C4 Kile Brokop & Kathy Tremayne - LEAN Program Management

LEAN Program Management: Using a Performance Wall to integrate strategic planning and Continuous Quality Improvement

Kathy Tremayne, BSN, RNProgram Director

Kile Brokop, BAQuality Analyst

Provincial Specialized Eating Disorders Program for Children and Adolescents andMental Health Metabolic ProgramBC Children’s Hospital

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Disclosure

• The presenters have no relationships or involvement with industry that may be perceived as potentially influencing the presentation of the educational material.

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Learning Objectives/Overview

Participants will:• Understand how Lean methodology has been applied at the Provincial

Specialized Eating Disorder Program for Children and Adolescents in Vancouver, BC

• Understand how a Performance Wall can facilitate the application of Lean dimensions of healthcare in program delivery

• How a Lean program management approach can refine and sustain a program’s vision, mission and strategic plan

• Understand how the Performance Wall can be used to sustain and monitor process improvements

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Why LEAN Process Improvement methodology at the Provincial Specialised Eating Disorders Program

LEAN process improvement methodologies were implemented in 2009 to ensure that access, quality and safety were maintained and enhanced throughout the change process

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April 2008~$1.5 million from

Ministry of Health Services

to expand tertiary

care

January 2009

Expansion of

Inpatient (10 to 14) and Day Treatmen

t programs (2 to 6)

June 2009Lean

Projects begin in Eating

Disorders Program

December 2009Lean

Program Management

begins

November, 2010

Outcome Measurement

Framework and

Performance Wall

established

November 2010

Team goal setting

process implemented

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Why Lean Program Management at the Provincial Specialized Eating Disorders Program?

• Based on the principles of the Toyota Production System, employees are empowered to redesign their workplace environment and processes to reduce waste and improve patient safety, quality and outcomes.

• Focused on providing value for patient and family

• Continuous review of value stream• Performance Wall monitors

processes and is hub of continuous improvement

Continuous Quality

Improvement

Required Organizational Practices and

Standards PHSA and BCMHAS

Strategic Plans

Value Stream Mapping

Program Strategic Plan

Rapid Process Improvement Workshops

Action Plans and Audits

Team Goal Setting

5S

Daily Management

Performance Wall

Lean Program Management

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The Performance Wall is the home of…

• Team Goal Visibility• Staff and Program Accountability

• Huddles• Addressing barriers• Plans to address process

improvements (project management/task tracking)

• Opportunities for dialogue• Performance Wall Operations

• Managing data/metrics• Process improvement monitoring

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Team Goal Setting: Driving Continuous Improvement

• LEAN Methodology drives goal setting for RPIWs in the following dimensions of LEAN healthcare: Quality, Safety, Delivery, Cost, Satisfaction

• Program goals are aligned with PHSA/BCMHAS strategic planning goals

• Goals and targets set through annual collaborative team goal setting process and Value stream map

• Accreditation Canada ROPs are considered in the development of RPIW projects

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Staff Engagement and Accountability

• Eating Disorder team meets at weekly stand up meeting at the Performance Wall (10 minutes) facilitated by Program Director, Clinical Director, and Quality Analyst

• These meetings are an opportunity for staff who are accountable for process improvements to discuss auditing, program metrics, and develop action plans in relation to targets with the team

• A place to celebrate success and encourage team problem solving

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Performance Wall Operations: Ensuring meaningful action towards goals

• Data-driven performance improvement

• Continous review of team goals

• Data is collected from many sources: program chart audits, Quality and Safety Department audits, Strategic Information Management

Review Goal

Performance

Monitoring

Analysis

Action Plans

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Case study: Ensuring timely access to tertiary services – Performance Monitoring

Ensuring timely access to tertiary services with increased demand for services - Analysis

Assessments Completed

6267 63

7988

0102030405060708090

100

2008-2009

2009-2010

2010-2011

2011-2012

2012-20132012-2013 data is a projection based on year to date.

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How are we sustaining the change today?

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Lessons Learned

• LEAN program management brings the program vision and strategic plan to life via the Performance Wall

• Performance Wall provides physical home for quality improvement initiatives

• Performance Wall is a vehicle that encourages staff engagement and collaboration

• Visibility and weekly stand-up meeting for monitoring facilitate sustainment of process improvements

• Performance Wall as a “container” for managing change and visibility of critical program metrics

Discussion