White Papers
At Catalysis we see how much great work is going on to increase value for patients in healthcare organizations across the United States and around the world. The purpose of these white papers is to share these achievements so that other healthcare organizations can learn and take action.
This is our way of sharing our knowledge and learning about healthcare transformation with the world in hopes that together we can change the healthcare industry.
We hope you enjoy reading!
EMH Patient Flow: Improvements remove wastes and delays from patient intake and bed placement processes
Emergency Mental Health Services (EMHS) on the University Campus of UMass Memorial Medical Center daily provides psychiatric evaluations and assessments of level of care for 12 to 15 patients arriving with an acute psychiatric crisis. The complex end-to-end EMHS process experienced significant delays in conducting evaluations of patients and in getting EMH patients admitted to an inpatient facility, and dissatisfaction with EMHS was high among both patients and UMass Memorial staff. Working with the health system’s Center for Innovation and Transformational Change to eliminate non-value-added activities and implement process improvements resulted in a substantial decrease to EMHS intake times as well as faster bed placements. Download now.
Preventing Harm: Bringing the Lean Journey to Your RCA Action Planning
In 2015, the Institute for Healthcare Improvement published a white paper, regularly referenced as “RCA Squared,” emphasizing the need for action planning during the RCA, in addition to analysis. Now in 2024, it remains a question: how successfully has healthcare incorporated effective action planning to the RCA process? Successful RCA requires skilled facilitation to achieve both a rigorous analysis and an effective action plan, sufficient to prevent repeat harm. There is a significant opportunity for harm reduction when healthcare organizations can ensure a functional link between RCA and their overall Lean improvement strategy. This white paper advocates for breaking down the silos between the Patient Safety and Lean improvement teams. Download now.
DCU Field Hospital: Rapid development of facility for COVID-19 patients eases capacity constraints in central Massachusetts
As the COVID-19 pandemic surged in early 2020, UMass Memorial Health — the largest healthcare system in Central Massachusetts — was asked by the state to establish a field hospital in Worcester and relieve the patient-volume strain hitting area healthcare providers. On April 9, 2020 — just 11 days after getting the go-ahead from Governor Charlie Baker to proceed with a field hospital and only eight days after starting the buildout — UMass Memorial opened the DCU Field Hospital, with patient-care capabilities comparable to its established hospitals. The rapid development illustrates what can be achieved when aligned problem solvers (leadership to frontline) armed with the fundamentals of continuous improvement and a well-developed management system collaboratively work together to address and solve problems. Download now.
University ED Redesign: Streamlined process flow for discharged patients breaks emergency department gridlock
In the first half of 2021, the Emergency Department (ED) at the University campus of UMass Memorial Health — a Level 1 trauma center for adults and children and the only major emergency room in central Massachusetts — was in a near-constant state of excessive backlog. Complicated by the COVID pandemic and despite multiple initiatives to improve the functioning of the University ED, demand was overwhelming the existing system. Read about how they redesigned the ED, defining the problem for the organization, engaging everyone involved in solving the problem, and then supporting those teams as they worked to transform the department from where they were to where they wanted to be. Download now.
Discharge Barriers Escalation (Radiology): Easy Access to Information and EHR Messaging Platform Reduce Discharge Delays
Prior to and during the pandemic, increased patient census and acuity levels at UMass Memorial Health decreased bed availability and increased discharge delays and length of stay. Some causes for delays were beyond UMass Memorial control (e.g., insurance-related authorizations), but other contributors could be addressed, such as Radiology services, responsible for 35 avoidable bed delays per month. A multifunction improvement team identified legacy communication processes (phone calls, voice mail, pagers) between clinical teams and Radiology contributed to delays, and Radiology lacked critical patient information (estimated discharge date and treatment team contact information) that could help prioritize and schedule patients. A two-prong solution was developed and executed: discharge date and clinical team information were made readily available in the Epic EHR system, and a process was established by which clinical teams and Radiology rapidly communicate and respond using Secure Chat in Epic. Download now.
Designing the Future of Healthcare: A How-To Guide for Developing New Care Models
The second installment of the three-paper series "Designing the Future of Healthcare" outlines practical steps to organize and execute a new care model development initiative. The framework is accompanied by two health system examples. A complete redesign of stage-4 CHF care at Bellin Health in Wisconsin, and the creation of Medically Home, a hospital at home program at Atrius Health in Massachusetts. The paper walks through strategic alignment, the formation of a development team, and how a 5-phase human-centered design process can be applied to develop a new care model. The design process includes exploratory research, concept development, fail-fast-forward prototyping, the development of a model cell, and spread and scale of the new care model to become the new way care is delivered across the entire health system. Download now.
Perioperative Preference Card Optimization: Improving Operating Room Standardization and Efficiencies at UMass Memorial Health
In early 2020, surgeons, anesthesiologists, and operating room leadership at UMass Memorial Medical Center (UMMMC) — the academic Level I trauma medical center of UMass Memorial Health that is affiliated with UMass Chan Medical School — were dissatisfied by perioperative processes that adversely affected operating room (OR) conditions, such as workloads, teamwork, surgeon standardization, and OR efficiencies. Four projects were created — including Preference Card Optimization — that could collectively impact the four rocks and improve conditions in the ORs of UMass Memorial Medical Center. Download now.
Improving Patient Safety in Public Hospitals in South Africa
The introduction of the organizational excellence (OE) management method in U.S. hospitals is emerging as an effective way to improve quality and lower cost in hospitals and health systems. OE is a system of management that relies on frontline workers to identify and solve problems and track results with patient outcome metrics daily. The management’s job is to assure that the workers have training in problem solving and that the cultural environment exists for workers to speak up about problems. Leaders and managers must also be trained to be able to train their workers. Download now.
Designing the Future of Healthcare
Improving traditional care models using value stream improvement techniques may be the right thing to do in your organization or it may be the wrong thing. You may need an entirely new care model. The future of healthcare depends on developing new care models. Download now
Shifting Behavior and Thinking Model
Southern Illinois Healthcare leaders have learned that establishing agreed-upon behavioral expectations enables teams to perform at the top of their capability. Download now
Evolving Leadership
Combining new leader competencies, standard work, and behaviors with a lean management system at Martin’s Point Health Care. Download now
No More Projects
After years of team-based rapid improvement events, Cleveland Clinic realized that they needed a different approach to process improvement. This white paper tells the story of how Cleveland Clinic engaged 52,000 caregivers in a culture of continuous improvement on the quest to deliver safer, more efficient, and more compassionate care. Download Now
Where’s the Strategy in Strategy Deployment?
Many hospitals are overburdened with too many strategic objectives. They struggle to differentiate themselves from their competition, forcing hospitals to try to do everything, for everyone. And in many cases, the pace of organizational learning can be slow and cause competitive hospitals to fall behind. Download Now
Kata in Healthcare
Kata doesn’t replace your current improvement approach. Practicing the Improvement Kata and Coaching Kata develops fundamental scientific thinking skills that make you better at whatever improvement approach you use. Download Now
Lean for Doctors
Physicians are finding new ways to analyze their work, reduce wasted time and effort, and improve productivity while improving the quality of care. Download Now
Building a Lean Hospital
Akron Children’s Hospital applies lean thinking and integrated project delivery to the planning, design, and construction of the $180 million Kay Jewelers Pavilion. Download Now
Systems Approach for Transforming Healthcare Organizations
After examining hundreds of healthcare organizations, we believe there is a framework that healthcare leaders can follow that explains what is required to focus on customer value. Download Now
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