Three Organizations Leverage Staff Expertise to Spur Improvement

​Speaking September 27, 2016, at a keynote panel during the annual conference of the American Society for Healthcare Risk Management in Orlando, Florida, Lisa Griffee, director of Lean operations, Greater Baltimore Medical Center, said that her organization started with Lean principles but eventually saw deterioration in the improvement work. So the organization transitioned to Lean Daily Management. A key element is daily rounds in which frontline providers and leaders present performance data to each other. Frontline providers choose metrics that matter for their department, and the executive staff present their own metrics (e.g., patient injury, staff injury). Although some of the tools they use "color code" concepts using red (which represents unmet goals) and green (which represents met goals), "red is not bad," said Griffee. "We wanted to build a culture of focused problem solvers throughout the organization," she explained. Rebecca Cady, Esq., BSN, CPHRM, DFASHRM, vice president and chief risk officer, Children's National Health System, said that her organization had seen a dramatic decrease in the incidence of serious safety events but a less dramatic drop in litigation. "We were looking at these events really from a provider-centered view," she said. Many cases stemmed from unexpected outcomes even when no gaps in care occurred, she noted.