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Roxanna Gapstur PhD, RN (Host): On this episode of Inspiring Health, we're exploring one element of WellSpan Health's lean management system. It's called daily engagement. So, today we'll talk about the purpose of daily engagement, the standards we're setting at WellSpan and how daily engagement connects to the other elements of the lean management system.

So, joining me is Carrie Willetts, Senior Vice President for WellSpan's Eastern Region. Carrie joined WellSpan in 2016 as a President for WellSpan's Ephrata Community Hospital. She has extensive experience in oversight of performance improvement and helped implement an early version of our lean day early management system at WellSpan Ephrata Community Hospital. Carrie welcome.

Carrie Willetts (Guest): Hi Roxanna. Thanks for having me. I'm so excited to talk about this transformational subject with you today.

Host: Great, well, you and I have both had multiple leadership roles, Carrie, and, and one of the difficult parts of any leader role is ensuring your teams are not only aligned with the organization's goals, but they're engaged in the journey to reach those goals. Carrie, how is daily engagement an answer to help our leaders keep everyone engaged and moving in the same direction?

Carrie: Great question Roxanna. Daily engagement involves the huddle, which involves the team to do three things, reflect on the prior day, plan for today and then engage in improvement conversation looking forward to tomorrow. More specifically, each team has standards they want to achieve daily to assure they are contributing to the very best care for our patients.

One example I think about is our caring behaviors. Those are our patient experience standards. The daily engagement huddle provides an opportunity to discuss gaps when those standards have not been met and to fix them going forward. That's part one. Part two, then engages the team to predict the demands for the day in front of them and to proactively set themselves up for success.

Sort of just a supply and demand assessment done proactively. Finally part three, engages the team to look ahead and link their work to the organization's strategic plan. Teams will visually display progress toward improvement goals and determine experiments to run in the days to come that will help us either meet or exceed the goals.

And of course, when success is achieved, we will acknowledge, celebrate and share. It's really important to note, Roxanna that this applies to both patient facing and non-patient facing departments because every WellSpan team and every WellSpan team member, has a role to play in our patient focused vision. When implemented with consistency and a sense of ownership through the organization, WellSpan will have the ability to accelerate our goals in engagement, patient experience, patient safety, employee safety, and beyond, you name it. Ensuring that our team members are knowledgeable and understand how their daily efforts lead to the organization's success is incredibly important for WellSpan's transformational journey.

Host: That sounds great, carrie. Now tell me what behaviors and standards can lead to successful daily engagement huddles.

Carrie: Well, first of all, we want daily engagement to be something that staff want to do each day, not something that they feel they have to do. So, it's important that we built in flexibility by department so that they can design their daily engagement huddle to meet their specific needs.

However, in order to optimize the experience and align the organization, we have created a series of best practice standards that we'll ask everyone to follow. I'll walk through each of them. So, first of all, we want to focus on team engagement. This is a team huddle, so it should not be a one-on-one conversation. It should be a team conversation. We want to use visual management with real time metrics and update them every day. So, team members can really see day to day progress on our goals and against our standards. We want everyone to hold their huddle at the same time every day to ensure predictability and consistency for the team members. We will want to operate with standard work that meets the specific needs of the department. We want our leaders to promote transparency. We want the huddle to be simple and brief. They really shouldn't last longer than 15 minutes.

Host: Carrie, that's right. These meetings are not where we solve issues and problems. They're really supposed to be efficient, but meaningful times together to reflect, plan and celebrate.

Carrie: Exactly Roxanna. These successes can't occur without a leader who develops and coaches their team members to get the most benefit out of the daily huddle. You know, throughout the organization, Roxanna you've met many leaders who are already engaged in daily huddles through the LDMS or lean daily management system.

We know that those leaders will quickly evolve as peer mentors and support for others who maybe are newer to the process. As I reflect back on the LDMS journey at Ephrata, you know, we really attribute the recent achievement of the CMS five star status to our team members' engagement in daily huddle. So, I can't wait to see how our complete lean management system, including this revised approach to daily engagement will completely transform the way we work together at WellSpan and the outcomes we will achieve as a system.

Host: Yeah, this is it's really exciting and transformational work for our teams, Carrie and allowing team members to engage in and drive the success of WellSpan as one element of WellSpan's lean management system. Can you tell me a little bit more about how daily engagement connects with the other elements, things like strategy deployment and real time problems.

Carrie: Sure. You know, daily engagement is really the connection to the rest of the lean management system for the frontline. I'll give you some examples. The first part of the tiered huddle, the reflect on yesterday section, will include a report on issues elevated the prior day through real-time problem solving. And then both the first and the second parts of the daily engagement huddle could generate items for escalation through tiered huddles. This really promotes a daily bi-directional communication from the frontline teams to the rest of the organization. And to you, Roxanna. And the third part of the daily engagement huddle, the improve for tomorrow element is the unit or departments link to our strategic plan through strategy deployment.

Host: Yeah, Carrie that's right. And later daily engagement will connect with the improvement report at work being led by Dr. Jeff Nicholson. The goal of that part of the lean management system will be to celebrate, share, learn, and connect as a system.

Carrie: Yes, Roxanna. And actually we created a video for the WellSpan leadership forum in August that helps to illustrate the connections with the other elements of the lean management system. Our team members can watch that by visiting our lean management site on the inet.

Host: Carrie. I'm glad you mentioned the daily engagement video that you created for the leadership forum. We've received powerful feedback from leaders that it really helped them make a few more things click in their mind. And I think other team members may have the same experience. Thank you so much for being with me today to explore daily engagement. I'm eager to see the results of our journey when we look back in the next few months and years.

Carrie: Oh, me too. And thank you Roxanna for setting a great example as a lean leader. You've created the leadership and vision we need to be a transformational organization.

Host: Thanks, Carrie. That's all the time we have for today. We hope you'll join us for the next episode of Inspiring Health.