What is Toussaint's Overall Strategy for ThedaCare - Assignment Example

Thedacare Case Study THEDACARE CASE STUDY What is Toussaints overall strategy for ThedaCare? Identify and evaluate the key elements. Toussaint’s overall strategy for Thedacare was aimed at improving the quality and efficiency of medical services. To do this, Toussaint borrowed from Toyota’s lean thinking model in order to provide patients with excellent services such as shorter waiting times for patients, training and certification of employees, as well as the increased use of technology to develop Mythedacare that is an electronic system for medical records, which could be used to provide improved service. This could be achieved by having the patients in the hospital monitored by hand. The development of TIS rested on three particular points. These were the improvement of employee morale, improvement of productivity, and improvement of quality. TIS was founded on a lean-thinking concept pioneered by Toyota, whose principles were value, value-stream, flow, pull, and perfection (Chalice, 2009). These five principles were used to identify waste and then eliminate the waste. The principle of value involved the amount, which the prospective and current customers would be willing to pay while value stream refers to the steps that Thedacare would take to deliver and achieve this value. The principle of flow involves the organization of the various value streams in a way that they could be continuous. Pull refers to the actions that Thedacare would take to trigger this flow from the various needs that the customer may have. Finally, the perfection bit references the continuous culture of change that Thedacare aims to have. 2. How would you assess ThedaCare’s evolving approach to process improvement? Determine appropriate criteria. Is it improving? Why, or why not? How? Thedacare has improved their service delivery in many different areas, including the response time for patients coming in for diagnosis and treatment, correction of the various mistakes that cost the institution, and implementation of strategies that changed the manner in which they arrived at work. Lean thinking and TIS were an important basis for the improvement of the current services currently offered at the institution. Another plus point for the approach is the division of specialists to different departments in their respective places of work, which is supported by the satisfaction of staff and patients working in the institution (Chatman, 2010). Front line employees were engaged in the assessment of the current approaches, rapid iteration of the new processes, and the collaborative effort aimed at redesigning the process. After each event, the institution carries out assessment on process changes to quantify the savings. By holding several processes aimed at mapping of the value stream, as well as lean events, phone triage, and patient registration, the results, were positive. There was a significant drop in accounts or receivable to 44 days from 56, which was equal to a reduction of $12 million. The patient registration process was also reduced to six questions while phone triage abandonment reduced to 3% from 11%. 3. What is the rationale underlying Orthopedics Plus? How is it different from other ThedaCare process improvement efforts? How would you evaluate the new unit? The implementation of Orthopedics pus has seen gains in cost cutting by avoiding the use of outpatient centers, reducing the treatment duration by approximately 50%, and the implementation of an optimal center that has working facilities, which offer high quality of treatment (Grunden & Haggod, 2012). The rationality behind it was the institution’s reticence to allow ambulatory care centers, under the patronage of doctors, to take ambulatory surgery. This was especially important since the institution got half of its profits from outpatient ancillaries and surgery. Therefore, Thedacare had to find a way in which they could work in tandem with the surgeons. Orthopedics plus differs from other process improvement efforts by its deviation from the lean thinking model. Since Thedacare was unable to agree terms with the orthopedics who worked for them at the time, they decided upon hiring new orthopedists as workers of Thedacare physicians. They were guaranteed salaries, as well as a new specialty center on-campus complete with a new model of practice. This was unlike other departments that were scaled back and were evolutions of the earlier departments. The new Orthopedics plus center encompassed all services related to orthopedics, including physician offices, staff, and orthopedic, related services, which also included facilities like radiology and physical therapy. It also includes surgeons, rheumatologists, physiatrists, and sport medicine doctors. This was unlike the other departments that became lean. Additionally, the department did not have any formal or informal requirements. 4. Why is Toussaint taking a leadership role in the two statewide information initiatives? John Toussaint has been the chair for two statewide information initiatives, which have set out to establish Wisconsin as a market leader in increased transparency concerning information on health costs and quality deliverance in hospitals. Additionally, he is now leading a new initiative aimed at developing a new system for payment. Dr. John Toussaint’s leadership in these initiatives is reflective of his confidence in the ability of Thedacare to compete. As long as Thedacare continues to improve over time, they will do better if their purchasing model is based on the value. He also hopes to address the customers on lean rapid improvement, since many local employers have allowed their managers and employees to attend these initiatives. 5. What are the challenges facing ThedaCare in 2007? Many independent specialists and Thedacare physicians have remained unimpressed and uncomfortable with the changes that the institution has introduced. Dr. John Toussaint and his team had managed to turn the institution into an innovation laboratory for health care delivery. However, the challenges of taking these innovations and integrating them throughout every facet of the institution still remain. Secondly, while early data was indicative of Thedacare providing quality care at substantially lower costs in comparison to other competitors, with self-insured organizations and major commercial payers taking note, this had not yielded an improvement in steering more clients to their facilities, or even improved the reimbursement process. Additionally, Aurora, a major competitor, was using their muscle to bargain for improved rates of reimbursement. 6. What should Toussaint do to address these challenges and extend its strategy? Dr. Toussaint needs to seek better ways to engage his physicians in this process. Strategies that he could take up include; the use of credible data to help identify areas that still require improvement for the physicians, provision of visible support through the leaders and managers at the institution and the identification and nurturing of physician champions in order to engage their peers (Graban, 2011). Additionally, he needs to communicate to the physicians the importance of their contributions to the success of the project. While Thedacare is making substantial gains in the form of care, which is provided to patients, they could make greater progress by greater alignment of the institution and physicians to work towards quality improvement together. Physicians via engagement from their employer need to be involved in quality management processes at the institution. The availability of credible data will motivate improvement while effective communication from the administration will spur the involvement of these physicians. References Ball, Katherine. (2008.). Leading in a continuous improvement healthcare environment: stories of transformation. Madison: University of Wisconsin. Chalice, Robert. (2009). Improving healthcare using Toyota lean production methods: 46 steps for improvement. Milwaukee : ASQ Quality Press. Chatman, Ilese. (2010). Medical team training: strategies for improving patient care and communication. Oakbrook : Joint Commission Resources. Nelson, Eugene. Latalden, Paul. & Godfrey, Marjorie (2009). Quality by design: A clinical microsystems approach. San Fransisco: Jossey-Bass. Graban, Mark. (2011). Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement. Boca Raton: CRC Press, . Joe, Aherne. & Whelton, John. ( 2010). Applying Lean in Healthcare: A Collection of International Case Studies. Boca Raton: CRC Press,. Koenigsaecker, George. (2012). Leading the Lean Enterprise Transformation. Boca Raton: CRC Press. Michael, Nelson. & Studer, Quint. (2011). Sustaining Lean in Healthcare: Developing and Engaging Physician Leadership. Boca Raton: CRC Press. Grunden, Naida. & Hagood, Charles. (2012). Lean-Led Hospital Design: Creating the Efficient Hospital of the Future. Boca Raton: CRC Press. Read More