Bridges Curriculum Ambassadors Summer 2014 @UCSFBridges Introduction Leading System-wide Change at SFGH at the Kaizen Promotion Office Matthew Cummings (P3), Julie Wu (MS2) Results Discussion ● Hospitals have begun implementing more efficient, patient-centered care models following passage of the Affordable Care Act. ● Lean: a quality improvement approach designed to eliminate waste from workflow through continuous improvement, or kaizen ● Kaizen Promotion Office (KPO): established 2012 at SFGH ○ Use and teach Lean principles with goals of decreasing wait times and waste, increasing patient safety and satisfaction, and increasing workplace communication ○ Value streams in 6 departments: Outpatient Pharmacy; Urgent Care Center; Radiology; OR; 3M Surg Clinic; 4D Med-Surg Unit ○ 3P Workshops for transition to new hospital; Kaizen workshops ● Curriculum Ambassador (CA) program: a pilot program for the new Bridges curriculum focused on experiential systems-based learning Methods ● Week-long Kaizen events with department to identify wastes, brainstorm and test solutions, report prioritized solutions to the hospital ● Week-long Kaizen 3P workshops with staff, stakeholders to design the layout and flow of their department in the new hospital ● Kaizen principles represented by the Lean House: ● Value stream mapping: detail steps in process, time spent, work inputs ● Observations and data collection at the site ● Weekly check-in meetings and planning meetings for events Participated in Kaizen events and 3P workshops: Emergency Department 3P Workshop; Maternal and Child Health 3P Workshop; Outpatient Pharmacy Kaizen; OR Documentation Kaizen. Results of two are highlighted below: 3P Workshop: Maternal and Child Health ● Current state (left), future state (right) ● Developed 7 priority areas for transitioning to the new hospital: Kaizen Event: Outpatient Pharmacy ● Introduced 11 new forms of standard work ● Decrease in initially observed prescription wait times ● Implemented color-coordination, visual workflow management ● Cross-trained pharmacy techs for flexible workflow coverage 1. Shared documentation system 2. Integrated rounding 3. Team-based assessments, care planning 4. Cross-training nursing staff 5. Patient/family-centeredness 6. Efficient, welcoming registration process 7. Integrated leadership, management, governance structure ● Learned and applied the Kaizen model of management ● Developed interprofessional communication and collaborative skills ● QI projects allow students to gain broad perspective of workflow in a hospital and gain transferable skills to identify and address any major wastes ● Integrating systems-based experiential learning into medical curricula will prepare students to practice medicine in the 21st-century