CBA 100 Day Workouts Deliver 50% Reduction in Wait Times for Appointments and Strengthen Patient Engagement.

Situation

As a winner of the 2011 Malcolm Baldrige National Quality Award, patient satisfaction is important to the Henry Ford Health System, a not-for-profi t corporation founded in 1915 by auto pioneer Henry Ford and consisting of hospitals, medical centers and the Henry Ford Medical Group of more than 1,200 physicians practicing in over 40 specialties. This study is part of a larger look at three hospitals in the system, and how each organization uses CBA 100 Day Workouts differently to drive change and solve challenges specifi c to each location. Macomb Hospital’s CEO had heard about the success of West Bloomfi eld, its sister hospital in the Henry Ford Health System, and wanted to test CBA’s 100 Day Workouts for solving its own challenges with quality, throughput and patient satisfaction.

Key challenges included:

• Facing big challenges with throughput. Not effective with:

   

  • No shows.
  • Cancellations.
  • Moving patients to out-patient clinics.
  • Leakage.
• Poor patient experience scores.
• Rejected specimens in the lab.
• Needed to improve responsiveness to patients and families.
• Needed better communication of delays in care.
• While they had an internal performance (PI) support team, that group was not driving the change in metrics that were important to the organization.
• PI team did not engage the entire organization.
• Looking for a unique approach and methodology to get leaders to work differently and embrace change.
• Competitiveness between hospitals in the system.

Solution Applied

Henry Ford Macomb Hospital engaged CBA, tapping its expertise and 15 years of ensuring continuity and sustainable work through leadership coaching that delivers improved margins while driving change and overcoming obstacles.

Engaging Leaders

CBA’s 100 Day Workout structure makes progress, or its absence, instantly visible, thus demanding a corrective response from leadership when unacceptable variations from workout goals occur.

Each workout included a minimum of two (mandatory) successful process changes for all managers, directors, and senior leaders, per month. This creates a sense of urgency and encourages the commitment to change to run throughout the organization while moving the hospital toward its financial goals.

In all, Henry Ford Macomb Hospital has completed two 100-Day Workouts focused on the following high opportunity areas:

• Patient Experience: CBA delivers the structure and proactive methods that enable all teams to help caregivers at the bedside by focusing on key strategic areas that drive the improvement of patient experience scores. This next-gen focus on patient experience goes beyond attitudinal changes alone, to creating an environment that focuses on responsiveness to patients and their families.
• LEAP (Leadership Effectiveness and Accountability Program) for One More Throughput: This leader development approach focuses on improvement plans in Access, Throughput and Quality Teams, with each director/manager implementing at least eight plans - four focused on outcomes of the assigned collaborative team, and four focused on the outcomes of any collaborative team.

Building Sustainability with the Right Tools

Throughout this process CBA also taught Henry Ford Macomb Hospital’s staff how to leverage its core programs like Rapid Cycle Testing and the resources of the CBA ToolBOX, so they could act on the information they were receiving to improve operating margin as a whole. This approach creates an experimental mind set, reducing the fear of failure, increasing speed and reducing barriers to change.

Most importantly, this introduced CBA’s EXCELeratorTM - an online accountability tool giving Henry Ford Macomb Hospital a structure for:

• Validating process changes that affect the bottom line.
• Creating a sense of urgency.
• Taking ownership of changes, assigning accountability and tracking key plans.
• Providing a way to monitor implementation.

Results

Plans were designed with a constant focus on implementation and accountability through coaching and mentoring for sustainable results beyond the initial engagement.

While specific financial metrics may not always be directly tied to patient experience or LEAP leadership training, the results can be measured in other ways, including in employee satisfaction scores and the overall margin improvements.

PI support is no longer the driver. Instead they support the leadership team with the use of tools and data gathering – a better use of their core competency.

Below is a detailed look at Henry Ford Macomb Hospital’s results:

100-Day Workout 1: Patient Experience – Directors and Physician Leaders

The first 100-Day Workout produced 182 completed changes.

Plans Completed	191 (96% of target!)
Targeted Plans	210 (105% of goal)
Savings from detailed plans	$26K
Completed changes	$26K
Director/manager changes	191: 7.6 per manager

Modifying schedules to 45 minute slots has provided an opportunity for moving up patient evaluations when cancellations occur.

Hardwiring incentives to many plans ensures that the changes are implemented and sustained.

Henry Ford Macomb Hospital saw additional results with its Patient Experience workout, thanks to technology implementations:

• 3.4% drop in no show/no calls after implementing Televox automated appointment reminder system.
• Clockwise MD reducing wait times in Urgent Care, increasing overall satisfaction.
• Diverting calls from clinical desk allowing staff to focus on patient care.
• Moving Lab Draw out of Urgent Care improved patient satisfaction and increased efficiency.

100-Day Workout 2: LEAP One More Throughput

For their second workout, Macomb wanted to ensure its leaders were focused on throughput challenges.

Plans Targeted	312
Plans Entered	275
Plans Implemented	235: 6 per manager