Friday, June 18, 2010

Behavioral Health at CCRMC Gets Lean: Kaizen Report-Out

It never ceases to amaze me when I go to the report-outs just how powerful these events are. I've stopped bringing paper and writing down numbers and achievements during your reports, because I have come to cherish the time spent listening and watching everyone report. I have learned to take the time to take it all in and celebrate with you. This means I don't have the exact numbers from the report-out, but I'll try my best.

Behavioral Health Kaizen Two Headlines

The Documentation Team: You can guess what this means! The team went piece by piece through all of the documentation. Even those working on the unit never realized how much time was being spent "nursing paperwork" instead of patients.

The Stay Team: Aiming to reduce lead time for individuals on the unit by reducing redundancy, non-value-added movement and re-work. The process for belongings was unbelievable.

The Disposition Team: Reducing lead time and creating a seamless transition home or to another placement. I assumed I had a pretty good understanding of this process having come from a background in bed control and operations. I learned, as did others, I really had no idea just how many moving parts were involved in this.

The Pathway Team: Getting the right care to the patient in the right place at the right time. The team began assessing the feasibility of a behavioral health Emergency FastTrack (urgent care). Through experimentation (yes I mean actual testing) the team determined that the volume is likely too low to support this service. At that time the team switched their focus from developing Fastrack to developing a Pathway, creating standard work for medication support and other frequently needed (and predictable) service.

Highlights...there are so many I haven't listed them all. If you're interested in the improvements made, and I hope you are, you can find the complete report on iSite.
• In all, over 60 hours per week of nursing time will be saved and redirected to patient care. Several forms were eliminated and in one case three forms were reduced to one - all agree (all being front-line staff and consumers and family members) that the single form is much better than the three put together.

• Mike Rona reiterated that he has done hundreds of Kaizen events and never has he seen so many community members (consumers, family members, advocates and other agencies) directly involved in the actual improvement work.

• Joining us today were representatives from Alameda County Psychiatric Emergency Services, California Healthcare Safety Net Institute, Ambulatory Care Behavioral Health, Mental Health Consumer Concerns, NAMI, Anka Behavioral Health, Inc. Nierika House Community/Behavioral Health, Employment and Human Services and staff from all departments of CCRMC.
To those who came,
On behalf of CCRMC I would like to thank you for joining us today. Your interest in and support of the work of the CCRMC improvement teams means a great deal and offers us the opportunity to learn and improve together.

To the teams,
I am grateful to all of you who generously share your skill and spirit in order to make the experience of care better for those we serve. You are making big change, one small test at a time.

Consumers and Families/our partners in transformation

Additionally, it was a wonderful day full of celebration and collaboration today at the Contra Costa Consumers and Families 21st annual picnic. I will admit that when Dave asked me to say a few words and chuckled when he said I would have to stand on a table and use a very BIG voice I thought he was joking. He was serious! My heartfelt appreciation for the warm welcome. Thank you for including CCRMC.

What a great day.
It is truly a privilege.


Kaizen pictures to follow very soon.

1 comment:

  1. How do you capture hope? You bring a group of passionate individuals together and offer them an opportunity to change the world for the better. Every Kaizen event brings a magical blend of minds, hearts, and experiences to weave a vision of hope for better patient care. This past week’s Behavioral Health Kaizen was another example of this special dance of ideas.

    It is not easy, this Kaizen stuff. Not for wimps. We start out on Monday as strangers, not knowing how we will fit together. We run around for a couple of days like “CSI” investigators. We question, test, measure, simulate, add and delete ideas. By Friday’s Report Out, we are bonded in hope for a chance to make a difference in somebody’s life and put a few band aids on a broken system.

    About 35 years ago, I visited my first psychiatric ward where my brother was being treated. It was a frightening and sad experience for me. Years later I would have similar experiences with my first born son. Kaizen events take me away from those sad memories and replace them with hope. They are a chance for me to help a consumer or family feel less fear, less sadness. They are also a chance to help those who are providing the care more time to stop and ask a patient, “How are you today?”

    Last July, I was invited to join a process that is helping to transform and improve CCRMC. I was a stranger to the hospital world and all of the language and protocols. After four Lean improvement events I feel like part of the family. I am invested in the improvement efforts because I have come to love the hospital and the people who work so hard to provide the best care. I love helping them do what they have dedicated their lives to…taking care of people. I love the process that allows deep democracy for the staff, the patients, the families, and all of the community partners.

    No “concrete heads” this week. We were a team of change agents filling each other up with ideas and hope. The results were simply inspiring. I can’t wait for next month and the chance to do it again.