Operational Redesign and Transition Update Iman Nazeeri-Simmons, Interim COO Lillian Chan, Transition Director July 8, 2014 1
Transforming Healthcare at SFGH • Rebuild Components – Operational workflow processes – New building, systems and technology – Transition Planning – Continuous improvement • Methodology follows Lean and 3P concepts – Product – Preparation – Process • Expected Outcomes – Service excellence – Clinical quality – Safety – Efficiency – Integration and collaboration across services 2
Why 3P Workflow Redesign? • Creating an exceptional patient experience • Establishing team-based care teams • Eliminating waste • Respect for Patients, Families and Staff • Improve Outcomes • Reduce cost – including house-wide 5S workflow organization 3
Current State San Francisco General Hospital is a world class hospital and trauma center in the elementary stages of adopting new systems of financial and operational accountability. In our current state we have silos of excellence composed of well intentioned, mission driven staff, hampered by aging infrastructure, lack of integrated and optimized technology, and disparate flows of communication. 4
Future State Lean Integrated Comprehensive Optimal use of Data to support Improvement Information Integrated Care Resources decision making Methodology Systems Model SFGH Mission: To provide quality healthcare and trauma services with compassion and respect . Vision for Bldg 25: To be the best public hospital by exceeding patient expectations and advancing community wellness in a patient Clear centered, healing Healing Communication: environment. Service Physical Staff Technology Excellence Environment Department W/ Patients 5
Patient Experience 6
Areas of Focus Surgical & Procedural Services • Scheduled to • Nursing Care • Instrument Set Emergency Department Inpatient Services launch in July Model Consolidation 2014 • Care • Governance Coordination • Pre-Procedural • Pediatrics / Documentation Obstetrics • Day of Service • Bed Documentation Assignments 7
Table-top Models 8
Patient Flow Simulations 9
Targets Inpatient Services Surgical & Procedural Emergency Department Services Patient and family is Number of instruments Coming Soon aware of anticipated removed from surgical discharge date instrument sets Key care plan items Staff hours saved (from documented and known reduced number of by core members of the surgical instruments care team being processed) Discharge patients by Consolidating surgeon noon preference cards Testing: Testing: o Interdisciplinary Team o New basic instrument set rounding with Family with general surgery Medicine. hernia cases. o Surveying providers, o Missing and broken item nursing staff, and log to support patients on coordination with Sterile communication and Processing Department overall satisfaction. 10
Targets Inpatient Services Surgical & Procedural Emergency Department Services Coming Soon Link to A3-3P: Processes are built around Link to A3-3P: Reliable processes utilize the patient, and services mistake proofing concepts are brought to the patient to eliminate defects whenever possible Staff has exactly what Patient Care needs are they need to do their job visual to all care team members There are no waits/ delays Care is delivered by in care respectful, high functioning, integrated care teams Decision making is guided by transparent information 11
Transition Program Transitioning into the New Hospital is about operational readiness, and planning and implementing the move of acute care services from the current hospital to the new hospital. The role of the Transition Director is to facilitate all transition planning and coordination activities to move into the new hospital. Goals for the transition include ensuring: o New operational workflows are planned and implemented in the new hospital. o All essential services are available for the first patient in the new hospital and the last patient in the current hospital. o There is a safe and efficient move of services. o Staff from across departments are actively engaged in the planning process. 12
Transition Program Key Components o Committee Work focused on key tasks and decisions o Transition Master Timeline o New Operational Workflow through Lean / 3P o Clinical and Operational Orientation and Training o Occupancy & Move-In o Licensing by CDPH o Patient Move Day o Post Move Management and Decommissioning 13
How will we get there? Transition Oversight Committee Approval authority for all Transition Plans and decisions Transition Steering Committee Reviews all recommended plans for soundness Support Info Systems/ Orientation & Marketing Operations Patient Care Services Telecomm. Training Communications 14
Transition Timeline 2013 2014 2015 2016 Work Stream Jan Feb Mar Apr Ma Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr Ma Jun Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr y y Project Activation & Transition Milestone Schedule Construction Complete Patient Move Day Dec 2015 Activation Development Transition Committee Work Dept. Move Dept. Move Transition Planning Dept Moves Sequence Planning Logistics Planning Owner Fit-Up Schedule Owner Fit-Up (moveable Planning equipment and supplies) Equipment FF&E Coordination Equipment and Training Technology IT Systems Systems Training Operations Redesign Workflow Redesign 5S 5S Simulations, Operational Orientation & Training Planning Orientation & Orientation and Training Training Clinical Training CDPH Licensing Survey Readiness Hospital Licensing Policies and Procedures Work Plan Review Licensing Patient Move Logistics Development Patient Move Coordination Move & Occupancy Dept Moves Patient Move Day Post Move Mgmt & 15 DRAFT June 2014 Decommissioning
Questions? 16
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