OasisLMS

Debbie Fernandez, MS, MHSA, LMLP, CPHQ, Marc Hoffmann, MD

This session aims to describe how we implemented a coordinated improvement structure to facilitate sustained improvement work. We will use improvement in patient experience scores to illustrate how this model functions. The component pieces include a huddle framework with feedback loops from the frontline to executive level and branches at each level consisting of focused improvement work via the A3 method and status reports on work at regular intervals between leaders.

Tool: We have combined three core tools of the Lean Management System--huddles, A3 improvement framework, and status reports in a structured format that cascades improvement vertically and horizontally across our production system (see image attached).

Problem: We began our Lean journey in 2015. By 2020 we had completed 18 lean events with variable sustainment of the countermeasures that were implemented. The primary gap we identified was the structure and implementation method of our Lean Management System.

Tool Selection: We selected a cascading structure for our improvement work because we needed a method that was able to combine improvement work and local communication, as well as create a system with bidirectional transparency and flow of the work from frontline to executive levels.

Usage: We implemented the tool in phases. First, we focused on standardizing our huddle framework. Next, we spent time aligning the improvement work with the huddle framework. Lastly, and still in progress, we focused on the cadence of status reports and participants.

Results: As an outcome, we have seen sustained improvement and transparency of our improvement efforts. As a case study, our patient experience data related to wait times has steadily improved from the 60th to 79th percentile rank leveraging this cascading framework. A barrier to this framework is matrixed reporting.