Training 30 percent more people. Implementing 30 percent more projects. Achieving 30 percent measurable improvement.
The team at Memorial Medical Center, in Springfield Illinois, calls this the 30-30-30 solution – a framework for their roll-out of Lean Six Sigma and, more broadly, their quality improvement work.
It’s an ambitious goal to set, let alone achieve. But as of 2018, Memorial has reached their 30-30-30 target each year. For eight years running.
“It’s really the driving force that has been giving us momentum to keep moving forward,” says Todd Roberts, Vice President and Chief Quality Officer at Memorial Medical Center.
In 2016, the team’s achievements were formally recognized, winning them the AHA Quest for Quality Prize. “We couldn’t believe it when we found out we won,” says Roberts. “It was a tremendous honor to be the first hospital in Illinois to win the award and it gave us a huge momentum boost and really validated the work we were doing.”
Since winning the AHA Quest for Quality Prize, Memorial has built even more energy behind quality improvement and received accolades on the national and international scale – reinforcing their commitment to quality internally and to the community they serve.
Maintaining pace eight years running
Quality improvement is an ongoing journey, and Roberts admits that maintaining momentum can be a challenge.
“There’s always that gravity that wants to pull you back and there are always initiatives that fail because they don’t have what we call the ‘escape velocity’ they need to,” explains Roberts.
In fact, it was Memorial’s awareness of this challenge and desire to overcome it that prompted the development and implementation of the 30-30-30 approach.
In the eight years that have followed, the results have been impressive. Memorial has trained over 2,500 staff in Lean Six Sigma, completed 450 projects and seen 30 percent return in terms of measurable improvement in the clear majority of them.
But with growth comes challenges, including maintaining momentum across a diverse portfolio of improvement projects. How does the Memorial team keep track of all the moving parts? According to Roberts, it’s by staying true to the processes that have always worked – even while scaling up their quality improvement work.
“We keep all our projects close,” says Roberts. “Every project is approved through our operations steering committee that approves and coordinates our projects to ensure we don’t get overloaded in any one area.”
Staff engagement is critical to maintaining the momentum that has underlined Memorial’s success.
This is due largely in part to the strong culture Memorial has built around Lean Six Sigma. To remain part of the Lean Six Sigma program at Memorial, staff must achieve a certain number of points, earned by participating in quality activities. It is also built into annual performance reviews.
“We are having more and more physicians wanting to do more advanced levels of training and so some of our best projects have been when physicians have led the project,” says Roberts.
Now, according to Roberts, Lean Six Sigma has become part of the fabric of the organization, and the language associated with it is now just part of everyday conversation.
Memorial’s quest for quality
Quality at Memorial is defined by four elements: safety, courtesy, improving outcomes and efficiency. Since winning the AHA Quest for Quality Prize in 2016, the hospital has worked proactively to achieve success in all four of these areas.
Over the past two years, Memorial has seen a 15 percent reduction in complications of care across the organization. In addition to the toll on patients and their families, the additional cost related to every complication of care can total upwards of $31,000.
“It’s a huge success,” says Roberts. “Complications in care increase the risk of mortality by 1.8 times and patients are 1.2 times more likely to be readmitted.”
Additionally, Memorial has reduced rates of hospital acquired conditions by 20 percent and reduced overall mortality by 10 percent.
“We are continuing to drive different safety reporting to give us early notification when an event has occurred, so we can act quickly,” says Roberts. “The faster that we react and take preventative action to make sure we stop these things from happening again, the faster we get to high reliability and the reduction of adverse events.”
By investing in decision science capability and prescriptive technology, Memorial is working to anticipate harm and stop if before It happens.
“We’re able to look at a patient and, based on data points in the profile, anticipate their likelihood of being readmitted or diagnosed with sepsis, for example,” says Roberts. “We are then able to implement interventions so that those predictions don’t happen.”
Bringing quality to the community
For Memorial, the quest for quality doesn’t stop at the hospital doors. Part of their focus has been on population health, bolstered with their partnership with the Southern Illinois University School of Medicine, which operates a federally qualified health center for under-served communities.
“We realized that there were patients coming to the hospital with concerns that could be better met out in the community,” says Roberts. “We wanted to figure out a way to improve their experience but also to reduce the burden on the hospital.” In many cases, patients needed access to behavioral health and primary care services.
To change this, Memorial worked with the school of medicine to embed primary care services in behavioral health organizations, so patients could see their needs met through one access point. By building their capacity for screening within the community, the partnership was able to see patients’ needs met more fully and efficiently.
The neighborhood in Springfield that has been the focus of these efforts has seen an increase in employment and household income as well as a lower crime and recidivism rates.
Their next frontier? “We’re starting to take the same approach to opioids now,” says Roberts. “We’ve put together a community group with the school of medicine, the Springfield clinic, the police department, rehab center court officials and even another hospital to standardize how we approach opioid use in the community.”
While providing the highest quality care within the hospital walls remains Memorial’s core focus, the success of community-based projects have led to a reminder that improvements to health outside hospital walls also translate to improvements within.
If the quality improvement journey at Memorial goes beyond the hospital walls, so does the celebrations of success.
“The support internally and in the Springfield community for everything we’ve been doing in terms of quality has been outstanding,” says Roberts. “As a community, we take tremendous pride in everything we’ve done together to achieve these milestones.
This year’s AHA Quest for Quality Award will be presented at the AHA Leadership Summit, July 26 in San Diego. Interested in applying for the 2019 award? Applications are now open - learn more!
RLDatix is proud to sponsor the AHA Quest for Quality Prize as the AHA’s Champion Sponsor for Quality.