Professional Documents
Culture Documents
The Impact of Job Instruction To Standardize Patient C Care: "If You Are Dreaming About It You Can Do It."
The Impact of Job Instruction To Standardize Patient C Care: "If You Are Dreaming About It You Can Do It."
The Impact of Job
Instruction to
Standardize Patient
Care Martha Purrier
Alenka Rudolph
Virginia Mason Medical Center
May 12, 2010
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
“If you are dreaming about it…
you can do it.”
Chihiro Nakao, Chairman and CEO
Shingijutsu International
November 4, 2003
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
1
5/7/2010
Our Strategic Plan
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Virginia Mason Medical Center
• An integrated healthcare system
• 501(c)3 Not for Profit
501(c)3 Not for Profit
• 336 bed hospital
• 8 locations (main campus and regional centers)
• 400 employed physicians
• 5000 employees
• Graduate Medical Education Program
• Research center
• Foundation
• $650,000,000 Net Revenues
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
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5/7/2010
We looked outside our industry, and found a model that we
were sure could work in health care—the lean thinking
philosophy, which we now call the Virginia Mason Production
System (VMPS).
Virginia Mason
Production System
One--by
One by--one confirmation to
Operate with the minimum detect abnormalities.
resource required to Standard Work in One Piece Flow Stop and respond to every
consistently deliver Production
• Just what is needed.
Materials Process
Supermarket
abnormality.
VMPS is modeled on the Toyota Production
System, a management method with over a
half‐century track record of success.
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
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5/7/2010
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5/7/2010
PREVIOUS
STATE
TIME
CURRENT
STATE
Waits and delays
Non value-
value-added
Drive
Flu shot Evidence--based value
Evidence
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
5
5/7/2010
Rapid Response
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Standard Work
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
6
5/7/2010
Need for standard work and training
“Without standards, there can be no improvement.” ‐
Without standards, there can be no improvement.
Ohno
Standards provide stability.
Stability provides visibility.
Visibility provides targets for kaizen.
(Purrier)
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
7
5/7/2010
JI Class
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8
5/7/2010
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
9
5/7/2010
Kotter and JI
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Why Change?
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10
5/7/2010
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
“Just do it!”
Tips for Trainers
1. When you get to a unit, check in…..
2. There is a limit to how many staff you can train
in one setting…
3. When teaching Hourly Rounding...
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
11
5/7/2010
Wins!
“ …Our transfusion safety officer took Metro #303
home a few days agoago. After she sat down on the
bus, took off her badge, and stored it in her
purse, she Purelled her hands. A woman was
watching her and remarked, “You must work at
VM.” When Melanie asked why the woman said
that,, the woman replied,
p , “That’s how theyy do it at
VM.”
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Go the Distance
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
12
5/7/2010
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
13
5/7/2010
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Customers inspecting:
Proper Hand Washing
“Recently I entered a patient's room on
L
Level
l 10
10. FFrom hher bbed,
d thi
this patient
ti t
watched me wash my hands. The patient
remarked, "That is so interesting!
EVERYBODY coming in here washes their
hands the exact same way! I've never
seen anything like it!"
Ellen Noel, Med-Surg CNS
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
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5/7/2010
Culture Change
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Continued Training
• Kelly Debbie Purrier Martha Verkler Arni Rudolph Alenka Kuykendall
Kelly LeBeau Andrew Kopf-Klakken Shirley Finley Christy Rhoades
Brittany Noel Ellen Crickman Rachael Westely Mike Russell
Katherine Anuradhika Anuradhika London Amy Sundet Allison
Ricardi Anthony Sarriugarte Jennifer Marotta Jill Ludgood Lisa
Tempel Rosemary Derheimer Celeste Eusek John Kudo Miwa
Jensen Elisha Honnold Kathryn Smith Donna Fuller Fariba Bishop
Robbi Penick Falon LeGore-Churchill Tonya Cyhan Tamara Haner
Mike Brown Laurel Hebish Linda Bickel Lara Haufe Susan Ching
Joanie Palmer LesleeAnn Luker Sam Knowles Brian Sausser Gail
Suko Jolynn Dolbey Suzanne Tufano Amy Rupp Steve Jachim
Jeannne Cutchin Debbie Phillips Jennifer King Rosemary Howie Jill
Graham Steve Perron Patti Kahn Dana Duscherer Linda
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
15
5/7/2010
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
16
5/7/2010
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
17
5/7/2010
• Infrastructure support
• Continue to apply it to healthcare
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Infrastructure
Targeting the right Jobs- Work to identify the
problem
bl that
th t a “S
“Supervisor”
i ” needs
d tto
solve. Using VMPS tools to identify current
state (Setting up for outcomes).
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
18
5/7/2010
Infrastructure
Trainer Capability Evaluation Sheet
Name:
Department:
Score Notes
Willingness to learn
Adaptability and flexibility
ersonal
eristics
Caring and concerns for others
Intuittive
Patience
character
ability/pe
Taking responsibility
Confidence
Questioning nature
Communication skills
Fundamental/
Attention to detail
Job knowledge
Respect of fellow employees
Willing and Able to Learn- the true Master Trainer is a Master Student. A trainer must have the desire and ability to continually learn
and grow and to reinvest his or her own learning into the teaching. People with this trait make efforts to learn on their own initiative
and accept new challenges.
Genuine Caring and Concern for Others - trainers must want the student to become successful in the task and as a person overall.
They respect others and can be empathetic of a person’s situation as a student. They demonstrate genuine interest in the individual and
naturally make efforts to help others learn- without being asked to do so.
Patience – Conditions for the ideal training situation rarely occur, and challenges are plentiful. Some students will need lots of practice
to master the job. If the trainer is easily frustrated, they will not be able to put the learner at ease so that they can concentrate on the
task.
Persistence – a trainer must stick with the process until the outcome is achieved. They must be “ok” that everyone has a different
capacity for learning new skills and that not everyone will learn at the pace that they have mastered a skill. Persistence should not be
confused with belligerence or doggedness- relentless pestering of the student leads to resentment.
Taking Responsibility - The responsibility for a successful outcome rests with the trainer. If the student hasn’t learned, the trainer
hasn’t taught. They must continue to adapt the training plan until the desired outcome is reached.
Confidence and Leadership - Trainers should be confident and self-assured; viewed as the content expert. They must be able to handle
having their capability challenged, their rationale questioned and should come across as an authority without being seen as an autocrat.
Questioning Nature - trainers should question the content of a job and fully understand why each step is important. They have already
asked all of the questions that students come up. They have sought out the answers on their own and are willing to share this insight.
CopyrightAdapted
2010 Virginia
Directly Mason Medical
from: Liker CenterToyota
and Meier’s All Rights Reserved.
Talent, Any further use of these materials is prohibited.
2007, McCraw-Hill.
Letters to Participants
19
5/7/2010
Leadership Support
Infrastructure
VMPS
Fellowship
VMPS
VMPS Certification
Leadership
Training
Intro to
VMPS
TIES
Orientation
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
20
Level
Periop
Level 8
Level 7
Surgical
L l 14
M edicine
NAMES
Radiology
RN Name
Anesthesia
MD Name
LPN Name
Hospitalists
M IH 102
cu IP
r S
V ri
M cul 103
cu um
V rricu PS
M P
c u l um rin
ci
pl
Pr rricu Hu
oc m e
ed l um an s
H
ur C Fa
ct
an a l P om
do au m or
ff se un s
U Ch ica
ltr ec tio
as n
SKILLS MAP FOR Patient Safety Curriculum JOB INSTRUCTION
90 min classroom
ou kl
U n is
ltr d t*
*
as us
o e*
M und *
D m
Re a
H sp ppi
an ons ng*
d et *
H
It yg o C
ta i all
ke ene s
s T **
M w
ed o*
ic
ati *
H
ig on S
h
R ol
ut
i
30 min Demo/Teach back
Se isk
t-u M on L
p ed ab
Sp S te C e
ec ril hec li ng
im e F k **
** Included in Workshop
Sk en L ield
in ab /
sit el Bar
Ce e p in r
nt r ep
g* ier*
* *
ra **
l
Th L in
15 min 1:1
or eS
ac im
Lu ent e ul
m s at
ba is S ion
Pa r pu i mu
ra nc l
ce t u a tio
D nte s re S n
on is im
S ul
Eq Pe rs im ati
D ui p ona ulat on
of m l io
t e P n
E Per nt rote
Dqui p son ct
iv
on m al e
120 min workshop
St en Pr
er t ot
ec
il e
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
D PP ti v
of
tS E* e
ter *
Application to Healthcare
i le
Application to Healthcare
PP
E*
*
30 min "Cost
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5/7/2010
5/7/2010
6. Document device is 4.
secured
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
References
Copyright 2010 Virginia Mason Medical Center All Rights Reserved. Any further use of these materials is prohibited.
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