Worth the read-
http://leaninalaska.wordpress.com/2011/08/13/moneyball-by-michael-lewis/

July 4, 2011 ~  A Roth

Two reasons I love this:

1. The message to health care exec's (the real reason)

2. It's about my team (a happy coincidence)

Simple rule - get to the base!

Many thanks to Patrick Anderson, Executive Director of Chugachmiut, Inc., an Alaska Native Tribal consortium, for taking the time to read about our efforts to improve access to our system. He notes that, " Chugachmiut went from waiting for up to 4 weeks for appointments to same day appointments in a short period of time. While our demand is not as great as Contra Costa’s, and we are nowhere near as big, the tools work the same in both our cultures."

You can read the full post here as well as many other interesting posts on Patrick Anderson's blog, Lean in Alaska.

CCMRC /CCHS July 22 Kaizen Report Access Value Stream/ Advice Unit

Jeff Selberg speaks to the team

Click on the slide to see the full slide set

I am posting a long overdue summary of the July 22 Kaizen Report out which focused on access to our system with an emphasis on the role of the Advice Unit.

I'd like to thank the team which included employees from across our system and patient volunteers/Healthcare Partners. Without you we could not accomplish what we have thus far. I also want to extend my gratitude to Jeff Selberg, Executive Vice President and Chief Operating Officer of the Institute for Healthcare Improvement (IHI), and Mike Rona, President and CEO of Rona Consulting, who joined us at the report out. Jeff commented that he was "wondering how we will accomplish all that we have to do" he went on to say, "now I know."

I have attached the slides which should be posted both above this post and within this post. If the slide show is not working you can click on the picture above and it will take you to the slides. I will post the rest of the pictures from the report out this week.

In summary, the team formed three work groups:
1. Flow

2. Patient Centered Medical Home

3. Advice Unit

Teams identified areas in need of improvement and in some cases began to cost out the opportunity. Each team developed proposed tests of change and began testing this week.

The Flow team  tested use of a triage system for MD access and sorting of calls.

Several ideas were considered around creation of truly patient-centered medical homes. The team has planned to test the proposed standard work with one physician in the first week of October.

Other test conducted this week included utilization of a MD in the Advice Unit. Based on national standards and protocols the team tested directing calls to an MD for intervention.

This is complex work and work that is now reaching far outside the walls of the medical center (CCRMC) into the health centers (clinics) and the health plan (CCHP). This is not easy work. It takes willingness, courage, caring and honesty to engage in a change effort [*]. Additionally, it takes constancy of purpose and discipline.

There are many distractions along the way and the force of the status quo is strong. Many have mastered the current state and their perceived power, position, and in some extreme cases, their identity can be based on that mastery. To seek a new order, to resist the urge to settle and to lead a transformation effort is indeed the work of the courageous. The first step is to change ourselves, which may be the most frightening step of all. Many will retreat to the status quo. Many will settle. We will not.

My deepest gratitude to the team and to all of you for your commitment to our mission and our community.

Anna

"You See"

PH 290.6 bSpace is now open!
I'm looking forward to a great semester.

Jeff Selberg and Mike Rona to join CCRMC Access Kaizen Report Out this Friday, July 22

Greetings,

I'm excited to have joining us this Friday at the CCRMC report out, Jeff Selburg, Executive Vice President and COO of the Institute for Healthcare Improvement, and Mike Rona, President and CEO of Rona Consulting. Please support the work of your colleagues and our patient and family partners as they draw on science and the energy and creativity of each other to continuously improve our health system.

As a reminder, in June a team of representatives from across our system and the community mapped the appointment process to observe and quantify how much time is seen as “value” for the patients when they are seeking an appointment. Ideas were then generated from the team about improvements that could be made to create an ideal “future state.”

Using the future state as a guide, three one-week long rapid improvement events (Kaizens) were planned. A recurring premise throughout the three planned improvement events (Kaizens) is creating a system that delivers the right care, in the right place, at the right time. The plan is presented on the A3 here. You should be able to click the A3 to better view it.

This week, your colleagues have been working with the Advice Nurse Unit. They are testing alternative models of service. One idea being tested is an Advice-Nurse-referred phone call from a virtually-embedded physician using evidence-based, national standards. Teams are also testing a revised message for incoming callers with clear direction for calls that are unrelated to the Advice Nurse Unit. A third area of work is focused on the Patient-Centered Medical Home model. In one clinic, the team will test a virtual liaison for a number of roles. These roles include; primary care providers, advice nurse, medical social worker, appointment unit representative, and care coordinator. Several other possible roles are also being considered for testing.

In summary, your colleagues are bringing together ideas from across our system and from science to test alternative models of care with three aims;

Better Care: Improve the overall quality, by making health care more patient-centered, reliable, accessible, and safe.

Healthy People and Communities: Improve the health of the population by supporting proven interventions to address behavioral, social, and environmental determinants of health in addition to delivering higher-quality care.

Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and local government.

You are invited to attend one of the three Kaizen Report Outs that will take place on Friday, July 22, 2011, as follows:
7:45 am Richmond Health Center lobby
12:15 pm Pittsburg Health Center lobby
1:45 pm Contra Costa Regional Medical Center lobby

Hope to see you there.
Anna

Just plain good.

Access to Care: Value Stream Mapping Report-Out Friday, June 24 in Richmond, Martinez and Pittsburg

See the slideshow here.

Contra Costa Regional Medical Center and Health Centers
              Mapping the Appointments Value Stream
 
On Friday, June 24, 2011, a Value Stream Mapping team will report on a week of analysis focused on improving access to Contra Costa Health Services’ Appointments. Staff and the public are invited to attend a presentation at one of the following locations:
​
​Richmond Health Center 7:30 am
​Contra Costa Regional Medical Center 10:00 am
​Pittsburg Health Center 12:15 pm
 
​Staff and community members are mapping the current state of Appointments from the perspective of the patient’s experience. During subsequent Rapid Improvement Events (Kaizen) over the next few months, synergistic teams will plan, test and launch innovative solutions to improve access to care throughout our health system. Results will be measured against the current state to provide powerful evidence of actual improvement.
 
Please join me to hear from the team this Friday as they present the results of their work.
Anna