GROOTE SCHUUR PERFORMANCE SYSTEM...
Transcript of GROOTE SCHUUR PERFORMANCE SYSTEM...
Dr Bernadette Eick
February 2018
GROOTE SCHUUR
PERFORMANCE SYSTEM
GPS
© Western Cape Government 2012 |
GROOTE SCHUUR HOSPITAL - OVERVIEW – THE CONTEXT
1938 - official opening of GSH
GSH is a Central Hospital providing tertiary & quaternary care as well as regional care for direct surroundings
GSH is a Public Hospital, providing the teaching and research platform to UCT, CPUT, UWC and other HEIs
R 2.2 Billion Budget, 975 beds, 3700 staff
Ca 370 000 OPD, 58 000 admissions, 6 days ALOS
© Western Cape Government 2012 |
EXTERNAL ENVIRONMENT - THE BURNING PLATFORM
Economic
growth
Service
deliveryMigration Urbanisation
Sanitation, environmental toxins, unhealthy diets, economic resilience, violence, refuse
removal, housing density …
© Western Cape Government 2012 |
PROVINCIAL STRATEGY - HEALTH CARE 2030
Need transformational leadership and designated change agents
The intension is to develop:
Leaders who:
• Embody the organisational values
• Depend on interpersonal power (not hierarchy)
• Enable innovation
• Draw on inherent and potential capabilities of employees
• Are visibly collaborative in their
relationships
Reciprocal (mutual ) accountabilityinstead of top down culture
Organisational effectiveness using a competing values framework
Collaborate(People)
Create(Innovation)
Control(Rules)
Compete(Results)
MentorFacilitator
New ideasPartnerships
PlanAchieveTargets
ComplyMonitor
The competing values framework
Source: R E Quinn et al; 2010
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LEADERSHIP AT GROOTE SCHUUR HOSPITAL
WHERE DO WE START?
HOW DO WE START CHANGING FROM BUSINESS AS
USUAL?
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THE GSH JOURNEY TOWARDS GPS – THE INSPIRATION
Based on the principles and lessons learnt
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THE GSH JOURNEY TOWARDS GPS – THE “divergent” START
Research by GSH Management member into various improvement projects at GSH
Provincial Flow Initiative focused on LEAN principles in the Emergency Centres, bed management
2011 Health Managers Development Programme indication of HRM potential of lean management to improve service delivery
2014 12 managers from MDT undergo a Lean Management Development Programme focusing improvement projects espon OPD folder, appointment and clinic and Pharmacy throughput times
2014 participation at LEAN summit – more ideas; more projects
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THE GSH JOURNEY TOWARDS GPS – GOING “GLOBAL”2015
• Develop the skill sets
• In-house workshops:
• Value stream mapping
• A3 charts
• Toyota Kata
• LMDP
• Contracted Lean Institute Africa
© Western Cape Government 2012 |
THE GSH JOURNEY TOWARDS GPS – THE EXECUTIVE INITIATIVES
Quality care and improved
patient experience
Leadership development
Innovation and Change Management
Professional support
stewardship
Improved environment
& safety
Engaged staff
Service delivery
Finance:
Improve folder removal time
from records by 50%
Support services:
Improve ID application
process to 18 hrs
Clinical services projects:
1. Improve access from
Emergency unit to CT scanning
2. Improve discharge planning
3. Improve theatre starting time
at 08h00 by 50%
4. Unbooked patients at Gynae
OPD
Human resources:
1. Improve time to fill posts
2. Wellness strategy
Pharmacy:
Reduce time to issue meds
to discharged patients by
20%Engineering:
Reduce electricity and water consumption
Project mentoring
On the job coaching
© Western Cape Government 2012 |
THE GSH JOURNEY TOWARDS GPS – IMRPOVING THE PATIENT JOURNEY
Entrance to Hospital
Emergency Unit – NJ, EW, TC
Entry System/Triage/Waiting TimeDocumentation
OPD – OPD Mx team, HODs
Create Proto type / SOPs/ Standard of Work/Gynae roll out
WardsMedical : Visual Patient
Flow –Whiteboards Roll Out
(EW & Team)Surgical: improve on t/o of
beds(BJ & Team)
Transversal ServicesTheatre Starting Time – AK and
teamRadiology Time Shift
(EW,LN,SB,NP)
OPD Lean Clinic Team
Medical Records (NW)Reception (WB)Pharmacy (VN)
O & G: clinic throughput (HA,SD,WB)
Discharge Planning
© Western Cape Government 2012 |
SOME RESULTS
© Western Cape Government 2012 |
SOME RESULTS
© Western Cape Government 2012 |
THE GSH JOURNEY TOWARDS GPS – THE DEVELOPING VISION
LEADING INNOVATIVE HEALTHCARE
2016
Leading
Every staff member can be encouraged to lead
Managers require specific motivational, inspirational and knowledge skills
This will be met through a leadership development programme
Innovation
Providing staff with the space to find new solutions to problems and facilitating these into action
Healthcare
Being person centered:
Caring for the patient; the staff; the patient’s family; the community; the environment and ultimately, the prevention of disease
Healthcare in a holistic manner
© Western Cape Government 2012 |
LEADERSHIP DEVELOPMENT : GROOTE SCHUUR HOSPITALLeadership Development Sessions 2016
Session Date Subject FacilitatorExecutive Management Team
Development11-Jul-16 Orientation Session Belinda Ketel
Executive Management Team
Development19-Jul-16 Emotional Intelligence Belinda Ketel
GPS Review Session 25-Jul-16 InnovationSenior Management Leadership
Programme01-Aug-16 Module 1 Chris Breen
Senior Management Leadership
Programme02-Aug-16 Module 1 Chris Breen
Executive Management Team
Development15-Aug-16 Coaching and Mentoring Belinda Ketel
GPS Review Session 22-Aug-16 InnovationSenior Management Leadership
Programme 13-Sep-16 Module 2 Pre-meeting Chris BreenSenior Management Leadership
Programme 14-Sep-16 Module 2 Chris BreenSenior Management Leadership
Programme 15-Sep-16 Module 2 Chris Breen
GPS Review Session 26-Sep-16 Innovation
GSH Leadership Learning Session 10-Oct-16 Research and Ethics HREC/Marc Blockman
GPS Review Session 24-Oct-16 InnovationSenior Management Leadership
Programme11-Nov-16 Module 3 Chris Breen
Leadership Conference 27-Nov-16 GSH/UCT FHS
Leadership Conference 28-Nov-16 GSH/UCT FHS
Leadership Conference 29-Nov-16 GSH/UCT FHS
Leadership Conference 30-Nov-16 GSH/UCT FHS
© Western Cape Government 2012 |
INNOVATION: AT GROOTE SCHUUR HOSPITAL
© Western Cape Government 2012 |
THE GSH JOURNEY TOWARDS GPS – STATUS 2016
LMDP graduates are coaching new improvement projects
Developing Daily Management System for front-line teams supported by Management Standard Workintroduced to address sustainability
Building capability in IMU to support managers with performance measurement and HR training to support frontline teams to implement the DMS
© Western Cape Government 2012 |
THE GSH JOURNEY TOWARDS TRUE NORTH - 2017
• Functioning GPS Review Committee
• On-going Steering Committee
• Developed and conducted coaching development program
• Executive Coaching by J. Touissant
• Opened GPS support office with 2 dedicated FT resources
• Setting up of Command Room
© Western Cape Government 2012 |
THE GSH JOURNEY TOWARDS TRUE NORTH - 2018
• Alignment of Annual Operational Plan to GPS
• Alignment of reporting structures of “projects” into the functional business reports
• Embed “7C” as the problem solving mechanism for GSH throughout the organisation
© Western Cape Government 2012 |
LEADING INNOVATIVE HEALTHCARE
Leadership
development
programme
Improved Person centered care
(Behavioural and organizational culture)
Creating an environment for continuous improvement
Patient centeredvalue
Organizational culture of Continuous improvement
Developing
the team(Capacity)
GPS management systemDeveloping
the self
• Number of leaders trained • GPS Management score
PRINCIPLES AND VALUES OF C2AIR2
I will respect you and you will respect me
QUALITY•Adverse events
• Organizational risk - measure
FINANCIAL•Financial stewardship – e.g. Cost
per PDE
CUSTOMER •Patient satisfaction
BUSINESS PROCESSES•Mortality rate
•Waiting time index
THE GSH JOURNEY TOWARDS TRUE NORTH
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LEADERSHIP AT GROOTE SCHUUR HOSPITAL
What have we learnt thus far!
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LEADERSHIP: GROOTE SCHUUR HOSPITAL : Lessons Learnt 1
• Understand your context and your business
• Have a strategy and alignment to external and internal stakeholders
• You need a vision / true north owned by the organisation of who and what you want to be and where you want to go
• Prepare for the journey
• You need a brought road map of how to get there
• You need a driving force
• Take stock:
• Skills , capacity, “equipment”
© Western Cape Government 2012 |
LEADERSHIP: GROOTE SCHUUR HOSPITAL : Lessons Learnt 2
The difference
• THIS IS A NEVER ENDING JOURNEY
• Hard work every day
• Have a friend (MDT)
• Ask for help / guidance / direction on the way
• Start small:
• model cell
• Keep connected to your environment:
• GEMBA
• Be aware of the impact on patients & staff
• Adapt (PDSA)
© Western Cape Government 2012 |
GSH - VISION
LEADING INNOVATIVE
HEALTH CARE
It is better to lead from behind and to put others in front, especially when youcelebrate victory when nice things occur. You take the front line when there is danger.Then people will appreciate your leadership.
Nelson Mandela
Thank you
Thank you
© Western Cape Government 2012 |
LEADERSHIP: GROOTE SCHUUR HOSPITAL : Lessons Learnt 3
Senior Leadership
Keep your focus on the True North
• The surprise:
True North is becoming the journey that never ends and our task as leaders changes to becoming “tour guides”
who are building a sustainable culture of continuous improvement
in which
People work together to adapt to what comes across their path
With a certain skill set which allows them to define solutions in a resilient and innovative way
In order to improve healthcare every time, all the time , everywhere
© Western Cape Government 2012 |
The GSH Journey to the GPS
• To keep the focus and make it sustainable
• Formed a Steering Committee
• Started to define True North
• Developed a Management (operating) System
• Started to develop standard work procedures
• Create an environment for sustainability
© Western Cape Government 2012 |
Lessons learnt2018/02/28
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We need to develop and actively drive leadership
Commitment to improvement
Journey of continuous learning
We need a goal / vision / true north
We need a plan / route map
© Western Cape Government 2012 |
Lessons learnt2018/02/28
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HOW:
Start small – experiment, built a model cell
Ask for help / guidance
Are we providing value and how are we measuring this?
Be constantly aware of the impact on staff
Bring it all together so that it speaks to the True North
© Western Cape Government 2012 |
Looking ahead – GPS
Changing mindsets
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Process thinkingProcess mapping Process design
Generating ideas and
flow of activities visualised
Ability to identify the
strong drivers of the
problem
Creating new processes
Redesigning existing processes
People development
Through learning
Leading for continuous improvement – Building the habit by changing
behaviour
© Western Cape Government 2012 |
Looking ahead – GPS
The work to be done
Build multidisciplinary teams
Start thinking of yourselves as part of the system
Create a culture of addressing challenges using a problem solving approach
Creating a culture of finding innovative solutions to improve healthcare
Creating a culture of continuous improvement
Creating the capacity to become sustainable
Improving the patient experienceThrough becoming the leaders who strive to achieve
‘Leading Innovative Healthcare’
© Western Cape Government 2012 |
Leadership at GSH2018/02/28
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VISION Leading Innovative Healthcare
MISSION Groote Schuur Hospital will remain a
beacon of service excellence by striving to
develop leaders who will build a culture of
continuous improvement through problem
solving in order to improve person
centered quality health care.
VALUES C2AIR2
BEHAVIOURAL
PRINCIPLE
‘I will respect you and you will respect me’
OUR MOTTO Servamus – We serve
© Western Cape Government 2012 |
Leadership at GSH
2013/14• Leadership, Innovation and Change
2014/15• Leading Innovative Healthcare
2015/16•Leadership development and GPS
2016/17
• Strengthening GPS and ongoing leadership development
© Western Cape Government 2012 |
GSH PERFORMANCE SYSTEM = GPS
Step 1: Set up a Steercom
Step 2: Understand what we mean by good leadership in our environment
Step 3: Develop and communicate the plan
Step 4: Agree on specific projects for each manager and set up project teams
Step 5: Develop a leadership training programme and SOP’s for each aspect of the
GPS.
Step 6: Project plans, A3 structure, Process observation standard work board, graphics
to monitor, etc.
Step 7: Include a larger team (Project members) to develop the A3, which is a
description of the problem, goal, gap analysis, countermeasures and results.
Step 8: Gemba visits; M&E tools; review periods; feedback and sustainability
Step 9: How do we know when we have reached our True North?
NB:
➢ Constantly keep the goal in mind.
➢ Team development coaching sessions
➢ Development of trainers and mentors
© Western Cape Government 2012 |
INNOVATIONS
▪ GSH HFB provided R2M to
promote Innovation
▪ Partnered with the
University of Cape Town
Business School Bertha Centre of Innovation and
Social Entrepeneurship
▪ Developed an Innovation
grand challenge program
▪ Reviewed 17 proposals, of which we have selected
15 for funding
▪ Dedicated a space for an
Innovation hub
© Western Cape Government 2012 |
MAPPING THE JOURNEY TOWARDS TRUE NORTH
GROOTE SCHUUR PERFORMANCE SYSTEM
(GPS)
Principles
Person centered
Quality of care
Values based
Improving the patient
experience
© Western Cape Government 2012 |
WHAT DO WE HAVE?
We can make a difference
We have a powerhouse of intellectual capacity
We are Partners with benefits
We have a strong and committed team
© Western Cape Government 2012 |
Achievement: Theatre
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Achievement: EU Triage
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The GSH Journey to the GPS
• Developed many projects with teams and team leaders
• Defined A3 – trying to find the right questions
• Observed -- Daily huddles and weekly Gemba’s
• Created value stream maps
• Started defining measurements
• Changed and started up again, allow time and experiment
• Review Processes
© Western Cape Government 2012 |
The GSH Journey to the GPS –Defining our Conceptual framework
PCE and PCC –Value stream for the Customer
Respect the knowledge and experience of front line staff
Ask the correct question
Started working on HRM In house training capability
GROOTE SCHUUR PERFORMANCE
SYSTEM
(GPS)
© Western Cape Government 2012 |
The GSH Journey to the GPS – The Road less travelled
ALIGNMENT STRATEGY: NB 2 MANDATES
• Academic Hospital:
• feeds into Recruitment strategy,
• Leadership
• competitive advantage
• Service Focus:
• PCE (Person Centred experience)
• PCC (Patient Care Continuum)
• Improvement Energy
• create Centre of operational Service Excellence`