Two of the prospective projects were not fully

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Two of the prospective projects were not fully implemented or completed during the study period Outpatient Electronic Health Records and Surgeons’ Preference Cards. The third prospective project was a study of the construction of a hospital using Lean principles. In addition, we studied two specific process changes implemented at L HC’s new Hor izon Hospital to enrich our findings. A total of 67 interviews were conducted with 65 staff members at various levels in the organization between December 2009 and September 2011. Data were collected during three site visits through digital diaries recorded by Lean project participants and through phone interviews. As part of Lean implementation and related efforts, interviewees reported that LHC has experienced improvements in organizational culture, employee satisfaction, and efficiency. Executives report a $29 million return on investment since 2000 when use of the external consultant’s process improvement toolkit began. A portion of that return on investment can be attributed to Lean, which was introduced in 2003. The LHC case highlights the importance of aligning Lean with the organization, having supportive and visible leadership, and including a multidisciplinary team in Lean projects. This case also points to the need for resources specifically staff time, data, information technology, and Lean expertise to implement and sustain Lean.
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20 In 2009, LHC acquired a series of physician practices and consolidated them into a medical group (called in this study “LHC Medical Group”), which employs approximately 200 physicians from various specialties, including family medicine, surgery, and oncology. In addition, LHC’s hospitals employ 130 hospitalists (physicians who specialize in treating inpatients) across the four locations. An additional 1,670 community-based physicians who are not employed by LHC receive privileges to practice at its hospitals and other care facilities (see Exhibit 1.3). Despite its large size, executives and other interviewees indicated that the structure of LHC was relatively “flat.” Although leadership staff for the hospital , LHC Medical Group, and ambulatory care center report directly to the COO of the organization, individuals at all levels have access to senior staff. LHC employs an extensive rewards system for staff performance. Hospital leadership bestows “Wow” Awards o n individual staff members who go above and beyond the call of duty. When an individual receives five “Wow” Awards, he or she can turn them in for a $25 gift card. Individuals and teams are nominated and awarded “STAR Awards,” which are likened to the Grammy Awards. LHC also offers monetary awards and end-of-year bonuses to staff, including management, directly tied to performance according to the five points of the star. Executives and management can receive a 10 to 40% incentive based on the five points of a cultural transformation initiative, which are the basis for setting management goals and objectives.
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