Thread by @MarkGraban

I'll be tweeting highlights from this #HCSummit22 session: Executive Led Transformation Toward ZERO Harm. 🧵

"How do we define the role of the executive in culture transformation toward zero harm?"

"How do we increase team engagement in safety during a time of high stress and burnout?"

"We all had different approaches to quality and safety" and different education / influences regarding #Lean. "Had seven different experts in Lean before we merged into one health system... everyone thought their way was right [in their fiefdom]."

Their #Lean model... elements that build upon others in the pyramid.

Shoutout to the help that @ValueCaptureLLC provided to develop their #Lean management system😊

Another representation of their #Lean management system

"Not just #patientsafety, but also team member #safety" is their focus.

'Real-Time Problem Solving' -- have we contained the problem so nobody else has it? Have we ID-ed the root cause? How do we check that we've succeeded? How do we share what we've done?" -- How to train 20k employees and how does the CEO create urgency and priority?

How is she (the CEO) going to be the voice about why #Lean is so important? How to not just understand it but to also lead by example?

"You can ask any employee how their job impacts #patientsafety." -- regardless of their role or level

Sensei challenged them to complete all tiered huddles within the first 2 hours of the day, so they could spend the rest of the day solving problems.

It was important to create ONE system... "the Wellspan system" for the entire health system. A challenge when different sites thought their system was the best. Having a standardized system is a better system.

Better management system, better problem solvers (trained all 20k team members to ID risks and solve to root cause) -- shifting from REACTIVE to PROACTIVE. Not just reacting to falls, but thinking about how to PREVENT patient falls. "Proactive risk assessment."

Better processes = "eliminate friction points across the health system" -- what's frustrating them?

All leads to better results. Aspirational goal to move toward #ZeroHarm with annual progress goals in that direction. Nobody has ever done it. We hope to do it.

CEO couldn't delegate the communication to leaders and front-line staff about the importance of the #Lean Management System and the importance of meeting objectives in results. Better process leading to better results.

Daily tiered huddle process is five tiers, going from front line up to the CEO leading a huddle with the senior strategy team

There are 9 criteria for what the CEO would escalate to the Board, speaking of "standard process."

Their "help chain" is focused on solving at the closest point to where the work is done, but with the ability to escalate problems when necessary.

In my experience, you can't escalate everything. You need specific criteria and feedback loops on that.

Solving problems to root has to happen ASAP -- within 24 hours. Can't wait weeks to start the problem solving A3.

Had to create a culture where it was safe to speak up.

Changed name from "Safety Reporting" to "Safety Awareness & Improvement System." Rebranding to "Safety 1st."

Patient safety AND staff safety -- it's AND. We can't emphasize that enough.

3 parts of their daily engagement huddles

1) address problems from yesterday
2) plan to win today
3) define today's improvements for better results tomorrow

Psychological Safety "plays a significant role" when asking team members to point out problems, risks, harms and to escalate them. What PS is and isn't... shout out given to @AmyCEdmondson

"Coaching is the secret sauce to everything #Lean."

Coaching tips include: Teach by asking instead of telling

The session will now go into a role play demonstration and Q&A -- End of thread. Great insights shared by @WellSpan Health!