Lean Principles and Peer-to-Peer Learning Improve Patient Value
Throughout 2014, members of the Healthcare Value Network (HVN) released results of their healthcare improvement efforts. That commitment to transparency now continues into the first quarter of 2015 with the HVN’s latest batch of results on the power of lean principles to drive improvement in care quality and value.
The HVN is part of the ThedaCare Center for Healthcare Value and consists of a peer-to-peer learning community of approximately 60 healthcare organizations across the United States and Canada. “These results show how improvement work impacts health systems and helps patients see the change and waste reduction being done to provide better care on their behalf,” said Director Mike Stoecklein.
Highlighted member results for this quarter include:
EXETER HEALTH RESOURCES (New Hampshire)
Improved Population Health Screening gap results after five months:
- Depression screening and follow-up from 33% to 88%
- Blood pressure screening from 73% to 97% and follow-up plans from 35% to 50%
- BMI screening from 0% to 78% and follow-up plans from 38% to 45%
- Medicare readmissions improved from 14.75% (Jun 2012) to 10.8% (July 2014).
- Percent readmit to acute care in 30 days decreased from 9.4% (June 2012) to 8.0% (July 2014).
Meaningful Use improvements:
- Table of Contents (TOC) Summary from 0% to 75%
- eTOC Summary from 6% to 35%
- Portal Education from 0% to 90%
- Portal Access from 0% to 10%
- Problem List from 7% to 100%
- I-Education from 10% to 95%
- Discharge Document from 0% to 100%
VNA and Hospice improvements:
- Percent of patient scheduling issues/calls decreased from 5% to 0%.
- Number of clinicians per episode decreased from 5.5 to 2.7.
- Employee satisfaction increased from 46.3 to 55.2.
- Manager’s average time scheduling/day decreased from 240 min to 42 min (82% reduction).
- Team coordinator’s average time scheduling/day decreased from 300 min to 180 min (40% reduction).
REGINA QU’APPELLE HEALTH REGION (Saskatchewan, Canada)
- Laboratory turnaround time for stat Emergency Department blood tests decreased from an average of 52 minutes to 41 minutes, while reducing the number of stat tests from 8,000 to 1,000 per week.
- Emergency Department X-ray turnaround time decreased from 67 min to 17 min (75% reduction).
- Reduced wait for Mental Health Clinic clients wanting to see a psychiatrist, from 400 clients (October 2012) to 13 clients (November 2014).
- Reduced the number of cancelled patient appointments at the Mental Health Clinic from 42% (May 2013) to 4.7% (November 2014).
- Designed Hip and Knee Treatment and Research Centre, providing one-stop care for osteoarthritis patients using 3P methodology. Approximately 2,200 patients, resulting in 9,000 visits, will receive all assessment, education, treatment and pre- and post-operative care at the site each year.
WINONA HEALTH (Minnesota)
Lab 3P redesign generated the following improvements:
- Turnaround time decreased from 48 min to 31 min (35% reduction).
- Receipt of specimen to lab bench decreased from 214 min to 66 min (69% reduction).
- Percent of batched specimens decreased from 64% to 10%.
- 1633 sq. ft. freed up and available for other work.
- Saved 4,134 (two miles) steps per day.
- Registration error decreased over eight months from 1,622 errors (2013) to 834 errors (2014) (49% reduction).
- Decision-to-admit in less than 30 minutes from patient walking into ED increased from baseline of 22% to current 76%.
- Reduced dropped/abandoned calls for Specialty Surgical Clinics to 3% from 12% and have sustained for eight months.
- Reduced scheduled C-section patient wait time before surgery by 50%.
- Improved average speed of answer in Patient Call Center from 33 seconds (Family Practice) and 50 seconds (other primary care departments) to an average of 15 seconds.
- The PCC reduced its facility fee $8,008 per month by merging two family medicine clinics and reducing 5,841 sq. feet using 3P space planning methodology.
“We can all learn from each other’s clinical results and stories,” said John Toussaint, MD, CEO of the Center. “HVN members are students as well as teachers, and their peer-to-peer learning encourages lean improvements throughout the healthcare industry.”
Established in 2009, the HVN was founded by the ThedaCare Center for Healthcare Value and the Lean Enterprise Institute. It is now an integral part of the Center and its healthcare mission.
THEDCARE CENTER FOR HEALTHCARE VALUE
The ThedaCare Center for Healthcare Value is an education institute that believes we must have three essential elements for sustainable change in healthcare: Delivery of care designed around the patient; Payment and incentives based upon value and outcomes; and Transparency of performance (quality and cost) throughout the healthcare system. Founded in 2008 and headquartered in Appleton, Wisconsin, we are a small not for profit with a big mission to help change the healthcare industry. Learn more at: createvalue.org.