Teamwork In Healthcare – Keys to Continuous Improvement

Posted on Posted in Lean Health Care, Lean Management

Teamwork is the New Normal

There are many models of excellent health care service and they have a few elements in common – teamwork and collaboration. You can quickly assess the quality of teamwork in A Guide to Teamwork in Health Careyour organization. My most recent book can help you improve it, directly and efficiently.

A recent book on the Mayo Clinic described their culture this way: “

Mayo Clinic is a collaborative organization, a pliable institution that assembles the expert care teams for individual patients. Imagine a huge store that sells everything, with experts in every department who work together to help customers. This is how Mayo Clinic is designed for medical customers. Patients don’t get just a doctor; they get, in effect, the ‘whole company.’ Some patients see more than one Clinic physician. Typically, the first doctor to treat a patient is responsible for coordinating the care plan with other Mayo clinicians and the patient’s hometown physician.” (Berry, Leanard L., Seltman, Kent D. Management Lessons from May Clinic. McGraw Hill, New York, 2008, p.49.)

But the Mayo Clinic is not alone in this regard. As lean management becomes more prominent in healthcare the emphasis on teamwork and continuous improvement will become the new normal. ThedaCare, a four hospital healthcare system in Wisconsin has become a model for lean management implementation in healthcare. Here is how they describe their new normal process:

“Instead of responding to hierarchy and heroically firefighting in an environment of shame and blame, Collaborative Care teams now meet in daily huddles to review any issue with patients or work flows. When problems arise such as a medication error or a patient fall, team members use PDSA (plan, do, study, act) cycles to determine what happened, find a corrective plan, implement it, and study the results on the process. Teams then create new standard work or if the change did not achieve the desired results, the PDSA cycle begins again.” (Toussaint, John, Gerard, Roger A., and Adams, Emily. On the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry. Lean Enterprise Institute, Cambridge, MA. 2010. P.28.)

 Teamwork & Lean Management – A Quick Test

 

Here is a quick to to determine whether or not your organization is doing what it should to promote teamwork and continuous improvement:

  1. Every employee, regardless of level or function, is assigned to a team with shared responsibility for improvement in their work area or function. How to test for this? Simple, walk around the work areas, from intake to surgery to the cafeteria, and simply ask ten employees “What team are you on and what is the responsibility of your team?” Ten out of ten employees should know the answer to this question.
  2. As another ten employees: “What was the last improvement, or experiment to find improvements, conducted by your team?” Ten out of ten should know the answer.
  3. Sit in on employee team meetings. Can’t find them? You fail. While observing team meetings observe the following:
    1. Is there a standard agenda?
    2. Is there a facilitator, a trained team member, who moves the conversation along and clarifies decisions?
    3. Are they reviewing data, their own scorecard?
    4. Do they review action items or prior decisions to follow up on those planned actions?
    5. Are they using some disciplined and simple problem solving model such as PDSA?
    6. Do they record decisions or actions with an action register including What, Who, and When
  4. Do you have coaches who provide training and coaching to teams to make them effective?
  5. Have teams mapped their work flow, defined standard work, and eliminated waste from their processes?

The above five items are simple tests of the degree to which your organization is living lean, practicing teamwork. This must now become the new normal in every healthcare organization.

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