialized medical care of a multi-disciplinary team at Mott, Larry Jr. overcame many setbacks. He is celebrating his 14th birthday on June 11th.

One of my IT leaders, Joe Kryza, Executive Director of Infrastructure and Systems Operations, has made significant contributions over the past 10 plus years to the Mott Family Network, a non-profit volunteer organization that many of our IT staff contribute time to. Continue reading →

The power of learning from your peers

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I spent the better part of a day this week at the annual meeting of the Epic Michigan Users Group (we call it eMUG). But I don’t want to focus on Epic. I want to talk about the value of learning from your peers. It could be any vendor or any user group.

This was our fourth annual eMUG conference. Given space limitations, we had 200 attendees last year and with the venue this year we were able to accommodate 400, a significant increase. With 11 health systems in Michigan on Epic, that’s a good size group from each organization.

When asked for a show of hands on how many had been to Epic’s national user group meeting (UGM) before, only 25-30% of the attendees raised their hands. Local user group meetings like eMUG give many more staff a chance to attend and connect with their peers. National user group meetings are costly with airline and hotel expenses for a couple days.

This eMUG meeting was a content rich day: Continue reading →

Making the tough decisions

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We make all kinds of decisions every day. Some are small yet seem difficult at the time. One I sometimes joke about is ordering off a restaurant menu that has too many good choices. When I finally make my order, I tell the server that I have made my “major life decision” for the night.

Sometimes a group makes a decision after weeks or months of lengthy deliberation: many groups have weighed in, expressed their concerns, asked their questions, refined the plan or recommendation, and only then ultimately provided their support.

And then there are the potentially very impactful decisions that must be made in a matter of minutes with the best information you have available after a very quick weighing of the risks. I had to make one of those decisions last Friday.

We had scheduled our Epic version 2014 upgrade for the weekend. The plan was to bring down the production system at 12:30 AM Saturday. The system would be down until 5:00 AM while the final conversion tasks were completed. IT and operations staff were scheduled in the command center to monitor the upgrade and address any problems. Leadership calls were scheduled daily to review issues starting Saturday.

At 11:51 AM on Friday, I got a text Continue reading →

Leadership huddles: not just another meeting

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It’s huddle time! No, I’m not joining a sports team.  But along with my leadership team, we are taking the next step on our lean journey. In a few weeks we’ll be starting twice a week 30 minute leadership huddles. This is part of Lean in Daily Work which also includes key visual metrics, visual boards, Everyday Lean Ideas (ELI), and leadership walks.

In a post last summer, I talked about the lean journey.  It is important for leadership to set common expectations throughout an organization.  So if we’re going to practice lean thinking as a department, our leadership team has to set the example.

The goals of this lean experiment include the following:

  • Create a common understanding of what our performance is compared to what we want it to be so that we can understand the gaps and improve
  • Make our work visual and actionable
  • Understand our business more deeply by asking questions and looking at trends
  • Surface, track and trend problems
  • Gain experience and practice with lean

Continue reading →