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TEAMwork System Moves St. Luke's Up the Board

By Dr. David C. Pate, News and Community
August 19, 2014

I am very excited about one of the newer additions to our St. Luke’s leadership team: Sandee Gehrke, St. Luke’s Health System vice president of operations improvement. 

Sandee is an experienced and accomplished leader, and I believe that she will help take our initial steps in implementing St. Luke’s lean operating system – TEAMwork – to the next level and toward having TEAMwork be our standard operating procedure throughout the System. 

TEAMwork is essential to drive out irrational variation, a source of waste and a cause of unintended variation in our patient outcomes. The identification of best practices, standardization of care processes across the System, and hardwiring of quality into our processes is in large part responsible for our leading quality outcomes and recognition by Truven Health Analytics as one of the Top 15 Health Systems in the country.  

I am proud of the work being done at St. Luke’s and excited about how much more we have to do, which means opportunity to be even better. Sandee is my guest blogger today and I have asked her to share her perspectives on TEAMwork and areas that she is focusing on.  Welcome aboard, Sandee!

As many know, St. Luke’s has embarked on a journey to achieve the Triple Aim: better health, better care, and lower costs.

With reimbursement models changing and utilization patterns shifting, effective and efficient care in the “right” location becomes even more critical to our success in achieving population health.

The work that will allow us to accomplish all of this is TEAMwork. TEAMwork, as many know, is our management operating system, the culture developed at St. Luke’s as a way of doing things that combines people, process, and problem-solving.


From left, Annette Monterrubio, Kara Dubin, and patty Skeie of the laboratory group discuss the recently installed microbiology TEAMwork board at St. Luke's Reference Laboratory with Vice President of Operations Improvement Sandee Gehrke.

One of our TEAMwork tools in particular has really started to take flight. We are excited and proud of the work being done around our TEAMwork boards. We first introduced a pilot project with TEAMwork boards more than a year ago. The boards are designed to better tap the collective knowledge of all St. Luke’s employees to improve our processes and to make process improvement a daily activity.

The boards provide structure and a visual management tool for staff and physician process improvement by making it more efficient, effective, and transparent. They also give leaders an opportunity to support staff members in process improvement.

We have more than 85 boards deployed across the system and dozens more requested and in the queue for deployment.

We can see how these boards are starting to enhance and promote progress toward department goals that support St. Luke’s Health System’s strategic goals and vision. During our recent Joint Commission accreditation survey in the Treasure Valley, the surveyors commented on how great the use of the board was and how engaged our staff are in solving problems that affect them and their work environments. They were truly impressed!

The process of the TEAMwork board is very straightforward – ideas are encouraged and simple to submit; the team evaluates and chooses an idea to work on; assignments and activities are completed as a result of team brainstorming and action planning; and solutions are implemented, measured, reviewed, and improved.

It’s a continuous improvement cycle to address those problems and issues that arise in daily work, and we are able to solve those challenges quickly at the front lines with those who are impacted the most. We want our teams to feel empowered to try things out and to feel safe in failing fast, as long as the solution isn’t going to hurt anyone, and we know this is an effective way to do that.

We are seeing our St. Luke’s clinics use the boards to identify and improve things as simple as patients struggling with heavy doors or as complex as bottlenecks in the lab specimen send-out process. Our hospital inpatient units have tackled critical medication IV drip order and delivery variation in the PICU as well as cross-department communication improvements. And our board members and executives are using the TEAMwork boards when rounding in the units.

When our boards embark on safety rounds, they gather at the TEAMwork board to see what staff members are working on and what they have identified as potential pain points in their daily work. This has been a great way to start discussions about those things that get in the way of providing exceptional outcomes and exceptional experiences, and allow board members to be part of the solution identification and implementation.

Our TEAMwork boards are just one of the tools and methods that our Performance Excellence team has been deploying for our leaders, physicians, and staff to be better equipped at continuous improvement and problem-solving. I’m excited about the progress we’ve made and look forward to sharing more with blog readers as we continue applying TEAMwork to improve the health of people in our region.


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.