The Healthcare Value Leaders Network members gathered in Winnipeg yesterday and today to review the great work going on there
St. Boniface has been at the lean transformation since 2007.The Healthcare Value Leaders Network visited the site on the 22nd and 23rd and found some powerful lean ideas.
I visited St. Boniface 8 months ago and the difference between now and eight months ago is remarkable.First, a few stats. They have taken the time nurses look for equipment from 45min. to 15 seconds by applying 6 S and supply chain work. They are ranked number 2 of all Canada's academic medical centers for hospital efficiency. This is measured by the Canadian Institute for Heath Information and is compared across all hospitals. The inpatient measure is cost/weighted case which takes into a number of factors including nursing wages,geographic wage disparity,hours worked per patient day,case mix, etc. and scores every service in the hospital which then roles into an all hospital score.
The focus of our visit was "sustaining the gains of lean improvement".St. Boniface is attempting to achieve sustainability by experimenting with a process of front line peer to peer coaching which is unique. After each kaizen event a team of front line workers are designated as coaches for the rest of the staff.These coaches are actually coached on how to be effective coaches by their managers and lean facilitators. Standard work has been developed for coaches. The newly minted coaches then work with the other staff on the unit to teach the the new standard work in the department and to get their feedback. The results are better staff satisfaction on the units.The staff have said they would much rather be coached by their peers than their manager on the new standard work. The coaches are full time front line workers who are given this additional front line responsibility to work with their peers.We asked three of the coaches if they felt burdened by this new role and additional work. They said that the work can be accomplished easily during their usual day. For the most part they have good relationships with their peers and usually coaching on the work changes doesn't take much of their time. The other learning is that when the new standard work is actually not working the front line staff will bring that to the attention of their peer coach naturally and freely. That's different than if they had to tell their manager about problems.In this way defects are being identified and corrected much more effectively than ever before. These managers now have a goal of training all of their staff to be coaches for each other.
There are many other good experiments going on at this hospital. I think part of the reason is the commitment of both their CEO and their board. For example we were impressed that most of their board members spent the whole day with us at gemba. They interacted with the staff and patients and found out what was really going on the hospital floors.This level of commitment at the top is bound to help keep St. Boniface on the path of total lean transformation.
Congratulations to the staff,doctors,administration and board of St. Boniface!
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