Frontiers of Health Services Management - Spring 2013 - (Page 8)

We now know this idea works in healthcare to improve safety, too. Staff at the christie clinic in champaign, illinois, meet every morning before clinic hours and ask a simple question: “are we going to have a good day today?” this question allows everyone on the team, from administrative assistant to physician leader of the ear, nose, and throat practice, to discuss problems and possible countermeasures. it builds teamwork and trust, and its affirmative foundation has led to improvements in patient wait times by 30 percent and throughput in the clinic by 10 percent in nine months. Staff satisfaction with this process scores 5 out of 5 points. The Management-by-Process Operating System the core principles provide the foundation for the ideal healthcare management system. i have rarely seen evidence of a formal management system that truly supports improvement. Most managers are accustomed to doing what they want with little oversight. in great lean companies, however, the management system is clear and deliberate, and it ties the work of the front line to senior management decision making and vice versa. for details about this healthcare management system as practiced at thedacare, review the article by Kim Barnas (2011), president of the hospitals at thedacare. other healthcare organizations, such as SickKids and the Scarborough Hospital, both in toronto, have rolled out a similar approach and collaborate with thedacare on a regular basis. Core Components of a Healthcare Management-by-Process System leaders of these and other lean organizations have found the following compo- nents to be critical to a management-byprocess system: • A3 thinking • Daily status sheet • Daily performance-and-defect review huddle • Unit-based leadership teams • Standard work for leaders and supervisors • Standard work audits • Visual progress tracking • Andons A3 thinking. leaders of a management team at any organization meet regularly. the difference in meetings conducted at a lean organization using a3 thinking— a type of focused problem solving (exhibit 1)—is the rigorous process approach employed for discussion. these meetings usually happen at gemba (the Japanese word describing the place in a company where value is created, such as a hospital unit or the factory floor). a3 thinking is an extension of the PDSa cycle but generated on a single sheet of a3-sized paper. the purpose is to capture the team’s opinion about the problem, including the background and current condition, represented on the lefthand side of the paper. on the right-hand side, the team characterizes the goals, possible root causes, and potential countermeasures or experiments discussed. this process allows for dialogue and captures all participants’ thoughts (Shook 2008). instead of engaging in circular arguments, the management team has gathered real data and determined a clear problem statement. this rigor helps to remove emotion and facilitates solutions. The daily status sheet. every morning, executives, managers, and supervisors at the Scarborough Hospital go to gemba during a two-hour meeting-free zone. 8 • f ro ntier s o f h ea lth s e rvic e s m a na g e me nt 29 :3

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