SFGH Management System 1 SFGH Management System Components Strategic Planning True North Improvement Management System Value Streams: Rapid Improvement Events Time 2 1
Refining our Strategic Planning PATIENT COMMUNITY With Ten Proposed True North Metrics VISION To be the best hospital by exceeding patient expectations and advancing community wellness in a patient centered, healing environment. MISSION To provide quality healthcare and trauma services with compassion and respect. VALUES Respect Responsibility/Ownership Teamwork Courage True North Metrics Quality Preventable Mortality Reduce Readmissions Safety Zero Patient Harm Zero Staff Injuries Care Care Experience Experience Patient Satisfaction Access & Flow Developing Developing People People Staff Satisfaction Develop Problem Solvers SFGH Management System Financial Stewardship Meet budget goals Decrease length of stay 3 Organization Transformation: At SFGH we are embarking on the development of a new management system, which will focus on developing staff to become problem solvers, as the ones who understand the work the best. This will create an environment of respect for both staff and patients and allow us to provide the highest level of quality and safe patient care. SFGH staff nurse on a model cell unit 4 2
SFGH True North Metrics People Staff Satisfaction Develop Problem Solvers Care Experience Quality Preventable Mortality Reduce Readmission Patient Satisfaction Access and Flow Safety Zero Patient Harm Zero Staff Injuries Financial Stewardship Meet Budget Goals Decrease Length of Stay 5 True North Quality Safety Care Experience Ten Proposed True North Metrics Preventable Mortality Sepsis AMI CHF PNA Stroke Flu vax Psych Perinatal TBI/Trauma 30d Mortality O:E Mortality Zero Harm VTE SSI/SCIP CLABSI CAUTI HAPU Falls VAP C. Diff MRSA Med Errors Patient Satisfaction HCAHPS o Hourly rounding o RN Leader rounding o CICARE training o Baseball card use o Improve dining experience CGCAHPS Developing People Develop Problem Solvers Lean Training Kaizen participation Huddle participation Stat sheets Personal A3s Financial Stewardship Meet Budget Goals Labor Contract Material & Supplies Staff Productivity Reduce Readmissions within 30 Days DC edu, Med rec f/u <7d, calls Zero Staff Injuries Injuries Assaults Falls Needle Stick Flu vaccine Patient Access/Flow ED flow Lead times DC <12 pm TNAA No Shows Cancellations Staff Satisfaction Staff Engagement Survey Hiring lead time <90 d Decrease ALOS Reduce LLOC Prevent Delays Diagnostic/tr eatment time 6 3
3.00 2.00 1.50 1.00 Jan Feb M ar Ap r M ay Jun Jul Aug Se pt Oct N ov D ec Target B aseline 5/22/2015 Model Cells for Management System 5D and Operating Room/PACU Q: What is a model cell? A: A learning lab for the organization an inch wide and a mile deep Q: What is the goal of a model cell? A: Create value for patients and staff (improve the way we work, achieve True North performance metrics, sustain and spread) Q: Why a model cell? A: To show the organization what good looks like, able to do rapid PDCA, rapid learning 7 The Daily Management System Model Cells Our Drivers True North Watch Metrics Monthly Score Card True North Visual Management Daily Status Sheet Unit Leadership Team Performance Huddle 8 4
The Daily Status Sheet Questioner (e.g. Manager) Asks set questions Coaches problem solving Goal: Shared understanding of the unit s business in alignment with true north, proactive planning, and developing leaders Respondent (e.g. Charge RN) Proactively plans the day Communicates barriers and problem solving 9 The Daily Status Sheet Examples Example Questions 5D Safety: What are the known safety risks for our patients? Quality: What is a potential quality issue for today? People: Who is going to need the most support today? OR Care Experience: What are our potential flow stoppers? Financial Stewardship: What are our financial risks? 10 5
The Daily Status Sheets Director CNO Manager Director Charge RN Manager Shared understanding rises from bottom to top Leaders develop other leaders 11 The Unit Leadership Team Goal: To develop unit ownership of the improvement work Member Examples: RN Managers Charge Nurse Clinical Nurse Educator PI Coordinator KPO Specialist Staff Nurse What is it? A team of the unit staff meets at least monthly to select drivers, design and review a unit scorecard, and guide improvement. 12 6
5/22/2015 The Monthly Score Card Example Owner Unit/Dept/Area Ethel Roque 5D True North Measures and targets chosen by organization that cover all aspects of improvement and impact all areas of its balanced score card Driver Measures and targets a unit chooses to focus on for problem solving and improvement to drive True North metrics Watch Indicator Measures we watch while problem solving is focused on drivers. (i.e. stable, not prioritized, or indirect outcome) 13 Visual Management Huddle Board Goal: Make the unit level team s collective ideas and improvement visual What is it? A hallway board where the unit collects and implements new staff improvement ideas and summarizes the unit s progress on each unit driver. 14 7
Visual Management Board 5D Huddle Board Example Driver Summary Chart Daily Worksheet Improvement Idea Card 15 Daily Performance Huddle Goal: Improve performance by using the team s collective knowledge and connecting their work to True North What is it? Daily huddle with leadership and frontline staff to discuss new problems, test ideas with PDCA, and review our unit s drivers. 16 8
Next Steps Roll out remaining parts of the Management System in Model Cells (June September) Leader standard work Leader standard calendars PDCA and countermeasure tracking A3 Thinking problem solving Standard Work Observation (process, calendar, ) Develop True North Visibility Room (June July) Spread to Med/Surg and ED (September April) Prepare for full spread (September July) 17 Thank you! 18 9