Selected Podcast
Ep. 3: Pursuing High Reliability
Roxanna Gapstur, President and CEO of WellSpan Health is joined by Dr. Michael Seim to discuss how to not only meet but exceed consumer expectations through reliability.
Featuring:
Dr. Seim joined WellSpan from Park Nicollet Methodist Hospital, the flagship hospital of HealthPartners Health System in Minnesota, a $7.5 billion integrated delivery and financing system, where he has served as the hospital’s Chief Medical Officer since 2017. He also served, simultaneously, as Interim Vice President of Quality and Safety for the Park Nicollet Methodist Hospital and Park Nicollet Clinics. Prior to his appointment as CMO, Dr. Seim served as Medical Director of the Emergency Physicians PA and Chair of Emergency Medicine at Park Nicollet Methodist Hospital from 2009 to 2017.
During his time as CMO at Park Nicollet Methodist Hospital, Dr. Seim served as chair of HealthPartners systemwide committee for quality performance and led a movement toward a more results-oriented culture. He has extensive training in both lean leadership practices as well as patient safety through the Intermountain Health collaborative and the Institute for Healthcare Improvement. His efforts included working across HealthPartners to coordinate with the system’s seven hospitals and its many outpatient clinics on quality measure performance, continuity of care and readmissions programs. In 2018, the hospital earned a Quest Citation of Merit from the American Hospital Association for quality programs, reducing the number of hospital-acquired infections and advancing a high-reliability organization.
Dr. Seim has also been actively involved in supporting diversity and inclusion efforts in the workforce, and in health equity quality measurement through the Institute for Healthcare Improvement’s Pursuing Equity initiative. As a result of these efforts, Park Nicollet Health Services reduced health disparities in mammogram and colorectal screening rates by 50 percent.
Dr. Seim earned a bachelor’s degree from the University of Notre Dame and his medical degree from Texas A&M’s Health Science Center medical school. He completed an internship and residency in Emergency Medicine at East Carolina University/Pitt County Memorial Hospital in Greenville, N.C. He is a board-certified Emergency Medicine physician, an Intermountain ATM Accredited Quality Improvement and Safety Officer, and has an Advanced LEAN Certification.
In January 2019, Roxanna Gapstur assumed the role of President and CEO of WellSpan Health. She has over 25 years of healthcare leadership experience working in group practice, academic, and integrated health care systems which included health plan operations. Prior to her appointment at WellSpan, Dr. Gapstur was a senior vice president and president within the HealthPartners system in Bloomington, Minn.
Dr. Gapstur has extensive experience in strategic planning, business development and operational leadership in both ambulatory and hospital settings. She has served in multiple executive roles including chief operating officer, chief nursing officer and as a senior executive accountable for population health.
Dr. Gapstur obtained her bachelor’s degree from the College of St. Catherine in St. Paul, Minn., and her master’s degree and doctorate from the University of Minnesota.
She was named a “Top 35 Women in Healthcare Leader” by Minnesota Women’s Health Leadership Trust in 2014. Dr. Gapstur has participated as a member and president of non-profit boards, including the Greater Twin Cities United Way, Minnesota Chapter of the National Hemophilia Foundation and the Minnesota Organization of Leaders in Nursing.
Michael Seim. MD | Roxanna Gapstur, PhD, RN
Dr. Seim was appointed to his current role in April 2020. As Chief Quality Officer, Dr. Seim is responsible for quality across the system, including Quality Management and Clinical Improvement, LEAN Management Systems, Infection Prevention and Control, Patient Safety, Performance Improvement, Clinical Risk Management and Regulatory Compliance.Dr. Seim joined WellSpan from Park Nicollet Methodist Hospital, the flagship hospital of HealthPartners Health System in Minnesota, a $7.5 billion integrated delivery and financing system, where he has served as the hospital’s Chief Medical Officer since 2017. He also served, simultaneously, as Interim Vice President of Quality and Safety for the Park Nicollet Methodist Hospital and Park Nicollet Clinics. Prior to his appointment as CMO, Dr. Seim served as Medical Director of the Emergency Physicians PA and Chair of Emergency Medicine at Park Nicollet Methodist Hospital from 2009 to 2017.
During his time as CMO at Park Nicollet Methodist Hospital, Dr. Seim served as chair of HealthPartners systemwide committee for quality performance and led a movement toward a more results-oriented culture. He has extensive training in both lean leadership practices as well as patient safety through the Intermountain Health collaborative and the Institute for Healthcare Improvement. His efforts included working across HealthPartners to coordinate with the system’s seven hospitals and its many outpatient clinics on quality measure performance, continuity of care and readmissions programs. In 2018, the hospital earned a Quest Citation of Merit from the American Hospital Association for quality programs, reducing the number of hospital-acquired infections and advancing a high-reliability organization.
Dr. Seim has also been actively involved in supporting diversity and inclusion efforts in the workforce, and in health equity quality measurement through the Institute for Healthcare Improvement’s Pursuing Equity initiative. As a result of these efforts, Park Nicollet Health Services reduced health disparities in mammogram and colorectal screening rates by 50 percent.
Dr. Seim earned a bachelor’s degree from the University of Notre Dame and his medical degree from Texas A&M’s Health Science Center medical school. He completed an internship and residency in Emergency Medicine at East Carolina University/Pitt County Memorial Hospital in Greenville, N.C. He is a board-certified Emergency Medicine physician, an Intermountain ATM Accredited Quality Improvement and Safety Officer, and has an Advanced LEAN Certification.
In January 2019, Roxanna Gapstur assumed the role of President and CEO of WellSpan Health. She has over 25 years of healthcare leadership experience working in group practice, academic, and integrated health care systems which included health plan operations. Prior to her appointment at WellSpan, Dr. Gapstur was a senior vice president and president within the HealthPartners system in Bloomington, Minn.
Dr. Gapstur has extensive experience in strategic planning, business development and operational leadership in both ambulatory and hospital settings. She has served in multiple executive roles including chief operating officer, chief nursing officer and as a senior executive accountable for population health.
Dr. Gapstur obtained her bachelor’s degree from the College of St. Catherine in St. Paul, Minn., and her master’s degree and doctorate from the University of Minnesota.
She was named a “Top 35 Women in Healthcare Leader” by Minnesota Women’s Health Leadership Trust in 2014. Dr. Gapstur has participated as a member and president of non-profit boards, including the Greater Twin Cities United Way, Minnesota Chapter of the National Hemophilia Foundation and the Minnesota Organization of Leaders in Nursing.
Transcription:
Dr. Roxanna Gapstur: When you think about your last healthcare experience, what were your expectations. You wanted to know your concerns would be heard, you'd receive the safest care, and you'd have the best possible outcome. In healthcare. This is the minimum that our consumers expect from us. But as an industry, we're only just beginning to meet these expectations consistently. Today, we'll explore the journey to high reliability through three topics, the road to consistency in healthcare, the best place to find solutions to not only meet, but exceed consumer expectations, and guidance for leaders to drive consistent, reliable results in any industry. Joining me today is Dr. Mike Seim, Chief Quality Officer for WellSpan Health. Mike, thanks for being here.
Dr. Mike Seim: Thanks Roxanna for inviting me.
Host: So Mike you've recently joined the team at WellSpan, and we're so glad to have you. You've made a commitment to our focus for high reliability, and you bring a wealth of experience to advance our journey. There's no business, more human, or perhaps more complex than healthcare. It makes the journey to high reliability, an absolute must for any organization delivering on promises to their consumers. What does high reliability mean to you Mike?
Dr. Mike Seim: High reliability to me is based on three guiding principles. First, it's a commitment by leadership to being trustworthy and setting a vision to become failure free over time. Second is creating a culture that allows team members, clinicians, and leaders to routinely recognize and report errors and improvement opportunities. Third, that we, as an organization are committed to the widespread use of lean principles and tools to drive for continuous improvement. Everyone on the team must be committed to providing care that is of the highest quality and safety and our patients and family are confident in the care that we provide and know what to expect from each of us on every visit.
Host: As a physician, you've experienced this from both the clinical and the administrative sides of the table. How has your own experience shaped your view of quality and safety?
Dr. Mike Seim: Like most clinicians who practiced for a number of years, there is always one or two cases that haunt us. I wish I could go back and change the events for some of my patients, but we know that's not possible, but what I can do is openly share my experiences of what went wrong and what we did to fix or prevent future failures, and actually provide an environment where clinicians won't be put in a position to make the same mistakes I did. I think it's important that we create processes that protect our patients and our team members, because nothing feels worse than knowing that you possibly could have harmed a patient.
Host: Yeah, that's a really good point. My health systems have worked to improve safety over the past 30 years or more, but we're not there yet, even though every member of the team works so hard to ensure safe care, each patient, each time, our healthcare system and others. Aren't perfect. And we as humans, aren't perfect either.
Dr. Mike Seim: Yes, I couldn't agree with that more. I think it's really important that we acknowledge that despite being vigilant, we still make mistakes. As a leader, I think we try to strive to understand that we have to be fixated on errors. We have to look at a system and think how it could go wrong in every aspect we need to use technology. And we need to really look prior to starting any case on what could go wrong. And if we were faced with that, how we would change our care plan to make sure that our patients are safe.
Host: Yeah. This element of safety so important, it's really a minimum requirement that patients experience a healthcare encounter, where we do no harm. How do we build a culture where safety is everyone's responsibility, Mike?
Dr. Mike Seim: Like I said, at the beginning, I think that starts with leadership Roxanna. I see the vision that you and other leaders have set for WellSpan and that really does bring home the point that we are committed to our patients' safety. We also have to be committed to continual process improvement. So despite making changes, we have to be fixated on taking something that's good and driving it to greatness.
Host: Yeah. One of the things that we've said is we have 20,000 problem solvers in our organization. And I think any organization needs to know that team members really have to drive the work. They need to feel ownership of the solutions as well. So culture is a key ingredient for high reliability and organizations that are looking to improve reliability really need to have that strong sense of curiosity when approaching difficult problems, we all need to be willing to assess and adapt flex and change. And making those changes, although difficult are important for our patients. Wouldn't you say, Mike?
Dr. Mike Seim: Absolutely. I feel it's really important that every person within WellSpan feels valued and that they have input in driving care. We're all equal members of the team with the same mission of creating an environment where our patients thrive, our staff feels supported and team members’ opinions are valued.
Host: That's great. You know, one of our values at WellSpan Mike is find a better way. And I'm just wondering if you could talk a little bit about our cycle of continuous improvement and what it means to standardize.
Dr. Mike Seim: Yeah. So I think that to means that we eliminate human error. So we really want to practice and create an environment that's based on evidence. So the more often we can create standard work or standard process, the less likely we will be to have an error reach a patient. So that is every aspect of the care we provide. A good example of what I'm speaking to Roxanna occurred. When we've looked to address C difficile infections within my last organization, we developed a team and initially we started with just care delivery. But given that we weren't improving at the rate we expected, we decided to redesign the entire process and we engaged housekeeping, our food service personnel, as well as care delivery. And what we realized were the two best ideas we had came from people who weren't on the original team. I always joke that my mom told me to wash my hands before every meal, but we never do that in the hospital.
One of the food delivery service team members suggested that we provide everyone with Purell before they eat and that they wash their hands. Once we did that, we saw a reduction in our C diff rate. The other opportunity was housekeeping question, why nursing was cleaning the equipment and they weren't. It really drove to us creating a process of standardized cleaning for each room, both during the hospitalization and at the final end clean. So those are examples where ideas came from people who aren't normally associated with process improvement in some organizations, but highlight the importance of every team member's ideas with us driving towards improvement.
Host: It's a great example of consistency, Mike. I mean, let's think about other experiences that we have as consumers, like going to the grocery store. You really expect to have a consistent experience each and every time. And you know where to go to get the milk, the bread, the eggs, you know, which aisle has your favorite cereal. Over the past few months during the pandemic, I don't know if any of you have gone to the grocery store, but the experience has been different. We don't know what to expect when we go, the experience is not consistent and you may not have the desired outcome or the right food items when you leave. We didn't experience what we were used to, and we didn't have the outcomes we thought. It's a lot like inconsistency in healthcare because it causes a lot of frustration. Consistency builds trust. Patients want to know what to expect each and every time. Mike, I know that a passion of yours is reliability aimed at improving health equity. How does high reliability support access to care and other resources?
Dr. Mike Seim: So health equity to me means that everyone has a fair and just opportunity to be as healthy as possible. Health equity means reducing and ultimately eliminating disparities in health, which adversely affect excluded or marginalized groups. So when I think of high reliability and how we use it in process improvement, we have to use data to look for areas of inequity within our care delivery system. We need to advocate for our patients, listen to them and actually work to improve the overall health of the population in South Central Pennsylvania with added resources, to those who have historically been marginalized by society.
Host: That's great, such a practical application of why reliability matters and it underscores the importance of why we need to keep focus in this area. Something you said earlier that I would like to circle back to the importance of vision. I'm really proud of WellSpan for its strong vision. It's a North Star for us, a trusted partner, re-imagining healthcare, inspiring health. Consider that first line, a trusted partner. We have 20,000 people driven by this notion that we must be a trusted partner to our patients and communities. So they feel safe and they're safe in our care.
Dr. Mike Seim: I agree. Roxanna. If I didn't see that in WellSpan, I don't think I would have moved across the country. I'm excited to be part of a team that's focused and committed to the wellness of our population. That's committed to continually seeking and driving to be the best and most importantly, to work with people who are so committed and compassionate about the care that they provide every day.
Host: Thanks, Mike. The takeaway today is that any leader can set direction for their team, empower your team to co-create the solutions you're seeking. As a recap, remember, culture starts at the top and the commitment transcends leadership. It takes consistent effort from every member of the team, a culture of high quality and safety evolves over time and can be shaped by best practices and sustained improvements. And it's driven by vision. Mike, thanks for joining me today and sharing your insights. I really appreciate your being here.
Dr. Mike Seim: Thanks Roxanna for inviting me. I appreciate your time.
Host: Thanks for tuning in everyone. We hope you'll join us for the next episode of inspiring health.
Dr. Roxanna Gapstur: When you think about your last healthcare experience, what were your expectations. You wanted to know your concerns would be heard, you'd receive the safest care, and you'd have the best possible outcome. In healthcare. This is the minimum that our consumers expect from us. But as an industry, we're only just beginning to meet these expectations consistently. Today, we'll explore the journey to high reliability through three topics, the road to consistency in healthcare, the best place to find solutions to not only meet, but exceed consumer expectations, and guidance for leaders to drive consistent, reliable results in any industry. Joining me today is Dr. Mike Seim, Chief Quality Officer for WellSpan Health. Mike, thanks for being here.
Dr. Mike Seim: Thanks Roxanna for inviting me.
Host: So Mike you've recently joined the team at WellSpan, and we're so glad to have you. You've made a commitment to our focus for high reliability, and you bring a wealth of experience to advance our journey. There's no business, more human, or perhaps more complex than healthcare. It makes the journey to high reliability, an absolute must for any organization delivering on promises to their consumers. What does high reliability mean to you Mike?
Dr. Mike Seim: High reliability to me is based on three guiding principles. First, it's a commitment by leadership to being trustworthy and setting a vision to become failure free over time. Second is creating a culture that allows team members, clinicians, and leaders to routinely recognize and report errors and improvement opportunities. Third, that we, as an organization are committed to the widespread use of lean principles and tools to drive for continuous improvement. Everyone on the team must be committed to providing care that is of the highest quality and safety and our patients and family are confident in the care that we provide and know what to expect from each of us on every visit.
Host: As a physician, you've experienced this from both the clinical and the administrative sides of the table. How has your own experience shaped your view of quality and safety?
Dr. Mike Seim: Like most clinicians who practiced for a number of years, there is always one or two cases that haunt us. I wish I could go back and change the events for some of my patients, but we know that's not possible, but what I can do is openly share my experiences of what went wrong and what we did to fix or prevent future failures, and actually provide an environment where clinicians won't be put in a position to make the same mistakes I did. I think it's important that we create processes that protect our patients and our team members, because nothing feels worse than knowing that you possibly could have harmed a patient.
Host: Yeah, that's a really good point. My health systems have worked to improve safety over the past 30 years or more, but we're not there yet, even though every member of the team works so hard to ensure safe care, each patient, each time, our healthcare system and others. Aren't perfect. And we as humans, aren't perfect either.
Dr. Mike Seim: Yes, I couldn't agree with that more. I think it's really important that we acknowledge that despite being vigilant, we still make mistakes. As a leader, I think we try to strive to understand that we have to be fixated on errors. We have to look at a system and think how it could go wrong in every aspect we need to use technology. And we need to really look prior to starting any case on what could go wrong. And if we were faced with that, how we would change our care plan to make sure that our patients are safe.
Host: Yeah. This element of safety so important, it's really a minimum requirement that patients experience a healthcare encounter, where we do no harm. How do we build a culture where safety is everyone's responsibility, Mike?
Dr. Mike Seim: Like I said, at the beginning, I think that starts with leadership Roxanna. I see the vision that you and other leaders have set for WellSpan and that really does bring home the point that we are committed to our patients' safety. We also have to be committed to continual process improvement. So despite making changes, we have to be fixated on taking something that's good and driving it to greatness.
Host: Yeah. One of the things that we've said is we have 20,000 problem solvers in our organization. And I think any organization needs to know that team members really have to drive the work. They need to feel ownership of the solutions as well. So culture is a key ingredient for high reliability and organizations that are looking to improve reliability really need to have that strong sense of curiosity when approaching difficult problems, we all need to be willing to assess and adapt flex and change. And making those changes, although difficult are important for our patients. Wouldn't you say, Mike?
Dr. Mike Seim: Absolutely. I feel it's really important that every person within WellSpan feels valued and that they have input in driving care. We're all equal members of the team with the same mission of creating an environment where our patients thrive, our staff feels supported and team members’ opinions are valued.
Host: That's great. You know, one of our values at WellSpan Mike is find a better way. And I'm just wondering if you could talk a little bit about our cycle of continuous improvement and what it means to standardize.
Dr. Mike Seim: Yeah. So I think that to means that we eliminate human error. So we really want to practice and create an environment that's based on evidence. So the more often we can create standard work or standard process, the less likely we will be to have an error reach a patient. So that is every aspect of the care we provide. A good example of what I'm speaking to Roxanna occurred. When we've looked to address C difficile infections within my last organization, we developed a team and initially we started with just care delivery. But given that we weren't improving at the rate we expected, we decided to redesign the entire process and we engaged housekeeping, our food service personnel, as well as care delivery. And what we realized were the two best ideas we had came from people who weren't on the original team. I always joke that my mom told me to wash my hands before every meal, but we never do that in the hospital.
One of the food delivery service team members suggested that we provide everyone with Purell before they eat and that they wash their hands. Once we did that, we saw a reduction in our C diff rate. The other opportunity was housekeeping question, why nursing was cleaning the equipment and they weren't. It really drove to us creating a process of standardized cleaning for each room, both during the hospitalization and at the final end clean. So those are examples where ideas came from people who aren't normally associated with process improvement in some organizations, but highlight the importance of every team member's ideas with us driving towards improvement.
Host: It's a great example of consistency, Mike. I mean, let's think about other experiences that we have as consumers, like going to the grocery store. You really expect to have a consistent experience each and every time. And you know where to go to get the milk, the bread, the eggs, you know, which aisle has your favorite cereal. Over the past few months during the pandemic, I don't know if any of you have gone to the grocery store, but the experience has been different. We don't know what to expect when we go, the experience is not consistent and you may not have the desired outcome or the right food items when you leave. We didn't experience what we were used to, and we didn't have the outcomes we thought. It's a lot like inconsistency in healthcare because it causes a lot of frustration. Consistency builds trust. Patients want to know what to expect each and every time. Mike, I know that a passion of yours is reliability aimed at improving health equity. How does high reliability support access to care and other resources?
Dr. Mike Seim: So health equity to me means that everyone has a fair and just opportunity to be as healthy as possible. Health equity means reducing and ultimately eliminating disparities in health, which adversely affect excluded or marginalized groups. So when I think of high reliability and how we use it in process improvement, we have to use data to look for areas of inequity within our care delivery system. We need to advocate for our patients, listen to them and actually work to improve the overall health of the population in South Central Pennsylvania with added resources, to those who have historically been marginalized by society.
Host: That's great, such a practical application of why reliability matters and it underscores the importance of why we need to keep focus in this area. Something you said earlier that I would like to circle back to the importance of vision. I'm really proud of WellSpan for its strong vision. It's a North Star for us, a trusted partner, re-imagining healthcare, inspiring health. Consider that first line, a trusted partner. We have 20,000 people driven by this notion that we must be a trusted partner to our patients and communities. So they feel safe and they're safe in our care.
Dr. Mike Seim: I agree. Roxanna. If I didn't see that in WellSpan, I don't think I would have moved across the country. I'm excited to be part of a team that's focused and committed to the wellness of our population. That's committed to continually seeking and driving to be the best and most importantly, to work with people who are so committed and compassionate about the care that they provide every day.
Host: Thanks, Mike. The takeaway today is that any leader can set direction for their team, empower your team to co-create the solutions you're seeking. As a recap, remember, culture starts at the top and the commitment transcends leadership. It takes consistent effort from every member of the team, a culture of high quality and safety evolves over time and can be shaped by best practices and sustained improvements. And it's driven by vision. Mike, thanks for joining me today and sharing your insights. I really appreciate your being here.
Dr. Mike Seim: Thanks Roxanna for inviting me. I appreciate your time.
Host: Thanks for tuning in everyone. We hope you'll join us for the next episode of inspiring health.