Data are collected from available systems including

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Data are collected from available systems, including electronic health records (EHR) and scheduling systems when possible. Most often, data are collected manually because the systems are not set up for easy extraction of the data, or data are not collected in the form required for the project. In 2010, during the time that this case study was conducted, the parent organization was updating the EHR system enterprise-wide, in part so that it would be compatible across the o rganization’s campuses. As a result, there was a moratorium on requests that would require modifications to the EHR system or other IT systems at either campus. At the end of the training, each team conducts a “100 -day report- out” to the EOT on results. I f the project has achieved its goals, it enters the “sustainment phase” (described in the next section). If the project goals have not been achieved yet, the team continues the implementation process, described previously. After the project has met its goals and entered the sustainment phase, the team lead is required to submit a quarterly report to the EOT on the project’s progress. The quarterly reports provided by all completed Lean projects are the primary means for monitoring overall implementation of Lean. The team leader, the project champions, and/or sponsors ensure that the project continues to be monitored. These individuals must also ensure that improvements are sustained and that staff are taking ownership of these changes. If progress slips, one of these individuals, usually the team lead, alerts the others and seeks a solution. Exhibit 3.12. Lean Project Roles Mapped to Functional Roles Lean project role Typical job title/role(s) Physician champion Department chair, physician Administrative champion Operations administrator Coach Systems & Procedures staff, analyst Team lead Manager, lead nurse Team members Physician, nurse, scheduler, receptionist, financial analyst, educator
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113 At the project team level, the ongoing monitoring and sustainment are highly dependent on the project. For example, daily monitoring may be necessary for projects that examine scheduling and patient flow issues. Other projects may require less frequent monitoring perhaps on a weekly, monthly, or quarterly basis. Monitoring may require an audit of a patient’s record or other documentation to show process compliance. Examples of other metrics include: turnaround time, number of procedures, cost reports, or frequency of falls or pressure ulcers Dissemination and Spread of Findings Spread of Knowledge and Findings Across Grand Hospital Center As discussed earlier in this section, during the study period, there were three waves of Lean training and 18 participating teams. As of April 2011, two additional waves of training were completed, one in late 2010 and another in early 2011; executives interviewed estimated that 10- 15 percent of the organization’s staff had participated in Lean. Among those trained in each wave, about half were people who had no previous Lean exposure. Given the level of Lean
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