AHCA AHCA Quality Quality

SymposiumSymposium

St. Louis, St. Louis, MissouriMissouri

February 6, 2009February 6, 2009

Sustaining The GainSustaining The Gain

from Tom Peters:

“Excellent firms don’t believe in excellence –

only in constant improvement and constant change.”

In Search of Excellence: Lessons From America’s Best Run Companies

The Human FactorQuality does not improve on its ownPeople tend to look at people when

things go wrong (94% of problems are related to systems)

People tend to jump to solutionsPeople forget to check if their

solutions worked

Models to Model Models that provide a framework for

organizational quality: International Organizations for Standardization ISO

9001 Malcolm Baldridge National Quality Award

Models that provide methods for improving quality processes: The Deming System (PDCA/PDSA) Toyota Production System (LEAN/Just in Time) Six Sigma (Eliminate Defects) (5 Whys)

Disclaimer!

I Only Know

What I Know

Our ChallengesOur Challenges

SilosSilosDataDataProcessesProcesses

SilosVertical, HorizontalVertical, Horizontal

Not my JobNot my Job

Learning to IntegrateLearning to Integrate

Voicing ExpectationsVoicing Expectations

Data:Too Little/Too Much…Too Little/Too Much…Too Confusing! Too Confusing!

How Do I…How Do I…Acquire, Present, Use, Crunch, Acquire, Present, Use, Crunch, Understand, Validate, Understand, Validate, Compare…?Compare…?

Processes:Why? Why? (Why, Why, Why, Why?)(Why, Why, Why, Why?)

Who?Who?

What?What?

When?When?

Where?Where?

How?How?

I USED TO RUN I USED TO RUN A BETTER A BETTER NURSING NURSING

HOME!HOME!

Our JourneyOur Journey

Processes:SIPOCSIPOC

Critical to Quality AttributesCritical to Quality Attributes

PDCAPDCA

Processes - SIPOC

The things necessary to perform the value-added tasks of the process.

Process Performers:

The individuals or groups who perform the value adding tasks in the process.

The individuals or groups who receive the outputs of the process; they do define the requirements of the outputs.

The products or services that the process delivers.

Key Performance Measures: The measures used to determine the “goodness” of the performance of the process; i.e., quality, cost, cycle time, satisfaction, value.

Stakeholders:

The individuals or groups that have a vested interest in the performance of the process but do not define the requirements of the outputs.

Process Owner: The person who is responsible for the goodness of the process irrespective of whether they own all of the resources performing the process

t (start): the most significant starting or triggering event that starts the process

t (done): the most significant completion event of the process cycle

Process frequency (volume): The rate of repetition of the process; i.e., how often the process occurs

Inputs: Customers:Process Name: the working name

of the processOutputs:Suppliers:

The individuals or groups that provide the inputs for the process.

Processes –Critical to Quality

Attributes Who Says This (which customer?)

Relative Importance Level?

How We Measure It?

What is Current Value/Level?

Product Reliability

Service Quality

Price

Processes - PDCA

Plan

Check

Act

Do

Data

Developed In House “Experts”Analysis and Presentation tools

– using ExcelMore Vigorous Search for Valid

Comparison Data Sources

Departmental Quality Plans

Indicators• High Volume• High Risk• Problem Prone• Sentinel

ThresholdsAction Plans

• Quarterly Plans, IDT Plans

Sustaining the GainSustaining the GainCan It Be DoneCan It Be Done

??

20 Leaders Said:

An impromptu ask, 2 responses each:

Leadership: 7 responsesStrategy: 6 responsesWork Force: 8 responsesCustomer Focus: 7 responsesProcess: 12 responses

Leadership

Our leaders challenge us to strive for excellence

Leaders do what they need to do, no one waits to be told what to do

Our different styles of leadership work well together

We want to follow our leaders High Accountability Factor

Strategy

We follow our plan We take time out to plan our future We think outside the box We plan our role as a facility, and

for our community. We have a balanced plan

Work Force

Our staff “get” and live out our Mission and Values

What we do, we are all doing well We work well together We all get after ourselves when things

slip, we don’t hide problems, or wait for someone to point out problems

Customer Focus

Everyone comes together for what our residents want and need

Every Resident is an Individual We look at residents’ quality of life

holistically, not just medically We know whose home this is, and

everyone works together to respond to what our residents’ want and need

Processes

Our processes work – we are proactive instead of reactive

We look for problems to fix, and not wait until they become “real” problems

A well oiled machine – each department does their job well

We challenge the normal acceptable standard, to make our own high standards

Results – Over Time Health Care: 5 of 5 still excellent results

– 4 of 5, no longer on “the radar” Customer: 7 of 7 still excellent Finance/Market: 10 of 10 still excellent Work Force: 4 of 5 still excellent Organization Effectiveness: 3 of 3 excellent Governance/Social Responsibility: 9 of 9 still

excellent

Jon Frantsvog, Administrator/CEOJon Frantsvog, Administrator/CEOSt. Benedict’s Health Center St. Benedict’s Health Center & Benedict Court& Benedict Court851 4th Avenue East851 4th Avenue EastDickinson, ND 58601Dickinson, ND 58601701 456 7305701 456 7305jon.frantsvog@bhshealth.orgjon.frantsvog@bhshealth.org

Thank You!Thank You!

Questions?Questions?