Leadership session: Establishing an Environment of Continuous Improvement

Editor's Note

Establishing an environment of continuous improvement is crucial to the quality of patient care, speakers told attendees during this Monday afternoon session at the OR Manager Conference. They shared how they improved the quality of care with a performance improvement initiative targeting first case on-time starts (FCOTS).

Matthew Miller, MD, associate professor of the Department of Otolaryngology at the University of Rochester—UR Medicine, noted that they “wanted performance improvement and efficiency” because when even one person on the staff was unhappy with the way things were working, it would trickle down to the entire staff. However, performance improvement is a process; it does not happen overnight. “We couldn’t be active participants and change because we didn’t have the right structure,” Miller said. “We had to start from scratch.” 

Carrie Steiner, senior director, Operations Excellence, at the University of Rochester—URMC, SMH, shared with attendees the 12-month implementation plan for improving FCOTS from 32% to 64% within 5 minutes of the scheduled start time. “It’s important to have everyone on the team involved,” Steiner noted. The project team consisted of sponsors, the process owner, stakeholders, the core team, an extended team, and a project manager.

The speakers shared how they utilized the LEAN Six Sigma DMAIC methodology, which is a structured approach to comprehend and attack a complex problem. “It’s not one thing; it’s multiple things that need to come together,” Steiner said, adding that it was important to understand the full scope of the problem. 

Attendees were given a take-home step by step guide for building a continuous improvement structure by incorporating the DMAIC methodology: 

• Define the problem 
• Measure the current state
• Analyze data and root causes
• Improve the process
• Control the new process.

Steiner shared that the on-time average has improved 11% in the past 4 months. But the process is ongoing. They will continue with holding monthly team meetings, during which they keep monitoring on-time percentage, as well as roll out and reinforce solutions.