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'TEAMwork is spreading ...'

By Dr. David C. Pate, News and Community
June 17, 2013

St. Luke’s has adopted lean principles, which we have branded as TEAMwork: Timely, Effective, Accountable, and Measureable work. Our System-wide goals this year are to create an exceptional patient experience and to create exceptional outcomes through TEAMwork.

I have asked Mike Reno, vice president for performance excellence, to be today’s guest blogger and to update you on some of the many different ways we are implementing TEAMwork to eliminate waste and reduce irrational variation from our care and processes. We’re even using TEAMwork to improve the care of our tiniest patients. And with the input of patients, we are utilizing TEAMwork in a redesign of our revenue cycle processes! Mike’s report follows:

TEAMwork is spreading throughout St. Luke’s, and we continue to expand our thinking about how to apply this management operating system in all our settings. Earlier this month, St. Luke’s leaders spent time with colleagues at Virginia Mason Health System in the Seattle area to see how these principles have been put into practice by a pioneer in the effort.  

Work started at St. Luke’s Clinic Internal Medicine (SLIM) Parkcenter about a year ago has demonstrated just how much improvement clinics, work groups, and teams can realize by learning and adopting these habits of thinking and acting efficiently. Those efforts now are expanding to SLIM Meridian and Jefferson.

And SLIM’s not alone in seeing the benefit. I wanted to share some other TEAMwork projects and successes, and what we’re currently working on.

St. Luke’s Magic Valley and Treasure Valley are piloting TEAMwork communication boards, visual management tools for physicians and staff members to use to identify, acknowledge, and solve problems that impact patient care and the operations of their areas and departments.

Use of the boards helps to make problem-solving a daily activity, keeps us from reinventing the wheel repeatedly in efforts to fix the same problems over and over, improves stakeholder engagement and satisfaction, and helps us make significant headway toward site and System goals and objectives.

Rapid improvement activities, where we engage in rapid-cycle improvements, have meant benefits at several locations and in a variety of settings.

In McCall, for example, the daily checking of crash carts has resulted in compliance improvement from 56 percent to 95 percent.

In the Magic Valley, staff members have created standardized perinatal fetal processes that have improved patient, family, and staff satisfaction.

In Meridian, staff members have created a standardized process and tool for monitoring and documenting policy compliance for nutrition screening and assessment.

And we have reduced the physician credentialing process cycle time in the Treasure Valley by 25 percent.

TEAMwork is serving St. Luke’s early population health management activities as well, in helping us to enroll patients for our CoPartner program, create registries, and produce individualized care plans.

We’re working to develop, pilot, and validate a standardized care model and improved coordination of care for pediatric patients. Scorecards with measures and targets have been established for Peds, NICU, PICU, and outpatients, efficiencies have been identified, and recommendations for change are being assessed for possible implementation.

We’re also using our TEAMwork approach to redesign our revenue cycle. This ambitious and important project involves dozens of employees from many different departments who are working to configure best-practice workflows and create an end-to-end value stream to meet the needs of our patients, family members, and employees. They are working their way through every stage of the billing cycle to identify pain points and solve problems.

We want to improve the patient billing experience and make sure that St. Luke’s continues to be top of mind when patients make their healthcare choices, ensure our financial stability, reduce waste, and improve satisfaction for everyone involved in billing processes.

TEAMwork is helping several St. Luke’s clinics with standardized work-flows and care plans for diabetes patients. A new patient-flow process has been mapped and a diabetes patient registry is being assessed.

And big system standardization initiatives are under way. We are working toward standardizing and streamlining our formulary across all St. Luke’s sites. Through our formulary standardization project, which takes evidence-based medicine as the guide to medication selection, we have evaluated and streamlined 30 of the 64 medication classes so far. 

We’re also working on our master purchase lists of supplies, devices, and other items, because we know that consolidated charge, formulary, and item master lists will go a long way toward our Triple Aim goals of better health, better care, and lower costs. We hope to have our consolidated lists in place this fall.

Training is ongoing. About 700 St. Luke’s leaders have completed TEAMwork Foundations training, and staff-level training began in April. Beginning this fall, the eight-hour leadership class will be taught twice a year, in late spring and in early fall. Staff-level training, which will introduce staff-level employees to the fundamental concepts of TEAMwork, will be conducted regularly in the Treasure Valley, the Magic Valley, and other locations.

Our TEAMwork efforts are one of our tangible commitments to the communities in which St. Luke's operates, and ensure our ongoing ability to provide quality, affordable, compassionate care to the populations we serve.


About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.