The Science of Improvement
The most innovative healthcare systems in this country don’t just try new ideas at random. They have well-designed systems or methodologies to guide their innovation process.
Much of the science of improvement comes from improvements of standardized processes in manufacturing. It might seem unsavory to consider the complexity and humanity of health care delivery in the same model as improving car parts, but standardizing processes that can be standardized – such as patient scheduling and test results communication – allows more time for the more engaging and healing parts of a health care provider’s work such as relationship-building and problem-solving.
The Model for Improvement and the Plan-Do-Study-Act Cycle: This process includes setting aims; establishing measures; testing changes by planning them, trying them, observing the results, and acting on them to try again; and implementing and spreading changes.
The Virginia Mason / Toyota Production System: An approach adapted from manufacturing that focuses on the patients’ needs and defines any activity that doesn’t directly serve those needs as waste to be eliminated.
Lean and Six Sigma: The Six Sigma methodology DMAIC (Define, Measure, Analyze, Improve, Control) is used to improve processes to deliver better outcomes. Combined with Lean (based on the Toyota Production System above to reduce waste), the model capitalizes both on improving processes to deliver better outcomes and reducing waste.
The Team Handbook is a particularly valuable resource for doing clinical innovation in teams which includes sections on team roles and responsibilities; doing work in teams, including how to most efficiently run meetings; tools teams can use to solve problems; and building an improvement plan.
Spreading Clinical Innovation