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Winona Health Continuous Systems Improvement. May 2011 Linda Wadewitz, Director of CSI Ann Baker, Director of Imaging. History. 1894 – Non-profit, independent, community-owned hospital founded

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winona health continuous systems improvement

Winona HealthContinuous Systems Improvement

May 2011

Linda Wadewitz, Director of CSI

Ann Baker, Director of Imaging

  • 1894 – Non-profit, independent, community-owned hospital founded
  • 1990s – Winona Health formed as an “umbrella” non-profit organization for the community’s growing healthcare needs, encompassing:
    • Community Memorial Hospital
    • Winona Senior Services
    • Winona Health Physician Clinics
    • Winona Health Foundation
    • Parkview Pharmacy
    • 2008-2009 – Clinic mergers

Our Mission

  • Devoted to improving the health and well-being of our family, friends, and neighbors

Our Vision

  • To be a recognized leader in the revolutionary transformation of community healthcare

Our Values

IntegrityDo no harm

ServiceServe with compassion, dignity, & respect

Loyalty Build relationships that exceed expectations

ExcellenceImprove performance through learning & innovation



  • Enhance the patient/resident experience
  • Improve health/outcomes
  • Reduce/control costs






continues systems improvement csi process aligns with baldrige criteria
Continues Systems Improvement (CSI) Process aligns with Baldrige Criteria
  • Organizational alignment with Baldrige criteria drives success of CSI initiatives (Cat. 2 – Strategic Planning)
  • Focuses on value in the eyes of our patients/residents while building and improving processes (Cat. 3 – Focus on Patients, Other Customers and Markets)
  • Data driven improvement (Cat. 4 – Measurement, Analysis and Knowledge Management and Cat. 7 – Organizational Results)
  • Employees engagement thru Kaizens, 5S, CIP and JDI projects (Cat. 5 – Workforce Focus)
  • The PDCA cycle is embedded in our work systems and key work processes to achieve better performance (Cat. 6 – Process Management)
  • CSI Process is leadership-driven (Category 1 – Leadership)

Culture Change

  • CEO Leadership-Observations-Walk the Talk
  • Leadership Driven; Empowering Staff
    • Reorganized structure
    • Physician Leadership
  • Systems Thinking-Innovations
  • Gemba Time-”No meeting zone”
  • Involve community members, organizations and patients in continuous improvement projects

MCQ Exit Comments

  • Innovations:
  • Commitment to community
  • Focus on the Customer:
    • Start the Kaizen mapping with patient perspective
  • Information Technology
    • Integration of EHR technology into workflows
    • Super user group: breadth and depth of its role
    • Clinical downtime recovery and backfill policy and procedure

Notable Strengths:

CSI Culture of change

Culture of Community/engagement

Living the mission, vision, and values

“Revolutionary transformation of community health care”

Integration of EHR into work processes using CSI framework

Diagnostic technologies


CSI Higher Learning



Train the Trainer

CSI Trained

Established CSI Team


CSI Events

Care Coordination - Visual board containing care coordination details for all admitted patients. Immediate buy-in by staff and providers. Reviewed twice a day.

Decision to Incision - Decreased time to Operating room from ED by 45%

Pathology Labeling - Zero defects per million

Volunteers - Improved retention of volunteers in long term care

Medication Reconciliation – Accurate medication list

Pre-Visit Planning – Improves the value of the

visit for the patient and provider


AODA – Alcohol & Other Drug

Abuse and associated mental disease

Involved community members and organizations:

City and County Law Enforcement

Community Mental Health

In-patient Mental Health MD/nurse

Ambulance Service

Emergency MD/nurse

ICU nurse

Social Worker/Hospital & County


Lessons Learned



Well planned Event Week

Team Leader Training

Improved Sustaining

Better planning during events

Reading Circles

How to apply Lean to healthcare

Leadership developed Pull system

Requests for mapping/standard work

A3 requirements


Pursuit of perfection with CSI process