Workflow Optimization Project. Martin’s Point Health Care Portland Health Center Julie Trimmer, Practice Director January 18, 2007. Share our Journey / Strategy What’s Inside our Toolbox. Objectives. Process Mapping Initiative – 2005 Opportunities Identified:
Martin’s Point Health Care
Portland Health Center
Julie Trimmer, Practice Director
January 18, 2007
What’s Inside our ToolboxObjectives
Communication: How we communicate with our patients. Multiple modes, many bottlenecks and rework loops.
Designing new processes
Electronic Health Record Implementation – 2005/2006
Preload (data/information extracted from paper records and loaded into EHR) - 2005
Scanning and Indexing – 2005
Full implementation – May 2006
New Clinic Planning – 2006/2007Our Transformation Journey…..
Minimum of 4 steps, maximum of 7 steps
Defines boundaries of the process to be mapped
High Level Example: Paper Medical Record Flow
Break down each high level into detailed steps:Mapping Your Process
Patient Info generated on Paper
Medical Record Created, Formatted &/or Maintained
Patient care provided, patient info generated on paper
Request for Release of Records, pt. transfer, or deceased
Is Med Rec w/ pt info?
Pt Info signed?
Label pt information with name, DOB, Med Rec #
File per format/ P&P
Place in numerizor/loose filing bin for med rec to return
Identify the “clogs” or “pain points” that cause the most breakdowns
Return to staff for signature
Scope the project:
How do we get from a “boil the ocean” to a precise target/goal?
From / To format (from x to y by z)
Decrease cycle time from 72 hrs to 48 hrs by 12/31/06
SMART goals (Specific, Measurable, Action Oriented, Realistic, Time-bound) – example
High Level Goal: Eat Healthier Food in 2007
SMART Goal: Eat 5 servings of Fruits and Vegetables each day.
Takes groups of data (brainstorming) and organizes to get consensus on the theme/issue.What Are We Aiming For?
Agree on issue – what prevents us from getting there?
Our Project Results:
Post It Notes- each team member answers – 1 complete sentence per note
Answers are grouped, titled, and voted by team
Example: Excellent Patient Service
What does that mean? (Knowledgeable Reps, Short wait)
How?(Rep accuracy, time on hold, time in waiting area)
Voice of the Customer
Takes the voice of the customer or customer needs and uses that information to produce design or improvements that meets those needs.What Do Our Customers Require?
Project Example measured::
What: reduce rework, adequate training, defined and consistent workflows
How: standard operating procedures, matching roles and responsibilities with skills and knowledge, training forums, reference guides/toolsRequirements / Specifications
Measurement Systems / Data Collection measured:
Primary Metrics (results measures)
Secondary Metrics (process measures)
Tally Sheets (reliability)How Will We Know If We Made a Difference?
Provide an explanation of why/what/how to track
Change Management measured:
Success at change can be directly impacted by effective change management.
How do you take a group or individual from the current state to the future state?
ADKAR: 5 Building blocks for successful change:
Awareness – where change begins, (WIIFM)
Desire – personal choice to support the change
Knowledge – understanding of HOW to change
Ability – achievement of the desired change in performance or behavior
Reinforcement – any action or event that sustains the change
Stakeholder Analysis: Identifies people or group inside and outside the organization who are impacted by the project or can influence it:
Gage level of commitment and develop communication strategy and ideas to relieve the resistance to change.How Do We Manage the People Side of Change?
ADKAR – Project Results (Providers, Clinical Support, Admin support)
Stakeholders - Sample
Action Plan to fill the gap
Process Mapping measured:
Roles and Responsibilities Matrix
Functional Job Analysis:
Training and Education required
Upon what instructions (knowledge, skill, ability, & performance standards)
To accomplish what organizational outcome or result?
For each task: verify task in question is performed, how frequently the task is performed, and how many minutes to complete one instance of the task.
Getting the right work to the right people
Identifies overlap in work performance in identifying opportunities to reassign task responsibilities.
Functional and skill ratings offers guidance as to who should perform tasks given the complexity of task performance.Who Does What?
Sort for overlap/duplicate tasks
Staff/Skill assessment comparison
Julie Trimmer, Practice Director: measured:
791-3841; [email protected]
Black Belt, EHR Implementation
Lauren Rice, Project Manager:
791-6986; [email protected]
Green Belt & Coordinator for Practice Projects
Michelle Wyman, Manager of Organizational Effectiveness:
253-6109; [email protected]
Certified in Change Management
Suellen Shaw, Black Belt: 253-6288; [email protected]
Project Leader: Workflow Optimization Project
Joanne O’Neil Lafferty, Manager Health Professional Development: 253-6316; [email protected]
Learning Collaboratives (Practice Redesign; Clinical Microsystems; Physician Leadership)How and Who to Contact