Friday, August 21, 2020

Taking Continuous Improvement to the Next Level

Back in 2013, we realized that GBMC was making progress towards our vision by using continuous improvement as our business model, but we were concerned that we were not moving fast enough. We engaged consultants who were experts in the use of Lean techniques in manufacturing, and their leader, Mike Holland, said to me, “You need to do Lean Daily Management.” I said to him, “Great, Mike. What’s that?”

Mike started our education with the “why?” He pointed out to us that all managers wanted to improve the performance of their unit or department, but they often pushed improvement work to the future because they were caught up in fixing the problems of the day. By creating a daily system for reporting and accountability, we would see an acceleration of meaningful change. Mike then taught us how to design Lean Daily Management (LDM). We started small, with one route and a few stops. As we got better, we built it out to five routes with six to seven stops each, and a walk on the weekend as well. 

Well, here we are seven years later. We have made so much progress! We have improved so many things under our Four Aims from the reduction of missing medications and employee injuries, to moving urinary catheter insertion to standard work and the resulting reduction in CAUTI’s, and on and on. So, now it’s time to take process improvement and our core competency, redesigning care, to the next level.

Under the leadership of Rhonda Wyskiel, Director of Performance Improvement and Innovation, we are rolling out what you might see as LDM 2.0, the Lean Management System (LMS). You will learn more about this over the next few months. The Lean Management System builds on LDM. It requires the creation of standard work, a process for teaching the standard work, and checking back to see that it is being done correctly. LMS also adds increased accountability through the chain of command. 

Rhonda and her team have begun rolling out LMS on medicine inpatient units, starting with the technique of purposeful rounding, to assure that scheduled check-ins with the patients meet the patients’ needs. This work has already led to significant increases in our HCAHPS overall score! The team is also working with the support systems of EVS, Transport, and Food and Nutrition. Stay tuned!

Wonderful Recognition for Our Pharmacy
GBMC is the recipient of the 2020 Minogue Award for Patient Safety Innovation from the Maryland Patient Safety Center (MPSC)! This award was created by the MPSC’s Board of Directors to recognize an organization within our state that has made a demonstrable difference in patient safety through an innovative solution. GBMC was chosen from over 70 submissions by a panel of independent judges, who are leaders in the Maryland healthcare community.

We received the award for our program: One Insulin Pen for One Patient, which was designed and implemented at GBMC under the leadership of Vaishali Khushalani, Pharm D., Medication Safety Officer, and Yuliya Klopouh, Pharm D., Director of Pharmacy Services. The program was created to reduce the risk of administering insulin with a pen from a different patient. After examining the possibility that an insulin pen from one patient could have been used on another patient in 2018, the pharmacy team was challenged to redesign the process for dispensing insulin pens. They studied the existing system and leveraged technology in a new safer system. Subsequently, GBMC has seen a decrease in missing insulin doses due to the redesigned process.

Our pharmacy is a leader in continuous improvement at GBMC and I am very proud of them. Please join me in congratulating them for getting this well-deserved award!

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