ATAC helping hospital create improvement culture

Students, practitioners and teachers of Lean Continuous Improvement (CI) endorse that sustained success is not a quick gain, but moreover, a continuous and disciplined effort based on the development of an organizational culture of problem solvers.

For the past four years, Auburn Technical Assistance Center (ATAC) -- an outreach unit of Auburn University’s College of Business and an Economic Development Administration University Center -- has partnered with East Alabama Medical Center (EAMC) in Opelika, Ala. to assist the hospital along its CI journey.

EAMC began working with ATAC in 2007 when personnel from its process and quality departments participated in ATAC’s open enrollment courses. EAMC administration determined that there was value to be gained by spreading Lean Continuous Improvement throughout the hospital organization and selected ATAC as a training provider and implementation facilitator. Dubbed ‘EPIC’ – EAMC Performance Improvement Culture -- EAMC’s CI program represents the hospital’s commitment to instilling and sustaining a culture of problem solving, standardization and improvement as its daily operating practice.

Recently, EAMC reported achieving a more than $1 million organizational savings as a direct result of its CI initiatives.

"The $1 million goal measured the areas of cost savings, cost avoidance and additional revenue or revenue enhancement," said Genia Odom, EAMC director of process management. "It has taken a couple of years to really begin seeing large tangible cost savings generated by our initiatives, but we now are recognizing some truly significant results."

Savings are not the result of large capital outlays for additional equipment, technology or manpower, Odom notes.

"Much of the savings have been realized through analyzing the situation with an eye toward recognizing and reducing or eliminating waste and non-value-added activity," Odom says.

In addition to receiving ATAC’s training for senior hospital leadership and other management and operational levels, EAMC multi-disciplinary teams have implemented more than 15 rapid improvement events throughout the hospital and several with an individual departmental focus. Odom says that waste reduction and cost savings have come about as these teams evaluated processes, discovered ways to streamline activity, and in many cases, eliminated a great deal of expense associated with time, supplies, inventory and purchasing needs.

"In some key areas, we have even been able to capture additional revenue by changing our claims procedures," Odom said. "We simply made system improvements that enabled us to more efficiently report and bill for services."

Additionally, EAMC’s EPIC initiatives have developed patient care procedure modifications that are reducing infection risks and improving treatment methods.

"We are not just focused on finding monetary savings," Odom says. "Just as importantly, we are finding that having every one of our employees thinking each day about how to make things better and more efficient, we are not only becoming more fiscally responsible, but also, more effective as a healthcare provider."

Cultural change is arguably the most difficult change to bring about within an organization, and Odom says it has not been an overnight achievement.

"Our internal employee communication program persistently reports CI achievements and other information about EPIC," Odom says.

Odom adds that support is from the highest level of the organization.

"We still are seeing changes in behavior and practice every day, but we can definitely say that everyone is now aware of what EPIC is about and everyone is taking interest."

Odom says that EAMC’s initial $1 million CI goal was focused only on the elimination of waste. Now that CI is an organizational way of doing business, Odom says the next year’s goal likely will involve multiple measurements of cost savings, visual management, leader standard work and other metrics that support improvement and efficiency.

Lean Continuous Improvement is based on the production process so effectively employed by Toyota in the automotive manufacturing industry, and is widely used among manufacturing and other industry. Its approach is focused on eliminating or reducing waste and non-value-added activities from a process and its methodology is readily transferable to processes other than manufacturing. A number of well-known hospitals, such as Virginia Mason Medical Center in Seattle, Washington and ThedaCare of Appleton, Wisconsin are implementing Lean into healthcare and achieving some extraordinary results in cost reductions, patient care improvements and satisfaction, overall efficiency and boosts in employee morale.

ATAC Lean Specialists have visited and studied Lean implementation at Virginia Mason and at other healthcare facilities and have tailored the training and facilitation programs being conducted at EAMC to healthcare. EPIC includes introductory training in Lean Continuous Improvement for various employee groups, coaching and facilitation in conducting multi-day Rapid Improvement Events focused on a variety of EAMC processes; and strategic planning with EAMC’s Administrative Team.