Using Lean Management to Drive Improvement at East Denver Medical Office

Abstracts from the Kaiser Permanente2018 National Quality Conference


Kristin Banks, DrPH, MPH; Tom Kazutomi, MA, NRP;
Mehul Gandhi, MD, MBA; Hanah Polotsky, MD, MBOE

From Colorado

Background: The East Denver Medical Office Building (MOB) has historically scored below the regional average in Patient Satisfaction and People Pulse scores. In early 2017, East Denver leadership partnered with the Kaiser Permanente (KP) Colorado (KPCO) Regional Performance Improvement team to implement a Lean Management system to drive MOB improvement. The system entailed conducting a value stream analysis, implementing an MOB visual management system and leader standard work, and conducting several innovative pilot projects aimed at improving the member experience.
Methods: In early 2017 the East Denver MOB leadership team consisting of department managers, chiefs, and unit-based teams coleads participated in a value stream analysis to identify areas of improvement. The analysis consisted of three interactive half-day sessions in which teams mapped the entire value stream of the member experience from MOB entry to exit. Several areas of opportunity were identified including 1) patient reception and welcoming process, 2) patient wayfinding and physical navigation, and 3) interdepartmental communication. The goal was to improve member satisfaction and create a “Speak-up” culture at East Denver MOB.
Results: Patient satisfaction scores improved significantly from 2016 to 2017 on a number of scales including Overall Satisfaction (59% to 68%), Likelihood to Recommend KP (46% to 52%) and Coordination of Care (43% to 49%). MOB People Pulse scores improved across all 15 indexes from 2016 to 2017. The following themes achieved the greatest improvement: Line of Sight (9% improvement), Feedback and Development (8% improvement), and Engagement Index (5% improvement). In addition, East Denver MOB scored higher than the Colorado Region on all 15 indexes with the most pronounced being Integrity (7% higher than KPCO).
Discussion: Implementing a Lean Management system in an MOB engages frontline teams in solving problems that can improve the member experience, patient outcomes, as well as employee engagement and line of sight. It has the potential to improve efficiency, reduce waste, and enhance communication. However, this system will be most impactful when adopted by senior leadership and across the Region.

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