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IU Health Transformation

IU Health Transformation. Introduction by Dan Evans. Alicia Schulhof. The IU Health Transformation. Agenda. Lean and The IU Health Transformation. What Is Lean?. Lean is way of thinking that enables the true performance potential of a process or business to be realized

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IU Health Transformation

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  1. IU Health Transformation Introduction by Dan Evans

  2. Alicia Schulhof The IU Health Transformation

  3. Agenda Lean and The IU Health Transformation

  4. What Is Lean? • Lean is way of thinking that enables the true performance potential of a process or business to be realized • Leans achieves this performance through the application of principles, tools and techniques that identify and eliminate waste Lean is an approach that enables Revolutionary Levels of Performance: 10%, 25%, 50%, 100%, 200% gains

  5. What Lean Is Not • A quick-fix; it takes time and active participation to change processes and cultures • Easy to do; it is often uncomfortable and even painful for some It takes time to transform an organization’s culture; it will take time and perseverance to transform IU Health

  6. Our Past IU Health Transformation Journey Limitations Our Challenge Solution Approach

  7. IU Health Transformation Journey Stories of Success from early adopters IU Health Arnett • Used Lean Six Sigma to tackle the problem of delayed first case surgical start times at its hospital and ambulatory surgery center • Lean tools helped identify causes of the delays and found solutions RESULTS: • 86% on-time start at the hospital • 90% on-time start at the surgery center • Vastly improved service • Generated cost savings estimated at $150 /minute

  8. IU Health Transformation Journey Pediatric Intensive Care Unit Team at Riley Hospital for Children • Developed a new protocol for continuously monitoring patients who require ventilator support RESULTS • Significant reduction in the need for lab work • Roughly $750,000 in savings annually • Testament to our physician leadership and their initiative to pursue

  9. IU Health Transformation Journey Service Lines at Riley Hospital • Care Model Redesign with several services lines • Multidisciplinary participation RESULTS • Several value streams and performance improvement initiatives now underway. Pulmonary (8W) Service Line

  10. “I wanted to share the latest results of the Core V care re-design efforts at Methodist. Through the work of many members of the team, the staff and surgeons have agreed to standardize suture for common procedures. The effort will result in an annual savings in excess of $67,000. As you can see from the attached picture, all of the adult CV surgeons have signed the poster that will hang in the core for posterity. Other projects are coming to fruition, as we move toward our goal of standardized, lean processes.” - Dr. Art Coffey IU Health Transformation Journey

  11. Limitations

  12. The Challenge • Identify single improvement model • Build upon Leading to Preeminence initiatives • Define our customer as the patient • Partner with industry transformation expert “We’ve set the very aggressive but achievable goal of improving productivity by 25 percent over the next four years.” Dan Evans, President and CEO IU Health

  13. Solution Approach

  14. Solution Approach 11/7/2019 15

  15. Present • Introduction to the Simpler Business System • Supporting Strategic Improvement • What Leaders Can Expect • The Leader’s Role in the Transformation

  16. Present • Simpler is our partner • Office of Transformation is established • Transformation Plan of Care (TPOC) is developed • Creating infrastructure needed for sustainability • Deploying communication and training

  17. Simpler Business System Timeline Simpler founded on the premise: “Maybe this can work outside of manufacturing” Administrative Areas Military / Repair Healthcare Rail 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Today SBS 1 SBS 2 …………………………………………… SBS 6 ……………………………………………………... SBS 11 Banking System is designed to work in every sector

  18. SimplerBusiness System Philosophy Based on Two Simple Concepts: • Respect for People, Patients and Society • Continuous Improvement Respect for all people is a foundational value that guides the Simpler Business System

  19. Simpler Business System Principles • The Patient Defines Value • Deliver Value to Patients on Demand • Standardize and Solve to Improve • Transformational Learning RequiresDeepPersonal Experience • Mutual Respect and Shared Responsibility Enable Higher Performance

  20. Supporting Strategic Improvement Characteristics of the Transformation • Patient first philosophy • Commitment and leadership • Innovation • Clear alignment to strategy and objectives • Structure and accountability • Continuous learning – in perpetuity! “Lean is a way to simplify my work so as to better serve my patient.”

  21. What Leaders Can Expect to Learn: • Key tools for identifying and eliminating waste • How to prioritize your efforts based upon impact • How to leverage the skills and talents of your team • How to think and lead differently • Innovation • Collaboration of “better” practices • “How to Fish”

  22. Pulse Check What is the most … Counter-intuitive? Surprising ? Unsettling ?

  23. Simpler Business System True North Metrics Human Development 40% 35% 30% 25% 20% 15% 100 10% 90 80 5% 70 0% 60 Jan Mar Jun Aug Oct Dec 50 40 30 20 Quality 10 0 Jan Apr Jun Jul Aug Sep Oct ov Dec Feb Mar Timeliness 88 900 900 86 800 800 700 700 84 600 600 500 500 82 400 400 300 300 80 200 200 100 100 78 0 0 76 Cost Mar Jun Aug Oct Dec Jan Transformation ContinuumSM TPOC Review 9 Week Event Cycle Growth Plan Execute Follow-up TPOC Review BENEFITS TRACKER Lean Accounting Steering Committee

  24. Transformation Support Structure

  25. Transformation Core Team Composition Dotted line back to system office, SVP Dotted line back to system office

  26. Lean Skills Development & Strategy Deployment • Lean Training/Participation opportunities • Executive Leadership Workshops (1x 3d) • Transformation Core Team workshops (1x 4d) • Value Stream Analysis workshops (cadence ~6mo) • Rapid Improvement Events (monthly/value stream) • Certified training for employees (ongoing + progressive) • green, bronze, silver, gold, platinum • Transformation Support • Gemba Coach (full time, site specific, first 6 months) • Site Sensei (monthly, value stream coach) • Executive Coach (2X monthly, executive leadership coach)

  27. Transformation Support Structure

  28. Strategy Deployment Lean organizations focus on the entire enterprise. They move from chaos to create a vision of alignment and focus to create momentum and eventually execute the strategic vision of the enterprise.

  29. The Leader’s Role in the IU Health Transformation “Example is not the main thing in influencing others…… it is the ONLY thing!” -Albert Schweitzer

  30. Jim Terwilliger President, IU Health Methodist and University Hospitals

  31. Key Points • This is the next step in our journey to delivering preeminent care • As leader you cannot delegate your role in transformation • Lean is how we accomplish results not “something else we do” • Must be an aligned and integrated approach – Standard Work • Your active participation and leadership is required, not optional

  32. Role of Leaders • Lead from the front • Transform the way we behave • Transform the way we think

  33. Transform the Way We Think Forever Improve Culture Change Developing New Beliefs Understanding & Embedding Principles Borrowing then Developing Technique Improvements in HD, Q, C, D, G Changing Values Apply tools Changing Habits Changing Actions Introduction Year 1-2 Intense Year 3-5 Development Year 5 - 10 Pace and Dedicated Resources to Continuous Improvement

  34. Pulse Check What is the most … Counter-intuitive? Surprising? Unsettling?

  35. Launch Sequence • Launch Month: Executive Leadership Workshops (1x 4d) • Launch Month/ +1: Transformation Core Team workshops (1x 4d) • Launch Month +1: Value Stream Analysis workshops (cadence ~6mo) • Launch Month +2: Rapid Improvement Events (monthly/value stream)

  36. Call to Action • Between now and your site launch, continue improvement efforts that are currently underway. We will work with you to assess the transition of work through the value stream analysis • Coordinate any new Lean related communication and training through the System Office of Transformation • Be a supportive ambassador for the transformation • Lead from the front • Keep informed and help others to understand • Own it – it is our IU Health Transformation

  37. Future Dr. George Palma, Simpler

  38. Kaiser Permanente North Valley Improvements Driven by the Lean Transformation

  39. Patient Satisfaction: Access to Specialty Care - 2009

  40. Patient Satisfaction: Access to Specialty Care - 2012

  41. Walk in Mammography Performance

  42. Walk in Mammography Performance

  43. Imaging Modalities Backlog Reduction

  44. Emergency Department Average Length of Stay

  45. Productivity Gains and Access Improvement Examples • MRI and CT capacity increased by 50% with no additional resources • PET-CT capacity increased by 100% with no additional resources • Complex pediatric MRI with anesthesia capacity increased by 38% • Same day access to cranial CT and MRI scans in place • General Surgery time to elective cases reduced from 12 to 4 weeks • Echocardiogram in / done times decreased from 60 to 45 minutes

  46. Panel Discussion Moderator: Al Gatmaitan Panelists: Dr. George Palma Alicia Schulhof Bill Clohessy

  47. Final Word Dan Evans, President and CEO, IU Health Charlie Golden, IU Health Board of Directors

  48. Lean Taskforce Recognition Diane Iseminger Sheriee Ladd Wesley Morgan Mary Sitterding Alan Weldy Deanna Willis, MD Michael Yost • Joe Arruda • Harold Berfiend • M. Carolina Braga • JoAnn Brooks • Linda Everett • Alfonso Gatmaitan • Sue Hill

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