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Creating a UBT Culture June 24, 2013

Creating a UBT Culture June 24, 2013. Welcome. Lisa Schilling, Vice President Center for Health Systems Performance. Rancho Cordova Eye Surgery Center Got Errors?. Our Team. Our SMART Goal.

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Creating a UBT Culture June 24, 2013

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  1. Creating a UBT Culture June 24, 2013

  2. Welcome Lisa Schilling, Vice President Center for Health Systems Performance

  3. Rancho Cordova Eye Surgery CenterGot Errors?

  4. Our Team

  5. Our SMART Goal Rancho Cordova Eye Surgery Center will identify, share and evaluate at least five errors per month that could have led to patient harm or injury, by November 30, 2012.

  6. Our Team Culture Was… • Efficient and safe • Lacked transparency in the department and among each other • Awareness suffered as a result • In a year period, had one never event and two near misses

  7. Motivating questions • How many errors potentially happen daily? • What do we do to prevent near misses? • How do we increase staff awareness?

  8. Our Small Tests of Change

  9. Challenges Staff reluctant to use form for various reasons: • “Flavor of the week” • Busy • Why mess with a good thing? • Punitive

  10. Overcoming challenges • Depersonalized the event • Education • Awareness • Testing “good catch” theme

  11. Our Team Culture Now… • Increased awareness • Better understanding of the project • Enhanced team work • Better communication • More transparency • Staff feel more empowered

  12. Our Key Learnings • Teamwork + awareness=safety • Education is key • Trust is essential • Use a safe word or phrase • Always room to improve

  13. Our NQC Experience • Involvement of entire staff is key to culture change. • Partnership and standardization plays a leading role in quality and service. • The everyday work you do has great impact on quality and patient satisfaction

  14. Emergency Department, Sunnyside Medical Center (Northwest)

  15. Our Team

  16. Our SMART Goal Kaiser Sunnyside Medical Center Emergency Department will decrease the patient length of stay from a baseline of 2.7 hours to a goal of 1.5 hours by the end of the year (2012) .

  17. Our Team Culture • High physician and management turnover • Low morale and low service scores • Non-functional UBT

  18. Our Small Tests of Change

  19. Our Small Tests of Change

  20. Fast Track Results

  21. Standardizing Rooms

  22. Standardizing Rooms From To 23

  23. Our Team Culture Now… • More satisfied patients • More open environment for offering ideas for improvement, as demonstrated in improved responses to key People Pulse question • Those initially most resistant to change became the biggest champions of change

  24. Our Key Learnings • What worked: holding offsite meetings to establish our new vision, hiring new managers, electing new UBT co-leads, redesigning patient rooms and stock rooms • Early wins are important • Must clarify expectations and roles, have process owners with clear accountability • Physician engagement is crucial

  25. Voice of the Customer

  26. Staff Perspective

  27. Our NQC Experience • Working in a unit-based team and becoming high performing is hard work. Once you reach your goal, it isn’t over. You have to continue to work on improvements and re-build when people leave or processes change.

  28. Histology Department (Northwest)

  29. Our Team

  30. Our SMART Goal KP Northwest regional histology lab will improve slide turn-around time from a baseline of 68.6 percent in 2011 to a goal of 90.0 percent by the end of 2012.

  31. Our Team Culture Was… • Plagued by inefficient workflows • Pathologists did not feel supported by the staff • Did not focus on quality assurance • Low People Pulse scores on Work Unit Index measures

  32. Specimen Life-Cycle Processing Recuts, Specials, Immunohistochemistry Specimen Collection Gross Exam Path Review Embedding Case Sign-out Accessioning Microtomy Staining Transportation Storage/ Archive Case Match/ Case Assembly

  33. Our Small Tests of Change

  34. Performance Improvement Tools

  35. Our Team Culture Now…

  36. Our Key Learnings • The UBT identified, planned and executed all PDSAs. • Strengthened alliance between Histology and Pathology, and the active involvement of Pathologists • Resources (time, money, expertise) vary in supply and pose barriers • Labor-to-labor communications strengthened engagement and commitment to the project. • Given adequate information, the UBT knows what improvements will make a difference.

  37. Our NQC Experience • Opportunity to learn from other teams • Sharing the journey of our team with others • Recognizing engaged sponsors, physicians and UBT team members as the key to success

  38. Closing Thoughts Lisa Schilling, Vice President Center for Health Systems Performance

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