Transcript Slide 1

TWI: The Link to Lean
In Healthcare
Joan Ching, RN, MSN
Administrative Director
Hospital Quality and Safety
Virginia Mason Medical Center
TWI Webinar
Oct. 13, 2009
Our Strategic Plan
Standards
“Without standards, there can be no
improvement.” -Ohno
Standards provide stability.
Stability provides visibility.
Visibility provides targets for kaizen.
(purrier)
Copyright 2008 Virginia Mason
© 2009, Virginia
Mason Medical
Center
Medical
Center
All Rights
Standard Work
A prescribed, repeatable sequence of
operations assigned to a single team
member.
Benefits:
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•
Insures that work and expectations are safe and
reasonable
Allows you to see abnormal conditions as soon as
they occur
Serves as a basis for future improvement efforts
Makes it easier to train staff
Ensures that we are creating value for every
customer, every time
Copyright 2008 Virginia Mason
Medical Center All Rights
Select Right Topic
• Tied to Organizational Goals
• An Important Problem to Solve
• High Visibility
Hand Hygiene and Patient Falls
When to Train
SEPTEMBER
12:00 AM
SEPTEMBER
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Martha
Purrier
Martha
Purrier
Janine
W.
Janine
W.
Charlene
Tachibana
Martha P.
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Debbie Kelly
Martha
Purrier
Janine
W.
10:00 AM
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Charlene
Tachibana
2:00 PM
Fe
Schanz
3:00 PM
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Janine
W.
Arni
Verkler
Alenka
Rudolph
4:00 PM
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Fe
Schanz
2:00 PM
Alenka
Rudolph
Arni
Verkler
5:00 PM
Joanie
Ching
6:00 PM
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Joanie Ching
Arni
Verkler
Date: Summer 2009
Level 9
Level 14
Level 8
Level 7
Level 17
Level 16
Level 15
Level 10
Turnover
Work Performance
X
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Sept 20th - 26th
Sept 13th - 19th
Sept 6th -12th
Aug 30th - Sept 5th
Aug 23rd - 29th
Department(s): 17,16,15,14,10,9,8,7
Aug 16th - 22nd
Job Name: 3. Hourly Rounding
Aug 9th - 15th
1. Hand Hygiene - Soap and Water
2. Han Hygiene - Gel
Aug 2nd - 8th
July 26th - Aug 1st
Time Table: Units
X
X
X
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X
Changes
in
Schedule
Time Table: Staff
Miranda Livermore
60
Karen Gormley
60
Christine Holbrook
60
Mariano Lara
60
Valentina Calabia
60
Mina Wirth
60
Sharon Veith
60
Derrek Dunn
60
Ana Hernandez
60
Debbie Lafave
60
Susan Lamar
60
Theresa Lehan-Anderson
60
Kristyn Albornoz
60
Mandi Cantera
60
Kevin Garcia
60
Lisa Oehl
60
Karen Symens
60
Diem Tran
60
Emily Cate
60
Debra Cavinta
60
Cindy Allen
60
Lori Anderson
60
Christopher Klein
60
Miaoduan Lu
60
Lori Marlenee
60
Claire Otebele
60
Elizabeth Field
60
John Berquist
60
Linda Hardin
60
Klayton Johanson
60
Jenna Stephens
60
Unit Training Minutes Left:
1860
F/U #5
F/U #4
F/U #3
F/U #2
F/U #1
Training
F/U #5
Hourly Rounding
F/U #4
F/U #3
F/U #2
F/U #1
Training
Hand Hygiene Gel
F/U #5
F/U #4
F/U #3
F/U #2
F/U #1
Hand Hygiene Soap/Water
Training
Name
Breakdown #
Name: Barnes
Group: RN
Dept: Neuro/Neph/Uro
Date: June/July 2009
Training Minutes Left
Job Instruction Training Timetable - Healthcare
Engage the Leadership
• Certified Leaders’ Collaborative- Certified
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Leaders in VMPS
Monthly Managers’ Meeting- all VM
Managers and Leadership for the
organization
Quarterly KPO Update- whole organization
KPO “Stand Up” Meetings
Grand Rounds- Physician Cont. Ed.
Engage Unit Leaders
• Unit Leaders trained early or first
• Unit trainers utilized as well as external
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trainers
Leaders taught how to conduct follow up
Packets on units to track progress
Frequent updates included progress (#s)
as well as stories
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3rd Quarter Focus: Safety/Quality Defect
Falls
Falls University, Falls Collaborative
Multiple PDSAs
Pharmacist responds to
Falling Star alerts. Reviews
medications post alert
Falls University
(weekly huddle)
started
Kaizen event:
Nursing/PT
Integration
Kaizen Events:
Toileting
Falls related to meds
Falls Collaborative
team formed
(multidisciplinary
team)
Purposeful hourly
rounding training
completed. (Sept. 30)
Results
“For a long time now, I’ve taught my staff that the
majority of patient falls occur during the toileting
process. Knowing, however, wasn’t enough to hardwire
actions to prevent patient falls. TWI provides the
hardwiring and rigor … toileting is planned for & built into
my staff’s work flow. It’s really made a difference on
Level 8.”
Rowena Ponischil, Director, Levels 7/8
With the implementation of hourly rounding using TWI
methodology, a unit that consistently averaged 1-2
falls/week has gone 45 days without a fall. It’s too soon
too tell but appears promising.
Results
• “Recently I entered a patient's room on
Level 10. From her bed, this patient
watched me wash my hands. The patient
remarked, "That is so interesting!
EVERYBODY coming in here washes their
hands the exact same way! I've never
seen anything like it!"
Ellen Noel, Med-Surg CNS