Frontiers of Health Services Management - Spring 2013 - (Page 7)

studying is a better description of the work of improving a process than checking is. teaching frontline workers to apply a standard process to solving problems encourages, excites, and engages them in ways i never imagined. the role of management shifts to encouraging and teaching staff to identify and solve problems. frontline staff typically are excited when their ideas for improvement are implemented. they brag a little to friends, and the energy goes viral. at thedacare, more than 20,000 staff ideas were implemented in 2011. the goal is to double that number in 2012. One-Piece Flow for Patients Standard work is an unwelcome term in healthcare. Physicians and nurses think of standardization as arbitrary rules—like policies compiled in dusty old manuals that hinder care. But in a lean environment, standard work is embraced as fundamental to improvement. Howard Jeffries (2012), a pediatrician at Seattle children’s Hospital, even described standard work as the fundamental principle underpinning the release of creative thinking. the example he cited involved using a standard protocol for albuterol treatment in children with asthma that identified immediately whether the treatment gave kids any relief. if it did not give relief, then doctors on the team were free to use their judgment and creativity to consider other potential diseases as causes. Without the rigorous application of treatment standards, Seattle children’s physicians might have misdiagnosed the disease. Respect for People respect for people as a key principle is difficult to define (liker and Hoseus 2008). the work of Paul o’neill, ceo at alcoa from 1987 to 1999, provides a good illustration. on taking over this closely watched, publicly held giant, o’neill told a large gathering of Wall Street investors in his first public remarks that creating a safe workplace was the company’s first job. to do this, leaders had to unleash the creativity of every individual, create an environment of continuous improvement, and help every associate do work that would give his or her life meaning. and creating work that is meaningful and safe is the mark of profound respect for people (o’neill 2012). John Toussaint • 7 f e a t u r e the success of one-piece flow requires that the care process be designed exclusively around the customer experience. the value stream should deliver care so that no stoppages, waiting, or defects occur. for example, if a cardiologist consultation is ordered, it should not be carried out the next day, at the cardiologist’s convenience, but rather immediately, so the patient can move along in the care process without interruption. the same principle applies to tests such as Mri scans and X-rays. every patient need should be delivered immediately once it is recognized. in the outpatient clinics at thedacare, more than 90 percent of laboratory tests ordered for patients in 22 clinics are performed and results provided to the ordering physician in less than 15 minutes. this timeliness allows the doctor to have the lab results before the patient leaves the office. the doctor can then adjust medications or make other suggestions face-to-face. this approach cuts down on phone calls and errors, and it allows patients to have all the information they need on a single plan of care before they leave the office. Standard Work for Clinical and Administrative Processes

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Spring 2013

Frontiers of Health Services Management - Spring 2013
Contents
Frontiers of Health Services Management - Spring 2013
A Management, Leadership, and Board Road Map to Transforming Care for Patients
Pursuing the Perfect Patient Experience
Adapting to the New Healthcare Market
High Reliability: Truly Achieving Healthcare Quality and Safety
Making Lean Progress Last: Why Sustaining Excellence Requires the Right Leadership Framework

Frontiers of Health Services Management - Spring 2013