Beaumont Health System, a three-hospital regional academic health system in the Detroit, Mich. area, is engaged in a process improvement plan involving the Kaizen performance improvement methodology. Kaizen, also known as continuous improvement, is a long-term approach with a goal of achieving small, incremental changes in processes to improve efficiency and quality.
Beaumont has taken a team approach to Kaizen, according to Carleen Penoza, R.N., the organization’s director of clinical informatics and electronic health record (EHR) implementation, in which the health system’s IT department is actively engaged with the clinicians to identify opportunities to improve processes within the EHRs.
Prior to a Kaizen, a request form and the scope document is created; depending on the project, the multi-disciplinary team may include members from the executive ranks, physicians, nurses, pharmacists, care coordinators, and other specialists.
The team is responsible for going out to clinical departments and spending time observing the processes and documenting problem statements. Each statement is reviewed by members of the Kaizen team, which recommends changes. It then makes a real-time observation of the Kaizen in the clinical department and documents the results.
Penoza says Beaumont has been using the Kaizen process for about four years, and the IT optimization team has been in place for about two years, after implementation of the EHR (supplied by Epic Corporation, Verona, Wis.) The idea of using Kaizen originated with Samuel Flanders, M.D., executive vice president of quality, safety and clinical effectiveness. Penoza notes that the Kaizen project has been budget neutral.
Kaizen At Work
Penoza gives three examples of Kaizen at work, all at the 1,070-bed hospital in Royal Oak: plan-of-care and caregiver communication improvement; delay reduction in the emergency center; and reducing missed physical therapy (PT) and occupational treatment (OT) missed evaluations and treatments.
Among the improvements, the numbers of OT and PT patients treated have increased significantly, as have the percentage of procedures performed, and missed PT and OT treatments dropped from 47 percent to 25 percent. As a result of the emergency center Kaizen, tracking of radiology tests has been streamlined, allowing physicians to see at a glance that tests are ready to be viewed. Also, immediate access to information about direct admits coming into the ED.
Summing up, Penoza says Kaizen has given Beaumont an opportunity to make on-the-ground observations about how well processes are working and implement workflow changes. The IT department is a critical link in this process: “With IT partnering closely with the hospitals, we are able to make significant improvements to the EHR and, therefore, patient care based on direct observation of bedside caregivers with their direct input,” she concludes.