Improving the Patient, Family & Clinician Experience
Transcript of Improving the Patient, Family & Clinician Experience
System Engineering:Improving the Patient,
Family & Clinician ExperienceGary S. Kaplan, MD
National Academy of MedicineSymposium on Health Services Research
© 2018 Virginia Mason Medical Center
© 2018 Virginia Mason Medical Center
The VMMC Quality Equation
Q: QualityA: AppropriatenessO: OutcomesS: Service W: Waste
Q = A × (O + S) W
© 2018 Virginia Mason Medical Center
Strive for Highest Satisfaction
Listen to understand
Keep your promises
Be encouraging
Connect with others
Express gratitude
Speak up
Walk in their shoes
Grow and develop
Be a team player
Share information
© 2018 Virginia Mason Medical Center
Experience-Based Design Is…
A philosophy and set of methodsfocused on an understanding of theexperiences and emotions of thosewho are involved in receiving anddelivering healthcare services, strivingto understand what people naturallydo and feel.
What really matters to our customers?
© 2018 Virginia Mason Medical Center
Where We’re Heading
© 2018 Virginia Mason Medical Center
Synchronized Ongoing Support (SOS): An Integrated Response to Unanticipated Outcomes
1. Major unexpected clinical need; or2. Major immediate family need; or3. Urgent non-clinical support need
SOS – A standard response that is transparent, individualized and phased to promote restoration and growth for all touched by the event.
Time zero –tailored
Within 30 minutes Within 12 hours Tailored to needs Tailored to needs Within 8 weeks
Dial ‘0’ for Patient Safety &
Patient Relations
Team debrief
Patient support ongoing
Resource huddle
Acknow
ledgement
Staff support ongoing
Quality im
provement
Identify needs,just-in-time coaching Administrator
Patient advocate
Mgr/Primary RN
RN supervisor
Spiritual care
Social work
Patient safety
Area leader
Involved team
Spiritual care
Patient safety
PSA processCare ReviewRoot Cause
Analysis
PreparationFollow up family meeting
Assess needs,align resources, plan next steps
Patient advocate
Patient safety
Provider
Clinical team
Peer to Peer
Support immediateneeds of team
Support needs of patient andfamily
Support needsof team member(s)
Systems review
Patient advocate
Tailored check-ins
Navigates needs
Coordinates follow up meeting
Team debrief
Tailored Check-ins
Spiritual care
EAP
Schwartz Rounds
Safety Innovation
© 2018 Virginia Mason Medical Center
Alignment
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Requirements for Transformation
Sense of Urgency
Visible & Committed Leadership
AlignedExpectations
Improvement Method
Technical & Human
Dimensions of Change
Shared Vision
© 2018 Virginia Mason Medical Center
VMPS Evolution
Time
Impa
ct
2002 2003 2004 20052006
20072008
2012
20092010
2011
2013
2014
2015
2016
2017-2020
The environment demands a continued acceleration of our improvement results:• Increased pace of change• Increase quality outcomes, reduce costs• Reduce stress and burnout
© 2018 Virginia Mason Medical Center
VMPS Evolution:House 2.0
Patients as Partners• Patient/family
partners• Experience
Based Design• Co-design
Accelerate the Impact• Speed and agility• Innovation• Plan-Do-Study-
Act (continuously evaluate and improve)
World Class ManagementManagement by Policy, Cross Functional Management, Daily Management
Engage Individuals and Teams• Organizational
compacts• Personal growth
& recognition• Leader
competencies
Quality Leader• Q = A * (O+S)
WQ: QualityA: AppropriatenessO: OutcomesS: Service W: Waste
• Patient Safety Alert System
Mas
ter t
he
basi
cs
Mak
e it
our o
wn,
fo
r our
pat
ient
s, te
am
mem
bers
and
com
mun
ities
VMPS Principles, Tools and Methods5S, Standard Work, Visual Control, PDSA, Innovation, Just in Time, Mistake Proof (Jidoka), Leveled Production (Heijunka)
Improving the Flows of Health Care
Respect for People Continuous Improvement
BUILD A STRONG FOUNDATION
Safe and Respectful Environment Increase Reliability and Effectiveness
Virginia Mason Production System
© 2018 Virginia Mason Medical Center
Our VMPS Journey
2002 20032004
20052006
20072008
20092010 2011
20122013
20142015
2016
2017
-Implemented Strategic Plan with Patient at the top
-Declared VMPS as our management method-Executives to Japan-Implemented PSA system-49 RPIWs, 3 3Ps
-Executives & KPO first to be VMPS Certified-7 KPO Staff Members
-Mrs. McClinton
-All Execs & Admin Directors Certified-110 RPIWs, 4 3Ps
-Kaizen Fellowship program-KPO rotational leader position created-24 KPO staff members-One organizational goal of Quality-KPO Goals instituted-Tuesday Standup begins
-HealthGradesDistinguished hospital award-Integrated VMPS efforts with supplier partners-VMPS training for managers-44 RPIWs, 1 3P, 51 Kaizen Events
-Defined standards for a Model Line-Improved VMPS curriculum for all supervisors and above-25 KPO staff members
-Virginia Mason Institute formed-Large integrated value streams-3P Certification-VMPS for Leaders prerequisite for Certification-31 KPO staff members
-Super-flow RPIWs-Study & apply Toyota Talent (TWI) training methods-66 RPIWs, 6 3Ps, 119 Kaizen Events
-Top Hospital of the Decade
-World Class Management system-Standard Work for Leaders
-Experience Based Design training-82 RPIWs, 8 3Ps, 238 Kaizen Events-26 KPO staff members
-Respect for People Training-Continuing education for VMPS Certified leaders-Innovation Events
-Patients as partners with our improvements-VMPS for Leaders training becomes “fit for duty” requirement of all admin and physician leaders
-One KPO-First daily management assessment org-wide-Introduced daily kaizen
-VMPS Priorities focused on improving the patient, family and staff member experience
-First Advanced VMPS Cohort- Memorial partnership & training
-Patient Co-Design next steps-Patient/Family Partners required for all RPIWs
2018-
2020
“In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists.”
- Eric Hoffer