FOCUS: Tobacco Use Screening and Cessation, Depression Screening and Colorectal Cancer Screening

OPPORTUNITY OR PROBLEM

Improved Prevention processes provide a proactive and patient centered approach in health promotion and disease prevention. Improvements will lead to improved patient health as early detection is the most proactive approach. This Hospitals prevention measures were:

Tobacco Use Screening = 73%

Tobacco Use Cessation = 84%

Depression Screening = 89%

Colorectal Cancer Screening = 84%

Additionally, this Medical Center measured Quality Care on a scale of 1 to 5, 5 being the highest. The quality rating was established at a 3. The Medical Center Director challenged the staff to hold Kaizen events that would contribute to improving the Quality Care score from a 3 to a 5.

APPROACH TAKEN

A team of healthcare providers and support staff participated in a Kaizen event, where they mapped the Population Health Value Stream and determined the Prevention Process Rolled Throughput Yield at .0057. The areas of concern were the beginning of the process during pre-planning for patient visits, coordinating with the patient, patient check in, and patient screening, where First Pass Yield was .40, .45, .40 and .40 respectively. A cause and effect diagram identified root causes stemming from constantly changing teams, multiple priorities to juggle, varying clinic schedules and support staffs with responsibilities for multiple teams. Several Lean/Six Sigma tools were deployed throughout Primary Care Clinics to include huddle boards and daily huddles, standard work for pre-planning patient visits, and leadership gemba rounds.

OUTCOME

In Primary Care clinics where huddle boards, daily huddles, pre-planning standard work and leadership Gemba rounds occurred, the following improvements were captured from the process results:

Tobacco Use Screening = 98%

Tobacco Use Cessation = 94%

Depression Screening = 96%

Colorectal Cancer Screening = 91%

These measures indicate prevention processes are running above the National Goals, which are established in the mid-80 percentages. This Medical Center also improved their Quality Care score from a 3 to a 4 in the first month of deployment, and then to a 5 in the sustainment phase of the improvement.

* Due to nondisclosure agreements, the organization referenced in this example cannot be disclosed.