In a few minutes I'll be starting my coverage of @VM_institute CEO Gary Kaplan's #Quality2021 talk about a comprehensive management system built on "people principles".

Here's a bit of background:
A bit more about Gary.

He has held the role of CEO, Virginia Mason Franciscan Health and SVP, CommonSpirit Health since 2021 and was CEO and Chairman, Virginia Mason Health System from 2000-2020. He is also a practicing internal medicine physician.

#Quality2021
We're hitting the ground running here.

Project-based approaches to safety and quality are rarely sustainable

System science offers huge opportunities for improving health and wellbeing.

#Quality2021
Gary's expanding on his organisational story here.

Central is the desire to improve people's health.

The challenge at board level came from realising systems were designed around doctors instead of patients.

#Quality2021
Virginia Mason were "in the market" for a comprehensive management system.

This was informed by their granular definition of #quality.

Note A for Appropriateness! (Phew!)

#Quality2021
Gary's learning took his team to other sectors, notably manufacturing.

Looking at Toyota's production line, where quality was embedded in the front line. QA is online, rather than retrospective.

For example, from this came their patient safety alert system.

#Quality2021
Another key learning was being transparent when things go wrong, including when a patient dies.

We have an obligation to learn from failure.

#Quality2021
So far, so mechanistic, you might think.

No. None of this would work without co-production, with staff and patients. Processes, communication tools, priorities are produced together.

This represents a shift in mindset for the whole organization.

#Quality2021
Can you answer YES to Gary's three questions testing how well we respect people?

Mandatory training, at all levels of the organization!

#Quality2021
If we do not embrace the human aspects of change, we will not succeed:

- Create a sense of urgency
- Visible leadership
- Shared vision
- Aligned expectations.

#Quality2021

Now onto the improvement methods
I think we're seeing the biggest challenge now: managing across functions.

Patients don't care what "department" they're going to.

Unlike manufacturing, in health care we have less defined systems and unpredictable inputs.

What else is holding us back?

#Quality2021
So, really, we're looking at whole system redesign.

Perhaps counterintuitively, this is collaborative rather than hierarchical.

See how the VM nurses redesigned care processes to use "cells" - shortest distance to walk, line of sight etc.

#Quality2021
Similar examples from redesigning bedside handoff, daily rounds, outpatients services. All co-produced by staff and patients.

Outcome data captured the improvements from the changes made. Here, reduced time spent walking between patients.

#Quality2021
This approach has put Virginia Mason at the top of regional health system performance.

Gary Kaplan's approach is sustainable:
- Based on systems thinking
- Facilitate problem framing
- Be visible

#Quality2021
On to questions now.

1) How do you make all this sustainable?

Gary observes that managerial turnover can be a problem. So engage the executive board. New managers will then know we're serious. Also, train them! I'm struck by the level of investment here at VM.

#Quality2021
2) How do you deal with, er, less enthusiastic managers

"Not everybody needs to be a champion, but nobody can opt out."

Also see 1) above - transparency at the outset about expectations.

#Quality2021
3) How do we sustain people's enthusiasm through failure?

"Failure is part of innovation."

It's what happens after failure that matters.

"Fail forward fast" is the mantra, as part of a learning organisation.

#Quality2021
4) How do you halt the flow in an acute setting where patients are deteriorating?

We standardise those things that add no value by variation. This yields more time for individual needs of the patient.

#Quality2021
5) How do you break down the silos?

Gary emphasises the importance of cross-functional management.

It seems that patients are an ally here - most of this stuff baffles us already.

#Quality2021
Many thanks to Gary Kaplan for providing so many practical examples of real-world benefits from strategic alignment around patient flow.

I think it's time to sally forth and smash some silos.

Hope you enjoyed this #Quality2021 session.

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Douglas Badenoch

Douglas Badenoch Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @DBadenoch

10 Jun
Leadership in crisis: reflections from leading Scotland's pandemic response - #Quality2021 with @jasonleitch .

Scotland's National Clinical Director has established a reputation for public health messaging during these worse of times.

Stream here: livestream.com/ifqsh/europe20…
On taking time out of co-ordinating a pandemic response:

"It feels different, but equally important to have this @QualityForum at this time."

#Quality2021
"If you're younger than 102, you've never known anything like it"

@jasonleitch #Quality2021
Read 14 tweets
10 Jun
Join me 1000 BST for a #Quality2021 workshop on Reliability and Resilience - moving from Safety I to Safety II. The discussion will be around improvement methodology, with @JBraithwaitee1, Axel Rose and @IanLeistikow.
A little background about our facilitators.

@JBraithwaitee1 is Founding Director of the Australian Institute for Health Improvement.

On his YouTube channel, he has a handy 3-minute video about #Safety-II. #Quality2021
Axel Ros is Chief Medical Officer, Region Jönköping County, Sweden, and a specialist in General Surgery. He sits on the Swedish national patient safety committee. #Quality2021

internationalforum.bmj.com/europe/2021/03…
Read 22 tweets
9 Jun
Starting soon at #Quality2021

@QualityForum presents a conversation with @MaryDixonWoods:

How can we improve #improvement in health and health care?

After all, improvement begins at home.

internationalforum.bmj.com/europe/2021/04… Image
Some significant challenges raised by @MaryDixonWoods

Not least amongst this is the reliance on unvalidated measures.

#Quality2021 Image
This is a substantial task.

Measures need to be co-produced and good enough for evidence-building.

@MaryDixonWoods #Quality2021 Image
Read 12 tweets
9 Jun
Next up at #Quality2021

Empathy, automation and #AI in healthcare: making technology person-centered.

Presented by @tlhardie1, @timjhorton, @ktclarke and @BecksFisher

Hot topic, starting in five minutes.
Let's meet the speakers quickly:

Tom Hardie is an Improvement Fellow @HealthFdn

More about his work here:
health.org.uk/about-the-heal…
Tim Horton is an Associate Director of @HealthFdn, specialising in policy and innovation.

health.org.uk/about-the-heal…
Read 17 tweets
9 Jun
Morning all. For the next three days I'm part of the #beyondtheroom effort at #Quality2021.

In 15 minutes it's Leslie Arnott and Mary Waria on a new way forward for partnering with consumers in health care.

Live stream will be here: internationalforum.bmj.com/europe/live/ Image
A bit of background about our speakers. Leslie Arnott is co-founder of The BEAR Program, Lamaze; Australia. Leslie Arnott has over 19 years’ experience as a consumer advisor and advocate in maternity services.

#Quality2021

internationalforum.bmj.com/europe/2021/03…
Mary Waria also co-founded The BEAR program. She is a Torres Strait Islander with over 15 years’ experience working in Indigenous Student Engagement roles at various universities for both Indigenous and non-Indigenous students.

#Quality2021

internationalforum.bmj.com/europe/2021/03…
Read 18 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!

:(