Friday, March 29, 2013

CCRMC Improving Primary Care: Welcome to your Health Home


The Kaizen this week was held at Concord Health Center (CHC). The team focused on improving the clinic visit "intake" process.
The team tested and developed standard work/practice to improve the intake process. Some of the improvements this week include: shifting tasks from the clinician to the intake MA/nurse, improved communication between clinician and nursing staff, a revised ccLink clinic roster "dot system," and quick huddles at the start of clinic to help anticipate the patient needs that day and ensure a smooth flowing clinic. You can review the slides above to "see" some of these improvements.

In the coming weeks, these changes will be tested with all the CHC primary care clinicians. Once, refined, standardized and sustained we will roll our new process system-wide. The work you see on the action bulletin begins Monday. Our Lean Promotion Office staff will be heading to CHC to work with front line teams to measure progress and continue to test with those who provide and receive care at CHC. Here is an example of some of the feedback the tea gathered this week as they were conducting tests. Your feedback is important and needed to design a process that works for those we serve and YOU. Please take the time to review the slides which show some of the many tests and improvements from this week. Many thanks to our Patient Healthcare Partner, Louisa, who was an essential member of the team providing much needed perspective as an expert in what it is to experience our system.

I've pulled out the A3 and A4 for your review. The Kaizen Post Card will be sent out in the coming days. Data/Results for this work can be found Conference Room One at CCRMC as well as on iSite in the Lean Folder.
How is it decided what we are going to work on during a rapid improvement event (Kaizen)? See the A4 below. This is designed by the team itself after review of performance and analysis of areas in need of improvement. The A4 helps the team segment the improvement work into achievable steps.
Many thanks to the team for your work this week and for all of those who came out at the three sites to hear this important report-out.
 
More very soon,
Anna

Saturday, March 2, 2013

Mapping the Way Forward: Concord Health Center Primary Care VSM Report Out

If you can't see the slideshow click here.

It was a great Report-Out this Friday. The VSM team which was made up of employees from clinics across our system and a patient Healthcare Partner came together to review the flow and experience of care in the Concord Health Center. The team uses direct observation to see and time our processes and then, from the patients perspective, value or non-value is assigned to time and tasks.

The team looked at direct care activities which focused on what happens when someone comes to the clinic, an example being an appointment to see your primary care provider at the clinic. Indirect care activities are processes happening in the background usually while a patient waits for something. A common indirect care activity are the process steps and time spent waiting for a prescription refill request from a patient calling in to their providers office. I've posted A4 above for your review.


The headline from the report: Unexplained Variation Must Go!

The team found multiple ways of refilling a prescription, they showed us six ways after only 3 days of observation at one clinic site. Roles and responsibilities of staff were variable as well. What the team reported and what you will see on the A3 is that the upcoming focus of the teams have a clear theme of removing variation and organizing to create predictable flow for both direct and indirect care processes.

The A3 is below for your review and the Kaizen Post Card will be sent out in the coming days. The data for this work can be found Conference Room One at CCRMC. Results of the tests of new work flows will be displayed there as well.


Many thanks to the team for your work this week and for all of those who came out at the three sites to hear this important report-out.

More very soon,
Anna