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A Look Inside the Transformation Journey at Saint Agnes Medical Center

Posted on by Tom Hartman

Saint Agnes Medical Center (SAMC), part of Trinity Health, is a 436-bed, state-of-the-art medical center in Fresno, CA. They strive to be “THE trusted health partner in Central California through its unrelenting pursuit of excellence.”

In July of 2016, SAMC began working with Catalysis to transform their culture and improve patient care. Catalysis engaged in on-site Executive Coaching and facilitated training for the development of the lean leadership capabilities of the executive team using strategic alignment and deployment through a Lean Management System. A former transformation leader at SAMC said, “Saint Agnes has accelerated the value it provides to patients and colleagues by aligning the organization, enabling its leadership and workforce through hands-on training and coaching to affect both small (daily improvement) and large-scale (Kaizen/Rapid Improvement Event) changes.”

The transformation at SAMC began with a principle-based approach to leadership that focused on personal behaviors of the executive leadership team. The executive team realized the importance of organizational alignment to True North goals through cascading goals that reached the frontline. SAMC implemented a Management System that created an enabling and empowering environment for teams; as well as providing a process for escalating re-occurring abnormalities.

Now 18 months into the lean transformation. Saint Agnes Medical Center realized some incredible results that have been sustainable in many areas of the organization, including the ED that averages over 87 thousand visits each year. SAMC has reduced the number of patients who left without being seen by 86% while the ED volume has increased by 7%.

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3 Responses to A Look Inside the Transformation Journey at Saint Agnes Medical Center

GScott says: 10/02/2018 at 10:40 am

I love to hear success stories where True North metrics are the foundation! It truly unites an organization and makes the direction clear so everyone can get on board. I would be interested in which metrics were chosen, how specific or broad they are, and the method used to define them. Congratulations and many more successes to you!

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BKidd says: 10/02/2018 at 4:18 pm

Hey GScott, thank you for the kind words for our humble work out here at Saint Agnes, we have worked hard for the improvements we have achieved thus far and appreciate the recognition.

The true north metrics are absolutely critical in laying out any kind of strategy development and path for a change in culture. Luckily, as a Catholic hospital, we have remained very rooted in our core values and mission statement- these translated very well into our true north metrics, in a target condition and target metrics sort of way. Just as Shingo teaches us, the guiding principles shape the sort of culture that we wish to foster and help us refine our systems to help determine the sort of tools and process changes that will get us to where we need to be.

We knew what kind of hospital we wanted to be and what we valued most, so set our targets accordingly to bring us closer to that vision. Our initial metrics were far-reaching and largely designed to give us an understanding of the work that we do, refining and changing those chosen metrics year over year as we improve and grow. Those early metrics were the ones you might expect at the hospital level, patient satisfaction, throughput metrics like patient length-of-stay in the ED as well as inpatient units, quality metrics like readmission reduction, and more generically business centered metrics on growth and cost reduction through med center visits and cost per discharge, respectively. Each value stream then has its own true north metrics that tie into those for the hospital, then each unit that will then tie into its value stream; this ensures that the work being done on each unit will directly link to the hospital’s own goals.
We also made sure to clearly define our metrics, from definitions to who would be compiling and in what method they will be collected for consistency and reproducibility, where necessary. At first, they were very broad, but now we are getting more zeroed in on those metrics that are true “drivers” of the work, allowing some of the more broad metrics to serve as watch metrics in a grand sense.

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Dan Grigg says: 11/07/2018 at 2:14 pm

As a former Saint Agnes leader I am thrilled to see the progress SAMC is making with Lean. Saint Agnes has a long history of focusing on quality and improvement and it’s great to see that continue. Best of luck to you.

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