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6 May 2016

Physician Spotlight: Gerald A. Maccioli, MD, FCCM

Dr. Maccioli serves as Sheridan’s Chief Quality Officer. Before joining Sheridan in 2015, he practiced Anesthesiology and Critical Care Medicine for more than 27 years. He served as Director of the American Society of Anesthesiologists (ASA) for North Carolina and as Chair of the ASA Section on Education and Research. He also served as President of the Society of Critical Care Anesthesiologists. As the Chair of the American Medical Association (AMA) Committee of Innovators, Dr. Maccioli played an influential role in developing comprehensive, progressively responsible healthcare reform strategies. He continues to serve on the AMA’s Quality Improvement Advisory Committee (QIAC) as well as the Committee on Practice Sustainability and Professional Satisfaction.

Dr. Maccioli is a highly respected subject matter expert on a wide range of medical topics. He has been an invited speaker at more than 70 state and national meetings on diverse topics including resuscitation, critical care medicine, public policy, payment reform and quality improvement. He also has contributed to or written more than 50 clinical papers, abstracts, editorials and book chapters. 

He completed a Fellowship in Cardiothoracic Anesthesiology and Critical Care Medicine at Duke University after completing his Residency in Anesthesiology at the University of North Carolina at Chapel Hill. 

Dr. Maccioli is a strong advocate for ensuring care quality in the move to value-based care using a variety of approaches, including using Kaizen events for engaged process improvement and urging healthcare leaders to frame all decisions with the “quadruple aim” in mind to prevent physician burnout and improve care delivery. He’s also a proponent of optimizing pre-admissions testing and establishing standardized, evidence-based care guidelines.

Large healthcare organizations that have vast pools of data to analyze and learn from, as well as a large team of dedicated physicians, need to lead the way in care quality innovation and establishing evidence-based best practices. Dr. Maccioli’s experience, expertise and leadership are helping Sheridan do just that.

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4 May 2016

Overcrowded EDs and Population Health

Unsurprisingly, yet another study has linked ED inefficiency with poorer population health outcomes. This time from George Washington University, the study found that the most crowded quartile of EDs had a much lower rate of adoption for common techniques that reduce overcrowding, such as bedside registration and surgical schedule smoothing. This finding is made more concerning by the fact that adoption of these techniques is increasing across hospitals as a whole. While the general adoption trend is positive, the hospitals most in need are also the ones improving the slowest.

Dr. Jesse Pines, a professor of emergency medicine and health policy at GWU and one of the study's authors, believes that a lack of resources is partially to blame. In an interview with the Washington Business Journal, he argued that cost can often be a barrier to adoption, saying that “the places that have been effective at reducing crowding have had to invest a lot of time and money into it.” If CMS were to penalize hospitals based on ED crowding in the future, it could potentially exacerbate the problem.

We agree with Dr. Pines, but also want to highlight the myriad options available for low-cost efficiency improvements in EDs. In most of the cases we've seen at our hundreds of partner hospitals, major investments in time and infrastructure aren't necessary to achieve significant efficiency gains. More often than not, some small tweaks to existing processes can deliver very high returns. The challenge is figuring out what those tweaks are, and how they should be systematized.

Process and Communication Errors

Most efficiency drains fall into one of two categories: process and communication. Let's start with communication. Contrary to popular belief, miscommunication is one of the leading causes of ED errors. Fortunately, it is also one of the easiest to solve. In our work – and particularly in Dr. David Mishkin's communication drill practice – we have found that simple changes in the way ED teams communicate information to one another can significantly reduce error rates and increase efficiency. Even just a few hours of communication drills can have a noticeable impact.

Process errors can be more challenging, but still require less investment than one might think. While large investments in software, systems and infrastructure are a necessary part of the complete solution, many process problems can be solved without them. Perhaps the best example of this principle is Kaizen, a continuous process improvement methodology that invites all members of a team to collaboratively design solutions to process problems.

One of the core ideas of Kaizen is that the people who regularly execute processes are also the ones with the best ideas on how to improve them. Giving these individuals a forum in which to share and develop their ideas consistently leads to more effective and lower cost solutions than top-down approaches. We have seen this play out in hundreds of our partner hospitals and are even beginning to apply the concept to less concrete processes, such as employee engagement.

Conclusion

Dr. Pines is right to emphasize the importance of large scale, top-down efforts to address ED inefficiencies. However, equal emphasis should be placed on the simple process and communication errors that are at the heart of many common efficiency drains in the ED. In many cases, solving these problems using Kaizen and other employee-driven methodologies is more attainable and cost-effective goal than a top-down overhaul.

If you're interested in learning more about how we have used Kaizen, communication drills and other strategies to improve ED efficiency, please check out our “The Evolving Emergency Department” white paper.

25 April 2016

The Drive for Process Improvement Part 5: Elevating Transformative Vision

Three leaders from the International Consortium for Health Outcomes Measurement (ICHOM) – a nonprofit founded by organizations known for progressive business practices and rigorous research: Harvard Business School, The Boston Consulting Group and the Karolinska Institutet – published an article in Harvard Business Review that analyzes the success some healthcare organizations have had in implementing patient outcomes measurement programs. The article lists five steps that should be applied when implementing major change or process improvement within healthcare systems. This blog post is the final in a five part series that critique and nuance each ICHOM step from a Kaizen perspective.

Be Prepared

The final imperative outlined by the ICHOM is to use early successes to scale and spread innovation. Scaling and spreading transformative improvements to hospitals can assist the healthcare system in the transition to value-based care. In this sense, communication of best practices between providers has the potential to benefit the entire healthcare system. Each organization has its own unique characteristics, therefore it is essential to make sure that scaled process improvements are rock solid and adaptable in implementation. At Sheridan, we have developed a robust system to ensure success in expanding improvements to other organizations.

We understand that in order to adapt an improvement to another setting, it is essential to form a foundation of standard work that provides those responsible for implementation with a specific understanding of how the improvement needs to function. An illustrative analogy can be found in football. For proper execution, a quarterback needs to know exactly where each of his players is going to be, when they will be there, and what responsibility each of his teammates has. Furthermore, the best way to ensure this understanding is through a precise language of illustration via X’s and O’s. To gain an understanding of how an improvement needs to look and function in a variety of different settings with different teams is an incredible challenge, standard work sheets illustrating the new process, expected timing, work content, and results must be made simple and transparent, this is the only way to effectively implement a change to its full potential.

Beyond Quantitative Goal-Setting

We invest in people as our most important resource. No matter how often a similar problem is encountered at different facilities the solution is always dependent on the factors present at a specific site, canned solutions are not viable. The greatest likelihood of sustained success if through the training and practice of the individuals actually doing the work. After participating on a kaizen individuals on the team should be able to analyze their own process going forward and solve the problems specific to their own role in the workflow. We regard every Kaizen team member as both a learner and a problem solver. Kaizen is a system that enables people to leverage their own unique perspective with effective team communication. We are confident that our events will leave each Kaizen team member more adept at solving problems through a communicative, systematic approach. In this sense, we regard Kaizen as a dual objective system. Even if the implemented process improvement does not have the desired impact, you have empowered your staff with skills necessary to re-evaluate and readjust the process. The most important outcome of the Kaizen is to enable staff to approach problem-solving logically and cooperatively through application of the scientific method.

Indeed, Sheridan has implemented a system to scale and spread its own vision of Kaizen process improvement to many organizations nationwide. In Part 2 of this series, we described how the facilitator acts as arbiter and guide for the Kaizen. Integral to the guidance of the facilitator is making people understand the skills they are quickly developing through their Kaizen experience. 50-70 percent of the time facilitators also work with trainees called facilitator technicians to train them to conduct Kaizens themselves. Facilitator technicians tag along for three to six Kaizen events before they conduct their own guided facilitation. With each event leading up to their facilitation, the technician gains additional responsibility. Technicians are invited to discuss with the facilitator how they would approach a problem. If the suggested approach is correct, the technicians are permitted to present their perspectives to the group. At Jupiter Medical Center in Florida, two facilitator technicians trained under an extensively experienced facilitator through five Kaizens. In the sixth, they were permitted to co-facilitate the event while their mentor shadowed for assistance. Through their extensive experience, the mentor’s guidance and their own collaborative effort, they effectively conducted a successful Kaizen.

Executive Guidance

After an event, the administration will review the outcome with Sheridan facilitators in order to determine where efforts need to be focused next. Additionally, Sheridan staff will engage in a walkabout to gain a visual sense of what’s working and what needs improvement. Ultimately, the review and walkabout enable targeted scaling and spreading to optimize the rate of change among our partners to ensure the implementation of best practices. If we were to constantly conduct Kaizens, we would constrain the staff and sub-optimize efficiency. The final goal of the targeting is to prevent organizations from spreading their human, technical and financial resources too thin. This strategy allows our work to amount to a controlled burn (rather than a raging wildfire) that will permit continuous, sustainable process improvement.

Finally, we want to recognize the high expectations that Sheridan’s administration has for both itself and the entire staff. President of Physician Services Robert Coward expects an outline to demonstrate a logical, clear approach to lean process improvement. These expectations constantly encourage Sheridan employees to proactively evaluate their own thinking when addressing a problem.

Final Thoughts

The imperatives developed by the ICHOM demonstrate the broad requirements of successful implementation of process improvement, but they are not complete. These imperatives must be nuanced through a Kaizen approach to allow organizations and people to internalize the changes made and to continually drive progress. We find there are two fundamental lessons in our analysis that the ICHOM misses in its presentation.

First, people are an organization’s most important resource. Without soliciting consistent input from a diverse selection of stakeholders, it will be impossible to optimize a process. Furthermore, cultivation of analytic problem-solving skills among your staff will determine the long-run prosperity of the organization. It is important to build a culture that promotes both independent thought and absolute commit to teamwork. In this sense, it is essential to constantly encourage employees.

Second, process improvement is never entirely complete. Organizations and their constituents need to constantly re-evaluate their myriad procedures in order to determine where deficiencies exist and what practices could offer solutions. You can only act as a leader in the value-based healthcare industry with consistently open communication and commitment to progress.

These lessons represent how organizations need to approach innovation to be successful in the future. Healthcare is a dynamic field and professionals must respond to its changes in order to provide the best care affordably. Only with a deep understanding of how lean processes are developed, maintained and constantly improved will healthcare providers achieve a premier standard of care.

Previous Series Installments:

Part 1: Making Champions of Believers

Part 2: Assembling Your Dream Team

Part 3: Commit to Your Vision

Part 4: Effectively Celebrating Progress

22 April 2016

Spotlight on Sheridan’s Comprehensive Teleradiology Solutions

Sheridan’s recently released FRESH ES/CTS Newsletter for Q1 2016 features FAQs with Chief Glenn Kaplan, M.D. about our teleradiology solutions. FRESH ES stands for Final Reads Electronically from Sheridan Healthcare Eco-System. This technology platform allows radiologists to view cases from multiple hospitals across the country, including relevant prior studies, and render a preliminary or final interpretation. The latest version enables radiologists to stream images rather than downloading the full DICOM data set. Among its many benefits, FRESH ES integrates the workflow between hospital-based radiologists and referring physicians, greatly increases efficiency, and enables significantly improved diagnostic accuracy and patient care. 

CTS, which stands for Comprehensive Teleradiology Solutions, is led by practice director Richard B. Sanders, DHA, MPH, FACHE. It oversees Sheridan’s teleradiology physician and support teams and deploys and maintains the FRESH ES platform.

The newsletter also presents highlights of FRESH ES/CTS achievements in 2015, including significant improvements in physician productivity and expanded services. Last year CTS read roughly 400,000 cases and 240,000 wRVU, with an impressive average turn-around time of only 14 minutes. Its call center was 100 percent staffed during hours of reading.

To better serve internal customers, CTS increased coverage for evenings, medical leave, plain films and onsite locums and facilitated PRN IR coverage. To better meet external customer needs, CTS also provided ER plain film services for 10 new facilities, added pediatric sub-specialization for two medical centers, expanded to cover three new facilities and three freestanding emergency rooms, and secured three facility trauma designations.

Sheridan is a leader in using teleradiology services to streamline processes, increase physician productivity and ensure timely, high-quality patient care. We support the growth of teleradiological health systems that establish measurable quality standards and accountability for diagnostic accuracy, appropriate utilization, service level excellence and patient care.  

20 April 2016

Sheridan Launches Investigator Initiated Research Program

As a physician-led company, Sheridan aims to support and develop our physicians’ expertise in the clinical, management and leadership arenas. This year, in order to build on and support the research interests and efforts of our physicians, we are launching Sheridan Scientific Intelligence, an investigator initiated research unit. The new group will provide resources and support for physician-initiated research and will complement the work done through our clinical research team. The program will be led by Jana Barlic-Dicen, Ph.D., Manager of Investigator Initiated Research. As a large, multispecialty organization, Sheridan has an opportunity to serve the broader medical community by addressing unmet research needs.

Sheridan Scientific Intelligence will serve the needs of our physicians, our partner institutions, and the medical community by:

  • Encouraging physicians to partner with Sheridan on their investigative research so they can take advantage of Dr. Barlic-Dicen’s extensive experience and expertise in this area, from helping to refine the idea for the study for greater impact (e.g., larger reach, stronger testing methods/data) to providing guidance and support regarding statistical analyses, publication, presentation and exposure for the physicians’ research findings.
  • Ensuring that all investigator initiated research is conducted in compliance with all federal, state and local regulations, especially when it involves patients.
  • Using the research findings to improve on current best practices at Sheridan’s partner hospitals and helping to publicize them so that other medical institutions and society as a whole can benefit from the research.

Sheridan Scientific Intelligence also will help to fund a certain number of studies each year. A call for research proposals will be sent to Sheridan physicians in the next few months.

Some of the areas that Sheridan physicians either have begun to research or have expressed interest in investigating include improvements to anesthesiology practices for obese and diabetic patients, and finding better radiology approaches and equipment, particularly for breast cancer imaging.

 

About Dr. Barlic-Dicen

Jana Barlic-Dicen, Ph.D. is the author of numerous peer-review publications and has been a speaker at multiple national and international meetings. She received her Bachelor of Science with Honors at the University of Ljubljana (Slovenia) and her Ph.D. in Microbiology and Immunology at the University of Western Ontario (London, Ontario, Canada). Dr. Barlic-Dicen was the recipient of the National Institutes of Health Intramural Research Training Award and served her post-doctoral research fellowship at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. She was a recipient of a prestigious Wellcome Trust Research Career Development Fellowship during her tenure at Imperial College London. She also served as a Principal Investigator at the Cardiovascular Biology Research Program at the Oklahoma Medical Research Foundation and as a faculty member in the Department of Cell Biology at the University of Oklahoma College of Medicine, where her research was funded by the award from the National Institute of General Medical Sciences.

14 April 2016

Allyson Kayton Addresses Senate Committee on the Need for Innovation in Neonatal Drug Therapies

Allyson Kayton, MSN, NNP-BC has tirelessly advocated for higher standards for neonatal care since her days working in Memorial Regional Hospital’s level II and level III neonatal intensive care units. Allyson was invited by Congress to address the Senate Committee on Health, Education, Labor and Pensions regarding S.2041 – Promoting Life-Saving New Therapies for Neonates Act of 2015.

Representing the National Association of Neonatal Nurses (NANN) and Florida Association of Neonatal Nurse Practitioners (FANNP), Allyson spoke extensively on the need to promote innovation in the development of neonatal research and drug therapy. Her testimony highlighted the existing treatment gap in neonatology and how ongoing research is necessary to address the challenges within the field. The bipartisan bill put forth by Senator Bob Casey (D-PA) and Senator Bill Cassidy (R-LA) would close the treatment gap by stimulating the development of safe, effective drugs for the neonatal population and providing incentives to drug sponsors who successfully develop products for neonates.

Thank you, Allyson, for your advocacy on behalf of our youngest, most vulnerable population. Your efforts are invaluable, not only to the field of neonatology, but to all prospective parents.

12 April 2016

The Drive for Process Improvement Part 4: Effectively Celebrating Progress

Three leaders from the International Consortium for Health Outcomes Measurement (ICHOM) – a nonprofit founded by organizations known for progressive business practices and rigorous research: Harvard Business School, The Boston Consulting Group and the Karolinska Institutet – published an article in Harvard Business Review that analyzes the success some healthcare organizations have had in implementing patient outcomes measurement programs. The article lists five steps that should be applied when implementing major change or process improvement within healthcare systems. This blog post is the fourth in a series of five that critique and nuance each ICHOM step from a Kaizen perspective.

Daily Progress

The fourth imperative outlined by the ICHOM is to set goals and milestones to recognize and celebrate incremental progress. Here we will discuss how to recognize small steps in process improvement and how to celebrate the end outcome. While it is indeed important to publicize the end outcome of process improvements, it is equally as important to encourage consistently attentive thinking to fuel ongoing innovation.

Process improvement is, in and of itself, a process driving consistently toward innovation to maximize efficiency and reduce waste. At Sheridan, our Kaizen events solicit input extensively from a cross-functional team dedicated to improvement in order to gain insight and develop solutions to the inefficiencies in organizational processes. Daily recognition of progress makes the drivers of process improvement and organizational administration mutually accountable. Thus, during a Kaizen, the team leader will present a 15 minute daily report out to the organization’s senior leaders in order to vet the ideas the team developed that day. The leader is additionally encouraged to include the names of everyone on the team to provide recognition for their roles in shaping the Kaizen’s discourse. These reports allow senior leaders to question ideas and guide progress, but also provide an opportunity for small-scale recognition of team members for their daily progress. By holding these feedback sessions daily we prevent the team from veering off course and ensure their valuable time is well spent. These small details go a long way in constructing a supportive culture that welcomes bold, innovative thinking and expression.

Concluding the Kaizen

Each Kaizen concludes with a series of final presentations, open to the organization’s staff, to share the progress that has been made and the changes that are being implemented. Each member of the team has an opportunity to laud the group and communicate lessons to senior leaders and peers. While some members of the team experience anxiety before the presentation, we ensure a celebratory atmosphere by providing constant support and enthusiasm that we hope will leave the team and the broader organization with a zeal for process improvement and innovation that can be carried far into the future.

While many final presentations consist of remarks from each member of the team, many are fun and creative. Some teams perform a skit to communicate the decisions that were made and the approaches taken. Ultimately, these presentations provide the team with broad organizational recognition and an understanding of the value that each member brought to the table during the collaboration. We also like to take photos of these events to post on the company website, newsletter or SharePoint to further publicize the team’s efforts and what they learned. The sense of achievement, purpose and mutual appreciation is tremendously apparent during these celebrations.

Beyond the Kaizen

While the Kaizen is a moment in time, its philosophy of tireless, collaborative effort for ongoing progress persists beyond the event’s conclusion. For this reason, we cultivate programs that encourage ongoing attention to detail and widespread adoption of new protocol.

For about three weeks following the Kaizen, we assign someone to engage in “softball coaching” dedicated to catching and rewarding people who do the process correctly. The coach is always an expert with total understanding of what the process should look like. The rewards for following new protocol come in the form of soft gratification, like praise or acknowledgment.

At Sheridan, we additionally have implemented a lanyard program (comparable to belts in karate) that displays understanding of the practice and philosophy of process improvement. There are four distinct notches on the lanyard that progressively increase in difficulty to achieve. The first notch is earned by expressing introductory knowledge on how a Kaizen is conducted. The second notch is achieved by demonstrating competency in executing a Kaizen. While the first two notches focus on the practice of Kaizen, the third notch is earned through internalizing a broad understanding of its philosophy. The fourth notch is earned when one effectively transforms an organization’s facilities for the purpose of process improvement. The lanyards are tangible rewards for commitment to ongoing improvement.

A Kaizen is not a lone guarantee of ongoing success or prosperity, rather it is a method that creates enthusiasm and the necessary momentum to make organizational progress. The essence of Kaizen is the collaboration of people for a greater goal, therefore it is important to encourage people to buy into a cooperative system where they are able to proactively work to improve processes. In this sense, they are constantly reminded of their own role and value when promoting quality patient care.

Previous Series Installments:

Part 1: Making Champions of Believers

Part 2: Assembling Your Dream Team

Part 3: Commit to Your Vision

29 March 2016

The Drive for Process Improvement Part 3: Commit to Your Vision

Three leaders from the International Consortium for Health Outcomes Measurement (ICHOM) – a nonprofit founded by organizations known for progressive business practices and rigorous research: Harvard Business School, The Boston Consulting Group and the Karolinska Institutet – published in Harvard Business Review that analyzes the success some healthcare organizations have had in implementing patient outcomes measurement programs. The article lists five steps that should be applied when implementing major change or process improvement within healthcare systems. This blog post is the third in a series of five that critique and nuance each ICHOM step from a Kaizen perspective.

Preparing to Drive Change

The third imperative outlined by the ICHOM is to allow an investment of time and resources for process improvement. The level of investment that each organization deems necessary is going to be unique to their circumstances. Here, we will discuss key commitments of time and resources. They may seem to go beyond those generally allocated for process improvement, but our experience has shown them to be critical to our success at Sheridan Healthcare.

At our Kaizen events we expect full time participation from all team members that includes physicians, nurses, nurse practitioners, physician assistants, and all other pertinent clinical and ancillary personnel. In the interest of keeping our clinicians’ time as value adding as possible, we do try and tailor our clinical Kaizen events to 3 intensive days so as to maximize their time. This approach has proven more effective than scattering process improvement meetings over several weeks or months. While the five day kaizen is still king, we have become adept at distilling the essence it’s most fundamental, and yet complete, form. In part two of this series, we outlined our model mix of players for a cross-functional team. Regardless of the seniority of the members this team, it is essential that they spend the time observing, analyzing, and experimenting with possible solutions that may improve their processes. 

To support this powerhouse group it is vital that all ancillary resources must be put on call during the planning and preparation phase. This ensures the team’s success is not hindered by a lack of supporting resources. Every department within the corporate office or the hospital must have someone ready to respond to the kaizen team’s needs. With a little advanced notice we can maximize the team’s time and minimize interruptions to supporting departments. Examples of resources commonly pulled into the event for brief supporting roles are IT professional for technical support, compliance officers, registrars, and materials management. It is well known to many process improvement professionals that changes to the physical workspace are perhaps the most effective way to ensure process changes stick; so, members of the facilities staff are often made available to make structural modifications to rooms.

Given the heavy resource and time allocation to develop and implement process change, we are obliged to provide the best facilitation services at our disposal. Sheridan Healthcare covers the cost of transporting a nationally certified facilitator to each clinical kaizen location in order to ensure the Kaizen runs smoothly and effectively though our standardized format. We invest heavily in the training and certification of our facilitators. They are required to pass the AME / SME Lean Bronze Certification and submit a portfolio for review, as well as complete our internal facilitator training program constructed with TWI elements.

Time and Space to Grow                                                                                         

All teams are provided a dedicated work space that serves as their home base throughout the Kaizen. This is where they illustrate their observations, brainstorm, deliberate, experiment and report out to leadership each day. For the entire duration of the event, it is essential for them to have an area for uninterrupted work. Often overlooked, this workspace should be near the area targeted for Kaizen. This allows teams to observe often, vet ideas, interview other frontline workers, and implement changes quickly. Nothing stagnates a team quite as easily as a 15 minute walk back and forth multiple times a day. If you want to lose touch with what is really happening in the work area just separate the team by a whole lot of distance. Although many hospitals have tight quarters and relatively little space to spare something can usually be done to put the team in proximity to the work area in question.

At Osceola Regional Medical Center in Kissimmee, Florida, a Kaizen was being held to improve the interventional radiation (IR) biopsy process. There didn’t appear to be any suitable space for the Kaizen team. But our determined team members were able to identify an old, and rarely used, waiting room with just a couple of chairs and almost no wall space. Since it was adjacent to the IR suite, we thought it would do just fine. A de facto waiting area was set up for patients near the entrance to the IR suite, and it had to be ‘right-sized’ due to the tight quarters. The team was then able to conduct the Kaizen successfully. Once the event had concluded, the staff was so pleased with newly freed up space that they decided to keep the changes in place. Our Kaizen team room was converted into a plan earmarking it for IR suite expansion.

Not every vital resource is immediately tangible. We find it is equally necessary for the team to have an emotionally supportive environment where they will feel comfortable expressing all sorts of crazy ideas and testing them. It is necessary for teams to have the confidence to think creatively in an uninhibited manner, and to develop innovations; at Sheridan we call this ‘Try-Storming’ a blend of brainstorming with a bias towards action.

In one memorable case, the team was developing a way-finding system that visitors could use to direct themselves to different parts of a corporate park and through multiple office buildings without getting lost. The team offered a free lunch to visitors who could find their way between two different locations, monitoring time, errors, and ultimately arrival at the desired destination. They tested every method they could think of, from colored strings on the ground to “airport terminal” style overhead signage. After a day of lighthearted but poignant trials the team came to a very real and objective conclusion, that terminal and gate markers with overhead signage were the most effective method for directing people to specific locations through a complex yet open floorplan. This experiment is an example of how it is essential for teams to have the time and resources to play with their ideas before committing to which work best. In this case, a relatively small investment of resources for experimentation resulted in a significant payoff.

Concluding Thoughts

Your team, department, or organization will never achieve their operational goals without first committing fully to the shared vision. And once activities have been aligned to drive directly towards that vision you can confidently dedicate the resources necessary to execute wisely. Ensure adequate time for all key stakeholders to understand, create, and implement new processes. We are often asked how someone can afford to dedicate physicians and executives as fulltime kaizen team members, our response is: how can you afford not to? Do you have time to rework the ideas, do you have the resources to implement ineffective solutions? We implore our partners to take the time and do it right, because the return is well worth the investment. Few things are as detrimental as lip service and half measure, they will drain resources and moral. Ensure you are working on the fewest number of crucial objectives and then prioritize the teams’ efforts above all else, facilitate their ability to make fast and effective change.

Previous Series Installments:

Part 1: Making Champions of Believers

Part 2: Assembling Your Dream Team

25 March 2016

Designing the Future of Emergency Medicine

The best emergency departments are those that consistently look for ways to optimize and streamline processes so that clinicians can reach patients as quickly as possible and care for them successfully. Mirroring these dynamic EDs, the emergency medicine field as a whole will need to look for ways to improve the delivery of care. As baby boomers age, systemic capacity for quality patient care will be strained by its sheer cost and volume. In this sense, it will be necessary for doctors to question the current best practices in emergency medicine. There is a mounting need for innovation within every facet of the workflow.

To address this need, Sheridan organized the Innovate Emergency Medicine (iEM) conference to stimulate creative thought and drive the changes necessary to make Sheridan hospitals more efficient and effective. The iEM conference provides numerous perspectives from which physicians are able to recognize inefficiencies that are taken for granted in many hospitals, and devise the best possible solutions to address these problems. The conference encourages quality patient care at reduced costs so that Sheridan may continue to set an example that will elevate the field of emergency medicine. As greater demands on quality and volume continue to challenge hospitals, events like the iEM conference allow physicians to innovate so that these demands are addressed creatively and proactively.

24 March 2016

How Technology Inspires Quality Patient Care in the Emergency Department

Emergency medicine clinicians must make important decisions quickly using the information readily available to them. To that end, EDs stand to benefit by harnessing technological advancements that bring actionable data to their fingertips. Ultimately, providing accessible data may improve the experience of providers and patients alike.

At Jupiter Medical Center, Sheridan developed and implemented the Inspire Quality system to create the infrastructure necessary for quality data tracking. The IQ system simplifies the process of identifying trends in patient care and physician performance. It provides a user-friendly interface to access, track and record patient data, and a way for physicians proactively evaluate their performance and the performance of their departments. At Jupiter, the staff has found it to be a powerful tool for enhancing the quality of patient care. Their experience encouraged Sheridan to roll out the system across the entire emergency medicine division.

As tech and analytic advancements continue to be made, hospitals too must evolve to ensure the highest level of care possible. Implementing quality infrastructure like the Inspire Quality system is an incremental departmental change that can have dramatic effects on emergency departments by leveraging physician experience with the necessary context.