page 1
page 2
page 3
page 4
page 5
page 6
page 7
page 8
page 9
page 10
page 11
page 12
page 13
page 14
page 15
page 16
page 17
page 18
page 19
page 20
page 21
page 22
page 23
page 24
page 25
page 26
page 27
page 28
page 29
page 30
page 31
page 32
page 33
page 34
page 35
page 36
page 37
page 38
page 39
page 40
page 41
page 42
page 43
page 44
page 45
page 46
page 47
page 48
page 49
page 50
page 51
page 52
page 53
page 54
page 55
page 56
page 57
page 58
page 59
page 60
page 61
page 62
page 63
page 64
page 65
page 66
page 67
page 68
page 69
page 70
page 71
page 72
page 73
page 74
page 75
page 76
page 77
page 78
page 79
page 80
page 81
page 82
page 83
page 84
page 85
page 86
page 87
page 88
page 89
page 90
page 91
page 92
page 93
page 94
page 95
page 96
page 97
page 98
page 99
page 100
page 101
page 102
page 103
page 104
page 105
page 106
page 107
page 108
page 109
page 110
page 111
page 112
page 113
page 114
page 115
page 116
page 117
page 118
page 119
page 120
page 121
page 122
page 123
page 124
page 125
page 126
page 127
page 128
page 129
page 130
page 131
page 132
page 133
page 134
page 135
page 136
page 137
page 138
page 139
page 140
page 141
page 142
page 143
page 144
page 145
page 146
page 147
page 148
page 149
page 150
page 151
page 152
page 153
page 154
page 155
page 156
page 157
page 158
page 159
page 160
page 161
page 162
page 163
page 164
page 165
page 166
page 167
page 168
page 169
page 170

November 07 Businessexcellence 103 SaintJohn’sHealthSystem “It’s been culturally huge for us.” From the start, Saint John’s recognized the importance of having buy-in from those employees. The support for lean also starts at the top, with the hospital’s board quick to back the effort with all the resources necessary. The 1,600 employees at the hospital were also quick to get on board, and enthusiasm for the efforts has grown as early work bore fruit. “We are a faith-based organization, so our associates have always been committed to our mission,” notes De Fur. “They have been a key ingredient in making this work the way it has.” The lean effort has consisted of creating rapid improvement teams that are charged with identifying a process they want to target for improvement. Those teams are then given a full week to work on the task. Teams issue daily reports to management, with feedback given to help keep them on track. At the end of the week, the group presents its fi ndings for recommending changes. “You can see the staff is really excited, because these are their process changes and they know they’re going to create a better environment for the patients. There a lot of pride taken in that and people are telling us they want to be on those teams more and more.” Eighteen months into the journey, Saint John’s has recognized it needs to ensure the infrastructure for continuing the effort is in place. It is about to bring on a full-time staff person to oversee lean, with that person being responsible for ensuring that past rapid improvement efforts are monitored and ideas brought forward are implemented even as new ideas continue to be brought to the forefront. More than 40 rapid improvement events have been held to date. “We still consider ourselves at the front end of it,” De Fur says. “I’ve concluded there is an endless amount of opportunity.” That Saint John’s was able to get buy-in from employees for lean is less surprising considering the hospital also managed to be one of the fi rst small hospitals to get the majority of its physicians to use electronic order processing systems as well. The hospital has long believed technology could help improve patient safety and reduce the chances for mistakes in the busy hospital setting. About seven years ago it began a push to bring its clinical information systems up to the state of the art. The systems now include a computerized physician ordering system and a bedside barcoding system that assists nurses in assuring patients get the medications prescribed for them. The Computerized Physician Order Entry, or CPOE, came about after a full year of preparation that included efforts aimed at ensuring there wasn’t a high level of resistance among doctors. A group of key physicians met every week with the information technology staff to help design a system that would work for doctors. “The result is that the doctors who were involved became our greatest advocates for the system,” De Fur says. By the end of 2007, Saint John’s believes 100 percent of its physicians will be using the automated system, the value of which is enhanced by the bar-coding drug administration system, which helps prevent communication errors. “We are administering thousands of medications every week. It’s very high volume and can be high risk—in a hospital setting you have shifts changing, and patients being moved, so the opportunity for confusion is high.” The success of the new initiatives results from the support of the front-line employees who are committed to the hospital’s mission and also from the highest levels of the organization. “Our board has been a tremendous leader in our initiatives,” says De Fur. “They’ve set high expectations for us and made sure we’ve stayed focused on what’s most important in terms of delivering care that is the highest quality and the safest it can be.” “We still consider ourselves at the front end of lean. I’ve concluded there is an endless amount of opportunity”