baptist management system · model based on the toyota kata book & research by mike rother. a...

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Baptist Management System The information presented in the following presentation are meant as a showcase of what our best, most motivated users have achieved. Expected outcomes and results may vary. All testimonials are real, may not reflect another user's experience, and are not intended to represent or guarantee that anyone will achieve the same or similar results. PDSA Model based on the Toyota Kata book & research by Mike Rother

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Page 1: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Baptist Management System

The information presented in the following presentation are meant as a showcase of what our best, most motivated users have achieved. Expected

outcomes and results may vary. All testimonials are real, may not reflect another user's experience, and are not intended to represent or

guarantee that anyone will achieve the same or similar results.

PDSAModel based on the Toyota Kata book & research by Mike Rother

Page 2: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Baptist Memorial Health Care & KATA

How does KATA and play with others at Baptist Memorial Health Care?

Page 3: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Deliberate Practice of

new Behaviors

KATA STARTS HERE.…….. SO WE CAN MOVE THIS

Drives the formation of new Habits

Habit formation leads to either

an open or closed Mindset

The sum an organization’s Mindsets and

Behaviors = Culture

Main Thoughts on DAILY, DELIBERATE PRACTICE of Kata Experimentation on Organizational

Culture...

Page 4: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

What is aKATA?

www.katatogrow.com

Page 5: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

A is a routine you deliberately practice, so its pattern becomes an automatic habit that gives you some new skills!

www.katatogrow.com

Page 6: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Show me your thinking

Page 7: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

1. All hospitals2. BMG3. Corporate HR4. Baptist Trinity5. Baptist Technology Services6. Research7. Baptist College of Health

Sciences8. Baptist & Semmes

Murphey joint venture9. Semmes Murphey

Daily Practice Routines (KATA)

Page 8: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Our Mental Model

Model based on the Toyota Kata book & research by Mike Rother

A Meta-Routine stays the same regardless of the circumstances-a routine way of acting and thinking.

Kata is an iterative process!

PDSA

Page 9: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

These are the headings

in our coachingcycles

Coaching: The Five Question Card

Page 10: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

A Culture Built on Principles

Page 11: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

TWI: JI, JR, JM

A3

Strategic Deployment

Leader Standard

Work

Toyota KATA

Value Stream Mapping

The Baptist Management System (BMS)

Page 12: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

What is a System?

Page 13: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

“All models are wrong, but some are useful”.

George Box

Model to explain BMS

Page 14: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

PDSA at Every Level of the Organization“All models are wrong, but some are useful”.

George Box

Page 15: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting
Page 16: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Coach is responsible for teaching the

improvement KATA, and for the results Learner & Team own the target

condition and work to achieve it

ProcessSupervisor

Manager

Director

Learner

Coach

The Roles – different Skills

2nd Coach is responsible for

assuring the development of the coach and

assuring alignment to organization

goals.

2nd Coach

Team

Page 17: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Skill Levels as it pertains to Learner, Coach, 2nd CoachShepherding Groups

BAPTIST MANAGEMENT SYSTEM

ETERNAL LEARNER

PROFICIENT

COMPETENT

ADVANCED BEGINNER

NOVICE

Page 18: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Our Mental Model

Kata Deployment at Baptist Memorial Healthcare

Page 19: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Kata: OR TAT < 25 min +/-5 min; Started 5/2016

BAPTIST MEMPHIS DEPLOYMENT

28 28 29

27 28

26

29 29

27

25 24 25

0

5

10

15

20

25

30

35

May-16 Aug-16 Nov-16 Feb-17

Tim

e (H

R:M

M)

Room Turnover

Room TOT

Challenge =

Kata Started here

I love the thought process that is generated using KATA. KATA can be used in every aspect of life when attempting to solve a problem

- Linwood White, Director of Emergency Services, RN,

Page 20: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Kata: OR TAT < 25 min +/-5 min ; Started 5/2016

BAPTIST MEMPHIS DEPLOYMENT

8%

2%

-6%

12%

4% 5%

21%

5%

19%

7%

4%7%

-10%

-5%

0%

5%

10%

15%

20%

25%

850

900

950

1000

1050

1100

1150

May-16 Aug-16 Nov-16 Feb-17

% C

hang

e

Mon

thly

Vol

ume

Monthly Volume Change

Volume YTD Variance

Kata Started here

Kata has given us a system of thinking that has allowed us to move the dial in regards to operating room efficiency like we never have before. Not only has Kata provided a catalyst for rapid change, but allowed us to shape behaviors and change a culture.- Matthew Dane, Associate CNO, RN, DNP

Page 21: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Kata: Lab Turnaround Time (Receive to Verify); Started 5/2016

BAPTIST MEMPHIS DEPLOYMENT

0.0

5.0

10.0

15.0

20.0

25.0

30.0

CMP Troponin

LacticAcid/Reflex

CBC PT UA QualHCG -Blood

EDQual

HCG -Urine

FY15 26.9 27.6 24.7 10.8 20.2 26.5 19.2 14.8FY16 24.2 22.1 22.6 7.9 17.4 20.3 16.7 11.3YTD (Oct-FEB) FY17 23.0 22.0 22.0 7.5 16.5 18.0 15.0 11.5

Rece

ive

to V

erify

Min

utes

Lab Test Type

Lab Kata on Turnaround Time Receive to Verify

FY15 FY16 YTD (Oct-FEB) FY17

“Your guidance as a coach has been GAME CHANGING, Brandon. I and the entire lab KATA team appreciate and applaud your patience, leadership and expertise. We couldn’t have achieved our successes without you! ”

- Tony Beard, Lab Manager

-5% -0.4%

-2.6%-5.3%

-12%

-10%

-1.5%

-5.3%

Page 22: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Kata: ED Length of Stay

BAPTIST MEMPHIS DEPLOYMENT

0

50

100

150

200

250

300

350

Oct

Nov Dec Jan

Feb

Mar

Apr

YTD

Length of Stay - Admit

FY 16 FY 17 LOS Admitted

-11%

0

50

100

150

200

250

Oct

Nov Dec Jan

Feb

Mar

Apr

YTD

Length of Stay - Discharged

FY 16 FY 17 LOS Discharged

-10%

Page 23: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Kata: ED Length of Stay

BAPTIST MEMPHIS DEPLOYMENT

0

500

1,000

1,500

2,000

2,500

3,000

3,500

Oct

Nov De

c

Jan

Feb

Mar

Apr

YTD

Hold Hours

FY 16 FY 17 Hold Hours

-2%

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

Oct

Nov De

c

Jan

Feb

Mar

Apr

YTD

Left W/o Being Seen %

FY 16 LWBS

-54%

Page 24: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

“Pioneering the KATA TWI Shepherd group has been a challenging journey that is showing great outcomes for the members, our staff and our patients. Without the leadership of the Shepherds, we are certain that TWI training, use of JIB’s and continued deployment that TWI would not have been embraced in the positive manner we have seen. Thus, our outcomes would have been reduced and processes less effective.”

- Judy Mann, TWI-JI Shepherd, Education

Started Kata May FY 16 Started TWI - JI

Shepherding Kata work on CLABSI - Oct FY 17

0

50

100

150

FY 14 FY 15 FY 16 FY 17

133

104

43

6

CLABSIs

BAPTIST MEMPHIS DEPLOYMENTKata: Reduce Central Line Acquired Blood Stream Infection (CLABSI)

A single CLABSI can cost theorganization $40,000Kata has reduced CLABSIs from43 – 6 = 37 fewer patients experienced a

CLABSI FY16 over FY17 YTD

Page 25: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

“Most significantly the deployment of Foley Insertion/Peri Care JIB’s to nursing, with the contingency that only nurses who have received the JIB training can insert foley catheters. We are confident this has led to the steady decline in CAUTI events in our hospital due to the JIB, TWI training, and validation on-going. TWI training with the JIB has provided our staff the training and tools for standard work to prevent harm and reduce infections relating to foley catheters. “

- Judy Mann, TWI-JI Shepherd, Education

Kata: Catheter-associated Urinary Tract Infections (CAUTI)

A single CAUTI can costthe organization $9,000Kata has reduced CAUTIs from 19 – 6 = 13 fewer patients experienced a CAUTI FY16 over FY17 YTD

BAPTIST MEMPHIS DEPLOYMENT

Started Kata May 2016

Page 26: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Kata: Falls 4 West – Med-Surg Kata Storyboard 1st Area that was started 5/2016

BAPTIST MEMPHIS DEPLOYMENT

1.651.7

1.751.8

1.851.9

1.952

2.052.1

2.15

4 West Falls per 2 Week

Page 27: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Kata: Med-Surg & Float Pool Falls Master Kata Storyboard

BAPTIST MEMPHIS DEPLOYMENT

0

10

20

30

40

50

60

% Assisted Falls

02468

101214

Base

line

2/3/

2017

2/17

/201

7

3/3/

2017

3/17

/201

7

4/3/

2017

4/28

/201

7

5/12

/201

7

5/26

/201

7

Fall per 2 Week Target Condition Since Kata

Added 4N

Page 28: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Kata: 5 West - Stepdown Reduce Turnover to < 14% for FY 17BAPTIST MEMPHIS DEPLOYMENT

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

Q3 - FY16 Q4 - FY16 Q1 - FY17 Q2 - FY17 Q3 - FY17

30.9%

22.0%

0.0% 0.0%

4.2%

RN Voluntary TO

Page 29: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Memphis Hospital

23 Improvement Katas launched in 12 months

FY16 vs FY 17

Estimated ROI

Approximately 55 x investment

Page 30: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Model based on the Toyota Kata book & research by Mike Rother

A Meta-Routine stays the same regardless of the circumstances-a routine way of acting and thinking.

Kata is an iterative process!

PDSA

Our Mental Model

Page 31: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

YES Kata Plays Very Well with Others

Page 32: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Show me your thinking

Page 33: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

Main Thoughts on DAILY, DELIBERATE PRACTICE of Kata Experimentation on Organizational

Culture...

Deliberate Practice of

new Behaviors

KATA STARTS HERE.…….. SO WE CAN MOVE THIS

Drives the formation of new Habits

Habit formation leads to either

an open or closed Mindset

The sum an organization’s Mindsets and

Behaviors = Culture

Page 34: Baptist Management System · Model based on the Toyota Kata book & research by Mike Rother. A Meta-Routine stays the same regardless of the circumstances -a routine way of acting

THANK YOU,For the Gift of Your Time Today!

“Focus on the People, and the numbers will come…

Focus on the numbers, and the people will Go!”

TM

Brandon Brown, P. [email protected]

479-856-1919