The University of Colorado School of Medicine is taking big steps forward as it develops training and leadership development programs that focus squarely on keeping patients safe, reducing waste and improving workflow.
In 2013, a team led by Jeffrey Glasheen, MD embarked on a large-scale, organizational development program for teams and clinics at the University of Colorado Hospital (UCH) and the Children’s Hospital Colorado. The program is helping the Anschutz Medical Campus develop leaders who can facilitate lasting and sustainable changes at the front lines of patient care, through an intensive, year-long certification program.
Twelve teams recently completed the program, and Dr. Glasheen is able to report some big wins:
Measurements of pre- and post-training program outcomes illustrate significant improvement. The cohorts’ self-reported understanding improved in such areas as business drivers, managing change, engaging teams, using quality improvement and process improvement tools, and identifying and using data for system improvement. For example, prior to the program, 36 percent of people reported having confidence in managing change. Post program, 82 percent reported increased confidence in their ability to lead organizational change.
Rampant waste was identified and plans are in place to mitigate. For example, a team from oncology infusion reduced excess “patient chair” time by 53 minutes—giving valuable time back to the patient and providing a potential $756,000 in cost savings.
Patient safety issues were identified and strategies are in place that reduce risk. For example, a team from the neonatal intensive care unit found that 10 percent of patients suffer discharge- related failures. Through the certification program, the NICU team learned that 41 percent of parents received discharge education within 72 hours of discharge. A process is now in place in which 97 percent of patients receive this education 72 hours before discharge, allowing more time for teach-back and skill development with the hope of reducing readmissions. During this time, the nursing staff satisfaction with the discharge process went from 2 percent to 65 percent.
Workflow can be improved. A team from the stroke unit discovered issues with flow after a comprehensive review of the timeline of a stroke patient within the department. The team implemented a project which reduced the length of a patient’s stay from 6 days to 5.3 days. These changes alone can potentially result in savings of $206,700 per year.
The incredible interest and engagement Dr. Glasheen has seen within the first cohort are also impressive. “I have to admit, at first implementing this program was like throwing a big party. I was just hoping people would show up,” said Dr. Glasheen. “Yet consistently, 64 people devoted significant time and energy to these projects. And they’re leaving this program with the right tools and resources to get the job done.”
In 2014, the IHQSE also implemented an introductory training program (ITP) that provides one-day courses in process improvement for frontline staff. “We’re helping everyone at Anschutz understand their roles in the bigger picture,” said Dr. Glasheen. “The ITP is a mechanism for helping ensure we’re all speaking the same language, without a significant time and resource commitment.”
The IHQSE will continue to implement programs and provide support for people at all levels who deliver care within the Anschutz community. Learn more about the institute.