The Lens

Paul Kempinski, President and Chief Executive Officer at Children’s Mercy Kansas City; a member of the Catalysis Healthcare Value Network, shares how Children’s Mercy now has a network of over 300 tiered huddles that occur throughout their organization each day and activating their over 8000 employees as improvement specialists.

Many news headlines have been highlighting the fact that the US is not vaccinating as many people per day as they had hoped. There is a myriad of reasons, but it often comes down to lack of planning, poor processes, and flow of the vaccines into the hands of those who administer them. But there are many healthcare organizations out there who are well versed in lean thinking and problems-solving that have created processes to achieve the necessary goals for number of people vaccinated per day. One of those organizations is Salem Health in Oregon. Today I am joined by Team members, Pam Reznicsek and Whitney D’Aboy, from Salem Health to talk about their vaccine clinic and how they are using continuous improvement methods to meet and exceed their goals for getting their community vaccinated.

The COVID-19 vaccine is on the minds of everyone around the world. Here in the US the vaccine roll out can be very different depending on state, county, or event city. We hope that by sharing work that is going on in healthcare organizations we can help others that may not be as far along in the roll out, or help others improve their processes. Today I am joined by team members from Torrance Memorial Hospital, a member organization of the Catalysis Healthcare Value Network. We have Jeremiah Hargrave, Leah, Romine, and Christopher Bacon who will share about the COVID-19 vaccination process and how it was developed.

Dr. Eric Dickson, CEO at UMass Memorial Health Care, and John Toussaint, Executive Chairman of the Board at Catalysis. We have invited them both to help us discuss the difference between continuous improvement and new care model development. Both methodologies are important for healthcare systems to utilize in order to remain competitive and relevant in the future. "We need both evolution and revolution. Right now we have great processes for evolution – continuous improvement of a value stream, which in some cases (as John mentioned) allows us to do the wrong thing more and more efficiently over time. So we get twice as good at doing the wrong thing. Sometimes that locks you into keeping it the same way. We need good processes to look for that revolution piece – that new breakthrough. It is something that I am looking forward to learning more about overtime." - Eric Dickson 

Steve Shortell, of the Center for Lean Engagement and Research (CLEAR), joins us to share some of the most recent research findings. Their research indicates that hospitals who are practicing lean as their continuous improvement methodology perform better on many commonly measured performance metrics. They see evidence that the greater the degree of lean practice in an organization, the lower the spend per patient, the lower their 30 day readmission rates, and the higher the patient satisfaction scores. Papers on this research are under review for publication. 

John Toussaint, MD, shares information from a recently published article in the Harvard Business Review about The Better Care Plan. This plan is based on a fixed amount paid paid to providers for each covered patient in a capitated payment model. This model also includes financial incentives for providers would improve quality and reduce total costs. 

A panel of Catalysis faculty members, including Ted Toussaint, Adam Ward, and Pete Knox join us to discuss new care model development and why this thinking is the future of healthcare delivery. New care models must be designed to meet the needs of the future healthcare environment. Process improvement techniques will not make a large enough impact to meet future demands.

Dr. Jeff Thompson, CEO Emeritus with the Gundersen Health System in La Crosse, WI, and Catalysis Board member, discussed the importance of culture and principles in effective and sustainable organizational change. As well as the steps necessary to operationalizing a principle-based approach to culture change and continuous improvement. A principle-based approach has been valuable to many healthcare organizations as they navigate and respond to the changing environment that the COVID-19 pandemic presents. 

Lisa Yerian, MD, Chief Improvement Officer and Gastrointestinal and Hepatobiliary Pathologist at the Cleveland Clinic, shares about how Cleveland Clinic engaged 52,000 caregivers in a culture of continuous improvement on a quest to deliver safer, more efficient, and more compassionate care. Dr. Yerian also explains how this culture has enabled the organization to remain nimble and responsive throughout the COVID-19 pandemic.

Orry Fiume former VP of Finance and Admin at Wiremold and author of the Shingo Prize winning book “Real Numbers: Management Accounting in a Lean Organization”. We are discussing ­­­­­­­­­­­­­­­­­­­­­­­­­the importance of good metrics and how to use them.  "Not everything that counts can be counted." - Orry Fiume

COVID-19 has impacted healthcare organizations across the globe in many different ways depending on the country or region they are in. We have found that those organizations who have a management system in place and are practicing the principles and behaviors of organizational excellence have been able to more rapidly adapt to the changing needs of their communities throughout the pandemic. For our first internationally recorded podcast, I am joined by Gladys Bogoshi, CEO of a hospital in the Gauteng province in South Africa, which is the smallest, but most populated province in the country. They have been at the forefront of fighting COVID-19 in South Africa.

The Shingo Principles are the foundation to building a culture of continuous improvement. A big part of shaping a culture that drives organizational excellence is aligning the entire organization to its big goal – its why.

A recent article on HBR written by Ken Segel and John Toussaint stated that before the COVID-19 pandemic struck the US health care industry suffered more than 550,000 work-related injuries or illnesses per year. This number is significantly greater than any other industry. Healthcare leaders can prevent work-related injuries. In this episode Ken Seagel, Managing Director at Value Capture LLC, and John Toussaint, Executive Chairman of the Board at Catalysis, share five leadership imperatives to protecting healthcare workers.

Teams all over the world are now adjusting their huddles and works systems to meet their needs in a virtual environment. Jenn Christison, Senior Director – Improvement Strategy at Seattle Children’s, and her team have been experimenting with ways they can stay connected as a team and move the work forward in a virtual environment.

Healthcare is in the midst of a massive disruption. With financial structures in tatters and the future uncertain, this is the moment to begin the revolution. But first, leaders need to learn how to support staff at all levels as they make transformational improvements in care. John Toussaint and Kim Barnas are joining me today to discuss how healthcare leaders are implementing behavior-driven strategies to ensure quality and create lasting change.

Catalysis Healthcare Value Network member, Christie Clinic in Champaign, IL, used to see full waiting rooms as a sign of success, but the COVID-19 pandemic changed their perspective. They have put many process changes in place to limit exposure to the virus. Now their goal is to have empty waiting rooms as a way to keep patients and staff safe. In this episode Michelle Antonacci, Director of Clinical Services, shares about these changes, including their innovative Curbside care approach.

The COVID-19 pandemic turned many of our lives upside down and inside out, which highlighted the need for leaders to be able to help their staff by translating behavior and shifting thinking to help keep work environments positive for everyone. Today Kerri Burchill, Organizational Development Leader at Southern Illinois Health, will share a methodology that leaders can use to help staff who are struggling in the rapidly changing environment that COVID-19 has presented. In this episode you will hear examples of conversations around tough topics facing healthcare workers across the country. These scenarios demonstrate the 4 step process that Kerri Burchill teaches. 

Jeremiah Hargrave, Process Improvement leader at Torrance Memorial in California, will talk with us about how they were able to help meet two core strategies; no layoffs and meet PPE needs by practicing their core values and continuous improvement practices. Check out this related article "Can You Answer These Five Questions?," by John Toussaint

Catalysis faculty member and author of Patient-Centered Strategy, Jeff Hunter to discuss some of the questions that he has been hearing from healthcare leaders on how COVID-19 is and should impact their strategy deployment process.

Mount Sinai Morningside Hospital in New York City has built a culture of improvement on a foundation of principles. In this podcast Maytal Rand, Emergency Manager, shares the story of their Haircuts for Heroes program. This is just one of the ways that they are showing respect for their staff during the stressful time COVID-19 has presented. This story presents evidence of their strong culture and principle-based leadership. 

Jane Jerzak, a partner with Wipfli, CPAs and Consultants, shares funding opportunities that are available for healthcare organizations to help with the significant financial burden that the COVID-19 is causing. Jane works with healthcare organizations in both larger communities and rural settings.

We continue the discussion with Lucy Xenophon, Chief Transformation Officer, Brian Radbill, Incident Commander and CMO, and Art Gianelli, President, from Mount Sinai Morningside Hospital in New York City. Being in New York City puts them at the heart of the crisis. They share what they are doign to support front line staff, how their improvement team has supported the organization during this time of crisis, as well as what systems they have put in place that have been particularly valuable in the fight against COVID-19. 

Lucy Xenophon, Chief Transformation Officer, Brian Radbill, Incident Commander and CMO, and Art Gianelli, President, from Mount Sinai Morningside Hospital in New York City share learings from the COVID-19 pandemic. Being in New York City puts them at the heart of the crisis. Hear about the current state at the hospital as well as advice they have for preparing for a possible surge of COVID-19 patients. 

The COVID-19 pandemic has changed lives for everyone across the globe and has hit the healthcare industry hard. Our Catalysis Healthcare Value Network members have shared a lot of standard work and other information with us that can be helpful for hospitals all over the world. We are grateful for the hardworking healthcare professionals who are working tirelessly under difficult circumstances. Catalysis is working to bring together resources to help our community learn, share, and connect around navigating through the COVID-19 pandemic. Catalysis will do all we can to leverage our resources and network to be part of the solution to this crisis. You can access resources on our website, createvalue.org, on the COVID-19 Resources page.

In this episode we discuss the management system at the model cell level with Kim Barnas, author of Beyond Heroes, and CEO at Catalysis.  If you use the model cell approach to implementing a management system you are able to see where your opportunities to improve are and are able to work those out before you spread to other areas. Each time you spread the management system to an new area or unit it is a chance for PDSA. The model cell approach is intended to keep you from spreading systems and processes that don't work.  

The Model Cell is a critical first step in an organization’s transformation journey. It serves as a test center where operations can experiment with ideas, embrace failure as a path to learning, and put new concepts into action. This area will become the demonstration site as you spread continuous improvement throughout the organization. It is important to support this team to develop behaviors and learn tools for continuous improvement and problem solving as will as support them through building a daily management system.

The improvement team is more than a group of people who carry a toolbox to support operations with the improvement process. This team supports both the senior leadership team and that model cell through out the cultural transformation by teaching and coaching to ensure that everyone in the organization has the knowledge and skills, and practices the necessary behaviors to propel and sustain the cultural transformation to organizational excellence.

Executives and senior leaders are responsible for ensuring that resources are available, so they deliver on the organization strategy, daily operations, and continuous improvement. The management system allows leaders to deliver on these expectations while adhering to the aligning principles of organizational excellence, including creating constancy of purpose and thinking systemically.

The Senior Leadership Team sets the tone for the organization transformation. Their commitment and understanding of the journey to come is essential to the success of the transformation. Defining leadership behaviors necessary to lead and sustain a cultural transformation is a critical part of their role. In addition, Senior Leadership Team must develop leadership standards, define the direction for the organization, and build an Executive Management System that will allow them to support the organization on the journey to organizational excellence.

Board engagement is often overlooked as part of the cultural transformation.  There are four content areas a board needs to focus on to provide needed support to management in this culture transformation journey. Ensure grounding through increasing their knowledge of principles, behaviors, and systems and practicing the methods of organizational excellence. Clearly establish the difference in roles between the board and management.  It’s the board’s responsibility to work with management to develop strategy and oversee critical functions however, not be involved in operations. Making the distinction clear results in the board and management functioning at a high level. Succession planning. They choose the next CEO and to choose new board members as terms expire. This can’t be done unless the board deeply understands the needs of an organization undergoing the transition to organizational excellence. Learn how to improve their own work. Specific systems need to be developed by the board that help to support governance improvement.

Healthcare organizations all around the world are working to transform their organizations to a culture of improvement to deliver continually higher value outcomes for patients, staff, and communities. In this podcast listeners will hear from healthcare leaders who are accelerating change within their organizations. Discussions will include topics like continuous improvement, strategy definition and deployment, and leadership behaviors for cultural transformation.