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Group Health wows crowd at lean conference

June 11, 2010

A delegation from Group Health stole the show here at LEI’s Lean Healthcare Transformation Summit with a demonstration of their lean management reporting process.  Rather than presenting a drab slide show, the folks from Group Health essentially pulled three “andon boards” off their walls in Seattle and Burien, flew them to Orlando and gave a live demonstration.

Group Health clinics have three levels of reporting: tier one is at the unit level, tier two is at the clinic level and tier three is at the corporate level.  So, each day, unit team members gather around the tier one board to review the previous day’s observations.  [Note: If I convey any of these facts incorrectly, I hope someone from Group Health will set me straight.] 

Tier one observations relate directly to patient care, right on the “shop floor,” so to speak.  Work is standardized at each level, so any deviations from standard at the unit level mean patients are not receiving adequate care.  Incidents of substandard care, essentially “defects,” are discussed among the nursing team and lean techniques are used to understand the problem and devise a solution to prevent the defect from occurring again.  Examples of lean techniques may include A3 problem solving or root-cause analysis.

Periodically, the unit manager meets with the clinic chief at the tier one board to discuss events of the past period.  The board is arranged so areas where work is proceeding according to standard are green and deviations are indicated in red.  The presentation is simple, clean and low-tech.

A Group Health andon board in the wild.

Similarly, key metrics at the clinic level are arranged on a tier-two board maintained by the clinic chief.  At the conference, clinic operations manager Alicia Eng gave her tier one presentation to clinic chief Wellesley Chapman MD and he, in turn, gave his tier-two presentation to primary care assistant medical director Paul Fletcher MD.  You could clearly see how managerial work is standardized; coaching occurs at each level; problems are addressed at the source; and information directly relevant to patient care moves up and down the organization.

The exchange between Dr. Chapman and Dr. Fletcher was particularly insightful, thrilling and, at times, painfully realistic.  It was as if they postponed their regular Monday meeting in Burien and conducted it onstage in Orlando on Wednesday instead.  Afterwards, I asked Dr. Chapman about this and he said he and Dr. Fletcher prepared some topics in advance but that the conversation was real and, in fact, Dr. Chapman walked away with a fresh list of to-dos based on the onstage conversation with his boss.

The next day, at lunch, I overheard a conference-goer say that one 20-minute “role-play” by the Group Health team was worth the price of admission.  Indeed, Alicia Eng, Wellesley Chapman, Paul Fletcher and Lee Fried should be congratulated for their much-appreciated contribution to the conference.

One Comment leave one →
  1. June 15, 2010 7:46 am

    Exciting stuff. I have read many great reports from this conference. It sounds like many great lessons!

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