DailyKaizen

Its been a long time since I woke up on a Saturday morning and had the energy to walk down my hallway and log onto my computer.  The last couple of months have been exhausting and to be honest I have felt removed from the work.  For the last year I have worked hard with our leadership team to define and implement a strategy deployment system.  While this work has been important it has meant I have been removed from the gemba for far too much of my time.  As the cloudy days of rain have come marching into Seattle I have gotten into somewhat of a “work funk” and its stuck with me for the last couple of months until yesterday, when finally, with a little help from a great team I broke out of it. 

For those of you that are not as familiar with healthcare there is currently a crisis happening in this country with Primary care based medicine.  Poorly designed incentives, long work hours, an over emphasis on throughput and a lack of financial reward have resulted in huge shortages of Primary Care physicians.  Many have burned out and students entering Medical School are choosing to become specialists as opposed to generalists.  This has put a huge strain on the the healthcare system with less preventative medicine, more expensive services, etc.  Being a Primary Care based system our leadership a couple of years ago decided that they were going to do something about this challenge.  They defined a set of principles that are patient centered, identified a pilot clinic and empowered a team of clinicians to help us define a new model of care that would be transformational.  Not just transformational for our clinicians, but also transformational for our patients.  This team has answered this charge and have created a new model for care that has resulted in improvement across almost every standard.  Now the challenge of the organization is to take this model of care and deploy it across all 26 of our medical centers.  Lean has provided the means by which the organization can make this happen. 

I have mentioned before in the last couple of posts that I would be transitioning my work at my own request and spending more and more of my time partnering with the leaders of our clinical teams.  Late Friday afternoon I drove out to hear a report out from a RPIW (rapid process improvement workshop) that had taken place all week in this pilot clinic.   The focus of the event was standardizing the process by which clinicians practice virtual medicine.  Allowing patients to get care in a convenient and timely way, clinicians to manage the chronically ill far more effectively and all around leveraging out model of care.  It truly would make a great case study in James Womack’s book Lean Solutions. 

As I sat in the back row and listed to the team of nurses, staff and physicians report out on the results of the five day event I could not help but think I was whitnessing an event with a far greater purpose then improving the systems of Group Health.  I have been to dozens of these type of report-outs in the past and as most of you know they are always exciting.  For me, this one was different.  There was a level of excitement in the room that I think can only be created when a team has figured out that they are onto something.  That something is a new system of providing medicine that connects back to the ideals that made them become caretakers in the first place.  An ideal that was lost somewhere along the way and was again awaken. 

Physicians stepped up and told story after story about how much more effective they are in taking care of their patients   They talked about how they intended to retire and now there was no way they were leaving.  They asked little of the senior leaders in the room, just thanked them for allowing them to have the opportunity to participate and urged them to continue to push this work forward.  The team was vested in the success of far more then the event itself.  They pledged to help spread the word to other parts of the organization and champion the change.  It was the definition of engagement in practice. 

While this might sound cheesy as I listened to the team tell their stories I could feel myself waking up.  My mind started to search for ways that I could join in and help move this system forward.  How I can help make this team successful.  Since walking out of the room I have been filled with energy.  Enough energy to get me up out of bed and in front of the computer on a Saturday morning.