The Amazing Race: Achieving IT Excellence in Healthcare

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The Amazing RaceAchieving IT Excellence in
Healthcare

• Tim Brogan, PMP

2006 Health Information Technology
Institute Wednesday May 17, 2006
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Learning Objectives

• Learn the basic concepts of World Class Service
  and Six Sigma methodologies
• Learn the Cleveland Clinic Approach to embedding
  excellence into every effort
• Explain project management and service support
  from a World Class perspective
• Learn why Cleveland Clinic employees embrace
  goals of excellence

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The Amazing Race

• Speed gets attention
• Speed minimizes scope change
• Speed minimizes effect of organization changes
• Speed can put you in first place
• Keep the end in mind

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Cleveland Clinic

• Multi-specialty, not for profit, integrated
  Health System
• Founded in 1921
• - Committed to patient care, research and
  education
• Global leader in health care
• Part of the14-hospital Cleveland Clinic Health
  System

Main Campus and Clinics in Cleveland

• 1,000 Available beds
• 2.8 M Total Visits
• 2,000 Physicians and scientists
• 3.3B Net Revenue

• 78 Operating rooms
• 68,052 Surgical cases
• 55,037 Admissions
• 18,500 Employees

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Strategic Direction

• Commit to Excellence
• Excellence is when employees feel valued,
  physicians feel the organization is the best, and
  patients feel the service is extraordinary.
• To be the highest
• rated healthcare
• provider in the U.S.

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Todays Session Flow

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World Class Service
WCS launched April 2002 to improve patient
experience

• Develop consistent measures goals across
  organization
• Pilot roll-out patient focused activities
• Develop awareness across employee base
• Focus on external (patient) Create patient
  focused culture
• Create new management training forums
• Implement across all hospitals and clinics

Goal Oriented Organization
Leadership Training
Focus on Patient Interactions
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World Class Service Teams
Executive Team
Operations Council
Innovation
Service
Teamwork
Quality
Front line skill Resource team
Scheduling
Service Recovery
Rewards Recognition
Patient Navigation
Pt. Preferences Loyalty
Leadership Academy
Patient Wait Experience
Cancer Center Patient Satisfaction
Logistics
Visitor Coordination
Emergency Dept. Patient Satisfaction
Patient Gown Redesign
Medicine Inpatient Patient Satisfaction
Inpatient Surgical Services Team
Childrens Health Ed.
Computerized Bed Technology
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World Class Service Methodologies

• Executive Rounding
• Goals Setting
• Idea Generation
• Education
• Leader training

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1. Rounding

• Why
• Employee satisfaction and to ensure we service
  what we build, communicate change and get
  feedback
• Who
• Leaders round on direct reports
• CIO and Executive rounding on all employees
• How Often
• Rounding on direct reports every 2 weeks
• Executive rounding (specific to area)

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2. Goal Development Process
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IT Performance Wheel (IT Goals)
11/05
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3. World Class Idea Program

• When an idea is submitted, the employee receives
  a badge backer.
• If the idea is implemented,
• the employee receives a pin for the badge.

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Idea Processing Statistics
Volume CCF 900 ideas / month IT 80 ideas /
month
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Ideas Changing Paradigms
IDEA PROGRAM AS AN INNOVATION CULTIVATOR
IDEA PROGRAM AS A SUGGESTION BOX
Focus on outcomes, develop a culture of ownership
that drives innovation (Quality vs. Quantity)
Focus on processIdea submission, review and
feedback Quantity vs. Quality
Innovation Focus - proactive, solution oriented
ideas that focus on departmental and
organizational goals/challenges
Suggestion Focus-reactive, individualized, not
solution oriented
Idea Reviewchanneled to appropriate
departmentefficient but promotes silo culture
Idea Collaboration-build on ideas, reduce silo
effect, promote brainstorming, involves
employees in the process
Results Feedback---Employees engaged in
implementation process, measurable results
Results Feedbacktimely employee feedback,
little employee involvement, limited ROI
VALUE ORGANIZATIONAL R.O.I.

• Feedback
• Innovation
• Intellectual Capital
• Results

• Feedback
• Employee concerns
• Perceived Barriers
• Suggestions for
• Improvement

Employee Satisfaction Employee
Empowerment Intellectual Property Recognition Rewa
rd
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4. Education

College of IT Excellence

• Purpose
• Build a culture around excellence
• Create and develop leaders
• Broaden knowledge beyond specialty
• Align behaviors to IT goals and values

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College of IT ExcellenceNot a Typical Training
Program

• Functions like a local college
• Teaches IT professionals to be healthcare workers
• Focus on skills outside ones specialty and
  towards organizational concepts
• Promotes IT professionals to coalesce as a group
• Credits are awarded for experience, course
  attendance, teaching and independent study
• SEA, managed by employees, paperless

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College of IT Excellence
Achievement Chart for Building Excellence
INNOVATION
Level 4 Total of 78 credits with at
least 15credits of Required courses, 6 instructor
credits, minimum of 5 years ITD service.
(Experience)
FINANCE
5 Yrs
GROWTH
Level 3 Total of 48 credits with at least 10
credits of Required courses, Minimum of 3 years
ITD service.
SERVICE
Years in ITD
3 Yrs
Level 2 Total of 24 credits with at least 5
credits of Required courses, Minimum of 1 year
ITD service.
QUALITY
1 Yr
AWARD RECOGNITION
PEOPLE
Level 1 Total of 14 credits (11 credits may be
exp), New employee must complete all New Employee
(N) courses.
Intellectual Infrastructure (Theory)
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5. Leadership Training
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Taught to be Intersection Managers

• Keep intersection open for information flow
• Reduce contradiction and confusion
• Develop courage and good judgment
• Develop leaders able to produce results

YOU
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What is Six Sigma?

• A disciplined process using customer
  requirements, data, and facts to improve business
  performance by consistently meeting customer
  expectations.

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Goal of Six Sigma (6s )

• Six Sigmas goal is the near elimination of
  defects from any process, product, or service.
• The numerical goal is 3.467 defects per million
  opportunities.

Six Sigma
IT Excellence
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Five Steps to Implementing Six Sigma
D.M.A.I.C. (Define, Measure, Analyze, Improve,
Control)
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Key Six Sigma Roles

• Key Roles
• Leadership Team
• Champions
• Mentors (master black belts)
• Experts (black belts)
• Participants (green belts)

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Six Sigma Process Capability
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Is 99 good enough?
6s (99.9997 Good)
3.8s (99.0000 Good)

• Two unsafe landings at Cleveland Hopkins Airport
  each day
• System unavailable 7.0 hours each month
• 50 newborn babies dropped at birth by doctors
  each day
• 5,000 incorrect surgical operations per week
• 1,240,200 wrong drug prescriptions each year

One short or long landing every five
years System unavailable lt 5 minutes per
month 3 newborn babies dropped in 100 years 1.7
incorrect operations per week 1 wrong
prescription in 25 years
Not if World Class Care is your Goal!
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Process Improvement Model
Objective Build a Model
Define/Review Performance Indicators, targets,
balanced scorecard
Integrate Successes (Organizational Learning)
Develop / Test Interventions
Develop Supporting Reports
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Project Management A New View
WORLD CLASS SERVICE EMPLOYEE
SATISFACTION SIX SIGMA
CUSTOMER SATISFACTION
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Nursing Unit of the Future
(What?) (How?) (Why?) (Whats Next?)

• Evaluated New Technologies to be used in the
  Hospital Environment
• Systematic approach
• Inpatient EHR implementation
• Future

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MyPractice Inpatient

• Defined the process improvements
• Solutions Focused
• Implementation Strategy
• EMAR implementation
• Pharmacy 2005
• COE, CPOE and Nursing (2006)

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Intranet Redesign

• A major redesign of the intranet
• Surfaced through WC Ideas
• Designed using Six Sigma concepts
• Tested through focus groups
• Implemented in 3 months

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Intranet Redesigned Home Page
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Measuring Outcomes

• Operational Performance Quality
• World Class Service
• Employee and Patient Satisfaction
• Innovation
• U. S. News World Report Ranking

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The Performance Wheel before Intervention
Operational Performance
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Before and After InterventionsOperational
Performance
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World Class Service 2002-2004
Patient Results excellent up from 39.5 to
50.2 no-show down from 16 to 5 increase - New
and Consult 5.57
Employee Results turnover down from 11 to 9
satisfaction up 3.47 35,000 ideas generated
Leadership Involvement Training 1200 leaders
at strategic forums
Goal Oriented Organization Institutional
goalsdown 5 levels
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Survey Results
Employee Satisfaction survey
2003 Results
2004 Results
2005 Results
IT
3.86
3.46
3.31
CCF
3.84
3.47
3.36
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Idea Submissions 2004 vs 2005
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• Cardiology, 1
• Digestive diseases, 2
• Urology, 2
• Rheumatology, 4
• Orthopedics, 5
• Nephrology, 6
• Neurology, 6
• Otolaryngology, 7
• Endocrinology, 8
• Gynecology, 9
• Respiratory disorders, 10
• Geriatrics, 12
• Cancer, 14
• Ophthalmology, 15

Overall 4 Hospital in US
Hospital Rankings, 2005
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ConclusionPatients First

• Begin with the End in Mind Customer Service
• Focus on speed to delivery
• Target zero defects
• Solutions oriented Its not about finding
  solutions for our customers. Its about finding
  the Right Solution.

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Summarize Learning Objectives

• Learn the basic concepts of World Class Service
  and Six Sigma methodologies
• Learn the Cleveland Clinic Approach to embedding
  excellence into every effort
• Explain project management and service support
  from a World Class perspective
• Learn why Cleveland Clinic employees embrace
  goals of excellence

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Questions
Performance Wheels
WC Service
Black Belt
Process Improvement
Green Belt
Six Sigma
Employee Satisfaction

Goal Setting
Speed
Rounding
Patient Focus
DPMO
Project Management
College
Ideas
Leadership Training
DMAIC