Chairperson: Steve Osborn, VP Quality Compliance and Improvement, Saint Vincent Health Center

In an industry that is undergoing intense scrutiny, ThedaCare, in Appleton, WI, has been advancing patient care by adapting lean manufacturing principles to the healthcare delivery process. With that work came a realization that we cannot brand ourselves effectively and credibly in our community if we do not first demonstrate the ability to consistently deliver on our brand promise. So, much of our lean work has been with the Human Development Value Stream as a core activity to ensure a primary focus on the people of the organization. This value stream has defined an overall approach to competency assessment and management, defined a specific employer/employee compact to guide the relationship between us, and to ensure continuation of our long-term no-lay-off philosophy, created a robust approach to staff redeployment for those whose positions in the organization have been obsolesced, implemented an A3 based framework for personal development plans for all managers in the organization (140), using the PDSA cycle to manage individual development, and established a rigorous approach to on- boarding and developing leaders in the organization. Specific training of managers and staff have included:
• A robust learning to see workshop (one day) for all ThedaCare staff (4000 people), so that there is a foundational understanding of lean, and why it is important to their work.
• An in-depth lean internship, to ensure the knowledge and skill practice of all lean tools and methodologies for those actively engaged in lean improvements.
• An in-depth working on the business management development internship offering (12 one-day sessions spread over 15 weeks) to ensure active management support and engagement in the lean work of the organization.
This work is now demonstrating significant and measurably positive results in overall engagement of employees affected, and is improving both the clinical and financial outcomes of the business units involved.
SPECIFIC LEARNING OBJECTIVES:
Upon completion of this keynote, participants will
• Be able to articulate the reason for and value of a concerted approach on the human factors in a lean enterprise activity.
• Be able to define their own approach to focus on employee engagement and development as lean changes their organization.
• Understand why it is critical for an organization to establish an internal brand, before going to the community with brand messaging.

Speaker: Dr Roger Gerard, Chief Learning Officer, Thedacare

• Overview of status and implementation of Health Care Reform
• Value based purchasing: progress so far
• Accountable care organizations
Speaker: Margaret Van Amringe, Vice President for Public Policy and Government Relations, Joint Commission

MemorialCare's Management System for the 21st Century (MC*21) is in its 5th year of system-wide deployment. With a booked commitment in our 10-year plan to reduce expenses by $195 million using Lean, we are transforming the way we approach both breakthrough and continuous improvement. Keys to successful deployment and lessons learned will be shared, including:
. Strategic linkage, with shared oversight across a system
. Growth from proof of concept to Value Stream and ˇ§swimlaneˇ¨ planning
. Design and deployment of methods, mindset and management system
. Approaches to resourcing, ROI and budgetary alignment
. Developing internal capability and tiered accountability to reduce dependence on external consultants
Speaker: Helen Macfie, Pharm.D., FABC, Senior Vice President for Performance Improvement and Strategy, Certified Lean Leader, MemorialCare Health System, California

Delivering continuous improvement in a repeatable, reliable way is key to the success of any organization. A two-part approach is needed to create an effective CI model. First, a culture must be established that supports setting goals, identifying gaps, and driving improvement. Second, a framework must exist to support improvement efforts. Proven approaches include Lean, Six Sigma, but may also include Project Management, PDSA, or others. Regardless of approach, an effective framework must exist within the organization to support project teams at the front lines of improving processes and delivering results.

Speaker: Guido Bergomi, Director, Quality & Patient Safety, Cleveland Clinic

Case Study in Clinical Utilization Management IT for Patient Flow

As a leader in the patient flow realm (with 30% of acute- care beds in Canada and an expanding international market), Medworxx shares patient flow best practices, and insights gained from the high pressure environment of Canada’s healthcare system.
Features case examples on how concurrent clinical reviews, and intensity assessments are used to tackle Length of Stay (LOS), readmission rates, and care coordination issues.
Explore why successful patient flow initiatives encompass both the clinical and operational front.

Speaker: Niels Tofting, Senior VP Sales, Medworxx

Flexibility and innovation are more important than ever to healthcare systems, as they transform themselves, slashing costs, redefining value, creating new products and services, and forging new alliances and relationships. For Lean Six Sigma, staying current means adapting, adopting, and reshaping itself to move beyond its traditional focus on efficiency and quality. Join John Cramer as he describes how one healthcare system’s Six Sigma program went from near extinction to re-emergence as a key business partner in going beyond cutting waste to creating value, driving innovation and growth, and a continuous improvement culture committed to delivering exceptional customer experience.

Speaker: John Cramer, Director of Organization Effectiveness/Lean Six Sigma, Memorial Hermann Healthcare System

• Getting people from results thinking to process and people strategy
• Achieving committed leadership: getting everybody in the same place
• Getting the C-suite engaged and then cascading throughout the organization
Speaker: Lisa Fuller, Director of Six Sigma, OSF Saint Francis Medical Center

Learn how a multi-disciplinary team was able to engage pathologists and partner with its hospital customers to achieve significant reductions in both patient identification errors and turnaround time. Sharp HealthCare in San Diego, CA operates a central lab for the processing of all pathology specimens for its multiple hospitals and dozens of outpatient sites. Two issues of concern had been raised by customers of the lab: 1) an increasing number of patient identification errors, and 2) turnaround times that exceeded the 48-hour CAP standard. Hear how the team took ownership and resolved the issues.
Speaker: Amy Kostifas, Lean Six Sigma Black Belt, Sharp Healthcare

After completing this activity, the learner will be able to
• Design a lean workcell
• Apply Lean tools and techniques to a process in order to maximize flow and minimize lead time which will result in reduced cycle time and reduced number of defects
• Understand impact of change and apply techniques to manage that change
• Review key learnings from actual case study
Speaker: Christine C Brown, Lean Six Sigma Master Black Belt, Abbott Diagnostics

• The value = quality/cost equation
• Projects aimed at reducing perioperative costs (5S, six sigma on case cart accuracy, anesthesia supplies, etc.) and improving quality.
Kimberly Hendricks RN, BSN, PCCN, Performance Improvement Leader, Lean Six Sigma Black Belt, Baton Rouge General Medical Center

• Organization level learning
• Getting true buy in from leadership
• The lean manager: a different way of managing
Speaker: Marie Segars, Senior Vice President and Administrator, McLeod Health

• Scheduling
• Process/Guidelines
• Standard Work & Communication
• Leadership & Frontline Management Alignment
• Physician Governance
• Collaboration between departments
• Real time measures
• Change Management
– “Team Grown” Solutions
– Accountability
– Transparency
– Consistency
Speaker: Ashley Simmons, PI Consultant, Florida Hospital

• Using Lean Six Sigma to schedule follow up appointments for patients
• Improving cycle times through better communication among the discharge team
• Increasing discharge completeness through enhancement of the electronic medical record system
Mary Spano, Project Manager/Black Belt Operational Effectiveness, Humility of Mary Health Partners

• Developing basic standards as foundations for improvement
• Holding people accountable to standards
• Ensuring there is no variation to how things are done
Speaker: Kathy Moorman, Director, Pharmaceutical Services, University Community Hospital

• Bridging the gap between payors and providers
• Partnering for better efficiency and service delivery
• Increasing communication and standard work between organizations
• Challenges in integrating systems with a wide range of drivers, goals, and missions
Speaker: Kyleen Gray, QAPI Manager, Venture Behavioural Health

Based on a firm foundation of Lean Six Sigma, in 2009, Mercy St. Vincent Medical Center in Toledo, OH embarked on a care transformation journey that resulted in the development of a performance and quality operating system (QOS) that was implemented throughout the hospital. Significant results over the past three years in length of stay, quality improvements, harm reduction, and employee engagement have been achieved. The QOS is now being rolled out across all CHP hospitals in the system.
Topics covered will include: the Case for Change; Vision for the Future; QOS Components, QOS Principles; and Results.
Speaker: Dawn Burgard, Master Black Belt, Mercy Health Partners

• Creating a measurement system that addresses the needs of an organization
• Relating projects to corporate metrics
• identifying process measurements that really matter to stakeholders
Keith Poole, Director, Performance Improvement - Lean Six Sigma, HCA Hosptial Corporation of America

• Lean operations planning: eliminating and reducing waste in the process system
• Improving future operations through spreadsheet analysis and Lean Six Sigma simulation
Speakers: Lisa Demko, Master Black Belt, Virtua Health
Tejas Gandhi, Director of Management Engineering and Lean Leader, Virtua Health

• How barcode technology can significantly prevent medication administration errors
• How to integrate bedside bar-coding into nursing administration workflow
• Understanding, evaluating and preventing the staff work-arounds with bedside bar-coding that can result from improperly installed processes
Michele Szkolnicki RN, MS, Senior Vice President, Patient Care Services, Cancer Treatment Centers of America at Eastern Regional Medical Center

Beyond Lean Six Sigma, tools such as process simulation can be utilized to further catapult your performance improvement journey. Process Simulation can enable hospitals and clinics to evaluate various “What If “ scenarios prior to constructing additional wings, hiring additional resources, and making other costly business decisions. Using process simulation will enable you to make better strategic planning decisions and differentiate your organization. Simulation incorporates the following Lean Six Sigma tools:

1. Process flow
2. Kanbans
3. FMEA
4. Monte Carlo analysis
5. C&E diagram
6. FTE variation
7. Value added vs. Non Value added activities

Speakes: Tandra Davison, Director of Quality Services, Franciscan Missionaries of Our Lady Health System
Stephen Griffin, CEO, 6SigmaTek LLC

Saint Vincent Health Center is in its 7th year of Lean Six Sigma deployment. Program costs and project ROI have been tracked consistently over that period, and 3 to 5 times annual returns have been consistently achieved, while providing dramatic improvement in customer value. The program includes review by the accounting department.
• Tracking your projects and their ROI
• What are the actual financial returns of Lean Six Sigma?
• Validating your financial results
Speaker: Steve Osborn, VP, Quality Compliance and Improvement, Saint Vincent Health Center

• Learning from a range of different industries
• Identifying successes and translating them to healthcare
• Avoiding the pitfalls
Speaker: Lee Campbell, Continuous Process Improvement Director, US Army Military District of Washington

• Discover how Raytheon Six Sigma is able to recognize the symptoms of waste and variation in healthcare training.
• Through the use of lean six sigma tools, gaps in critical skills and competencies are diagnosed and treated for improved speed proficiency and enhanced patient care.
• Examine lessons learned of ad hoc training processes, tacit knowledge transfer, and measures of learning effectiveness.
Bernie Saboe, Performance Consultant, Raytheon Six Sigma Master Expert, Raytheon Professional Services, LLC

• Discovering Deficiencies in Six Sigma Programs
• Establishing an Identity
• Envisioning the Future & Talent Retention
Jennifer Hackler, Manager, CCES (California Claims and Encounters Strategy) Six Sigma Program Kaiser Permanente

Dr Kaplan will describe how Virginia Mason Medical Center has been applying the principles of the Toyota Production System (TPS) for the past 10 years. In 2002 Virginia Mason leaders created their management system now called the Virginia Mason Production System (VMPS). He will share examples of the methods and tools applied in hospital and clinic settings, the results to date, and the challenges we still face. The VMPS is not just a set of tools but a way of managing to achieve zero defects, lower cost and higher satisfaction for our patients

Participants will be able to:
1. Describe the components of the Virginia Mason Production System, TPS applied to health care
2. Describe key leadership behaviour and structures needed to adopt this management method
3. Assess their organization’s readiness to transform to a “seeking perfection” culture
Speaker: Dr. Gary Kaplan, Chairman and CEO, Virginia Mason Health System

Over the past 4 years, Baton Rouge General has embraced Lean, Six Sigma, and Change Acceleration methodologies to transform the organization’s quality, patient safety, and performance improvement culture. In this presentation, BRG will share specifically the successes of applying Lean and Six Sigma principles in preparation for health care reform and value based purchasing. Examples include improving compliance with evidence based process measures, eliminating health care acquired conditions, improving patient satisfaction, and avoiding incremental costs associated with additional clinical abstraction and public reporting.

Speaker: Erin R. Zeringue, FACHE, CPHQ, Vice President Quality and Performance, Lean Six Sigma Master Black Belt, Baton Rouge General Medical Center

• Building expectations: designing a system that targets zero errors
• Using EMR as a tool for eliminating errors
• Ingraining it into the corporate culture
• Case studies in getting to zero errors in hospital quality and safety
Speaker: Erik Steele, Chief Medical Officer, VP, Eastern Maine Healthcare Systems

• Adopting a partial or modified approach to Lean Six Sigma without the cost of widespread application
• Integrating Lean Six Sigma with other existing quality initiatives
• Making the most of the manpower and funding available
Speaker: Karen Wolk Feinstein, PhD, President and CEO, Jewish Healthcare Foundation. CEO, Pittsburgh Regional Health Initiative

Panelists:
Stephen Griffin, CEO, 6SigmaTek LLC (Chairman of Panel)
Karen Wolk Feinstein, PhD, President and CEO, Jewish Healthcare Foundation. CEO, Pittsburgh Regional Healthcare Initiative
Marie Segars, Senior Vice President and Administrator, McLeod Health
John Cramer, Director of Organization Effectiveness/Lean Six Sigma, MEMORIAL HERMANN HEALTHCARE SYSTEM
Bob Hody, Assistant Director, Lean Sigma Deployment, Armstrong Institute for Patient Safety and Quality, JOHN HOPKINS MEDICINE
Forrest Breyfogle, CEO and President, SMARTER SOLUTIONS

• Putting the patient at the centre: using a Patient Aligned Care Team that delivers efficient, comprehensive and continuous care through active communication and coordination of healthcare services
• Changing the culture to create a patient focussed approach
• Improving access to care
Speaker: Susan Yu, Chief of Systems Redesign, Veterans Administrative Medical Center

• Design and implement a systematic approach to problem solving based on lean principles
• Drive discipline in solving problems in your organization
• Increase effectiveness of problem solving
• Develop a culture to support a problem solving system that increases the rate of continuous improvement
• Achieve better business results through effective problem solving
Maria Galaviz, Manager, Lean Six Sigma Department, Sandia National Laboratories
Tamara Rodriguez, Manager of Active Ceramics Production and Development, Sandia National Laboratories

• Using data to identify root causes for why CLABSIs and VAPs are occurring
• Implementing interventions to address root causes
• Developing a culture of safety at the unit level to prevent infections
• Gaining acceptance through physician education, participation, understanding, and support
• Developing a plan to monitor interventions and ensure improvements are realized and maintained
Speaker: Kristi Hanson, Process Improvement Leader, Northwestern Memorial Hospital

• Using Lean Thinking and Process Simulation to understand patient needs and how to meet them
• Whole system partnership to create learning and cultural change
• Surprising discoveries and benefits

Speakers: Andrew Fordyce, Consultant Oral and Facial Surgeon, South Devon Healthcare NHS Foundation Trust
Dr. Michael Swart, Consultant Anaesthetist and Intensivist, South Devon Healthcare NHS Foundation Trust

Managing projects in a large healthcare system
• Dealing with multiple facilities and locations and different leadership silos
• What does lean system-wide mean?
• Ensuring accountability and tracking performance
• Achieving visibility and control thorough the entire process
Ekta Punwani, Director, Operations Improvement, Advocate Health Care

• Case studies of clinician driven Lean Six Sigma projects
• Working towards a zero error rate
• Demonstrating and quantifying improvements in patient safety
Bob Hody, Assistant Director, Lean Sigma Deployment. Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine

• Using an electronic callback system
• Getting patient feedback and opportunity to intervene before the patient satisfaction survey
• Results achieved and tools used
Speaker: Dale Wood, Chief Quality Officer, Charleston Area Medical Center

Healthcare and other organizations often report performance metrics through a table of numbers, pie charts, stacked bar charts, red-yellow-green scorecards with variance to goals, and/or time series charts. Organizations that use this form of historical data reporting for running a facility is not unlike driving a car by only looking at the rear view mirror – an unhealthy practice.
Described is a unique predictive organizational performance measurement and improvement system that can be used to orchestrate efforts for addressing today’s healthcare challenges. This system provides an integrated methodology where organizations can “look out its windshield” and, if they don’t like what they see, can make adjustments through targeted improvement efforts that positively impact the business as a whole.
Speaker:Forrest W. Breyfogle III, CEO and President, Smarter Solutions

No clinician wants to accept the occurrence of medical errors as inevitable. A team of nurses and pharmacists aimed to reduce medication administration errors in their Pediatrics unit by using Lean and Six Sigma to:
• Examine the process flow to understand where errors could occur
• Identify potential causes of errors via Ishakawa diagrams
• Analyze survey results of staff and patients pre- and post-intervention
• Introduce visual cues for improved communication among all staff
Speaker: Valentine Boving, Senior Quality Engineer, Office of Performance Improvement, U.T. MD Anderson Cancer Center

•the many faces of innovation in healthcare
• the benefits of innovation in healthcare
• the disruptive nature of innovation in healthcare
•keys to innovation
• inspiration
• integration
• implementation
•innovation leadership
• fostering the culture
• staying out of the way
• team development
•barriers to innovation (and how to overcome them)
• cultural
• financial
Dr. Robert Lancey, Medical Director and Chief of Cardiac Surgery, Bassett Healthcare