"And now let us welcome the new year, full of things that have never been.”
—Rainer Maria Rilke
Greetings,
It’s an exciting time to work in a safety net hospital. We are privileged to serve the residents of Contra Costa County and it is my privilege to work with all of you. This year Contra Costa Regional Medical (CCRMC) begins a three-year planned cycle of ongoing quality improvement using a number of new approaches. CCRMC has seen promising results in clinical system performance with our initial redesign efforts. We are now well into the next phase of system redesign and performance improvement using leadership systems and tools like ‘systems engineering’ and ‘lean management’ to accelerate the transformation of our health system.
Fulfillment of our mission is a dynamic and ongoing process. In order to “do common things uncommonly well,” we need objective information to support us. The heart of the work ahead must focus not only on science, but also on action. Quality must be at the heart of all operations. Our efforts must be directed toward specific areas of work to assure no needless pain or suffering, no helplessness in those served or serving, no unwanted waiting, no waste and no one is left out.
Currently, health care makes up about 17% of our nation's gross domestic product (GDP) and is climbing at a steady and unsustainable rate. In America, we hear daily debates about bailouts, stimulus packages and health reform. Although the solutions are still in the development phase, it’s clear we will change course nationally and we must do the same here at the local level. Our mission is being challenged by the current economic downturn. The number of people who are struggling to meet their most basic needs is increasing in our community. It’s during these difficult times when safety net hospitals are called on to stretch already tight resources making quality, evidence-based practice, teamwork and communication the keys to success.
The debate will continue in our nation’s capital about what reform legislation will look like. Yet it is here, at the local level, that the actual impact of health reform will be determined. Just as an individual's experience of our system is determined at the point of care delivery and not in a conference room, health reform will be realized at the local level, not far away in the halls of Congress.
Together, in partnership with those we serve, we will continue to provide quality care to all people in Contra Costa County with special attention to those who are most vulnerable to health problems. We recognize and stand ready to embrace our responsibility to engage as active members of America’s Health Care Safety Net and as participants in the nation’s movement toward health for all.
Now let us welcome the new year.
Anna
Thursday, December 31, 2009
Tuesday, December 29, 2009
Contra Costa County Health Services: Improving Surgical Care -Kaizen 3
What? First Kaizen Event of 2010.
When and Where?
Improving Surgical Care-Kaizen 3 Overview/Introduction:
Monday January 4, 2010 at 11:00 AM to 1:00 PM at Contra Costa Regional Medical Center (CCRMC) in Building One, Conference Room One.
Improving Surgical Care-Kaizen 3 Report-Out:
Friday January 8 at 10:00 AM to 10:30 AM at CCRMC in Building One, Conference Room One.
Note: The introduction and report-out for each Kaizen Event is video-taped and placed on CCHS-iSite.
I look forward to seeing you there.
Be well,
Anna
Tuesday, December 22, 2009
Remembering my Dad on his birthday...
Although System Redesign is no longer a group, rather a set of coordinated efforts aimed at transforming our system for the better, the lessons learned remain with us. We learned to challenge the status quo by centering our efforts on real time observation and proven science. We learned that although we are very similar to others and can adopt proven strategies from them, in general, local adaptation based on our unique culture remains essential to realize meaningful and enduring change. We learned how important it is to not only involve, but to tirelessly support, those on the front line being actively engaged in design and improvement teams. We learned you cannot improve that which you cannot measure. By listening to patients and families, we learned how much we don't know. We learned what we thought was important to those we serve was not always the same as what was really important to those we serve. We learned the importance of shared vision and aims. Did I say anything about measurement? I know I already stressed measurement, but I thought I would throw it in once more for good measure! We learned how important it is to acknowledge and celebrate all efforts - even what seems the smallest accomplishments - and to accelerate our efforts to assure no needless pain or suffering, no helplessness in those served or serving, no unwanted waiting, no waste and no one left out. Celebration and acceleration, do you remember?
Like so many of you, I too am eager for a new day. I still haven't come to any definitive position on pacing other than action is needed for change. I acknowledge "soon is not a time." However, I do believe that big change begins with a bold aim and a small test. It starts with us, transforming our system, one test at a time.
It looks to be exciting days ahead.
More very soon...
Striking a balance between between celebration and acceleration.Recently, I've been thinking a great deal about pacing. When I recall CCRMC's efforts with System Redesign which began in 2005, I remember many of the crucial lessons learned from our participation in the IHI 100k lives Campaign. One year ago today I wrote about our redesign efforts and again today my thoughts drift to System Redesign, an important anchor in our transformation efforts.
Although System Redesign is no longer a group, rather a set of coordinated efforts aimed at transforming our system for the better, the lessons learned remain with us. We learned to challenge the status quo by centering our efforts on real time observation and proven science. We learned that although we are very similar to others and can adopt proven strategies from them, in general, local adaptation based on our unique culture remains essential to realize meaningful and enduring change. We learned how important it is to not only involve, but to tirelessly support, those on the front line being actively engaged in design and improvement teams. We learned you cannot improve that which you cannot measure. By listening to patients and families, we learned how much we don't know. We learned what we thought was important to those we serve was not always the same as what was really important to those we serve. We learned the importance of shared vision and aims. Did I say anything about measurement? I know I already stressed measurement, but I thought I would throw it in once more for good measure! We learned how important it is to acknowledge and celebrate all efforts - even what seems the smallest accomplishments - and to accelerate our efforts to assure no needless pain or suffering, no helplessness in those served or serving, no unwanted waiting, no waste and no one left out. Celebration and acceleration, do you remember?
Like so many of you, I too am eager for a new day. I still haven't come to any definitive position on pacing other than action is needed for change. I acknowledge "soon is not a time." However, I do believe that big change begins with a bold aim and a small test. It starts with us, transforming our system, one test at a time.
It looks to be exciting days ahead.
More very soon...
Celebrate and accelerate- do you remember?
Remembering my Dad on his birthday...
Although System Redesign is no longer a group, but rather a set of coordinated efforts aimed at transforming our system for the better, the lessons learned remain with us. We learned to challenge the status quo by centering our efforts on real time observation and proven science. We learned that although we are very similar to others and can adopt proven strategies from them, in general, local adaptation based on our unique culture remains essential to realize and embed real and enduring change. We learned how important it is to not only involve, but to tirelessly support, those on the front line being actively engaged in design and improvement teams. We learned you cannot improve that which you cannot measure. By listening to patients and families, we learned how much we don't know. We learned what we thought was important to those we serve was not always the same as what was really important to them. We learned the importance of shared vision and aims. Did I say anything about measurement? I know I did but I thought I would throw that in for good measure! We learned how important it is not only to acknowledge and celebrate all efforts even what seems the smallest accomplishments, but also to accelerate our efforts to assure no needless pain or suffering, no helplessness in those served or serving, no unwanted waiting, no waste and no one left behind. Celebration and acceleration, do you remember?
Like so many of you, I too am eager for a new day - hence, my original question about pacing. How big do we design and how fast do we go? If I draw from the original lessons learned I would look to real time observations and proven science. What would Deming say if we could ask him? It is well documented that he did believe and teach that all transformation begins with the indvidual. Many of the tests we designed began with one patient, one doctor, one nurse, one day, one shift, one time...you get the idea. You can learn more about the Model For Improvement and how we at CCRMC have used it in our improvement efforts here.
Striking a balance between between celebration and acceleration.Recently, I've been thinking a great deal about pacing. When I recall CCRMC's efforts with System Redesign which began in 2005, I remember many of the crucial lessons learned from our participation in the IHI 100k lives Campaign. One year ago today I wrote about our redesign efforts and again today my thoughts drift to System Redesign, an important anchor in our transformation efforts.
Although System Redesign is no longer a group, but rather a set of coordinated efforts aimed at transforming our system for the better, the lessons learned remain with us. We learned to challenge the status quo by centering our efforts on real time observation and proven science. We learned that although we are very similar to others and can adopt proven strategies from them, in general, local adaptation based on our unique culture remains essential to realize and embed real and enduring change. We learned how important it is to not only involve, but to tirelessly support, those on the front line being actively engaged in design and improvement teams. We learned you cannot improve that which you cannot measure. By listening to patients and families, we learned how much we don't know. We learned what we thought was important to those we serve was not always the same as what was really important to them. We learned the importance of shared vision and aims. Did I say anything about measurement? I know I did but I thought I would throw that in for good measure! We learned how important it is not only to acknowledge and celebrate all efforts even what seems the smallest accomplishments, but also to accelerate our efforts to assure no needless pain or suffering, no helplessness in those served or serving, no unwanted waiting, no waste and no one left behind. Celebration and acceleration, do you remember?
Like so many of you, I too am eager for a new day - hence, my original question about pacing. How big do we design and how fast do we go? If I draw from the original lessons learned I would look to real time observations and proven science. What would Deming say if we could ask him? It is well documented that he did believe and teach that all transformation begins with the indvidual. Many of the tests we designed began with one patient, one doctor, one nurse, one day, one shift, one time...you get the idea. You can learn more about the Model For Improvement and how we at CCRMC have used it in our improvement efforts here.
Sunday, December 20, 2009
What do people mean when they talk about disparity in health? You can find a powerful graphic display published by the Contra Costa Times of life expectancy by zip code here.
New York Times article on errors, safety and accountability.
This article highlights much of the tension that exists in creating a culture of safety.
This article highlights much of the tension that exists in creating a culture of safety.
Saturday, December 19, 2009
Learning from others
I was looking at the work done by those tackling other social issues that are, in fact, our issues as well.
The video below focuses on homelessness in California, specifically Ventura County. Unfortunately, Contra Costa County looks no better. Each year, an estimated 15,000 people experience homelessness in our County, and on any given night, more than 4,800 people are homeless. 23,861 calls were received by the Hotline last year from homeless families and individuals seeking shelter in our communities. You can find the link to Contra Costa County Homeless Services here.
Note: By his courage to relentlessly pursue what he believes in, Joe McCannon, Vice President at the Institute for Healthcare Improvement (IHI), inspires me to challenge my own thinking. It's just so easy to find safety and comfort "inside the box" isn't it?Here is a link to the 10 year plan to end chronic homelessness in our communities, published by United States Interagency Council on Homelessness. I find the diffuse leadership structure of particular interest. In addition, the "Cost Implications" (#5) seem very familiar.
The video below focuses on homelessness in California, specifically Ventura County. Unfortunately, Contra Costa County looks no better. Each year, an estimated 15,000 people experience homelessness in our County, and on any given night, more than 4,800 people are homeless. 23,861 calls were received by the Hotline last year from homeless families and individuals seeking shelter in our communities. You can find the link to Contra Costa County Homeless Services here.
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