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Spur Innovation with a Continuous Improvement Focus

January 30, 2017
by Carly Dunham, consultant, Freed Associates
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In health care, “innovation” is often thought of in the context of life-changing tools and technology, such as the late 1970s introduction of magnetic resonance imaging (MRI) or the more recent advent of modern telehealth.

Yet the reality in health care – steeped in tradition and entrenched cultural norms – is that “innovation” often initially comes in smaller bits and bursts before widespread, systemic adoption. Consider how often in health care new ideas or workflows figuratively start as mere embers before they spark and catch fire.

That’s why a growing number of hospitals and health systems in recent years have embraced the principles and practices of continuous improvement (CI) as a transformative way to improve or remove waste and inefficiencies from their systems and processes. CI initiatives generally consist of systematic and continuous actions that measurably improve quality and safety, and enable health care organizations to deliver the best care possible to patients and their families.

By adopting a CI culture, health care organizations commit to improving themselves and sending a distinct “you truly matter” message to their patients/customers and workforce. CI helps reduce operational expenses, as streamlined processes require less time, effort and resources. CI signals to your patients/customers that they are the ultimate judge of the quality of your services – a key consideration in today’s consumer-centric era in health care. It also says you care about having an educated, empowered and motivated workforce, as these are the most important factors to the success of a CI initiative.

Carly Dunham

In this article, you will learn CI best practices, as well as the five most important steps to take when implementing CI efforts:

Target specific areas for improvement – Based on statistical and anecdotal input, you should have no problem identifying multiple opportunities for improvement in your organization.

Determine what processes/procedures can be modified – Up front, identify what potentially can be changed, what cannot, and proceed accordingly.

Ongoing leadership encouragement – Your organization’s leaders should proactively and visibly support CI efforts, to encourage employees to pursue CI.

Implement effective CI strategies – No matter what formal or informal CI model you use, ensure that it measurably improves quality.

Communicate improvements – It’s not enough to simply adopt improvements made possible through CI; tell your employees about it! By doing so, you’ll reward the original source of the CI idea and encourage others to provide their own CI ideas.

While all of the steps listed above are important, Step 1, “Target specific areas for improvement,” and Step 5, “Communicate improvements,” are often overlooked or shortchanged in action. To emphasize the importance of these specific action steps, see the following two client success stories below.

Targeting Productivity for Improvement

Creating a culture that embraces and applies CI begins with an organization’s leadership being very specific about the areas needed for improvement. Ineffective leaders set vague or distant goals that very few ultimately take seriously. Or these leaders set too many goals resulting in the easiest or most enjoyable goals being completed first, and the toughest ones last or not at all.

Leaders will more likely see CI-related benefits consistently happen by targeting specific areas for improvement, presenting specific goals around these areas in a clear and compelling way, and insisting upon employee efforts to achieve them.

Specificity was the mandate of a large multi-specialty clinic – a client of Freed Associates (Freed) – that wished to increase its productivity based on the volume of patients seen each day. Unsure of how or where to begin by objectively assessing themselves, the clinic’s leaders turned to Freed for help.

Freed began by initiating a time/motion study of the clinic’s most productive physician, a dermatologist, to understand his success. Freed discovered that this dermatologist had trained his team to place every clinical item in every exam room in exactly the same place. He took photos of every drawer, counter, and workspace to train his staff on where he wanted everything placed. Then, he used this same system to develop his par supply levels inside the exam and supply rooms. This way, he never wasted a second looking for anything. He could essentially navigate his exam room blindfolded and still get through a visit quickly, without rushing.

Freed used the same time/motion study process with the clinic’s other high-performing providers, without impacting clinical visits, until all of the clinic’s specialties were covered. Through the productivity insights gained, analyzed, and acted upon, Freed was able to help the clinic increase its overall productivity by 20 percent and reduce its supplies inventory, which lowered the clinic’s operating budget. Providers, staff members and even patients all noted the productivity gains and were pleased with the outcomes.

Based on the clinic’s CI-derived productivity gains, it would not be surprising if this clinic tackles other CI-related changes. By paving the way for the clinic’s employees to identify and implement improvements, the clinic’s leaders made it clear that it’s culturally appropriate – and desired – for employees to take the initiative to improve operations. That’s why well-led and properly executed CI enhancements often beget further CI improvements.


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