Over the past week, you may have seen articles about our current financial performance (Note: subscription may be required for some of this content: Worcester Telegram & Gazette, Boston Business Journal ). As the articles suggest, the patient (us) has been stabilized, but it is not out of the woods yet.
Yes, things are getting better financially, but more importantly, we are seeing improvements on our primary inpatient quality measures (patient boarder hours) and our primary outpatient quality metric (AQC score). Thanks to everyone who has helped improve our performance in these areas;I know it has not been easy.
Standardization of our clinical and business processes has helped us get back on track and will continue to be a major priority for us moving forward. During the Institute for Healthcare Improvement (IHI) “100,000 Lives” campaign, we were successful in saving more than 100,000 patients by standardizing care across most US hospitals for the prevention of ventilator-acquired pneumonia, central line placement and surgical site infections.
Standardization is not the loss of autonomy for our caregivers; it is the adoption of excellence.
We are working to standardize our care processes and our businesses processes throughout the organization, including they way we staff to meet the needs of our patients. For example, we are in the process of working with some of our Worcester-based nurses to come up with a way to standardize the length of shifts on units and minimize very short “bridge” shifts.
Many thanks to those that have sent me and Medical Center President Patrick Muldoon constructive notes and thoughtful ideas about how this could be done. Let me reassure you that no decision has been made about this and that we understand how disruptive changing shift length can be for our caregivers. We will definitely take this into account as we make a decision.
Below is my favorite quote about standardization from management consultant Masaaki Imai, I think it best summarizes what we are trying to accomplish with standardization.
“It is impossible to improve any process until it is standardized. If the process is shifting from here to there, then any improvement will just be one more variation that is occasionally used and mostly ignored. One must standardize the process before improvements can be made.”
Standardization is not easy, as it typically requires that some group of people change the way the way they do things or treat patients differently as they conform to the new standard. The key is to develop the standard with the people being asked to follow it. It’s all about getting people to go from doing it “my way” as individuals to doing it “our way” as a team. Below is a figure that illustrates how Intermountain Healthcare goes about standardizing and continuously improving care.
Thanks for your help in standardizing the way we deliver care and for taking great care of our patients and one another,