THE BOTTOM LINE: In 2013, when Dr. Eric Dickson took over as President and CEO of UMass Memorial Health, the large healthcare system was in financial trouble and patient and caregiver satisfaction was waning. He proceeded to establish a management system that defined standard processes and behaviors throughout the organization, engaged everyone in improvement activities, and developed the means for caregivers to offer tens of thousands of innovative ideas — leading to substantial improvements for patients and staff and financial stability.
When Dr. Eric Dickson became President and CEO of UMass Memorial Health in 2013, the healthcare system was close to default and patient and caregiver satisfaction was waning. In this white paper from Catalysis, learn how Dr. Dickson established a management system that defined standard processes and behaviors throughout UMass Memorial — now with more than 15,000 employees and 2,500 physicians — and engaged everyone in improvement activities.
Dr. Dickson began to learn about and apply lean thinking in healthcare while Head of Emergency Medicine and Interim COO at University of Iowa Health Care. He was inspired by a presentation by John Toussaint, then CEO of ThedaCare in Wisconsin and now Executive Chairman of Catalysis, and the two have remained connected by lean for decades. “When he talked to me after the presentation, I could see this guy gets it,” recalled Toussaint. “I wasn’t sure where he was going to go exactly, but he was one of the few in the audience that actually had any clue about what I just said.”
Dr. Dickson proceeded to visit ThedaCare often, initially while at Iowa and often with teams from UMass Memorial. He and others were seeing and understanding that leadership isn’t about telling people what to do — a trait deeply embedded in MDs, especially Emergency Department MDs. He instead recognized that leadership is about treating everyone with respect and engaging those doing the work in improving the work.
He said a lean transformation of a healthcare system must begin by defining True North, which must come from the CEO.
Start by understanding where you are and then where you want to be — True North (best place to give care, best place to get care).
“Then organize and engage every one of your people every day to move from where you are to where you want to be. When I ran a department, I could do that for the department. When I was CEO of a hospital, I could do some of that. But there’s no position like the CEO position of a healthcare system to really drive culture change and lean.”
Dr. Dickson used UMass Memorial’s success with clinical standardization as a springboard to convince managers throughout the healthcare system to standardize management processes and join frontline caregivers in continuous daily improvement. He installed the UMass Memorial Management System, an early, decisive step based on his realization that the role of leaders needed to be redefined: healthcare leadership is about taking care of those who take care of patients — a core principle built into UMass Memorial’s management processes. The management system today consists of nine standardized processes and three levels of engagement — system (e.g., presidents, senior VPs, etc.), entity (unit leaders), and departments (managers and frontline associates) — with teams regularly using visual management and problem solving and catchball occurring up and down the levels.
Another key element of UMass Memorial’s lean transformation has been the expectation that all caregivers participate in improvement initiatives and propose improvement ideas, using a technology platform called “Innovation Station.” The system has resulted in 132,000 frontline staff ideas in the past decade, with a 48% year-over-year increase.
System-wide improvements that have occurred at UMass Memorial would not have been possible without providers and staff adhering to the UMass Memorial Management System — everyone, regardless of role, business unit, or department, collaboratively marching to the same beat. Many of these system improvements have been documented by Catalysis, including:
- Redesigning an emergency department to streamline patient flow, which significantly reduced discharged patient length-of-stay.
- Reducing communication barriers and improving access to information between clinical teams and Radiology that were contributing to significant discharge delays.
- Setting up a field hospital during COVID in just 11 days, one with all the capabilities of a brick-and-mortar hospital.
- Life-saving improvements to the follow-up of sub-acute, unexpected, actionable radiology findings to ensure patients and their physicians receive timely awareness of needed care.
UMass Memorial improvements under Dr. Dickson’s watch have included increased patient performance scores (willingness to recommend the hospital) and financial stability (highest bond rating in healthcare system’s 35-year history).
“I just really want to know that this is becoming a better place for our people. I know it’s better for our patients,” said Dr. Dickson.
And then the most important thing for me right now is … to make sure that I’ll turn this place over in better shape than I got it and that I set the next CEO up for success.
“And that’s having a great team around them, that’s having a great culture, that’s making sure we get somebody that fits into that culture.”
Dr. Eric Dickson will deliver a keynote at the LEI Lean Summit in Houston on March 12-13.
LEI has partnered with Catalysis to offer a healthcare track at the Summit, with keynotes and learning sessions led by healthcare leaders.
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