Original Publish Date: March 26, 2020
The coronavirus (COVID-19) was declared a pandemic by the World Health Organization on March 11, 2020, and it has disrupted the global health community, sparking immediate concerns for all types of health care organizations.
With more than 438,100 global cases known at the time of publication—and approximately 59,000 of those in the United States—your organization should be asking important questions, including the following:
Lean methodologies—an approach to health care that focuses on continuous improvement and long-term success, rather than finding quick fixes—help provide insight into improving patient and staff safety. Our lean health care professionals—including physicians, clinicians, and former health care C-suite administrators—have confronted similar health crises with these practices, including the Ebola scare and the Swine flu, and can guide you through a pragmatic lean approach to help you prepare.
Below, we explore how lean can help your organization combat the coronavirus and establish best practices in the following categories:
Leadership responses and actions will need to vary by level.
During times of increased stress, it’s important that leadership stays focused and aligned to support the organization as a whole. Executive leadership should prepare by taking the following actions:
Leadership at the management level will want to focus on how effectively current processes within the organization are operating, and how they can be improved or amended based on patient influx or other unpredictable events.
With a crisis at hand, leadership will likely have to make many tough decisions in a short period of time. Avoid planning through excessive administrative meetings in conference rooms. Instead, learn by going to the gemba, or the place where the actual work is being done.
Here, leaders can better observe current conditions and practice humble inquiry—the act of asking rather than telling—to more immediately identify issues affecting patient care that require attention. Your leaders will see firsthand how patients move through your system, and how caregivers interact with them.
In addition to observing your people, your leaders will also be able to assess the use of:
By going to the gemba, you can determine what your teams need to do their work most effectively and experience the barriers that get in their way.
Consider planning a kaizen, or continuous improvement, workshop to evaluate and make changes to your current processes and operations. Kaizen workshops help to quickly:
These workshops can also help management create standard practices and provide methods to train staff. Workshops also allow management to explore better methods for organizing workspaces.
With an increased workload and pressure to act quickly and effectively, management will need to stay focused and organized. Help keep important plans front of mind through the following actions:
Daily Management System
Implementing a daily management system can build quality into your processes and help reduce clinical variation that prevents timely and appropriate care. Once in place, a system provides the structure and standard procedures needed for continuous improvement, against which you can reliably measure progress. Consistent use of a daily management system includes the following best practices:
A3 thinking—a structured problem-solving approach that relies on critical thinking and root cause analysis—can help your organization identify and solve issues within your processes. By doing so, you’ll want to consider the following questions related to problem-solving:
Kata Coaching—or Structured Teaching Routines
In a complex, rapidly changing setting, it’s often hard to know where to start in problem solving. Kata coaching is a consistent practice that can help you deliberately form new habits that spur improvement.
Management should help train staff members to form patterns of behavior that develop their skills to the point where actions become second nature. When confronting challenges and aiming for continuous improvement, leadership should ask staff structured questions to help them move from their current, or actual, condition to their target, or future, condition and to define barriers that need to be overcome.
These questions include:
During an outbreak, patient volumes and demand for appointments and advice will increase across all points of access, from scheduled and walk-in visits to phone calls and emails. It’s likely your organization will be inundated with information requests and communication needs, both internally and externally. Actions that can help support these influxes include the following:
Preparing phone and front-desk scripts for staff to share with patients can help address their anticipated concerns. Helpful messaging directives could include the following:
Consider how infected patients will move throughout your organization if demands for care increase. You can address these issues by working to:
Keep in mind how the virus and dealing with its effects may impact your staff schedules and care teams. Support their well-being through these actions:
If patient population numbers increase, you could experience an increased demand for supplies, as well as an influx of new test kits and safety materials. Keep procedures in place around organizing and monitoring necessary supplies through the following actions:
With increased activity across your organization, it will be easy for misinformation to spread or for directives to get lost in the shuffle. Keep your staff organized and updated with crucial information through the following actions:
Triage and Treatment
Your frontline teams are often your best resources in determining how to confront problems that arise. Help empower your staff to prepare for a situation like the coronavirus with these actions:
Consider how you will need to interact with patients based on the setting in which they’re being treated. Actions based on settings may include the following:
Compose and implement separate evidence-based triage and care pathways for ambulatory patients who call, email, or walk into your clinics and hospital settings, including the following categories:
Patients will be worried and look to your professionals for information and reassurance. Keep patients properly informed and comforted through the following communications tactics:
We’re Here to Help
To learn more about how lean methodologies can help your organization prepare for and manage cases of coronavirus that could present in your health system, or to start testing your preparation process, contact your Moss Adams professional.
Dahlia Mak is a managing partner in the Lean Health care practice of Moss Adams. Dahlia coaches leaders from large integrated delivery systems, academic medical centers, and public health systems in quality and patient safety, process improvement, strategic planning, and change management. She brings together executives, boards, providers, frontline caregivers, and staff, to apply lean methodology and solve complex problems. She can be reached at firstname.lastname@example.org or (206) 302-6888.