Selected Podcast
Ep. 19: WellSpan’s Lean Management System Drives 2025 Value Transformation
On this episode of Inspiring Health, we’re exploring WellSpan’s Lean Management System and how this connected system of management approach will help us achieve high reliability and value for patients and team members.
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.
Roxanna Gapstur PhD, RN | Michael Seim, MD
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.
Transcription:
Roxanna Gapstur PhD, RN (Host): On this episode of Inspiring Health, we're exploring WellSpan's lean management system and how this connected system of management approach will help us achieve high reliability and value for patients and team members. Today, we'll talk about why WellSpan's implementing a lean management system and how each element of the system connects. Joining me today is Dr. Mike Seim, our Senior Vice President and Chief Quality Officer at WellSpan. Mike's responsibilities include the executive sponsorship of WellSpan's lean management system implementation. He has extensive experience in lean as both a mindset he developed as an emergency department physician, and a tool that he's continued to advocate as an executive. Mike, thanks for being here.
Michael Seim, MD (Guest): Thanks Roxanna. It's my pleasure to be here and talk about a subject that's so important to you and me.
Host: Absolutely. As I joined WellSpan, the organization had seen a period of great growth with lots of new partners joining our organization. We're a multi-hospital system that has affiliated with numerous systems, hospitals, physicians, and team members in a very quick timeframe. This of course led to several issues, including disparate reporting systems, different ways to escalate issues, different standards, policies and procedures. While excellence was everyone's goal, we strived forward in different ways across the system. Mike, how do you think a lean management system helps WellSpan Health?
Dr. Seim: I truly believe that the lean management system will provide a structure to our daily work and accelerate our goal to achieve systemness. Every organization that grows through affiliations struggles, aligning processes that meet the need of every one of their team members. Often teams are asked to choose or adopt one of the affiliating organization's standard work rather than engaging team members closest to the work to create a new process based on best practices that are designed to be the safest, most efficient and highly reliable. The lean management system is designed to engage all of our team members and encourage problem solving as close as possible to team members who are doing the daily work.
Host: Mike, what do you think WellSpan's leadership team will need to do to ensure that our lean management system is successful?
Dr. Seim: Everyone, myself included, will need to be a lean student, teacher and coach. We all must learn WellSpan's organizational approach to lean and use these learnings to build and implement our lean management system. Every leader must regularly visit the gemba, observe how their team members do their daily work, practice lean behaviors, such as humble inquiry, respect for all, and seeing, solving, and sharing to coach their teams. Remember, as a coach and a teacher, you won't have all the answers. The lean management system is based on escalating issues and using our real-time problem solving tools and help change to solve to rude.
As a leader, you also need to develop psychological safety among your team members. They need to feel safe bringing issues or concerns to you. They need to feel safe when they make an error to bring it to you, so together, you can figure out why it happened and how to fix it for the future. Remember that most errors are the results of a poorly designed process.
Host: Thanks, Mike. That's so true. And as WellSpan leaders, it's important for us to help staff be successful at problem solving and continuous improvement. You mentioned going to the gemba. Gemba is a Japanese word, that means the place where the work is being done. There isn't anything that's more valuable than leaders and teams working together where the work is being done. As leaders step into the lean management system, we're all learning about six elements of the system. Can you help us Mike understand how those elements connect and what makes each individual element a part of a bigger system?
Dr. Seim: It's really important that we look at how we do our work every day and understand that each part of the system isn't meant to stand alone. It's designed to help us create a process within WellSpan, that drives excellence. So, let's start with strategy deployment. This is how the health system can identify and focus our work on the most important issues for WellSpan to address each year. It's done using catchable sessions that engage our entire team and allows everyone to have input in identifying the most important areas we need to work on to achieve our 2025 vision.
Strategy deployment is also the way we focus our work and make sure that key initiatives are cascaded to frontline team members and are incorporated into our huddles at all levels of the organization. Our goals will be our primary focus in our daily huddles, discussed by our teams. And we will track our results using visual management. By including goals in our daily engagement huddles, everyone in the organization, is part of the problem solving team; they're responsible for driving continuous improvement and are owners of the results we achieve each year.
Host: That's great, Mike. I'm wondering if you can explain a little further how that element of daily engagement connects?
Dr. Seim: The daily engagement huddle is the time when our team members plan their day and assure that they have all the resources they need to be successful in their work. It's also a time for leaders to review with their teams our real-time problem solving issues, any open foresee report. Relevant system to share entries and unique data that measures our progress to achieving goals, both at the entity and system level. It's the way to engage frontline team members in our safety work and is the first step of our tiered huddle. This component of the management system brings all six elements together.
Host: Those daily huddles are such a great way for teams and leaders to stay connected. I can see how that connects to the element of visual management too. So, offering our leaders the ability to quickly visit the gemba, look at their huddle boards and see any status updates or improvement projects occurring on the unit is a great first step when you're starting your day. Now teams will be holding these daily huddles, but how does that link to the element of tiered management?
Dr. Seim: The tiered huddles and tiered management, or the way that we as an organization are held accountable. It's a way to make sure that we're identifying key safety concerns and serious events, though we're solving these issues to root and then sharing our findings broadly across the organizations to be proactive in preventing harm. The tiered huddles are also a tool we use to identify trends and issues that are occurring at more than one entity or area within WellSpan.
Host: Well, now that a team is confronted with an issue, let's say a safety issue or a business issue, is that where real time problem solving comes into play? And how does that connect to the other elements?
Dr. Seim: Yes, real-time problem solving is the way that we approach each problem. It's a standardized process that our team members can use to identify and evaluate safety issues and escalate them to their leaders. It's the process of using our help chain to engage key stakeholders from multiple departments and ensuring that we're solving a problem to the root cause and not solving only a small component of the problem or placing a bandaid on an issue. By reviewing real-time problem solving as part of our daily engagement huddles, we have the opportunity to engage all team members and ask them to participate in identifying the event's root cause, providing input on countermeasures that will prevent a similar event from happening at another place or entity.
Host: Mike, thanks for that explanation of how we engage all 20,000 employees. I'm wondering now on the element of shared learning, how does that connect to the other elements?
Dr. Seim: So, I have always been taught that quality and safety work is learned and shared. To be the safest healthcare system for patients and team members, we must use the system to share tools that are built as part of our real-time problem. The system to share tool is the way we can share four Cs and corrective action plans that will help leaders across the health system identify potential safety risks for their areas. This is part of our work to be proactive in addressing risk by implementing countermeasures, to prevent a similar event from happening in another area of WellSpan. The second way that we're working to improve our communication is by developing a visual management system. This will be a single site or place where team members can review and connect our strategic plan, A-3 documents, process improvement workshop report outs, and data that measures our performance and progress to achieving our goals. The information available in our visual management system can then be used and shared within our organization, including in our daily huddles. The final tool that we're working on is a standard approach to report out. This is important as it will allow us to develop our strategy and future improvement work.
Host: Mike, this has been a great conversation and a solid reinforcement that lean management's not something new to do, but an actual new way of managing and leading our team members, so we can really work as one and achieve our 2025 goals. I appreciate your partnership on this lean journey, and I can't wait to have you back to discuss some of the things we've learned and the ways that we're continuously improving.
So thanks for being with me today.
Dr. Seim: Thank you, Roxanna.
Host: That's all the time we have for today. So, we hope you'll join us for the next episode of Inspiring Health.
Roxanna Gapstur PhD, RN (Host): On this episode of Inspiring Health, we're exploring WellSpan's lean management system and how this connected system of management approach will help us achieve high reliability and value for patients and team members. Today, we'll talk about why WellSpan's implementing a lean management system and how each element of the system connects. Joining me today is Dr. Mike Seim, our Senior Vice President and Chief Quality Officer at WellSpan. Mike's responsibilities include the executive sponsorship of WellSpan's lean management system implementation. He has extensive experience in lean as both a mindset he developed as an emergency department physician, and a tool that he's continued to advocate as an executive. Mike, thanks for being here.
Michael Seim, MD (Guest): Thanks Roxanna. It's my pleasure to be here and talk about a subject that's so important to you and me.
Host: Absolutely. As I joined WellSpan, the organization had seen a period of great growth with lots of new partners joining our organization. We're a multi-hospital system that has affiliated with numerous systems, hospitals, physicians, and team members in a very quick timeframe. This of course led to several issues, including disparate reporting systems, different ways to escalate issues, different standards, policies and procedures. While excellence was everyone's goal, we strived forward in different ways across the system. Mike, how do you think a lean management system helps WellSpan Health?
Dr. Seim: I truly believe that the lean management system will provide a structure to our daily work and accelerate our goal to achieve systemness. Every organization that grows through affiliations struggles, aligning processes that meet the need of every one of their team members. Often teams are asked to choose or adopt one of the affiliating organization's standard work rather than engaging team members closest to the work to create a new process based on best practices that are designed to be the safest, most efficient and highly reliable. The lean management system is designed to engage all of our team members and encourage problem solving as close as possible to team members who are doing the daily work.
Host: Mike, what do you think WellSpan's leadership team will need to do to ensure that our lean management system is successful?
Dr. Seim: Everyone, myself included, will need to be a lean student, teacher and coach. We all must learn WellSpan's organizational approach to lean and use these learnings to build and implement our lean management system. Every leader must regularly visit the gemba, observe how their team members do their daily work, practice lean behaviors, such as humble inquiry, respect for all, and seeing, solving, and sharing to coach their teams. Remember, as a coach and a teacher, you won't have all the answers. The lean management system is based on escalating issues and using our real-time problem solving tools and help change to solve to rude.
As a leader, you also need to develop psychological safety among your team members. They need to feel safe bringing issues or concerns to you. They need to feel safe when they make an error to bring it to you, so together, you can figure out why it happened and how to fix it for the future. Remember that most errors are the results of a poorly designed process.
Host: Thanks, Mike. That's so true. And as WellSpan leaders, it's important for us to help staff be successful at problem solving and continuous improvement. You mentioned going to the gemba. Gemba is a Japanese word, that means the place where the work is being done. There isn't anything that's more valuable than leaders and teams working together where the work is being done. As leaders step into the lean management system, we're all learning about six elements of the system. Can you help us Mike understand how those elements connect and what makes each individual element a part of a bigger system?
Dr. Seim: It's really important that we look at how we do our work every day and understand that each part of the system isn't meant to stand alone. It's designed to help us create a process within WellSpan, that drives excellence. So, let's start with strategy deployment. This is how the health system can identify and focus our work on the most important issues for WellSpan to address each year. It's done using catchable sessions that engage our entire team and allows everyone to have input in identifying the most important areas we need to work on to achieve our 2025 vision.
Strategy deployment is also the way we focus our work and make sure that key initiatives are cascaded to frontline team members and are incorporated into our huddles at all levels of the organization. Our goals will be our primary focus in our daily huddles, discussed by our teams. And we will track our results using visual management. By including goals in our daily engagement huddles, everyone in the organization, is part of the problem solving team; they're responsible for driving continuous improvement and are owners of the results we achieve each year.
Host: That's great, Mike. I'm wondering if you can explain a little further how that element of daily engagement connects?
Dr. Seim: The daily engagement huddle is the time when our team members plan their day and assure that they have all the resources they need to be successful in their work. It's also a time for leaders to review with their teams our real-time problem solving issues, any open foresee report. Relevant system to share entries and unique data that measures our progress to achieving goals, both at the entity and system level. It's the way to engage frontline team members in our safety work and is the first step of our tiered huddle. This component of the management system brings all six elements together.
Host: Those daily huddles are such a great way for teams and leaders to stay connected. I can see how that connects to the element of visual management too. So, offering our leaders the ability to quickly visit the gemba, look at their huddle boards and see any status updates or improvement projects occurring on the unit is a great first step when you're starting your day. Now teams will be holding these daily huddles, but how does that link to the element of tiered management?
Dr. Seim: The tiered huddles and tiered management, or the way that we as an organization are held accountable. It's a way to make sure that we're identifying key safety concerns and serious events, though we're solving these issues to root and then sharing our findings broadly across the organizations to be proactive in preventing harm. The tiered huddles are also a tool we use to identify trends and issues that are occurring at more than one entity or area within WellSpan.
Host: Well, now that a team is confronted with an issue, let's say a safety issue or a business issue, is that where real time problem solving comes into play? And how does that connect to the other elements?
Dr. Seim: Yes, real-time problem solving is the way that we approach each problem. It's a standardized process that our team members can use to identify and evaluate safety issues and escalate them to their leaders. It's the process of using our help chain to engage key stakeholders from multiple departments and ensuring that we're solving a problem to the root cause and not solving only a small component of the problem or placing a bandaid on an issue. By reviewing real-time problem solving as part of our daily engagement huddles, we have the opportunity to engage all team members and ask them to participate in identifying the event's root cause, providing input on countermeasures that will prevent a similar event from happening at another place or entity.
Host: Mike, thanks for that explanation of how we engage all 20,000 employees. I'm wondering now on the element of shared learning, how does that connect to the other elements?
Dr. Seim: So, I have always been taught that quality and safety work is learned and shared. To be the safest healthcare system for patients and team members, we must use the system to share tools that are built as part of our real-time problem. The system to share tool is the way we can share four Cs and corrective action plans that will help leaders across the health system identify potential safety risks for their areas. This is part of our work to be proactive in addressing risk by implementing countermeasures, to prevent a similar event from happening in another area of WellSpan. The second way that we're working to improve our communication is by developing a visual management system. This will be a single site or place where team members can review and connect our strategic plan, A-3 documents, process improvement workshop report outs, and data that measures our performance and progress to achieving our goals. The information available in our visual management system can then be used and shared within our organization, including in our daily huddles. The final tool that we're working on is a standard approach to report out. This is important as it will allow us to develop our strategy and future improvement work.
Host: Mike, this has been a great conversation and a solid reinforcement that lean management's not something new to do, but an actual new way of managing and leading our team members, so we can really work as one and achieve our 2025 goals. I appreciate your partnership on this lean journey, and I can't wait to have you back to discuss some of the things we've learned and the ways that we're continuously improving.
So thanks for being with me today.
Dr. Seim: Thank you, Roxanna.
Host: That's all the time we have for today. So, we hope you'll join us for the next episode of Inspiring Health.