A pioneer in applying lean methodology in healthcare, ThedaCare is redefining the patient experience though a collaborative care system. Results to date show that the inpatient-care model is succeeding in improving safety, efficiency, and effectiveness.
blogs.hbr.org/2013/09/redefining-the-patient-experience-with-collaborative-care/
A lot has been written regarding ThedaCare’s work on redefining patient care from the patient’s perspective. The following article clearly describes just what the inpatient care redesign coined “Collaborative Care” is and isn’t; how lean principles were utilized to create it; and what the results are to date. Continue reading →
Wisconsin is known for cheese, the Green Bay Packers, and beautiful Door County. What you may not know is that it is also home to a leading non-profit healthcare collaboration among providers, insurance companies and leaders in the community, government and business: the Wisconsin Health Information Organization (WHIO). Last week, an article about WHIO was published via the Associated Press and appeared throughout the country. http://www.miamiherald.com/2013/08/28/3586841/wis-takes-collaborative-approach.html
The Center is extremely excited about WHIO’s recent coverage and success. John Toussaint, MD, was the initial force in getting WHIO off the ground; Julie Bartels, our EVP of National Health Information, served as its CEO; and WHIO’s founding story is a highlight of our second book, Potent Medicine.
Steph Van Vreede, Operations Manager at the ThedaCare Center for Healthcare Value, shares Lean lessons from her garden.
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“What is the big deal about looking for waste? I am getting my job done, hitting deadlines, things are going smoothly.” Ever hear this line of reasoning from staff? As long as customers are not complaining, some don’t see a need to take a second look at their processes with an eye to improvement, identifying gaps, and looking for waste. I used to have that “don’t rock the boat” attitude, too, until I saw the benefits—not only for myself, but for the customer. Let’s take a walk around my garden, and I’ll explain. Continue reading →
There has been much debate lately on just how to make healthcare information transparent. I have blogged for years and recently published a detailed article in JAMA co-authored by Don Berwick on the subject. In the article, we describe both how Medicare data should be released and what it should be used for. Continue reading →
The argument that “we do not make cars” just does not hold water anymore. The lean methodology has been shown to work in almost every industry. Food banks? Of course. Food banks have processes to deliver products and services just like car manufacturers or hospitals. Most of the time these services are delivered in an inefficient way. But it doesn’t have to be that way.
Some of the results in the Food Bank for New York City: “At a soup kitchen in Harlem, Toyota’s engineers cut down the wait time for dinner to 18 minutes from as long as 90 minutes. At a food pantry on Staten Island, they reduced the time people had spent filling their bags to 6 minutes from 11 minutes. At a warehouse in Bushwick, Brooklyn, where volunteers were packing boxes of supplies for victims of Hurricane Sandy, a dose of kaizen cut the time it took to pack one box to 11 seconds from 3 minutes.
Toyota has “revolutionized the way we serve our community,” said Margarette Purvis, the chief executive and president of the Food Bank.
Better serving the underpriviledged should be a focus for all of us who have been given a great deal. Toyota leads the way again in showing us how to do just that.
In 2012, 23% of all healthcare dollars in America were spent on diabetic patients.1. In Wisconsin, where we live, the direct cost of diabetes is estimated to be over $4.07 billion per year, with the state bearing an additional $2.04 billion in indirect costs from lost productivity 2. And our numbers are headed in the wrong direction: Wisconsin has a prevalence of diabetes increased 13% from 2008 to 2011, while the incidence of pre-diabetes increased 37%.2 These trends are unfortunately not unique to Wisconsin. When they are considered in combination with our ongoing national epidemic of overweight and obesity in children and adults, it is clearly more important than ever to find cost-effective ways to improve the quality of medical care for diabetes and associated co-morbidities, such as hypertension, ischemic heart disease (IHD) and hyperlipidemia.
Coordinated, multi-level, team-based interventions are known to work for managing diabetes and other chronic illnesses. However, the current fee-for-service (FFS) payment system too often does not reimburse many of the vital components of this type of care delivery. Preventing complications of diabetes through proper management of the disease and its associated comorbidities not only represents the best outcome for individual patients, these strategies have been shown to reduce overall healthcare costs by avoiding costly inpatient and ER visits.
It is critical for the future of our country to begin to achieve breakthroughs on cost and quality of medical care delivery. This week, the federal government reported that there have been some breakthroughs with the Pioneer ACO program. In fact, The Bellin- ThedaCare Pioneer ACO was able to show a 4.6 % reduction in the total cost of care, year over year, for the first year of the pioneer program.
Imagine if every market in America could show similar results. A 40 billion dollar reduction on the 800 billion dollar Medicare spend would quickly remove us from the crisis.
What is the secret sauce in Northeastern Wisconsin? ThedaCare has been on the lean journey for over a decade. This has allowed them to reduce readmissions and streamline care more quickly than other organizations. This cost reduction was possible because quality has been improving at a rapid rate. In February, Consumer Reports had reporting data from the Wisconsin Collaborative for Healthcare Quality which had shown that ThedaCare Physicians was number one in the state on an important set of physician quality performance measures.
Of 20,000 Medicare beneficiaries cared for by The ThedaCare and Bellin ACO, more than 13,000 of them are cared for by ThedaCare Physicians. ThedaCare’s partner, Bellin, cares for the rest. Bellin has also been on a quality journey for many years. Although not necessarily utilizing the lean methodology they have achieved a high level of quality performance.
What is remarkable here is that the ThedaCare Bellin program is also one of the lowest cost of the 32 pioneers to start with. This data has not been publicly released yet. The point being is that no matter how good an organization is, improvement is possible. There is a lot of improvement that must be made in American healthcare and The Bellin-ThedaCare Healthcare Partners give all of us hope that it is going to be possible.
Link to WSJ article http://online.wsj.com/article/SB10001424127887323664204578608252999249808.html?mod=WSJ_WSJ_US_News_5
When safety and healthcare are said in the same sentence, you automatically think of patient safety, right? Patient safety has been a top priority for healthcare professionals and although progress has been made, we still have a ways to go to fill the gap. However, it is acknowledged, measured, tracked and reported publically.
I would like to highlight another facet of safety in healthcare- safety of the healthcare worker. Did you know healthcare is one of the most dangerous industries in the United States? Yes, it’s true; the injury rate (total recordable) 1 of workers in healthcare even exceeds manufacturing and construction, only surpassed by policemen. I am sure you are asking yourself, how can that be? Healthcare workers are highly educated, motivated and dedicated.
Donald Berwick, MD and John Toussaint, MD discuss how removing barriers to the fee-for-service data from the Centers for Medicare & Medicaid Services (CMS) would help increase efficiency in health care delivery, reduce costs and improve the quality of care.
To download the article, click here
