What Matters Most? Integrating a Culture of Improvement with a long-standing Culture of Excellence at the Cleveland Clinic

Transcription

1 What Matters Most? Integrating a Culture of Improvement with a long-standing Culture of Excellence at the Cleveland Clinic Tim Pettry Process Improvement Specialist

2 Cleveland Clinic Top 5 U.S. Hospitals U.S. News and World Report Local Name, Worldwide reach 44,000 Caregivers Main Campus Cleveland 27 Institutes 8 Regional Hospitals 18 Family Health Centers Weston, Florida Lou Ruvo Center for Brain Health, Las Vegas Toronto, Ontario, Canada Abu Dhabi, UAE

3 Continuous Improvement Department 34 People Medical Director Senior Director Hybrid Structure Embedded Institute Resources Central Team Process Improvement Specialists Focus shifting from Tools Principles Discrete projects model areas

4 Equip and Coach Institutes/Hospitals, How to Execute using Continuous Improvement Cycle Set Goals Review Performance Improve Reward / Recognize Culture To Sustain Goal Setting Scorecards/ Dashboards Q-Boards Plan Initiatives Benchmarking Interviews Bus. Rvw. Process Perf. Mgt. Reviews Follow-up Action Plans Resource Action Plans Initiatives Reviews Solutions ID & Share Project Mgmt tools Problem Solving - FasTrac - Productivity Mgmt - Lean - Solutions Website - IDEAS - Others Recognition Development Plans Growth Opportunity Structure, Tools, and Creating a Culture for Execution Methodology Copyright Orion Advisory, LLC

5 Value Time CI Journey / Progress Next Milestone 2012 Base Camp Sponsors Acceptance (Improvement work) Reliable Demand Value: $ Impact, Skills & Behaviors Disposition: Reactive Team to Department Leadership: Unilateral to multiple inputs

6 Tools based Principle Based

7 Internal Shingo Assessment Feedback reports Digestive Disease Institute Organizational Alignment Strategy developed not deployed Visual Management Nothing in place opportunity Problem-solving sporadic Standardization - sporadic Decision Support Services Organizational Alignment Good start VISUAL management - Problem-Solving Strength Standardization - opportunity Taussig Cancer Institute Strong systems in place Organizational Alignment Visual Management Problem-solving Standardization

8 Simplify the assessment process

9 Clarify the message

10 Shift from Assessment to Aspiration Organizational Alignment Visual Management Problem Solving Standardization Identify and communicate what matters most Manage what matters most Improve what matters most Sustain what matters most Right Systems Right Behaviors Right Results

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12 STANDARDIZE AND SHARE (Yokaten) Guiding Principles that helped shape the COI program DIRECT OBSERVATION (Gemba) Caregiver Engagement Cleveland Clinic Improvement model Respect for every Individual Embrace Scientific Thinking Assure Quality At the Source Focus On Process Constancy Of Purpose b Think Systemically Lead With Humility Flow and Pull Value Seek Perfection CONTINUOUS IMPROVEMENT (Kaizen) Create Value for the Customer Value for the Patient REFLECTION (Hansei) The Importance of Thinking of Ourselves as "One Cleveland Clinic Dr. Toby Cosgrove, Toby s Blog, 3/11/2010

13 Surgical Supply A Case Study in implementing a Culture of Improvement Program

14 Start with Leadership support and Employee engagement Can we have 2-4 hrs. week? Can we have 30 minutes a day? 18 chairs and 4 tables? A projector and screen? A place to meet? Let s do it!

15 Lean Simulation using Scrabble Introduce systems: Organizational Alignment Visual Management Problem-Solving Standardization

16 Ask What Matters Most? Inventory Accuracy

17 Introduce Visual Management 1. First iteration Inventory accuracy % by item count Standard Huddle agenda 2. Second iteration Directional Arrows Back Orders 3. Third Iteration Inventory accuracy by % absolute $ variance 4. Fourth Iteration Absolute $ Variance Standards for not taking weekly cycle counts Manage What Matters Most

18 Problem-Solving Improve What Matters Most

19 Standardization Sustain What Matters Most Standard team huddle process allows for rotating huddle leaders

20 Self Assessment

21 Developing standard process to find root cause of inventory variance

22 What have we learned? 1. Communication / Engagement 2. Teamwork 3. How hospital works working smarter, not harder 4. Flow 5. Importance of metrics 6. Didn t take a lot of work to get better results 7. Data can be our friend 8. Communication of the data, understanding what it means

23 Measuring Engagement

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25 8/28 9/4 9/11 9/18 9/25 10/2 10/9 10/16 10/23 10/30 Chagrin Falls Family Medical Center 100.0% The time spent on the Culture of Improvement initiative this week was value-added to me. % to Goal 90.0% 87.5% 80.0% 70.0% 60.0% 60.9% 63.6% 77.6% 76.5% 75.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% % to goal

26 Employee Engagement Survey Results What matters most? TRUST

27 Definition of Trust Working together Having each other s back Mistakes are viewed as learning opportunities Our best interests are kept in mind

28 Pete can not be trusted because He talks down about everyone He has been caught in lies He looks shady He has no face He does not keep us updated on any changes He shares information told to him in confidence He talks too much He told things to others that were shared in confidence with him He shows up late He spreads rumors He does not follow up or follow through I can not depend on him He does not know my area Owes me money! He wants me to fail He is forgetful He can t doesn t communicate with someone

29 Bill can be trusted because He has good work ethics He helps job go smooth He does what he says he will do Of his knowledge He has worked my area and knows my items He keeps you updated on any changes His words match his actions He has not done anything to lead me to not trust him yet Shakes hands He wants me to fail I can depend on him Fixes issues of mine on their own He shows leadership He has my back I know he is detail oriented and will follow through. I can count on him. Keeps you updated on any changes and makes job go smooth Helps others out

30 Tracking Question of the Week There is a climate of trust within my work group. Completely Agree Somewhat Agree Somewhat Disagree Completely Disagree

31 Trust Survey results

32 Results

33 Results after the first year Reduction of absolute inventory variance $395,620 $42,987 Reduction in net variance $136,000 $5,184 Overtime reduction > $20,000 Zero employee turnover since we started the program in July, 2014 CEO, Toby Cosgrove visits the team to share their story with the rest of the Clinic on his bi-monthly Connections webcast. Employees arrange a thank-you celebration for their Director

34 Connections - Sharing our Success

35 Recognition I LOVE hearing the success stories of this team! Without Surgical Supply, our ORs would not be running! You all have done a wonderful job making your work efficient and effective!! GREAT JOB!!! Coord Research Nurse, Lou Ruvo Center for Brain Health, Las Vegas

36 Questions?

37 Thank You! Please complete the session survey at: Session: ThP/53 What Matters Most? Integrating a Culture of Improvement with a long-standing Culture of Excellence at the Cleveland Clinic Tim Pettry Cleveland Clinic pettryt@ccf.org