{"id":5363,"date":"2015-04-23T00:00:00","date_gmt":"2015-04-23T00:00:00","guid":{"rendered":"http:\/\/localhost:10003\/the-lean-post\/articles\/using-value-stream-management-to-better-care-for-stroke-patients\/"},"modified":"2022-05-17T08:51:59","modified_gmt":"2022-05-17T12:51:59","slug":"using-value-stream-management-to-better-care-for-stroke-patients","status":"publish","type":"post","link":"https:\/\/www.lean.org\/the-lean-post\/articles\/using-value-stream-management-to-better-care-for-stroke-patients\/","title":{"rendered":"Using Value Stream Management to Better Care for Stroke Patients"},"content":{"rendered":"<p>Value Stream Management brings more value to the customer or client by working to transform\u00a0<em>both<\/em>\u00a0process and people. At my organization INTEGRIS, structurally-speaking, value stream management helps us manage multiplestreams of patient care delivery and other supporting business systems.<\/p>\n<p>But to make value stream management really work, the most significant cause for transformation lay simply in the shifting of team members\u2019 mindsets. It\u2019s been a long process, but over the past 5 years INTEGRIS has slowly developed a new Stroke Value Stream Management System comprised of functional team units working together to continuously improve the quality of care of stroke patients and their families.<\/p>\n<p>We\u2019re on our 11<sup>th<\/sup>\u00a0revision with 7 distinct component parts <a href=\"https:\/\/www.lean.org\/lexicon-terms\/value-stream-mapping\/\">value-stream mapped<\/a>:<\/p>\n<ul>\n<li>Preventive education<\/li>\n<li>Community-based care using tele-stroke<\/li>\n<li>ED<\/li>\n<li>ICU<\/li>\n<li>Stroke Unit<\/li>\n<li>Rehabilitation<\/li>\n<li>Post-follow up care and support<\/li>\n<\/ul>\n<p>We at INTEGRIS have made improvements to work processes through what we call integrated care teams that manage the various horizontal patient experiences and process flows. Using this approach, we\u2019ve been able to achieve the following:<\/p>\n<ul>\n<li>deeper knowledge and understanding in specific patient populations<\/li>\n<li>achievement of higher levels of service excellence<\/li>\n<li>continuous improvement of care coordination and transition management<\/li>\n<li>a much better understanding of the patient\u2019s perspective of value-added experiences<\/li>\n<li>improved coordination of patient care through a team dedicated to horizontal problem-solving<\/li>\n<\/ul>\n<p>During these years, as a result of INTEGRIS\u2019s efforts to think across all patient experiences and process flows, the team has had\u00a0<em>major<\/em>\u00a0mindset shifts. As a coach, I\u2019ve asked people to tell me more about how exactly their thinking has changed over time and here\u2019s what a few people have said:<\/p>\n<p><em>\u201cWhen we I looked at the whole flow on the value stream, I had to come out of my own &#8216;piece&#8217; of the patients experience before I could &#8216;truly see&#8217; how each &#8216;piece&#8217; effects everyone else. It really demonstrated just how integrated we really have to be to deliver high value to our patients.\u201d<\/em><\/p>\n<p><em>\u201c\u2019We didn\u2019t know what we didn\u2019t know\u2019 was a shift for me. We always looked at things from a single perspective and in boxes and I never realized that a change in my area could potentially shift a lot more burden to another department that is caring for the same patient I am.\u201d<\/em><\/p>\n<p><em>&#8220;One of the most significant mind-sets shifts for me was when we converted one of our analytics regarding \u201cdoor to drug\u201d time to \u2018neurons saved.\u2019 It truly defined what we do much better than meeting a metric that we were required to meet. It became real when our Neurologist and our Medical Director sat in our team meeting and indicated that if we calculated that time by minutes, we need to think of it as \u20181 minute longer could destroy 1.9 million neurons.\u2019 That woke us up.\u201d<\/em><\/p>\n<p>This is one of my favorite stories:<\/p>\n<p><em>\u201cFrom my view, it helps us to \u2018truly see\u2019 what we need to do to provide the best patient care. It becomes less about me \u201ctrying really hard\u201d and more about a team that helps each other be successful even in the midst of our many moving parts.<\/em><\/p>\n<p><em>For example, there was a time we were all doing \u201cfairly well\u201d within our own departments with our measures and the numbers looked good on paper regarding our \u201cdefect free\u201d stroke care for the patient. But our mindset shifted dramatically when we actually started auditing horizontally within the patient record which included all of the transitions of care for the patient. We were quickly humbled when we discovered one defect occurrence, or more, in each functional department in the horizontal flow of the patient. We were not defect-free and that created a new way of calculating our defect-free measure. As time went on, we actively worked around the value stream on improvements rather than making incremental departmental improvements in one area that might not work for all. No matter how hard we worked on our \u2018piece\u2019 of the stream, we knew we couldn\u2019t really feel successful unless all of our component parts were successful. Our thinking had changed. And we each feel much more connected to each other now as a result of working together around the map because we know and can clearly see that we are producing more value for patients and their families.\u201d<\/em><\/p>\n<p><strong>Where We Are Today<\/strong><\/p>\n<p>The success of our model-line for stroke value stream management has allowed us to spread the structure, process design, and deployment for the cancer patient, pulmonary patient, surgical patient, and sepsis patient. It\u2019s also helped us spread this work across the supply chain and now we are proud to share our story with others.<\/p>\n<p>On a personal level, in my 27 years of healthcare experience, this has been the most meaningful and transformative work I\u2019ve seen to achieve continuous improvement in both patient care delivery and other business systems.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&#8220;To make value stream management really work, the most significant cause for transformation lay simply in the shifting of team members\u2019 mindsets,&#8221; writes Lori Smith.  It\u2019s been a long process, but over 5 years her team INTEGRIS has transformed the way they work. Learn what they did and read team members&#8217; feedback about the process in their own words.<\/p>\n","protected":false},"author":1,"featured_media":5364,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"12549,11564,12196,13037,11694,13076","_relevanssi_noindex_reason":"","footnotes":""},"categories":[31],"tags":[30],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Using Value Stream Management to Better Care for Stroke Patients<\/title>\n<meta name=\"description\" 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