Conference Program & Guide

www.leanhealthatstanford.org

Lean Healthcare Academic Conference at StanfordUnderstanding how improvement delivers value

Frances C. Arrillaga Alumni CenterPalo Alto, CaliforniaSeptember 26-27, 2016

LEAN HEALTHCARE ACADEMIC CONFERENCE AT STANFORD

On behalf of the organizing committee we are delighted to welcome you to the inaugural Lean Healthcare Academic Conference at Stanford.

From its inception, this conference was designed to foster an increased and deeper understanding of lean improvement in healthcare with a specific focus on academic teaching hospitals around the world and more broadly through a program modeled on an academic format. An international call for abstracts has served as the basis for the program design and the submissions have exceeded our expectations. More than 60 participants have been selected to present in the oral plenary and concurrent sessions and in the poster sessions. We are excited that greater than half of the program is dedicated to delegate contribution! It is our hope that by learning from one another we can continue to accelerate our advances in the application of Lean in healthcare and that this forum may serve as a rallying call for further academic collaboration. This conference is a partnership between Stanford Children’s Health, Stanford Health Care and the Stanford University School of Medicine. It has been very rewarding to come together and share our improvement work. We are now pleased to be joined by clinicians, leaders and improvement practitioners from over 30 other healthcare systems and we look forward to gaining a deeper understanding of lean in healthcare through our formal and informal sharing. Through our networks we have accessed a diverse group of world-class speakers and contributors and we are extremely grateful that they have taken the time to participate in the conference. We would like to thank the Lean Enterprise Institute and the Thedacare Center for Healthcare Value for supporting and attending our event. We would like to offer specific thanks to the VA Palo Alto Health Care System and Keck Medical Center of USC who have supported the conference as organizations with 10 or more delegates. We are grateful to our colleagues who helped us organize this event. For many of you it was a first time experience and we appreciate the way you have taken on the many and varied tasks required to bring this event together in such a short time frame. We would like to acknowledge our executive sponsors, James Hereford, Anne McCune and Sam Zelch for their interest, enthusiasm, encouragement and involvement. Finally, we would like to express our deepest gratitude to our conference attendees, especially those delegates who submitted their work for presentation so that we can all learn from your efforts. We hope you enjoy the conference and, in true lean fashion, we value your participation and feedback.

With warm regards,Denise Bennett and Terry Platchek, MDConference Conveners on behalf of the Conference Organizing Committee.

TABLE OF CONTENTS WELCOME

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WELCOME 2

ORGANIZING COMMITTEE 3

CONFERENCE PROGRAM 4-6

INVITED SPEAKERS 7-8

SPECIAL CONTRIBUTORS 9

WIRELESS NETWORK ACCESS 10

CONFERENCE OVERVIEW 10

VENUE FLOOR PLAN 11

LEARNING LABS 12

OPTIONAL SITE VISITS 12

NOTES 13-15

PROGRAM OVERVIEW 16

The Lean Healthcare Academic Conference at Stanford Organizers Acknowledge the Support of the Following Organizations

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ORGANIZING COMMITTEE

Terry Platchek, MD, Medical Director for Performance Improvement at Stanford Children's Health. Terry serves as the Medical Director for Performance Improvement at Stanford Children's Health and as the Fellowship Director of Stanford University's

Clinical Excellence Research Center. He is a Clinical Assistant Professor of Pediatrics and Internal Medicine at the Stanford University School of Medicine. Dr. Platchek's career focuses on using Lean to improve quality, safety, cost, appropriateness and service in healthcare delivery. He is specifically interested in the education and engagement of clinicians in improving healthcare delivery systems and the development of innovative models for delivering higher value healthcare

Denise Bennett, Senior Improvement Coach, Stanford Children's Health. Denise has a nursing background, but for the past 12 years has supported Lean Thinking transformations in healthcare and other service environments. Passionate about sharing and learning,

Denise co-founded the Australasian Lean Healthcare Network in 2005 and has since organized annual conferences. She has temporarily re-located from Australia to Palo-Alto, California to work with the team at Stanford Children's Health.

Marlena Kane, Executive Director, Performance Excellence and Medicine Services, Stanford Health Care. As Executive Director of Performance Excellence and Medicine Services at Stanford Health Care (SHC), Marlena Kane partners with the executive team on the

development, implementation, and sustainment of the Stanford Operating System (SOS) across the entire organization. In partnership with administrative and physician leaders, this role is also responsible for the planning and execution of key value streams identified by the organization for breakthrough improvement, as well as supporting overall design and execution of SHC's annual strategy deployment process. In addition, Marlena serves as the direct administrative liaison with Department of Medicine leadership to optimize the patient experience across the Medicine service line, with a focus on optimizing patient flow and transitions of care.

Benjamin R. Elkins, Director, Performance Excellence Stanford Health Care. As a part of the Performance Excellence leadership team, Ben leads several Kaizen Promotion Offices that support improvement work throughout Stanford Health Care

(SHC). He also partners with senior leadership on the development and deployment of the Stanford Operating System at an enterprise-level. Prior to his current role, Ben worked on a variety of improvement initiatives at SHC, including the development of model line clinics within the Cancer Center, the Patient Flow value stream for General Medicine inpatients, readmissions reduction for Heart Failure patients, and post-operative variation reduction for Cardiac Surgery patients.

Mike Spencer , Admin is t ra t i ve D i rec to r, Performance Improvement, Stanford Children's Health and Lucile Packard Children's Hospital Stanford. Mike joined Stanford Children's Health as Administrative Director of Performance Improvement in

April 2011, coming from Bay Area biotech company Genentech. Mike brought many years of process improvement and operational management, gained across multiple industries and countries. Having held positions in operations, project management, manufacturing, and finance, Mike brings a very cross-functional, service-oriented perspective to the lean transformation.

Michelle Suyehiro, Performance Excellence Operations Manager at Stanford Health Care. As the Operations Manager of Performance Excellence at Stanford Health Care, Michelle Suyehiro manages the operations of the department to support and improve the

workflows of the improvement teams deployed to key value streams. She also partners with operational and physician leaders to support enterprise-wide Stanford Operating System (SOS) initiatives, including strategy deployment and SOS site visits. Previously, Michelle worked on the Patient Flow value stream and improvement initiatives within Patient Care Services.

Bonnie Tsang, Director of Process Excellence, Stanford University School of Medicine. Bonnie is currently Director of Process Excellence at Stanford University School of Medicine and is leading the school in the transformation of its management system to one based

on lean principles. Prior to this role, Bonnie held positions in Stanford Children's Health in Perioperative Services Business Operations and Performance Improvement.

Lisa Perry, Executive Assistant, Performance Improvement, Stanford Children's Health. Lisa has been with Stanford Children's Health for 24 years holding various positions. Currently she is an Executive Assistant in the Performance Improvement Department and the

Fellowship Coordinator for Pediatric Surgery. Prior to that she was the Division Administrator for Pediatric Surgery.

Lisa Warner, Executive Officer, Lean Enterprise Australia and Australasian Lean Healthcare Network. With more than thirty years in the conference and event management industry, Lisa has an extensive background in client orientated service operations and business

development, including sales, marketing, strategic planning and client relationship management. Innovation, creativity, professionalism and a commitment to excellence has formed a large part of Lisa’s career experience and these skills along with her enthusiasm are of great benefit to the lean community in Australia, New Zealand and now the USA!

CONFERENCE PROGRAMDay 1 - Monday September 267.30am Registration Desk Opens. Breakfast Available

8.45am WelcomeTerry Platchek, MD, Medical Director Performance Improvement, Stanford Children's Health and Denise Bennett, Senior Improvement Coach, Stanford Children's Health

8.55am Conference OpeningLloyd Minor, MD, Dean, Stanford University School of Medicine

9.00am Opening Plenary: Understanding ValueModerator: Terry Platchek, MD, Medical Director, Performance Improvement, Stanford Children’s Health

9.00am A Societal Imperative to Produce Better Health With Less SpendingArnold Milstein, MD, MPH, Professor of Medicine and Director, Clinical Excellence Research Center at Stanford University

9.30am When Quality Improvement is Neither Quality Nor Improvement (And What To Do About It)Michael Howell, MD, Chief Quality Officer and Director, Center for Healthcare Delivery Science and Innovation, University of Chicago

10.10am Is Lean Thinking Making a Difference in Healthcare?Stephen Shortell, PhD, Director, Center for Healthcare Organizational and Innovation Research (CHOIR) Dean Emeritus, School of Public Health, Professor of Organization Behavior, Haas School of Business UC-Berkeley

10.50am ReflectionJohn Shook, CEO, Lean Enterprise Institute and Lean Global Network with Terry Platchek, Stanford Children's Health

11.00am Break

11.25am Plenary: Stories of ImprovementModerator: Benjamin Elkins, Director, Performance Excellence, Stanford Health Care

11.25am Improving Care, Improving the WorkCarlos Frederico Pinto, MD, Executive Director, Instituto de Oncologia do Vale, Brazil

11:55pm Deployment of Problem Solving Skills to Leaders: 2 Case Studies and Reflection.Michael Chris Decker, MD, Chief Transformation Officer, Medical College of Wisconsin

12.25pm Better Patient Flow at Stanford Children's HealthDenise Bennett, Stanford Children's Health

12:50pm Lunch and Poster Presentations

2.05pm Interview and Panel SessionModerator: Marlena Kane, Executive Director, Performance Excellence and Medical Services, Stanford Health Care

2.05pm Leading by Asking Questions: An Interview with Professor Edgar Schein, John Shook and James HerefordProfessor Edgar Schein, Professor Emeritus, MIT Sloan School of Management John Shook, Lean Enterprise Institute and Lean Global NetworkJames Hereford, COO, Stanford Health Care

2.40pm Panel: Physicians Leading Lean Leadership - What is Required and How Has it Helped?Jack Billi, MD, Vice President for Medical Affairs at the University of Michigan and lead for the Michigan Quality System and Carlos Frederico Pinto, Instituto de Oncologia do Vale, Brazil will be joined by local Lean thinking physicians David Larson, MD, Associate Chair of Performance Improvement, Department of Radiology, School of Medicine, Stanford University and Daniel Murphy, MD, Medical Director Ambulatory Services, Stanford Children's Health. Facilitated by Lesley Doherty, Senior Advisor, Healthcare Simpler Europe

3.15pm Break and View Posters

3:40pm Plenary: Creating Value Over Time – Reflection on Improvement JourneysModerator: Denise Bennett, Senior Improvement Coach, Stanford Children’s Health

3:40pm Lessons in Humility: 10 Years of Using Lean Thinking to Cross the Quality Chasm at an AMCJack Billi, MD, Vice President for Medical Affairs, University of Michigan and Lead for the Michigan Quality System

4:25pm Getting Better at Improvement - Measuring Organizational CapabilityJane Evans, Director, Organisational Redesign and Performance Excellence, Eastern Health, VIC, Australia

4.50pm Lean Leadership: The Key to Organizational TransformationJames Hereford, Stanford Health Care

5.20pm ReflectionDenise Bennett, Stanford Children's HealthAlice Lee, Executive Director, Strategy and Administration, Lean Enterprise Institute

5.30pm - 7.00pm Welcome Reception

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Day 2 - Tuesday September 277.30am Registration Desk Opens. Breakfast Available

8.00am Welcome to Day Two

8.10am Delegate Plenary PresentationsModerator: David Ben-Tovim, Flinders University Australia

8.10am Implementing Split Flow Strategy for Emergency Department Vertical Patients By Utilizing Lean Manufacturing PrinciplesSam Shen, Clinical Associate Professor, Emergency Medicine and Patrice Callagy, Director of Emergency Services Stanford Health Care

8.30am Improving Patient Flow from the ED to Inpatient Units at Howard County General Hospital, a member of John Hopkins Health SystemJon Cohen, Senior Director, Innovation and Continuous Improvement Howard County General Hospital, John Hopkins Medicine

8.50am Impact of Scheduled-Based Family Centered Rounds in a Pediatric Inpatient Cardiology Unit at an Academic Medical CenterShannon Feehan, Nurse Educator and Shirley Cheung, RN, Case Manager Stanford Children's Health

9.10am New Hanover Hospitalists Choosing Wisely: TelemetryCharmaine Lewis, Quality Director, New Hanover Hospitalists

9.30am Utilization of Key Lean Principles to Create and Implement a Novel MD-RN Delirium Prevention and Management Protocol for Non-ICU Patients in the HospitalNidhi Rohatgi, Clinical Assistant Professor of Medicine, Stanford University School of Medicine

9.50am ReflectionDavid Ben-Tovim, MD, Flinders University, Australia and David Larson, Stanford School of Medicine.

10.00am Break

10.30am Delegate Concurrent Presentations

A. Contemporary Examples of Lean Healthcare Improvement to Drive ValueModerator: Mike Spencer, Administrative Director, Performance Improvement, Stanford Children's Health

B. Contemporary Examples of Lean Healthcare Improvement to Drive ValueModerator: Jonaelle Lucas, Director, Process Excellence, Mater Health Services, Australia

C. Developing Lean Capability and a Culture of ImprovementModerator: Marlena Kane, Executive Director, Performance Excellence and Medical Services, Stanford Health Care

10.30am Why Don't Doctors Report Clinical Incidents?Arjun Shivananda, Resident Medical Officer, Sir Charles Gairdner Hospital

A LEAN Approach to Care Transitions Reduces Readmissions for Heart Failure PatientsCharlene Kell, Administrative Director, Cardiovascular Health, Stanford Health Care

Change? What's in it for Me?Linda Duncan, Chief Operational Excellence Officer, Penn State Hershey Health

10.50am Early Discharges and Patient Flow: Importance of a Shared Mental Model and Culture ChangeLauren Destino, Clinical Associate Professor, Pediatric Hospitalist and Christy Acuna, Clinical Instructor Stanford University School of Medicine

Criteria Led Discharge in CardiologyDean Jones, Associate Program Director, Specialty Medicine, Eastern Health and Lisa Watson, Nurse Unit Manager, Box Hill Hospital

Concurrent Approaches to Developing Lean Leaders at Johns Hopkins MedicineRobert Hody, Assistant Director Lean Sigma Deployment, Johns Hopkins Medicine - Armstrong Institute

11.10am Increasing VA Outreach to Incarcerated Veterans: A Lean ApproachDavid Grillo, Veterans Justice Outreach Programs Manager and Kate Severin, LCSW Homeless Programs Chief, VA Palo Alto Health Care System

Reducing ED Wait Times Using Lean MethodsJennifer Ellman, Process Improvement Specialist,VA Palo Alto

An Ethnographic Study of Organizational Learning (lead by Lean Consultants)Melissa Valentine, Assistant Professor, Stanford University

11.30am Improving Liver Transplant Waitlist MortalityZeynep Tulu, Quality Improvement Manager, Stanford Health Care

Value Stream Improvements Across the Orthopedic Joint Service LineTina Orlando-Cortez, Performance Improvement Consultant, Stanford Health Care and Mark Welton, Chief of Staff, Stanford Health Care

Changing the Culture of a Senior Leadership TeamAllan Cumming, Improvement Advisor, Southern District Health Board

11.50am We DO Have Time for That: Using Simple Lean Concepts to Improve Patient Satisfaction in a Busy Environment?Amin Eddebbarh, Patient Satisfaction Program Manager, VA Palo Alto Health Care System

A Hospitalist-led Intervention to Reduce Length of Stay on TelemetryLijia Xie, Hospitalist, Stanford Hospital/Stanford Healthcare

Enhancing Your Improvement Capability with the RITE ProgramJake Mickelsen, Quality Improvement Manager, Stanford Health Care

12.10pm Transforming Cancer Care: Learnings from Year 1 of the Model LinesBenjamin Elkins, KPO Director and Sridhar Seshadri, Vice President Cancer and Heart Centers, Stanford Health Care

Continuously Improving Planned Surgical Flow at Lucile Packard Children's HospitalRebecca Claure, Faculty, Pediatric Anaesthesia, Lucile Packard Children’s Hospital at Stanford

Support for Teaching Quality Improvement at All Levels of Medical Education: Role of the Clinical EnterpriseJack Billi, Vice President for Medical Affairs, University of Michigan

LEAN HEALTHCARE ACADEMIC CONFERENCE AT STANFORD

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CONFERENCE PROGRAM

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Day 3-Wednesday September 28 – Optional Site Visits7.30am to 12.00pm Stanford Health Care

1.15pm to 3.45pm Stanford University Campus Tour

Day 2 - Tuesday September 2712:30pm Lunch and Posters

1.25pm Concurrent Learning Labs: From Thinking to Practice - Interactive Sessions Designed to Increase Improvement Skills

A: A3 ThinkingJohn Shook and Alice Lee, Lean Enterprise Institute with Jack Billi, MD, University of Michigan

B: A Taste of Design ThinkingHelen Waters, Administrative Director in Product and Service Integration, Melody Lau, Design and Innovation Leader, Product and Service Integration and David Janka, MD, Lecturer, Innovation Consultant and Medical Device Entrepreneur, Stanford Health Care

C: The Practice of Building RelationshipsProfessor Edgar Schein, MIT Sloan School of Management and James Hereford, Stanford Health Care

3.25pm Break

3.50pm Closing Session

3.50pm Poster Presentation Awards

4.00pm Closing Plenary - Understanding How Improvement Delivers Value: What Do We Know Now? What Do We Need to Know?Moderated by Terry Platchek, Stanford Children's Health commentary by Stephen Shortell, Haas School of Business UC, Berkeley Lisa Freeman and James Hereford, Stanford Health Care

4.30pm Conference Close

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INVITED SPEAKERS

Our conference invited speakers will provide a diverse perspective on Lean thinking concepts as they apply to healthcare. Speakers at the conference will include:

Michael D. Howell, MD, Chief Quality Officer and Director, Center for Healthcare Delivery Science and Innovation at the University of Chicago. Dr. Howell is the Chief Quality Officer and a practicing intensivist at the University of Chicago Medicine, where he also directs the

Center for Healthcare Delivery Science and Innovation. Before entering medicine, he worked in materials purchasing workflow analysis and automation for the company which built most of the space shuttle. Today, he serves on quality and safety-related national advisory panels for the CDC, Medicare, Society of Critical Care Medicine and others. His team has a particular competency in leveraging highly granular, extremely large datasets from electronic health records for insight into topics in quality, safety, patient-centeredness, and critical care. Dr. Howell has published more than 90 research articles, editorials and book chapters that have been cited more than 4,000 times and incorporated into national guidelines. These studies have also held an interest for the public and have been covered by the New York Times, Wall Street Journal, Forbes, CNN, and Consumer Reports.

Stephen M. Shortell, PhD., MPH., MBA. Blue Cross of California Distinguished Professor of Health Po l icy and Management and Professor o f Organization Behavior at the School of Public Health and Haas School of Business at University of

California-Berkeley, Director, Center for Healthcare Organizational and Innovation Research (CHOIR). A leading health care scholar, Dr. Shortell and his colleagues have received numerous awards for their research examining the performance of integrated delivery systems; the organizational factors associated with quality and outcomes of care; and the factors associated with the adoption of evidence-based processes for treating patients with chronic illness. He is currently conducting research on patient engagement and the performance of Accountable Care Organizations (ACOs). He is an elected member of the National Academy of Medicine and a recent recipient of the AHA/HRET TRUST Visionary Leadership Award.

John Shook, Chairman and CEO of the Lean Enterprise Institute and acclaimed author of Managing to Learn and Learning to See. John Shook is the Chairman and CEO of the Lean Enterprise Institute and the affiliated Lean Global Network. Having previously

served as Toyota's first American manager in Japan, John is a true lean sensei and acclaimed author. He has influenced the development of lean thinking around the work, including in healthcare.

Carlos Frederico Pinto, MD, Executive Director at the Instituto de Oncologia do Vale and board member for the Brazilian Program for Patient Safety and Hospital Regional do Vale do Paraiba (HRVP). Dr. Fred is Medical Oncologist and Healthcare Administrator. He is

currently Executive Director at the Instituto de Oncologia do Vale and board member for the Brazilian Program for Patient Safety and Hospital Regional do Vale do Paraiba (HRVP). He has several articles and book chapters published in Brazil, US and Europe and is a requested lean lecturer with presentations in Brazil, US, Australia and Europe. He is also author of the book In Search of the Perfect Care, published by the Lean Institute Brasil. Fred has served as President and Secretariat of São Paulo Medical Oncology Society and Treasurer of Brazilian Medical Oncology Society and also as a board member to São Paulo Medical Council and the Brazilian Cancer Association. Dr Fred is a passionate and humble lean leader whose has led the lean effort to benefit patients, staff and the organisation.

Professor Edgar Schein, Professor Emeritus at the MIT Sloan School of Management and acclaimed author of the coaching texts Helping and Humble Inquiry. Ed Schein is Professor Emeritus of the Massachusetts Institute of Technology (MIT) Sloan

School of Management. He was educated at the University of Chicago, Stanford University and Harvard University, where he received his Ph.D. in Social Psychology. He worked at the Walter Reed Institute of Research for four years and then joined MIT, where he taught until 2005. He has published extensively and broadly including Helping (2009), a book on the general theory and practice of giving and receiving help followed in 2013 by Humble Inquiry which explores why helping is so difficult in western culture and which won the 2013 business book of the year award from the Dept. of Leadership of the University of San Diego. He has just released Humble Consulting which revises the whole model of how to consult and coach and is currently working with his son Peter on Humble Leadership (2017) which challenges our current theories of leadership and management. He continues to consult with various local and international organizations on a variety of organizational culture and career development issues, with special emphasis on safety and quality in health care, the nuclear energy industry and the US Forest Service. An important focus of this new consulting is to focus on the interaction of occupational/organizational subcultures and how they interact with career anchors to determine the effectiveness and safety of organizations. He is the 2009 recipient of the Distinguished Scholar-Practitioner Award of the Academy of Management, the 2012 recipient of the Life Time Achievement Award from the International Leadership Association, the 2015 Lifetime Achievement Award in Organization Development from the International OD Network and has an Honorary Doctorate from the IEDC Bled School of Management in Slovenia.

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James Hereford, Chief Operating Officer at Stanford Health Care. In his role at Stanford, James is operationally responsible for all aspects of care delivery throughout a system of inpatient, ambulatory and ancillary care settings. He is also a recognized leader nationally in the implementation and use of lean and the lean

management in health care, and has lead the implementation of lean as the Chief Operating Officer of the Palo Alto Medical Foundation and as the Executive Vice President of Strategic Services and Care Delivery Services at Group Health Cooperative.

During his twenty-five year career in health care, James has been responsible for the design and implementation of one of the first and most expansive care delivery patient web portals while at Group Health, and for the selection and implementation of the Epic electronic medical record. At Group Health and at Palo Alto Medical Foundation, James led the redesign of primary care and several other organizational transformations. At Stanford, he is again leading the implementation of the lean management system and is focused on helping Stanford create the preeminent academic care delivering system in the world, delivering leading edge and coordinated care. James has also served on the faculties of the University of Washington, the Ohio State, the Institute of Healthcare Improvement and continues to teach in programs at Stanford University.

LEAN HEALTHCARE ACADEMIC CONFERENCE AT STANFORD

INVITED SPEAKERS

Jack Billi, MD, Vice President for Medical Affairs at the University of Michigan. Dr. Jack Billi serves as Professor in Internal Medicine and Learning Health Sciences (Medical School), Health Management and Policy (Public Health), Integrated Systems and Designs (Engineering), and Associate Vice President for Medical

Affairs at the University of Michigan. Dr. Billi's management and research interests are in health services delivery, especially the use of lean thinking to improve quality and efficiency, the creation and use of evidence-based guidelines, population health, clinical practice transformation tied to value-based reimbursement and conflict of interest management. Dr. Billi leads the Michigan Quality System (MQS), the University of Michigan Health System's (UMHS) business strategy to transform clinical and administrative operations through development and deployment of scientific problem solving at all levels.

Dr. Billi is active in regional initiatives to improve quality and efficiency of care, especially the use of community collaboration to support coordinated quality improvement. He chairs the Michigan State Medical Society's (MSMS) Committee on Health Care Quality, Efficiency and Economics. He serves as Secretary on the MSMS Board of Directors and chaired the Board's Health Care Delivery Committee from 2009 to 2012. He co-chairs the Michigan Quality Improvement Consortium (MQIC) Medical Director's committee, a statewide group that consolidates evidence-based practice guidelines and coordinates implementation across 13 commercial and Medicaid healthplans representing over six million members in Michigan. He also serves on the AMA's Professional Satisfaction Practice Sustainability Task Force.

Jane Evans, Director, Organisational Redesign and Performance Excellence, Eastern Health. Jane Evans is Director, Organisational Redesign and Performance Excellence at Eastern Health, a multi-site health service in the Eastern Metropolitan region of Victoria, Australia. Jane is responsible for the development and implementation of

the redesign program and methodology across all Eastern Health sites and programs to ensure Performance Excellence. Previously, Jane was Manager, Health Reform Programs, Department of Health where she was responsible for the development and implementation of the Redesigning Hospital Care Program across Victoria.

Alice Lee, Executive Director of Strategy and Administration, LEI, USA. Continuous improvement leader and coach, Alice Lee is the executive director of strategy and administration and a member of LEI's executive team. Her responsibilities include collaborating with universities and other research communities, leading

long-range strategic planning, administration, finance, and HR functions, developing educational content in traditional and new media and coaching executives in creating continuous improvement cultures.

Helen Waters, Administrative Director in Product and Service Integration at Stanford Health Care. Helen is interested in the interplay of behavior design and system design in healthcare. Helen led a Project Partnership with a hospital team at the Stanford's Hasso Plattner Institute of Design ('the d.school') on redesigning the oncology

inpatient experience, which has translated into a hospital-within-a-hospital renovation underway. She is currently working with teams to design a Patient Plan and to redesign the surgery case scheduling experience. Helen has an MBA in Statistics and Operations Research from NYU-Stern and a BA in Economics from the University of Michigan.

Melody Lau, Design and Innovation Leader, Stanford Health Care. Melody is a Design and Innovation Leader II in the Product Services and Integration Team at Stanford Health Care. She most recently has been designing and prototyping to understand the care delivery needs for our aging adult population and is redesigning the

hospital attire experience with patients and families. Melody has a Masters of Public Health from UCLA, and her Bachelor's in Psychology from the University of California, Irvine.

David Janka, MD, Lecturer, Innovation Consultant and Medical Device Entrepreneur. David is interested in the intersection of design with healthcare. David graduated from Stanford Medical School and was a fellow at the Stanford Institute of Design ('the d.school'). Over his

five years as a member of the d.school teaching faculty, he has taught classes on design process and its application to emerging markets, healthcare, public policy and creative organizations. David currently works with Stanford Health Care to bring design thinking mindsets and approaches into the organization's operations, innovation work and culture. Additionally, he has collaborated with the Harvard Center for Primary Care on a novel healthcare innovation fellowship and with faculty at Stanford Medical School and Jefferson Medical School to bring design thinking into medical education.

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SPECIAL CONTRIBUTORS

Daniel Murphy, MD, Professor of Pediatrics (Cardiology), Stanford School of Medicine. Dr Murphy is the Medical Director of the Outpatient Heart Center at Lucile Packard Children’s Hospital and the Medical Director of Ambulatory Services for Stanford Children’s

Health. Since 2013, Dr. Murphy and the Ambulatory team have employed Lean methodology to transform the model of ambulatory care for children at Stanford.

David B. Larson, MD, Associate Chair for Performance Improvement, Department of Radiology, Stanford University. David is a national thought leader in radiology quality improvement and patient safety and a regular speaker regarding topics ranging from pediatric CT

radiation dose optimization to radiologist peer review. He is the executive director of Stanford's Realizing Improvement through Team Empowerment (RITE) program and co-director of the Clinical Effectiveness Leadership Training (CELT) program.

Michael Chris Decker, MD, Chief Transformation Officer, Medical College Milwaukee. Chris is a professor of emergency medicine and a practicing physician. The 'T office' supports the physician practice in achieving its quality and strategic goals.

Lesley Doherty, Senior Advisor, Healthcare Simpler Europe. Lesley is an experienced nurse, working in senior roles across the NHS. In 2010 she became CEO at Bolton Hospitals NHS Trust, developing a national and internal reputation for lean in healthcare and winning the European

Best Process Improvement Programme in 2012. Lesley has held national roles as Chair of the Neonatal Nursing Association, regional lead for the National Leadership Programme, and is one of the Clinical Advisors on the NHS Constitution. Lesley now works in lean healthcare consultancy and is a non-executive director for NHS Wirral Clinical Commissioning Group.

Professor David Ben-Tovim, MD, Flinders University, SA, Australia. Professor Ben-Tovim was the inaugural Director of the Redesigning Care program at the Flinders Medical Centre in Adelaide, South Australia. Started in 2003, Redesigning Care was the first program in

Australia, and one of the first in the world, to apply Lean Thinking to Healthcare in a large general hospital. Professor Ben-Tovim has written a number of articles on Lean Thinking and Healthcare in the peer-reviewed literature. He is also the author of 'Process Redesign for Health Care Using Lean Thinking: a guide for improving Patient Flow and the Safety and Quality of Care' which will be published by Productivity Press in 2017.

Lisa (Elizabeth) Joyce Freeman, Senior Advisor for Clinical Affairs, Stanford University School of Medicine. Lisa joined the Stanford University School of Medicine staff in June 2016 as the Senior Advisor for Clinical Affairs. Reporting to the SHC CMO, Dr. Norman

Rizk, her current projects include enhancing Palliative Care and participating in the Core Team for the Senior Care Value Stream. Lisa previously served as the CEO of the VA Palo Alto Health Care System from 2001 to 2016. In 2009, she and VA Palo Alto leaders instituted the Lean/based Service Improvement Model focusing on the Daily Management System, Goal Deployment and Value Streams as "the way we run the business".

Lauren Destino MD,, Lucile Packard Children’s Hospital. Lauren is the Associate Medical Director of the Pediatric Hospital Medicine Division and Associate Medical Director of the acute care floor at Lucile Packard Children’s Hospital (LPCH) Stanford and a clinical

assistant professor at Stanford University. She is involved in a number of quality and performance improvement related activities at LPCH and directs QI/PI education for trainees.

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LEAN HEALTHCARE ACADEMIC CONFERENCE AT STANFORD

ABSTRACTSAbstracts for oral presentations are available for all delegates in a separate handbook provided at registration.

CATERING BREAKS/DIETARY REQUIREMENTSAll catering breaks including lunch, morning and afternoon teas will be served outside the main meeting rooms. Those who have indicated special dietary needs should speak to staff at the registration desk for arrangements.

CREDIT CARDSVisa and MasterCard will be accepted at the Registration Desk.

DRESSSmart casual attire is appropriate for the Conference and networking event.

MOBILITY NEEDSShould you require specific assistance, please see staff at the registration desk.

MOBILE PHONESPlease respect the presenter and other members of the audience by ensuring your mobile phone is switched off or on silent whilst you are in sessions.

NAME BADGESEach delegate registered for the Conference will receive a name badge upon registration at the registration desk. This badge will be your official pass and must be worn during the Conference.

REGISTRATION DESKThe Registration Desk for the Conference is located in the main foyer of the Frances C. Arrillaga Alumni Center, adjacent to the main meeting room and will be open during the following hours:

Monday September 26, 2016 0730 – 1700Tuesday September 27, 2016 0730 – 1700

THE LEAN HEALTHCARE ACADEMIC CONFERENCE AT STANFORDConference OfficeCell: + 0407 512 969Email: lisa@lean.org.auWebsite: www.leanhealthatstanford.org

CONFERENCE OVERVIEWFRANCES C. ARRILLAGA ALUMNI CENTERSTANFORD UNIVERSITY WIRELESS GUEST NETWORK ACCESSImportant Notes:! The wireless Stanford network in the Alumni Center is NOT a secure

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! Use of the wireless Stanford network at the Alumni Center is done so at your own risk. We are not responsible in any way if your computer stops working or if data gets corrupted, hijacked, etc.

! The Alumni Center staff reserves the right to immediately remove any wireless guests from the Stanford network should improper activity be detected, or to deny requests for wireless service and/or help.

! If you encounter any problems accessing the wireless network, please see the Troubleshooting Guide for additional instructions.

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4. Select “Sponsored Wireless Guest” the select “Guest Network Access “and enter the username and password provided to you by your event contact. Select “done” when finished. USERNAME: LeanAcademicPASSWORD: LeanAcademicDATE ACTIVE: September 26 - September 27, 2016

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Stanford Wireless Network Details:! The wireless Stanford network operates on 802.11b technology,

running at 11mbps; the entire 1st floor of the Alumni Center has wireless coverage, including the immediate outside perimeter.

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VENUE FLOOR PLAN

OUTDOOR POSTER AND CATERING AREA

REGISTRATION DESK

OUTDOOR DININGAND WELCOME RECEPTION

ACCESS TO CONCURRENT SESSIONSACCESS TO

cM CAW HALL

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LEARNING LABSTUESDAY SEPTEMBER 27On Tuesday September 27, you may attend a series of Learning Labs, designed to increase your improvement skills in a variety of topics. Learning Labs will include:

A3 ThinkingJohn Shook and Alice Lee, Lean Enterprise Institute with Jack Billi, MD, University of Michigan

What makes projects fail? How do you smoke out disagreement? How do you identify barriers early in problem solving? How do you build consensus in your organization? How do you ask questions that don't take responsibility away from the problem-solver?

Lean thinking is not a spectator sport, it is a contact sport! Come practice your scientific problem solving, coaching, and mentoring skills with colleagues in this interactive, hands-on learning lab. Work in groups on an A3 with feedback from faculty and fellow participants. Practice asking good questions.

A Taste of Design Thinking Helen Waters, Administrative Director in Product and Service Integration, Melody Lau, Design and Innovation Leader, Product and Service Integration and David Janka, MD, Lecturer, Innovation Consultant and Medical Device Entrepreneur, Stanford Health Care

This interactive workshop will immerse participants in introductory design thinking methodology. You will practice multiple design thinking tools in a hands-on participatory session that will challenge the way you frame healthcare challenges. We will have a conversation about how design thinking can augment your Lean toolkit.

The Practice of Building Relationships Professor Edgar Schein, MIT Sloan School of Management and James Hereford, Stanford Health Care

Professor Schein will start the learning lab with a brief overview on helping questions, after which you will practice using the questions to work with fellow participants on a real-life problem. Following a reflection on the application session, James Hereford and Professor Schein will lead a discussion on the role of inquiry in the work of building relationships to improve healthcare delivery.

OPTIONAL SITE VISITSWEDNESDAY SEPTEMBER 28

7:30am to 12:00pm

Stanford Health CareThe Stanford Operating System (SOS) is rooted in lean methodologies. Our lean journey began with an intense focus on improvement initiatives across the institution, to build awareness and early buy-in. We then focused on building our Management System, developing our leaders into lean leaders and aligning our improvement efforts through our Strategy Deployment process.

Objectives:

! Share our Stanford Health Care lean journey! Learn the components of the Stanford Operating System (SOS)

Management System! Strategy Deployment! Active Daily Management! Value Stream Management

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PROGRAM OVERVIEWDay 1 - Monday September 267.30am Registration Desk Opens. Breakfast Available

8.45am Welcome

8.55am Conference Opening

9.00am Opening Plenary: Understanding Value

9.00am A Societal Imperative to Produce Better Health With Less Spending

9.30am When Quality Improvement is Neither Quality Nor Improvement (And What To Do About It)

10.10am Is Lean Thinking Making a Difference in Healthcare?

10.50am Reflection

11.00am Break

11.25am Plenary: Stories of Improvement

11.25am Improving Care, Improving the Work

11:55pm Deployment of Problem Solving Skills to Leaders: 2 Case Studies and Reflection.

12.25pm Better Patient Flow at Stanford Children's Health

12:50pm Lunch and Poster Presentations

2.05pm Interview and Panel Session

2.05pm Leading by Asking Questions: An Interview with Professor Edgar Schein, John Shook and James Hereford

2.40pm Panel: Physicians Leading Lean Leadership - What is Required and How Has it Helped?

3.15pm Break and view Posters

3:40pm Plenary: Creating Value Over Time – Reflection on Improvement Journeys

3:40pm Lessons in Humility: 10 Years of Using Lean Thinking to Cross the Quality Chasm at an AMC.

4:25pm Getting Better at Improvement - Measuring Organizational Capability

4.50pm Lean Leadership: The Key to Organizational Transformation

5.20pm Reflection

5.30pm Welcome Reception

Day 2 - Tuesday September 277.30am Registration Desk Opens. Breakfast Available

8.00am Welcome to Day Two

8.10am Delegate Plenary Presentations

8.10am Implementing Split Flow Strategy for Emergency Department Vertical Patients By Utilizing Lean Manufacturing Principles

8.30am Improving Patient Flow from the ED to Inpatient Units at Howard County General Hospital, a member of John Hopkins Health System

8.50am Impact of Scheduled-Based Family Centered Rounds in a Pediatric Inpatient Cardiology Unit at an Academic Medical Center

9.10am New Hanover Hospitalists Choosing Wisely: Telemetry

9.30am Utilization of Key Lean Principles to Create and Implement a Novel MD-RN Delirium Prevention and Management Protocol for Non-ICU Patients in the Hospital

9.50am Reflection

10.00am Break

10.30am Delegate Concurrent Presentations

A. Contemporary Examples of Lean Healthcare Improvement to Drive Value

B. Contemporary Examples of Lean Healthcare Improvement to Drive Value

C. Developing Lean Capability and a Culture of Improvement

12:30pm Lunch and Posters

1.25pm Concurrent Learning Labs: From Thinking to Practice - Interactive Sessions Designed to Increase Improvement Skills

A: A3 Thinking B: A Taste of Design Thinking

C: The Practice of Building Relationships

3.25pm Break

3.50pm Closing Session

3.50pm Poster Presentation Awards

4.00pm Closing Plenary - Understanding How Improvement Delivers Value: What Do We Know Now? What Do We Need to Know?

4.30pm Conference Close

Day 3-Wednesday September 28 – Optional Site Visits7.30am to 12.00pm Stanford Health Care

1.15pm to 3.45pm Stanford University Campus Tour