The Benefits of Engaging Staff in Daily Improvement

Do you engage your medical practice or hospital staff in daily improvement? Doing so can bring huge benefits to your organization, according to Rhonda Stewart, a faculty member with Virginia Mason Institute, a leading provider of lean healthcare training, workshops and seminars.

“Engaging staff is important because they're the ones doing the work,” Stewart explains. “They’re the ones that can come up with the great ideas about improving their work.”

But doing so on a daily basis? Isn’t that overkill? Not according to Stewart.

“It has to do with addressing the problem as it happens,” she says. “When we talk about mistake-proofing, we talk about addressing a defect as it occurs.”

Huddling Up

One of the key elements covered in the institute’s Engaging Staff in Daily Improvement workshop is the morning meeting, or huddling up. Doing so every morning enables staff and leaders to get at the root cause of problems occurring at the moment, not one month later when a report comes out and staff can’t recall what happened to which patient.

“We want to [huddle up] as close to the problem as possible,” Stewart says. “In some of our activities when there’s a defect, like a patient fell in the hospital, we’re going to come right to the patient’s bedside and address it at the point of the fall.”

If that sounds a little like benchmarking, it is. Stewart says the morning huddles help to identify problems and establish a baseline from where the team will work through a problem. It also encourages staff to come up with, and own, their ideas.

“We have a system called the every day lean idea system,” she says. “Staff can come up with ideas and test it themselves if it’s a small scope. They can share it with their coworkers maybe at tomorrow’s huddle. Leaders can then help coach the staff through the process.”

Overcoming Challenges

Stewart says one of the biggest challenges she has to overcome during workshops is when participants say they have too many meetings, and don’t have time to meet with their staff every day. Her comeback is that those individuals—leaders within their healthcare organization—need to figure out a way to get all or some of those meetings off their calendar. Or at the very least, schedule their staff huddle at a time when they’re least likely to miss it, such as first thing in the morning.

“Having the huddle first thing in the morning, and addressing the issues with the staff right away, will enable staff to be more productive throughout the day and get their work done,” Stewart explains.

Another challenge can be personality and culture issues among staff members. For some, culture dictates that they remain quiet and not voice an opinion. Others may be very outspoken and tend to dominate the conversation at a meeting. Stewart says there are techniques to address those situations.

“In the huddle, you might have a different leader each day,” she says. “Pass the baton around, and have the quiet person lead the huddle on Monday. That gives everyone a turn to be the speaker and have their say.”

And that helps build consensus, a critical element if positive change is going to occur. Even if some staff members can’t give a proposed change in procedure an enthusiastic thumbs up, if they understand why the change needs to take place—such as leading to a better patient experience—they can agree the change is something they can live with.

Financial Impact

Engaging staff in daily improvement can positively impact a medical facility’s bottom line. Consider the morning huddle. Stewart explains that by preparing for the day ahead, even the next day to come, staff can make certain that everything is in place when each patient comes in.

“It’s making sure you get set for the day so it runs smoother, more efficient,” Stewart says. “And it helps with overtime. That’s a big factor that has gone down because we know when to do the work and we’re staffed to do it. And because we’re more efficient, it allows more patients to be put on the schedule, which translates into more revenue.”

Another financial consideration, says Stewart, is standardizing every room in the practice. In other words, having the same equipment and the same supplies stocked. Have procedure kits set up for any type of procedure the physician may need to perform, so that he or she doesn’t have to run in and out of the exam room looking for supplies.

“And as you standardize the inventory, then you have to hold less inventory,” she says. “That means more money in the bank versus money sitting on the shelves.”