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Sustaining The Gain. AHCA Quality Symposium St. Louis, Missouri February 6, 2009. from Tom Peters:. “Excellent firms don’t believe in excellence – only in constant improvement and constant change.” In Search of Excellence: Lessons From America’s Best Run Companies. The Human Factor.
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Sustaining The Gain AHCA Quality Symposium St. Louis, Missouri February 6, 2009
from Tom Peters: “Excellent firms don’t believe in excellence – only in constant improvement and constant change.” In Search of Excellence: Lessons From America’s Best Run Companies
The Human Factor • Quality does not improve on its own • People tend to look at people when things go wrong(94% of problems are related to systems) • People tend to jump to solutions • People forget to check if their solutions worked
Models to Model • Models that provide a framework for organizational quality: • International Organizations for Standardization ISO 9001 • Malcolm Baldridge National Quality Award • Models that provide methods for improving quality processes: • The Deming System (PDCA/PDSA) • Toyota Production System (LEAN/Just in Time) • Six Sigma (Eliminate Defects) (5 Whys)
Disclaimer! I Only Know What I Know
Our Challenges • Silos • Data • Processes
Silos • Vertical, Horizontal • Not my Job • Learning to Integrate • Voicing Expectations
Data: • Too Little/Too Much… • Too Confusing! How Do I… Acquire, Present, Use, Crunch, Understand, Validate, Compare…?
Processes: Why? (Why, Why, Why, Why?) Who? What? When? Where? How?
Our Journey I USED TO RUN A BETTER NURSING HOME!
Processes: • SIPOC • Critical to Quality Attributes • PDCA
Processes - SIPOC Stakeholders: The individuals or groups that have a vested interest in the performance of the process but do not define the requirements of the outputs. Process Name: the working name of the process Suppliers: Inputs: Outputs: Customers: The things necessary to perform the value-added tasks of the process. The products or services that the process delivers. The individuals or groups who receive the outputs of the process; they do define the requirements of the outputs. The individuals or groups that provide the inputs for the process. t (start): the most significant starting or triggering event that starts the process t (done): the most significant completion event of the process cycle Process Owner: The person who is responsible for the goodness of the process irrespective of whether they own all of the resources performing the process Process Performers: The individuals or groups who perform the value adding tasks in the process. Key Performance Measures: The measures used to determine the “goodness” of the performance of the process; i.e., quality, cost, cycle time, satisfaction, value. Process frequency (volume): The rate of repetition of the process; i.e., how often the process occurs
Data • Developed In House “Experts” • Analysis and Presentation tools – using Excel • More Vigorous Search for Valid Comparison Data Sources
Departmental Quality Plans • Indicators • High Volume • High Risk • Problem Prone • Sentinel • Thresholds • Action Plans • Quarterly Plans, IDT Plans
Sustaining the Gain Can It Be Done ?
20 Leaders Said: An impromptu ask, 2 responses each: • Leadership: 7 responses • Strategy: 6 responses • Work Force: 8 responses • Customer Focus: 7 responses • Process: 12 responses
Leadership • Our leaders challenge us to strive for excellence • Leaders do what they need to do, no one waits to be told what to do • Our different styles of leadership work well together • We want to follow our leaders • High Accountability Factor
Strategy • We follow our plan • We take time out to plan our future • We think outside the box • We plan our role as a facility, and for our community. • We have a balanced plan
Work Force • Our staff “get” and live out our Mission and Values • What we do, we are all doing well • We work well together • We all get after ourselves when things slip, we don’t hide problems, or wait for someone to point out problems
Customer Focus • Everyone comes together for what our residents want and need • Every Resident is an Individual • We look at residents’ quality of life holistically, not just medically • We know whose home this is, and everyone works together to respond to what our residents’ want and need
Processes • Our processes work – we are proactive instead of reactive • We look for problems to fix, and not wait until they become “real” problems • A well oiled machine – each department does their job well • We challenge the normal acceptable standard, to make our own high standards
Results – Over Time • Health Care: 5 of 5 still excellent results • 4 of 5, no longer on “the radar” • Customer: 7 of 7 still excellent • Finance/Market: 10 of 10 still excellent • Work Force: 4 of 5 still excellent • Organization Effectiveness: 3 of 3 excellent • Governance/Social Responsibility: 9 of 9 still excellent
Thank You! Questions? Jon Frantsvog, Administrator/CEO St. Benedict’s Health Center & Benedict Court 851 4th Avenue East Dickinson, ND 58601 701 456 7305 jon.frantsvog@bhshealth.org