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How to Establish a Foundation for Process Improvement in Healthcare

Posted by Greg Jacobson

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Sep 5, 2018 6:43:00 AM

Pretty young nurse pressing modern medical type of buttonsIt seems like every other day or so, I come across an article detailing how the American health care system is “broken.” These articles are usually focused on things like escalating costs, rising drug prices, problems with the Affordable Care Act, and other large-scale systemic issues. Finding the billion-dollar idea to solve any of that just isn’t realistic, but healthcare leaders can make a substantial impact on their organizations, improve conditions for employees, and secure better healthcare outcomes for patients by focusing on daily process improvement. Small positive changes might not make headlines, but they can save significant dollars or maybe even lives.

For a culture of improvement to thrive in any healthcare organization, it is necessary to develop a solid foundation by putting the essential principles of process improvement to work.

Process Improvement is Continuous

It would be nice if we could take a few weeks, fix every problem with every process and move on, but that’s not how it works. Healthcare organizations that achieve process improvement success practice it every day. Each employee is empowered to identify opportunities for improvement and given the tools they need to report them. Once a change is implemented, results are measured to determine if positive change has been achieved. If so, a new improvement cycle begins to take the operation to the next level. Process improvement should be a way of life from the C-suite to the front line.

All Processes Should Create Value

Often the best way to improve a process is to eliminate it. If each activity doesn’t provide value to its customer (internal or external), it should be targeted for elimination or reduction. In healthcare, these wasteful processes take the form of things like unnecessary paperwork, overly complicated approval processes, diagnostic tests that aren’t needed, data entry into multiple EHR systems, and so forth.

Goals and Objectives Must be Aligned

Healthcare organizations often have competing priorities. Patient care is always first, of course, but folks are still concerned about profitability, public relations, staffing issues, quality metrics, growth, and more. That’s why it is essential that the most critical objectives of the organization are clear and that they are cascaded down the org chart so that every employee understands how their work and their decisions will roll up to the top level goals. Each process improvement should be related to the overall strategy and align so that everyone is rowing in the same direction.

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Everyone Can Be an Asset

Successful healthcare organizations hold respect for people as a guiding value. When it comes to process improvement, this is critical. When something goes wrong, smart healthcare leaders look to the process, not the actor, to find solutions. They listen to improvement ideas from employees and collaborate until a workable solution is uncovered. Most importantly, they create the conditions under which every employee can do their best work.

Visualization is Used Whenever Possible

Process improvement in healthcare is accelerated with visual cues are used to convey information. This might take the form of Kanban cards for inventory management, digital huddle boards for daily staff meetings, color coding abnormal test results, using wallboards to display out of range wait times or other concerning variation. People comprehend visual information much more quickly than text, so when working on an improvement cycle, be sure to consider how the process could be made easier to visualize.

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Standard Work is Essential

The terms “standard” and “change” seem to go together like oil and water, but in fact, one is necessary for the other. Standard work is the current best practice for performing a task or process. It forms the basis for any future improvement. The people that do the job should craft standard work. It should be documented, consistently applied, and measured. If an improvement is to be made, the results following the change are compared to the Standard to determine if the improvement has been useful.

Leaders who apply these principles to process improvement and spread them far and wide can expect to see more processes improved and better results for each change that goes into effect. Process improvement in healthcare should always feel intentional and managed. The stakes are too high for anything less.

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