So what’s the problem – A3 thinking

Posted by on

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 →

A year of blogging. . .

Posted by on

People often ask me, “How do you find time to write”? I have been writing this blog every week for over a year. A very senior leader in our organization who always compliments my writing told me recently, “If you can find time to write it, then I can find time to read it”. I appreciate all the comments on the posts where people share their own perspective and stories.

It is a weekly discipline. But knowing that the content is appreciated and has an impact keeps me going. Writing has also been a great method of reflection for me – Hansei as the Japanese call it.

I guess with over 450 subscribers and more than 27,000 views to date, it’s more than just my family and closest friends who are reading it – that’s all most bloggers ask for.

Regular subscribers get an email notification for each new post. Beyond that, how do I reach readers? I promote each post through the usual social media channels – Facebook, LinkedIn and Twitter — each of which has its own particular audience. I also promote my posts through Next Wave Connect, a social media platform focused on health care.  I’m grateful to Anthony Guerra and Kate Gamble at HealthSystemCIO.com for re-posting most of my blog entries; my CIO colleagues who aren’t connected on social media will see them there. And now I publish some posts directly on LinkedIn at the request of one of my connections. He said it would make it easier to share with all of his connections. Continue reading →

Marriage equality, it’s personal

Posted by on

I usually stay away from politics here, but last Friday was just too monumental.  On June 26th, the U.S. Supreme Court ruled definitively in favor of marriage equality. It’s now the law of the land, and for me, it’s personal.

Many families have secrets. Something everyone knows but nobody talks about. But that sounds so yesterday. And yes, for many it is. Yet many families still struggle with acknowledging that a loved one is gay or lesbian. Yes, family secrets – we all have them.

My family is no different. My Aunt Dorothy was born in 1914 and died in 1997 at the age of 83. She lived her entire adult life with her partner, Teal. There was never an open discussion in our family; to us, they were just “life-long friends”. Dorothy and Teal met while serving in the Women’s Army Core (WAC) during WWII, and lived together until Teal died in 1990.

Dorothy, a life-long Roman Catholic never heard a Pope say, as Pope Francis has, “who am I to judge?”

The pain of same sex couples to be accepted and respected in our society was never more evident for me than when Teal was in her final days. Dorothy had cared for her at home as long as she could, but once Teal was hospitalized, the hospital staff ignored Dorothy.

Dorothy was there all day every day and managed all of Teal’s care, but when Teal died the hospital didn’t call her. They called Teal’s nephew instead who had visited her only once or twice while there.

Dorothy walked into Teal’s room to find an empty bed.  Continue reading →

Our collective interoperability journey

Posted by on

If you remember the CHIN (Community Health Information Network) attempts in the 1990s or the next incarnation in the mid-2000s referred to as RHIOs (Regional Health Information Exchange), you know we’ve been on this interoperability journey in health care a very long time. And it’s not over.

Creating sustainable Health Information Exchanges (HIE), not to be confused with a Health Insurance Exchange, is what we are all focused on now. The Office of the National Coordinator for Health IT (ONC) published “Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap” for public comments earlier this year. There has been progress over the years but we still have a long ways to go.

The ability to easily access and share data with other health care providers in Michigan is critical for UMHS – we are the only provider in the state that serves patients from every county. But HIEs are important for all providers regardless of their reach.  For example, when a patient shows up at an emergency room away from their primary hospital and physician, basic information should be readily available.  This includes a patient’s current problem summary list, allergies, chronic conditions, and medications.  Having this kind of information can make a qualitative difference in their care. And knowing that a certain test or procedure has recently been done along with the results can avoid duplication, saving both time and money.

Yet, unlike other industries where basic information is easily accessible and shared, health care lags far behind. Continue reading →

Investing in the success of others

Posted by on

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 →

Safety hurts, service heals

Posted by on

Patient safety is at the top of our list as health care providers. My experience on a recent flight from Boston to Detroit reinforced the importance of “safety first.” We left an hour late due to weather. But, twenty minutes into the flight, the pilot told us there were problems with the landing gear; the safest thing to do was to return to the Boston airport. He told us he’d know more after we landed. Problems with the landing gear but we were going to land OK? Of course the next half hour was one of the longest ever. We did land safely, de-boarded and waited for news of when we’d depart.

The first word we got was via text and email notification – we’d depart on a different plane around 11:20PM. We originally were to arrive in Detroit at 9PM. In the next few hours, the departure notifications got worse and worse – 11:45PM, 12:20AM, 12:45AM, 1AM, and back to 12:45AM. Passengers with connecting flights tried to get re-booked on other flights that night or in the morning. Some decided to fly to other cities first adding to the number of connecting flights they’d have. I was on a direct flight heading home so I waited patiently for whenever we would eventually leave.

We finally departed at 1:45AM. I got to my house at 4:30AM – about six and half hours later than planned.

What amazed me during all this was that Continue reading →

At work and at play: IT leaders connect with patients

Posted by on

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 →

7 tips for managing in the fast lane

Posted by on

It’s generally a bad sign when the seat belt warning light for the passenger seat comes on but you are the only one in the car. You’ve got too much weight on that seat and the car thinks it’s a person who needs to fasten their seat belt.

This has happened for me a few times lately.  It’s when I have thrown my briefcase and stacks of work for the weekend or the evenings on the seat.  Or I’m out of my office at hospital meetings for several days in a row and need various files with me.  The passenger seat becomes my file cabinet until I’m back in my office.

If I’ve been out of town to visit family or on business, it gets even harder to manage the volume.

People say they don’t know how I do it….how do I keep on top of everything. I respond, typically, “I don’t do it that well.” I’m my own worst critic. But I try my best.

So how do you survive and be your best at times like this?

Triage skills – Review your email inbox and make sure that the time sensitive ones are answered. Look for emails from your direct reports, boss, peers and customers to handle. Continue reading →

Where do new ideas come from?

Posted by on

New ideas can come from many places. Are new ideas the same as “innovation” which has become almost a buzzword these days? According to Webster’s Dictionary, the answer is yes. Innovation is defined as “the introduction of something new OR a new idea, method or device.”

In the past week, I’ve met with health care CIO colleagues from around the country, heard some excellent speakers at our UMHS annual leadership day and met with my staff at our semi-annual all staff meeting.  New ideas came from all those varied places.

Meeting with CIO colleagues last week, I heard a lot of great ideas. I learned about a new mobile app that addresses the stress that families feel when their loved one is in surgery because they lack information. I learned about a storefront “genius bar” service inside a hospital that helps patients and families sign up for the patient portal, get information about the best mobile health apps, and connect their FitBit or glucose monitoring device to health apps. I learned how one colleague is applying a successful implementation go live readiness assessment approach to ongoing project and support work. And I learned how a colleague is leveraging a product’s additional functionality only to realize that we haven’t begun to make the most of that same product here at UMHS. I will be sharing all these ideas in more detail with my leadership team in the coming days. Continue reading →

A salute to the nurses among us

Posted by on

National Nurses Week officially ends today, May 12th on Florence Nightingale’s birthday. But of course you can thank a nurse and recognize him or her any day, any time. Many of us have personal stories of being cared for by a nurse with great skill and empathy.

When I was growing up, I wanted to be a teacher. But my part-time high school and college jobs were actually as a nurse aide in nursing homes. I saw firsthand how nurses cared for the elderly and how hard their work was.

There are several nurses in my family whom I love dearly and respect greatly. I know I can call on them whenever I have a health question. I have to be careful to not abuse this access.  Every family who has a nurse or doctor amongst them knows how valuable they can be.

My sister, Mary Sheehan, is a nurse. She went on to get a master’s degree in public health. She ran just about every division in the Minnesota public health department during her long tenure with the state. Before retiring she served as a county health and human services director. Continue reading →