Download - Renewing Your Quality Process
Through the Looking Glass: Reviewing, Renewing Your
Organization’s Commitment to Quality
Through the Looking Glass: Reviewing, Renewing Your
Organization’s Commitment to Quality
HCW: 11 ASQ World CongressHCW: 11 ASQ World Congress
Management Consulting in Healthcare & Katherine Reller Consulting
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Through the Looking Glass: Surviving and Reviving Your Organization’s
Commitment to Quality
Through the Looking Glass: Surviving and Reviving Your Organization’s
Commitment to Quality
Management Consulting in Healthcare & Katherine Reller Consulting
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SESSION OBJECTIVESSESSION OBJECTIVES
• Identify the importance of recognizing ‘cornerstones’ of organizational quality
• Conduct a reflective review of your organization’s quality direction and /or programs
• Identify the importance of recognizing ‘cornerstones’ of organizational quality
• Conduct a reflective review of your organization’s quality direction and /or programs
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Management Consulting in Healthcare & Katherine Reller Consulting
SESSION OBJECTIVESSESSION OBJECTIVES
• Identify commonly missed “danger signs” that a focus on quality is lost
• Discover how past lessons can renew hospital wide quality efforts
• Identify commonly missed “danger signs” that a focus on quality is lost
• Discover how past lessons can renew hospital wide quality efforts
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Management Consulting in Healthcare & Katherine Reller Consulting
Today’s workToday’s work
• Conduct a reflective assessment of your own organization
• Review the ‘real life’ case study
• Discuss lessons to apply to your own organizations
• Identify real strategies and tools to take home to apply
• Conduct a reflective assessment of your own organization
• Review the ‘real life’ case study
• Discuss lessons to apply to your own organizations
• Identify real strategies and tools to take home to apply
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Management Consulting in Healthcare & Katherine Reller Consulting
Your expectations of the morning?Your expectations of the morning?
What are 1-2 major questions you would like answered, as a part of
today's workshop?
What are 1-2 major questions you would like answered, as a part of
today's workshop?
Management Consulting in Healthcare & Katherine Reller Consulting
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Healthcare 25 Years AgoHealthcare 25 Years Ago
Continuous reimbursement
dance
Recruitment issues
High cost
High regulatory&
patient expectations
Transparency & disclosure expectations
High public scrutiny
High Leadership
turnover
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Management Consulting in Healthcare & Katherine Reller Consulting
Healthcare TodayHealthcare Today
Continuous reimbursement
dance
Recruitment issues
High cost
High regulatory&
patient expectations
Transparency & disclosure expectations
High public scrutiny
High Leadership
turnover
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Management Consulting in Healthcare & Katherine Reller Consulting
The “Hidden Costs”? The “Hidden Costs”?
• What can be the result, if organizations don’t focus on internal quality?
• What are some signs and symptoms that you may be getting off track?
• What can be the result, if organizations don’t focus on internal quality?
• What are some signs and symptoms that you may be getting off track?
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Management Consulting in Healthcare & Katherine Reller Consulting
The “Hidden Costs”? The “Hidden Costs”?
• What are some things that can distract organizations?
• If you are off track how do you recognize it, gather support, and get going in the right direction?
• What are some things that can distract organizations?
• If you are off track how do you recognize it, gather support, and get going in the right direction?
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Management Consulting in Healthcare & Katherine Reller Consulting
The Self AssessmentThe Self Assessment
EXERCISE ONE
DO YOU???
EXERCISE ONE
DO YOU???
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The Case StudyThe Case Study
Caring Medical CenterCaring Medical Center
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Management Consulting in Healthcare & Katherine Reller Consulting
The Case StudyThe Case Study
• Caring Medical Center (C.M.C.)– 501(c)3, 150 bed hospital– Located in a Midwestern city /population 125,000
(500,000 county) serving 3 counties– Today, part of a four hospital system – 1200 employees– Several major hospital competitors in a 3 county area
• Caring Medical Center (C.M.C.)– 501(c)3, 150 bed hospital– Located in a Midwestern city /population 125,000
(500,000 county) serving 3 counties– Today, part of a four hospital system – 1200 employees– Several major hospital competitors in a 3 county area
Management Consulting in Healthcare & Katherine Reller Consulting
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A Bit’o HistoryA Bit’o History
What was happening in healthcare in 1995?
• Approaches to quality?• Approaches to cost• Approaches to staff empowerment?
What was happening in healthcare in 1995?
• Approaches to quality?• Approaches to cost• Approaches to staff empowerment?
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What Happened Next?What Happened Next?
• Front line employees were trained in multiple improvement techniques selected by the training department– Leaders sent to seminars– Team members received in-house training
• Employee led teams select quality projects generated via idea box – teams meeting weekly
• Some projects selected by management • Employees encouraged to solve problems• Many projects with many employees underway
• Front line employees were trained in multiple improvement techniques selected by the training department– Leaders sent to seminars– Team members received in-house training
• Employee led teams select quality projects generated via idea box – teams meeting weekly
• Some projects selected by management • Employees encouraged to solve problems• Many projects with many employees underway
Management Consulting in Healthcare & Katherine Reller Consulting
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1 Year Later Quality Improvement “Lite”1 Year Later Quality Improvement “Lite”Less work – Less filling• Fewer employees working on fewer projects • No oversight, each department goes it’s own
way• New silos established (some continue strong)• Fewer improvement ideas generated – no
tracking• Quality newsletter established (plus, slogans,
posters, etc.)
Less work – Less filling• Fewer employees working on fewer projects • No oversight, each department goes it’s own
way• New silos established (some continue strong)• Fewer improvement ideas generated – no
tracking• Quality newsletter established (plus, slogans,
posters, etc.)
Management Consulting in Healthcare & Katherine Reller Consulting
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Results – 2 years laterResults – 2 years later
Groups took on a series of small to medium issues• Little evidence of measurable results• Support dried up and projects stopped being
chartered• Sponsors focused on financial issues• Quality newsletter still published
Groups took on a series of small to medium issues• Little evidence of measurable results• Support dried up and projects stopped being
chartered• Sponsors focused on financial issues• Quality newsletter still published
Management Consulting in Healthcare & Katherine Reller Consulting
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A New Perspective….A New Perspective….
• A new CEO came in and brought with him a new perspective on organizational systems and customer service
• Many service departments faced cutbacks • Clinical areas were immune to review• A new wave of change was in the air• The season of “reengineering & redesign
began”
• A new CEO came in and brought with him a new perspective on organizational systems and customer service
• Many service departments faced cutbacks • Clinical areas were immune to review• A new wave of change was in the air• The season of “reengineering & redesign
began”
Management Consulting in Healthcare & Katherine Reller Consulting
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Re-engineer the System! Re-engineer the System!
The new CEO brought with him consultants to “re-engineer” organizational systems
The new CEO brought with him consultants to “re-engineer” organizational systems
Management Consulting in Healthcare & Katherine Reller Consulting
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Two Years Later…..Two Years Later…..
No evidence of re-engineering could be found No evidence of re-engineering could be found
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Attack Customer Service!Attack Customer Service!• A new VP Ops. The introduction of a
packaged program successful at “my previous hospital”
• Everyone trained… and trained• Customers and families were surveyed • Rewards were distributed depending on
manager’s level of buy in
• A new VP Ops. The introduction of a packaged program successful at “my previous hospital”
• Everyone trained… and trained• Customers and families were surveyed • Rewards were distributed depending on
manager’s level of buy in
Management Consulting in Healthcare & Katherine Reller Consulting
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Then what happened?Then what happened?
• Area hospital competition increased and revenue stagnated. Several area hospitals added new clinical service programs
• CMC implemented a hiring freeze, stopped all travel to seminars and meetings and started planning a new medical office building
• Area hospital competition increased and revenue stagnated. Several area hospitals added new clinical service programs
• CMC implemented a hiring freeze, stopped all travel to seminars and meetings and started planning a new medical office building
Management Consulting in Healthcare & Katherine Reller Consulting
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Then ….Then ….
A nearby larger facility brought CMC into their system of 3 hospitals
A nearby larger facility brought CMC into their system of 3 hospitals
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Management Consulting in Healthcare & Katherine Reller Consulting
Progress…Progress…
• A new wing was added to the hospital with new OR’s as a major part of the construction project
• CMC builds ambulatory surgical center on the edge of town
• A new wing was added to the hospital with new OR’s as a major part of the construction project
• CMC builds ambulatory surgical center on the edge of town
Management Consulting in Healthcare & Katherine Reller Consulting
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Devastating News…Devastating News…• CMC receives its worst JCAHO review ever.
– A very public discussion of the level of hospital quality takes place in the area’s largest newspaper
• A significant group of surgeons leaves CMC to open own ambulatory surgery center
• The board of directors holds a retreat to discuss their role in quality improvement – brings in Don Berwick
• CMC receives its worst JCAHO review ever.– A very public discussion of the level of hospital quality
takes place in the area’s largest newspaper
• A significant group of surgeons leaves CMC to open own ambulatory surgery center
• The board of directors holds a retreat to discuss their role in quality improvement – brings in Don Berwick
Management Consulting in Healthcare & Katherine Reller Consulting
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Devastating News…Devastating News…
• NOW, what do you think happens?• NOW, what do you think happens?
Management Consulting in Healthcare & Katherine Reller Consulting
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Who’s at Fault?Who’s at Fault?
• The board of directors asks for and receives resignations of:
»CEO»COO»CFO»VP Nursing
• The board of directors asks for and receives resignations of:
»CEO»COO»CFO»VP Nursing
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And then there were none… And then there were none…
Management Consulting in Healthcare & Katherine Reller Consulting
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Massive Layoffs in the CommunityMassive Layoffs in the Community
• The area’s largest employer lays off 1,000 people for an unknown period of time
– Service volumes increase for a short period, then decline by 10%
• The area’s largest employer lays off 1,000 people for an unknown period of time
– Service volumes increase for a short period, then decline by 10%
Management Consulting in Healthcare & Katherine Reller Consulting
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TransitionTransition
• CMC looking for new leadership
• High unemployment in community
• High public scrutiny from poor JCAHO review
What should CMC do now?
• CMC looking for new leadership
• High unemployment in community
• High public scrutiny from poor JCAHO review
What should CMC do now?
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Management Consulting in Healthcare & Katherine Reller Consulting
Lessons LearnedLessons Learned
EXERCISE #2
Where did CMC go wrong?
• What were the danger signals?
EXERCISE #2
Where did CMC go wrong?
• What were the danger signals?
Management Consulting in Healthcare & Katherine Reller Consulting
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Current StateCurrent State
EXERCISE #3
• CMC next steps?
EXERCISE #3
• CMC next steps?
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Management Consulting in Healthcare & Katherine Reller Consulting
Your OrganizationYour Organization
EXERCISE #4
• Charting your hospital’s condition
EXERCISE #4
• Charting your hospital’s condition
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Management Consulting in Healthcare & Katherine Reller Consulting
Through the Looking Glass- Reviewing, Renewing
ASQ World Congress
Through the Looking Glass- Reviewing, Renewing
ASQ World Congress
Kenneth G. Bast
Management Consulting in Healthcare
1505 Rushmore Drive
Burnsville, MN 55306
www.MgtConsultinginHealthcare.com
Cell: (612) 817-3548
Kenneth G. Bast
Management Consulting in Healthcare
1505 Rushmore Drive
Burnsville, MN 55306
www.MgtConsultinginHealthcare.com
Cell: (612) 817-3548
M. Katherine Reller RN MS, CPHQ
Reller Consulting
3936 HWY 52 North Suite 285
Rochester MN 55901
Office: 507-206-3023
Cell: 507-261-4873
M. Katherine Reller RN MS, CPHQ
Reller Consulting
3936 HWY 52 North Suite 285
Rochester MN 55901
Office: 507-206-3023
Cell: 507-261-4873
34Management Consulting in Healthcare & Katherine Reller Consulting