Kicking Off A New Approach to a Culture of Improvement

meeting to discuss opportunities for improvement

Last month, I had a great opportunity to work onsite with one of our customers, Mary Greeley Medical Center, in Ames, Iowa. They’ve been using our software to manage and track their “Rapid Improvement Events” and followup actions. Mary Greeley also worked with one of our consultants and used our system to facilitate a “KaiNexus WorkOut” process last year, where they implemented dozens of improvements over three months that netted over $800,000 in financial savings, among other benefits.

A Strong Foundation

Mary Greeley already has a great foundation of improvement work, which has led to them recently receiving the “Gold Achievement” recognition through the Iowa Recognition for Performance Excellence process. As we say at KaiNexus, to have a culture of improvement and innovation, you need three things: a methodology, leadership, and enabling technologies. Mary Greeley has all three of those elements in place.

A Focus on Daily Continuous Improvement

I was there to help them further their efforts to practice Kaizen, or continuous improvement, on a daily basis. My three day “Kickoff” engagement started with a three-hour interactive class and workshop that I taught for leaders and staff. Mary Greeley’s leadership commitment was clear when their CEO, Brian Dieter, didn’t just introduce me and leave (as executives at other hospitals so often do). Brian and the CFO, among other senior leaders, stayed and were very engaged the entire time. They were there to learn and to set a good example for others. Kaizen education and practice starts at the top, in terms of learning new behaviors and mindsets that make continuous improvement a reality.

In the workshop, I talked about core Kaizen principles, including how to work with staff to identify opportunities for improvement, how to take quick action, how to resolve the opportunities, and how to recognize people for their participation. We did a fun interactive simulation exercise that allowed us to get out of our seats to improve a process by finding problems, brainstorming ideas, and entering them into KaiNexus to show or remind people how the software works. We had a lot of good discussion about the role of leaders in this process, including how to coach and ask questions instead of giving solutions to your employees, and how to how to be constructive instead of negative when there’s a “bad idea” brought forward.

Who Participated?

The participants in the workshop included clinical supervisors and directors from a number of departments, including two areas that were selected to pilot their new daily “Bright Ideas” process that now involved KaiNexus and some new approaches. In the KaiNexus process, most opportunities for improvement are evaluated and implemented within the local department, rather than being submitted to a committee.

Key Principles Emphasized:

Over the next two and a half days, I spent time working with the leaders from a surgical inpatient unit and the materials department. Ron Smith, a Process Improvement Coordinator, and Karen-Kiel Rosser, a Vice President of Quality, were with me to help facilitate and support the department leaders. The department leaders and I shared some of the key mindsets that would drive the practice of Kaizen in KaiNexus going forward, including:

Every idea is worth bringing forward and discussing, no matter how small
Instead of focusing only on cost savings, find ways to save time and make the work easier for staff, improve quality and safety, or improve the patient experience in some way
Each improvement idea should be acknowledged and discussed promptly
Staff should be empowered (and given time) to research and work on their improvement ideas
It’s important to identify a problem, not just have an idea or suggestion, because the role of leaders is to work with staff to find something that solves the problem, even if the initial idea is not practical for some reason

Ideas From Staff

As we rounded in the departments, ideas were solicited from many staff members. “Of course I have a lot of ideas,” said one employee in the materials department. In two and a half days, 27 opportunities for improvement were entered in KaiNexus, split just about evenly across the two departments.

Some of the initial opportunitis for improvement included:

A dumpster that is too tall for the space it's in, so staff asked for a dumpster with lower sides
Couriers could use a dedicated parking spot because they waste time searching for a spot each time they return to the hospital
Improving the consistency of bedside meetings
A patient care tech noticed that cords can be messy or tangled in patient rooms, so he suggested a simple, inexpensive cord organizer be purchased for each room (with an initial test on one room first, in accordange to Kaizen principles).

We spent a lot of time rounding, but we also called staff members into their conference room to discuss ideas and interact together in the system.

At the end of each day, a report out was held in the auditorium so senior leaders and other workshop attendees could hear about the progress in the pilot units. Many questions were asked, as many of the leaders from other departments were interested in quickly rolling out this process in their departments - to better engage their staff and to drive more improvement in the new year.

I also had some strategic wrap up discussions with the process improvement team and hospital leaders to talk about their next steps about how to evaluate the work in the pilot departments, how to make adjustments to their approach, and how to spread this to other departments (including a discussion about how quickly this could be rolled out).

It was great working with the Mary Greeley Medical Center team. This, yet again, reinforced to me that hospital employees know where the problems and opportunities are. When we engage them, asking to come up with lots of little ideas that can implemented, we start building enthusiasm and a culture that allows people to then also take on bigger challenges. Since our software is web-based, it’s easy for me to follow their progress and to provide coaching remotely.