In an earlier post I mentioned that M.D. Anderson, and particularly my Division (Clinical Support Services) is totally focused on meeting customer expectations and improving our financial position through performance improvement efforts. These are formally recognized or "chartered" projects that seek to improve the efficiency and effectiveness of work processes and thereby improve quality, customer satisfaction, outcomes and the bottom line.
It is a Division requirement that every Department have at least two formally chartered PI projects. My Department (Rehabilitation Services) actually has 5 or 6 (what I can say, we are over achievers!)! Another requirement is that the Director lead 1 PI project and I have to choose mine and have my charter ready to submit in just about a month. Well, the choice was easy to make.............
While I have an AMAZING staff with "mad skills" who work incredibly hard......guess what? Productivity is an issue.....(heard that before?!).
The Department of Rehabilitation Services has undergone a very fast, very large expansion of services and so in addition to a considerable number of long-term veterans there are a lot of new staff. There are barriers to efficiency including work processes that have not been standardized and problems with methods and materials.....). Like many other rehabilitation departments, we have a situation where sometimes we have waiting lists and are not meeting all of our customer expectations and yet some of our staff are not consistently meeting their expectations for billable service. Because our Department is expected to continue to grow in response to expansion of medical services the next year is going to be tricky.............needing to consider adding staff AND improving productivity at the same time; but how to do that will be the trick!
So, when it came time to choose the PI project that I will lead it was a no brainer........improving productivity will do it all; improve employee satisfaction and decrease their frustration, improve patient, physician and other customer satisfaction, improve quality and outcomes, and improve the bottom line which feeds back into all the other metrics I just mentioned!
I am beginning to organize my thoughts to be ready to introduce the skeleton of a plan at our next all staff meeting on Valentine's day..............
I am sure the plan will examine at all the usual suspects (documentation, scheduling, access to equipment and materials, responding creatively to cancellations and patients being unavailable etc). The really cool thing is that the environment and culture at M.D. Anderson really supports approaching performance improvement in the true sense as a management philosophy and a set of tools and techniques. I think I am going to get the chance to apply all of the approaches that I have taught and written about for the last decade.
Over a decade ago I taught "CQI Leadership" at UIC and learned a lot about quality improvement. I have always said that is was the single most important knowledge and skill set I have ever been exposed to. Let's hope it serves me well as I start on this new endeavor. I am sure that I will have lots more to share.....as I am viewing this as a long term (1-2 year) project!
I would love to hear from those of you who have addressed some of the issues I will face and have been successful in making improvements!
Just leaving an encouraging note. I am sure this endeavor will be successful for you as I witnessed your ability to organize 1st hand on the RA. In all the years I had been on the RA, your years as the Speaker demanded the most flexibility, creativity and fast-thinking! You have an ability to facilitate and execute plans that are effective for large groups of people. I am sure you don't need a pep talk, but I just felt the need to let you know what others see in you.
Thanks Julie! I am flattered and encouragement is always welcomed!
Brent
So great to see you post this! We are excited to see how this project will "improve performance" and most importantly help us to deliver the best patient care!
Jennifer
We did a SWOT analysis (strengths/weaknesses/opportunities/threats) as a group a year or 2 ago to form the equivalent of your PI groups. One of these has been focused on "barriers to efficiency" and trying to overcome that. But in any acute care, and I would think especially with a medically complex population prone to fatigue, there are a lot of hoops to jump through as a therapist before you can treat. I feel that in this environment I need to be especially certain that I can treat safely and not cause a pt. harm. We often end up holding evals until a test or consult is done, there's also no accounting for a pt. being off the floor and unable to be seen. There will be up days and down days from a billable perspective. I certainly don't have the answer, but I will be interested to see what you and your staff come up with. we also talk about this topic on the Acute Care OT board if you want to pop over.
Cheryl,
Acute care certainly has its challenges. This is the third environment where I have supervised staff who see medically acute and fragile patients.
Productivity expectations may vary from setting to setting but I think (I hope) that one key is successful benchmarking. Many acute settings are similar. Likewise, while my staff are TOTALLY special :) there are other cancer hospitals who treat both acute and rehabilitation patients, and who see peds and adults and who see both inpatients and outpatients.
I am hoping that by effective benchmarking and collaboration with managers at like facilities I can set reasonable and appropriate expectations and meet them by standardizing work processes and eliminating unnecessary work and rework.
I am 100% positive that the majority of barriers to efficiency are related to systems and environments. However I am equally certain that some of the barriers are related to unnecessary variance in employee practice. Some work processes will have to be standardized more to eliminate the need for decision making and assuring standard outcomes.....that part is going to be tricky!
I will check out the discussion on the acute care board....we can always learn from others and I don't want to reinvent the standard process!