BTOES Insights Official
June 02, 2021

BTOES HEALTHCARE LIVE - SPEAKER SPOTLIGHT: AI-Powered Digital Transformation in Healthcare

Courtesy of Dell Technologies' Bill Wong, below is a transcript of his speaking session on 'AI-Powered Digital Transformation in Healthcare' to Build a Thriving Enterprise that took place at BTOES Healthcare Live - A Virtual Conference.



Session Information:

AI-Powered Digital Transformation in Healthcare

AI is fundamentally changing how healthcare institutions operate, redefining the way people work and transforming how patient care is delivered around the world. In pursuing digital transformation initiatives, organizations need to capitalize on the opportunity with intelligent algorithms and models, improved processes, a data-centric culture, and an optimized software and hardware infrastructure to realize their full potential.

Healthcare specific highlights from the latest Dell Technologies Digital Transformation worldwide survey include:

  • 43%  of healthcare respondents stated that they have successfully accelerated  their digital transformation strategies for remote patient care and  diagnosis, ranking third on the overall list against other industries.
  • 55% of healthcare respondents stated that they have successfully implemented, or are in the process of implementing, emerging technology—like robotics or VR—to support safe treatment of patients at a distance.

Key takeaways include:

  • Learn about key highlights in Healthcare with their Digital Transformation initiatives
  • Learn about the current AI Trends and Directions
  • Learn about the various options organizations have with AI Accelerators
  • Learn about data best practices and multi-cloud deployments

Session Transcript:

Today, and we're going to kick off with the leader from the University of Pennsylvania Hospital, Get  is with us. Cats is coming from Philadelphia today, very excited to have you here, Cat. Get is a lead performance improvement advisor and Lean six Sigma Black Belt with Dan Medicine at the hospital of the University of Pennsylvania.

A 789 bed Magnet designated Adult Acute Care Hospital, where she leads large, cross functional process improvement initiatives, as well as teachers lean six Sigma.

In this role, Get Services Internal Consultant. Within the Department of Operations Improvement, addressing clinical capacity and other operational challenges get. It's a real privilege to have you with us. So, excited to hear about your journey of transformation in the hospital.

Good morning, thank you, chose a and as you mentioned with the pandemic and the impact on health care, It's really taken an opportunity to highlight some of the process improvement, cultural challenges. We still tried to implement process improvement even during this global pandemic. It became more, so important as we were staffed, shortages and resource shortages. So really highlighted some of the challenges that we face as an organization with process improvement and change. And so that's really what led to this presentation this morning and hopefully can lead to some insights for you as well for your organization.

So, really what I learned in this time during the global pandemic and uncovering some of the cultural challenges that we have a process improvement is that we've built this misconception around what process improvement really is. So with us being internal consultants, and not really embed it within a specific department, we looked at these experts that are pulled in to help when there's challenges in a reactive way. So we're brought into help, define the problem, develop the perfect solution, and then problem solved. And this is really the expectation that our clinical teams have won were brought in on a process.

So really, it's more of the expectation of, we're just gonna solve it for you guys. We're gonna come in, like the Avengers, solve all the world's problems, and then we step out and we're on to the next.

But really, the reality is very different from that. And what we're really asking the teams, and what the misconception is that we're coming into define the problem. We're helping you develop the solution. But then it's really going to take you doing the work, the consistent adaptation of the new process, making adjustments and being persistent with it. And only then, are we actually going to progress towards our goals? It's not going to be a media. It's not going to be this magic wand that comes and solves the problems yet. We've built this misconception within our culture of process improvement, because of our historic ability to achieve results quite quickly. I'm coming in rapidly do it, and we really build our reputation on that. Now, when we're faced with these much more complex challenges across multiple areas, it has become evident that this culture and this framework doesn't really work and doesn't really hold true.

Screenshot (89)-1And so, what I really came to the conclusion of is that what our teams, especially our clinical teams want from us, is this diet pill.

They want the quick, easy solution, that doesn't require a lot of work, and that's gonna give them immediate results.

You know, in our society today, everything is immediate gratification, and we just want things at our fingertips. We want the answers right away. We're so used to it with the technology advancement, Having easy access, and being able to troubleshoot and solve very quickly.

Yet, really, what process improvement is, is it's a gym membership. We're giving you the tools that you need to make meaningful change and make lasting change. And this isn't a quick fix, it's never a quick fail. It's really it takes time to learn the new process and get embedded in a new process. It needs to be used consistently, just like a gym membership of a new process isn't followed and isn't used consistently, it's going to fail.

It's not going to make meaningful change and it needs to be continual and constant and consistent. So if we're not using it the same way, we're really not going and continually, we're really not going to see the types of changes that we really want to see.

And I think this was really important, because this is the culture we had set up. We had set up the need, the demand, and the request for diet pills when really the product that we're presenting them with is a gym membership.

And this is why a lot of our products, and a lot of our projects, I'm not sustained. So we see good momentum going forward with our initiatives. We get them up and running, and then we come a few months down the road.

And we're seeing that we're just starting to have people abandon the process, and we're voting to the way that the process was originally. And this is challenging because now we have to start again from square one.

So not only did we lose all of those resources and all of that time that we spent building this initiative and building this solution that we are pretty confident will get us the results we want, but that I was gonna take work and take time.

So now we've lost that and we're starting back to square one to figure out where we went wrong.

And so we started seeing this happening a little more consistently and it became a little more evident during the global pandemic because anything that was mandatory and that was clinical and required, we were still able to execute that and do that quickly. And so, we have that false perception that that's how our process improvement initiatives, we're working as well. And that's the impression our teams had, because we were often involved in those initiatives.

And so, that distinguishing the difference of these non mandatory, non clinical operational improvements, versus some that are more required, and have a definitive deadline, and that are really enforced and mandated became a lot more blurred. So, with the pandemic it really highlighted that, the difference, especially in times where we are constrained, and that the focus and the operational piece is not necessarily a priority that really, we built this subculture and we reinforce this subculture of wanting a diet pill, but giving a gym membership.

So I recognized in this that there are really three types of different change that we've implemented within the organization, or that we try to implement within the organization. And so the first one is the diet pill. So that's usually adding a resource or automation or a new technology.

So it's something that's a quick fix in a sense. And what I mean by the diet pill type of change is that we're taking mental capacity off of the team.

We're taking some, either task or some type of process off of them and just shifting it. So we're not really solving the problem.

But we're shifting the problem. So we're making the team feel like the problem is being addressed. But really, we're just shifting it into a different resource. So that's a lot of the type of change that the team wants because obviously everyone wants their workflow to be easier without having to put the work in. So this is usually the type of change that's wanted and demanded. But really, the gym membership is true process improvement. So that's really making those meaningful changes, and that's what most process improvement initiatives really are.

Btog CTASo, it's going to take the work, and it's going to take the time. And it's really just a tool. It's a vehicle to get us towards the outcomes.

And the last one is really a shifting culture.

And this one can be an entire presentation all on its own, And it's something I'm actually very interested in and trying to start resourcing, researching how to actually take learnings from social media.

In ways to subtly change behavior is to build an underlying cultural change, that it's almost undetectable to the teams and to the organization, but we're really embedding a culture change to make more sustainable change. So, those are really the three major types of change that I identified. And for the sake of this presentation, I'll really just focus on the diet, pill and the gym membership, and how we can take our teams grow and really change this mentality, and how we can support our teams through this kind of chain.

So I think one of the key things is we need to understand why a gym membership and why process improvement is necessary, so it's not always just throwing technology at it.

We really need to have the processes that go with it.

And I think the first thing that comes to mind is, if I were to ask you today, if you want it to write a 10 page research paper, or if you wanted to type a 10 page resource paper, I'm guessing most people would want to type the resource paper.

But if you're my age or older here 40 or older and you learn how to type in, you know, middle school on a typewriter, You know how hard that was? It was very difficult. You had to keep your hands on the appropriate keys at all times. You were looking up and down at your paper, back and forth, making sure you are correct. If you are lucky enough to have correction tape, you were able to kind of go back and correct, because we're making a lot of mistakes.

Or if you had a use white out, had to go back, and change it, and make mistakes, and go back through again, and really learn how to type.

And it wasn't easy, it was difficult, But then, computers came along, and we learn to type even more.

And so, it became easier, because we were practicing, and we're using it a lot, and we were doing it a lot, so it became easier, Then, as new products were built, and technology advanced, it became more embedded into the fabric of our society, and we were forced in a way to learn how to type, and then now we got smart phones, and our re learning, how to type, but just our thoughts.

And it's the same thing in our clinical areas with paper charting versus electronic medical records.

So, staff originally would chart on paper.

And for those of the organizations that have moved over to electronic medical record systems, like we have for several years now, if you were to ask the team to go do downtime procedures where they're having to paper chart, you know, they'd rather be back in the electronic medical record. However, that was a big push. That took a lot of time. It took a lot of resources, It took consistency, and again, that was something we built off of. And now many workflows and many processes are aligned with our electronic medical record.

So, it's the same concept with process improvement.

Every change is going to be hard until it's not hard anymore.

And this is what we really need to help the teams to see. And it's more than just about one initiative and making one initiative successful.

Because, as we see with change, if you don't continue to evolve, if we didn't continue typing, if we didn't practice typing, and then the rest of the world is now on computers, and smart phones were behind the curve, and we're playing catch up!

And the same thing is true with our process improvement initiatives. If we're not seeing them through the tough times, we're behind the curve, and we're going to continually be playing catch up, instead of leading the pack.

And if you don't think it's important, just take a look at Toys R Us, and Kodak and Blockbuster, you know, are our mentality, our culture is that, what's working is working. We're getting the job done. There's really no need to put forth the energy and resources to change, but if you use those as examples, it really shows why this gym, membership type of change is really important.

This continual practice is continually evolving in process improvement, because we will fall behind the curve, if we don't stay ahead of it.

So what does it mean to actually start using a gym membership, and how does this relate to process improvement?

So if we think about what it means when we get a gym membership, when we start going to the gym, the layout is very unfamiliar. If we're not used to working out, we're not used to what the machines are. We don't know what they do. We don't know where to find everything. We don't even know where to start and it feels very uncomfortable, and it feels very overwhelming.

So having that theme, unfamiliarity, and the uncomfortableness of it were hesitant, we don't want to start. We don't want to jump into it. And we may just want to quit before even starting, because it does feel so very overwhelming.

And it's also difficult, and time consuming.

It is physically difficult, because it's something we haven't done before, and it's time consuming, because we have to take the time out to mentally think about what the next step is, and where we should be working on. And what machine does what.

And it's not part of our daily routine, so we really go out of our way when we get a new gym membership to try to make it fit into our daily routine.

And the same thing is true for process improvement initiatives. And when we start thinking about it in this way, we can help our teams to be more successful in implementing that change.

So, when we're starting out with a new process, it's the same thing. The process is unfamiliar, so even though it's something we do on a daily basis, we're changing it. And this new part and these new steps to us are very unfamiliar. We might not know the order in which the new steps go. And again, even though it's something that we're already used to doing, so it feels overwhelming. We're used to being an expert in our area, and now, we're trying this new process, and we're no longer experts, so it feels very overwhelming to us, and makes us uncomfortable.

And, again, it's difficult and more time consuming. Instead of doing something that you inherently did day-to-day, you now have to stop and think about it. And, for teams, that makes it difficult to continue doing, because they want to go back to the way that they just know how to do, and get the job done.

Again, especially in times like, now, where we're resource trained, and we're just in a crunch to get things done, and it's the new process is not part of their daily routine. We're trying to build it into their daily routine, but it's not right now. So, they have to, again, stop and think, and try to find a way to fit it, into, what was their normal routine.

And so this is why we find it very difficult for our teams to make it through that tough part of continuing these process challenges.

So if we can help them work through, we get them to continue going to the gym.

We help them see what order in which to use the machines, what the benefit is. We have to continually be helping them work through this. We have to help them to understand what each machine does, what the benefits of each machine is, the correct order to do it, if they get out of sequence, helping them get back into sequence, and really making sure that following the plan as it is prescribed.

32And it's still a little bit time consuming that gets a little bit easier as they learn what the actual steps are, what the actual machines do. They're able to do it a little bit quicker, and it's becoming a little bit easier and less uncomfortable for them. And really, the key part to this is having a personal trainer, A personal trainer keeps you on track. Make sure that you are getting the most benefit out of the tools and out of the machines and out of your exercise program.

And it's the same thing with our process improvement initiatives. We want to make sure that the team members are still going to at least trying the initiative and are using the in the process the way it was designed.

We're helping them make sure they're doing the process steps now in alignment in the right sequence, and not out of order.

That we have compliance with the new process.

We're helping them to learn to do it a little bit quicker and making it smoother for them as they go through, and we're really supporting them. And we'll talk about this in a few more slides in how to actually support during these times.

But we're really trying to get them just used to the process. and really trying to get them, to understand the benefits of it, and understanding that the work has to be put into it in order to see those results.

And this is where we come in, as trainers, or as process improvement experts as champions to help support that team. And it's much more than just giving them the gym membership. It's much more than just giving them the tools.

It's really more about how to help them continue to come back to the gym to continue to come back to the new process instead of reverting to their former process.

How to get them to continue following the process apps in the way it should be because of natural tendencies to build workarounds or band-aids around new processes that are unfamiliar and to mask it similarly to their former process. Which really doesn't help us truly advance.

And so these are some of the challenges that we see when we start looking at process improvement initiatives as gym memberships.

We really can understand what the teams are going through, and how challenging it feels for them.

And the underlying context to this is, we think, give them a really good tool, but if they're not going to use it, it's not going to matter.

And the reason we stop using it is because of how it makes us feel.

Again, if we're experts in our area and we're following the same process for a prolonged period of time, changing it into a way, we're now new at it, we're no longer experts, and that makes people feel very uncomfortable with change in general. And so really understanding what the team is feeling going through this as well.

And how we can support them in the same way that we think about giving someone a gym membership and how we would support them to reach their goals by using it, can help us make more meaningful change in our organization.

So after we get everybody using the process, we find that we get to the quitting point. And as I said earlier, change is always difficult, until it's no longer difficult. And that seems simple, but it's not conclusion that the teams come through on their own.

It's going to be difficult until it's part of the culture. And once it's part of the culture, it's no longer change. So change is always hard until it is not part anymore.

And if we think about it in the context of the gym membership and the quitting point of the teams, we can really think about it in the same way with process improvement. So New Year's Eve. Everybody's motivated, They want to make their New Year's resolutions, to go to the gym, to get healthy. Live a better lifestyle, to maybe run a marathon and everybody's motivated because they're excited about the potential outcome.

So we go to the gym January first, and you see everybody there. Everybody's working out, and everybody is motivated, and trying out the machines and trying to go through the time it takes and build it into their daily routine, and we're able to do that for a few months. And you'll see that the gym stay crowded, probably up until February, March.

And then the gym's are empty, and why is that?

And a big part of that, and if we think about it, again, in the same context with process improvement, is because we're not seeing the results in three months.

We are not seeing the outcomes in three months that we want to see, despite the amount of work and effort that we're putting into it.

So when we think about it in that context, what we were doing before was working. It may not be optimal. It may not be the most efficient.

It may not be achieving any further results, but it's working.

And so, it's that same mentality with the process improvement initiatives that, after a few months of trying, if we're really not seeing any new results, if we're not seeing and feeling that difference as teams, we're willing to abandon it.

Not realizing and not understanding that it's just difficult, because it's new.

Not that it's difficult, or that it's the wrong solution, or it's not going to work. Just because we don't see the results right now.

So, that really brings us into a key part of how to help the teams, to identify when it's not working.

And really when it's not working because it's new or when it's not working, because it's not a good solution. And the first thing we have to identify is, is it not working just because there's a knowledge gap. If there's a knowledge gap, or it's unfamiliar that's easy to solve. We can continue with the teams. We can reinforce the training. We can go back and do additional communication and training with a team, and we can continually remind them that, hey. This is a new process. We need to give it time. I think we're very easy to abandon things. Just because they're new. When we don't see those results right away. So helping the team come to that conclusion. And just helping them to see the process and understand the process and get quicker at the process. And embed it into the culture will help us come over that hurdle of quitting point.

And then secondly, as I kinda touched on, the inherent variation that comes with implementing a new process, everybody has their own way of doing something and there's always natural variation within a process and that's no different when a new process is implemented. So, doing observations at this time is really critical. Because when you put things on paper and then we translate it into real process, there are things that we don't account for. We don't account for the way people feel about a process. So we might design this process to be ideal. It's operationally ideal if flows within their workflow. And the workflow makes sense. But once we put it into practice, there might be something that we're missing underneath the surface that we hadn't anticipated. So it's really important to understand the inherent variation that will come with a new process and then address it. And we'll talk a little bit about supporting the team, and how to build in the feedback mechanism to address that winning point. But it's really important at this point in time at this tipping point of quitting point.

Screenshot (4)A few months down the line.

When everybody's getting a little more familiar with the process, making their own variations to go back to the process and make sure everybody's using it consistence insistently.

But, then, if there is some variation that is happening, asking why that variation is happening is really important, because maybe that's something you need to address and you need to change as well.

And, if the team is really just wanting to give up because it's still new, They're just not giving it enough time and that's something you really need to reinforce with the team. And, more often than not, this is the situation. This is what is causing the abandoning and the failing of a project to continue to sustain and the momentum of the project to continue because, it's just now and the team hasn't really given it enough time and given a chance to become part of the culture to become part of their daily routine. And, so, we really need to make sure we're encouraging our teams to continue doing the process and continuing the chain.

So, how do we flip the switch? one of the most critical things is to help the team identify a diet pill solution versus a gym membership solution.

And what I mean by this is a diet pill solution is something that the team thinks is going to be better, but we don't actually necessarily fit an outcome metric.

And then versus the gym membership is really the outcome driven process changes that we want to see. And so I think about the diet pill. That's more the qualitative outcomes rate.

It's more how the team feels about it, versus the gym membership, which is really that quantitative outcome and our metrics. And we're seeing it in the bottom line.

And a good example of this, if a discharge initiative I have been working on in our organization, and so what we developed was a tool, a checklist.

We thought we were giving the team what they wanted. We were hearing that. The problem was, we need to have all of this information that is getting lost throughout the course of the admission. But it's really pertinent to a patient at the time of discharge.

There's no centralized location for it, and we're not able to address potential barriers proactively, because we're not thinking about it, again, until the end of the patient's admission.

And so what we heard and what we developed was, OK, we need to have a centralized location for the team to be able to capture this information and to be able to address it proactively.

And what the team really wanted was the diet pill solution. They want it to know that somebody is doing something with that information.

So it was more than just having the information that we could address proactively. It was really that feeling also about what we need from our intervention. And so, on the surface, they can both look very similar. So, one was a resource. So, addressing, having somebody come in and help with those tasks, and the other was the tool. And they can both look very similar on the surface. But we have to ask, what is it that the team is really asking for and what do they really need to know what the difference is between the qualitative and the quantitative or the diet pill and the gym membership initiatives.

And so how do we encourage our teams to use the tool? Versus just wanting that additional resource?

or just wanting that diet pill solution?

And it's really, we, there are several things we can do, and, again, I'll kind of go into this, a little more on how to support the team in using the tool. But really, what it comes down to is awareness of the difference, awareness to the team that we're giving you something that's going to take time.

It's going to be something that you're going to have to work at, And that's not a quick and easy fix, So even if it seems that way on the surface, there are processes that need to go with it, Then concrete examples, so the example of typing in the typewriter, the example electronic medical records, and going back, if we were to have the paper chart now, and maybe there are some examples within your organization where change was really, really difficult.

But you stopped with it, and it took some time, but then the outcomes were achieved versus something that was perceived to be a good solution and didn't work.

Because, again, it was really just touching the surface, and addressing the feeling, and not the gym, membership type of process improvement initiative, where it was really addressing the full outcome metrics, then setting the clear expectations. I think this is a really important one. It is definitely something we have as a culture within our organization. Cultivated, as I talked about earlier. Is this perception that process improvement is a magic wand and effect effect, and how do we change that perception with our team?

And then, reassurance and reinforcement of the new process, and sticking with it is also very important.

And then Accountability.

And again, I'll kinda talk about this a little more, But, within healthcare, and especially during this time, one of the biggest questions I get asked, when we're going in to do a new process improvement initiative is, Is this mandatory?

And the answer is usually, no, it's not mandatory, but it is executive driven. But we still have some challenges. And what really that told me and that really uncovered this gym membership mentality is that if it's not mandatory, they're not interested. The teams aren't interested, they don't have the mental capacity to take on another priority. So how do we build these systems in and give them that diet pill feeling, that they feel that the mental capacity has been taken away from them? But still building that gym membership process improvement.

And so building in accountability in that way will really help the teams, to take on the tools and use the tools and not just look for the easy way out.

Then really listening to the team. Again, understanding that feeling that comes behind it, the feeling that the diet pill gives them and how to embed that into a gym membership is a good way to help the teams. to start learning. To. Invest in the tools and adaptive process improvement, the way we need it to for successful meaningful change.

Screenshot (89)-1Now, how do we do that? How do we infuse the diet pill mentality into our process design? And really, it comes down to designing for feeling as much as we design for function.

So when we designed, for function, redesigned for the process and to build into their work plan and try to make it make sense.

So, with the checklist, we analyzed it. We went through the high level barriers that typically are seen at discharge and we put it into the workflow. We re-organized that we reshuffled it. We put it into an app that they're in every day that they're already looking at.

So, we tried to embed it as much into their workflow, but again, we missed that, keep weight of what they wanted. They wanted the immediate answer. They want the immediate resolution and they want it to know that somebody was doing something with that information. So, when we think about it that way, we would maybe design arch capitalist to have read receipts to have alerts. So it gives them that diet pill feel that we're giving them instant gratification that they no longer have to think about it.

because when they were putting it into the checklist, they were still having to think about it. So we weren't really taking that away from them and they didn't feel like that it was a benefit because they were still worrying and still tracking the same things. But they just now had a place to track it.

So, being aware of that underlying feeling, and how do we do that, is really asking the question, what does the team really want or need mentally, from the solution, and I think that's something we had typically miss.

And when you're working with clinical staff, and trying to infuse operational changes for clinical staff, you think about the way they operate, they, they function based off of how they feel for their patients. And so, that feeling piece of it, and trying to relate that to operations, and relate that, the process improvement becomes very important, because that's speaking their language. And that's a big disconnect from a process improvement and a clinical perspective that We've seen in the culture, in our organization. So really asking the team, what do they want? What do they need from the solution? From a mental standpoint? from a feeling standpoint. And then understanding what that benefit is that they need, and how to build that into the checklist, or into the solution. So my example of the checklist is, you know, those, read receipts, that's building that, feeling into, what, our gym, membership was that will help get a, little bit more buy in, into making sure we're staying with the process instead of abandoning it because it wasn't giving them what they needed mentally.

And it's the same thing with an actual gym membership. If the people using the gym membership aren't feeling that they're getting what they need out of it, they're more likely to abandon it. So when we think of it in this way, it helps us to better support our team, because it's much more than function in their workflow. It's how they feel about the function and the work.

So how do we support the team? And I really love this quote.

Perfection isn't attainable, but to chase perfection, we can achieve excellence, and I think this is really important, because the misconception is that our improvement initiative is going to be perfect on day one, It's the perfect solution. It's gonna address all of our problems, are all pretty confident it's going to work. So it should be good on day one, it's going to be perfect. therapy, is going to do it. Right. And we're gonna see results immediately, and this stems from not just our teams, but throughout our, entire organization. And that's a really hard standard to live up, to. So really level setting expectations as one of the best ways to support the team.

And what I mean by that, is, someone coming to the gym for the first time, who has a goal of running a marathon in six months, You're not going to tell them, you know, three weeks into it, that, hey, you should be able to run a marathon today, now it's going to take time, it's going to take progression is going to take work, it's going to take effort, but yes, you will get there in six months.

It needs to be the same with process improvement. Yes, We have to put in this work. Yes. We are trying to achieve this goal, and, yes, it's going to take time.

And being really realistic with those expectations, and the time it will take to see the outcomes we're looking for is really important for our teams.

That will help them with that quitting mentality because if they feel they're chasing an unattainable goal in such a short period of time, with so much work being put into it, they're gonna want to abandon it.

And really, a good way to support our team is using personal trainers. And so, I know this sounds also pretty obvious, but the way in which we use our personal trainer. So typically, historically, what we've done is, we develop the solution, we do the training and education, we do the operational plan, we assign process owners, and we hand it over, and then we just check in on it.

And I think that really, as a culture, needs to change.

And what we think of as a process owner shouldn't really just be one person owning this process, and it really needs to be more engaging. So we need to have personal trainers, not just a personal trainer. So we really need to have some way.

Have champions have those connectors that are embedding as personal trainers and ensuring that questions are being answered in real time, and that there is help with the process as it needs to be implemented. And this becomes very challenging what resources and as restrained, but really making it more engaging in that way. And having the personal trainers embedded within the areas can really help to support the teams through those really difficult times of the unfamiliarity, the uncomfortableness, the unsure process steps, and really helping correct it within the right time and getting better compliance with it. And then making it fun, just kinda a little fun fact. one thing we did with the Discharge Initiative is we named it Project Jedi. That stood for a joint effective discharge initiative, and we, themes, everything, Star Wars, We even put Star Wars Music into our videos and just to engage the team a little bit more. And there's no reason not to make it fun and make it engaging. That keep people coming back. And if we take notes from social media, that's what they do.

They're constantly trying to get your attention with something. with new features. And so, we want to kind of do the same thing with our process improvement and make it more engaging, because the more you engage them more, they're going to use it.

And, really just encouraging the team, and keeping them going, and that's, that's really a critical part to our, what we're calling, our personal trainers, or, you know, our champions within the areas.

And then, you know, I think the, the other thing is, building and team support. So, when you see your co-workers working towards the same goal, and when you guys are doing it together and you can answer questions together, that's really important. That also really helps to grow the engagement, So, when you're working out, it's much better to run 10 miles with a partner than running 10 miles on your own. So, we want to kind of encourage the same thing, and building it into our teams, and building buddy systems, and partners to really work through the process. And I think that's something historically, we haven't really done.

Again, we kind of just rely on our process owners, but really building in the support systems for the major changes that we want to make, really help us to stick it out and grow the engagement a little bit easier.

32Then, continual communication and feedback.

Having a feedback mechanism is critical, again, when we have that inherent variation within the processes, having the feedback to address that early is great. So, we also did QR Codes for this, for the team to be able to give instant feedback, and we were able to address it, adapt the process. And listening to them was really improvement. So, also helped to reinforce the process when we're listening to the team, taking their feedback and adjusting it based on those feelings and those needs.

And then again, the accountability: No, it's not mandatory, but we need to have a way to track if it's being followed, if it's being followed correctly, and if it's being implemented. This also helps us to focus on where we might need more engagement, versus just trying to continually do, you know, large, especially on our larger initiatives.

Constant, You know, accountability and tracking and engagement with everyone.

We could really focus in on where we are doing well, and then focusing on where we might need some more support, and then I think this next one is Really important, is focusing on the process metrics. Early on, as I mentioned, you want to tell somebody that they're gonna be able to run a marathon in three weeks if they've never run before, when their goal is to run one in six months.

So you wouldn't say to them, hey, it's two months in. You can't run a marathon yet, but you might say to them, hey, you're up to 10 miles. That's great. We want to do the same thing with our process improvement initiative.

Highlighting the process metrics really highlights the usage of our process and sticking with our process versus not quitting mentality of Well, we're not reaching it anyway, So why should we continue trying? So really, using it in that way, and highlighting the process metrics as a great way to support the team, and also encourages others. Especially if there's a little bit of competition, we like a little healthy competition amongst our different teams and our different units.

So it really, by focusing on those process metrics, really helps to encourage more usage and engagement with our process improvement initiative, so keeping the team renewing the membership. So even if we're not getting towards the goal, what do we need to do? so that feedback and the iterations, and really investigating the feelings?

So using that feedback to investigate the feeling, what is it that's missing? What is it that the team needs from us, even if it's a great intervention? And we gave them what they want, what's the underlying feeling? And how can we address that? To really get them through the not wanting to quit, because the feeling of it not working?

Then really, to sustain the big challenge. And one great way to do that, and to support the teams, is to don't lead up until it is no longer change until it's part of the culture, and then building other solutions off of it. So, when you start embedding, if you think about the electronic or electronic medical record, and about the cell phone, and the typing, the more dependencies, you build on your process improvement initiatives. The harder it is for people to quit. We want to do the same thing with our initiative, So, maybe the discharge Initiative, we embed that in with rounding, because the two are so closely related. And we can build interdependencies to make each one of those more difficult to quit.

So really, those are some keys to helping the team to re-use, renew the membership and keep using the jam.

So, key takeaways is process improvement is not a diet pill. It is a gym membership. It takes a lot of work. It takes a lot of time, takes a lot of effort, and level setting the expectations for our team. And building a culture where that's acceptable, and getting over that quitting mentality within the instant gratification culture can be challenging. But there are ways we can support the team to do that. And then helping the team to recognize when it's not working just because it's new, versus it's not working because it's not the right solution.

And I'm working through that quitting mentality by supporting them as being personal trainers.

And I think, really, what the underlying tone is that there is rarely an easy solution. If there were, we wouldn't have to go in and fix everything. Everything would be solved already. And change is never easy, but it's always impossible when you give up.

So thank you all very much for your time. I'll answer any questions anyone might have.

That was terrific. There was terrific. Cat, lots of great comments about how we have to exercise our muscles for sustainable improvement and innovation. So, we got several questions and happening here. We have about four minutes for Q&A, so I'm gonna dive, go right into it First, one is just setting a little bit of a stage at the hospital. What has been kind of the history of continuous improvement and innovation at the hospital, and when did you apply this new approach, and what the results look like?

Yeah, great question. And so we have a little bit of a different structure. Our process improvement team is separate from our quality improvement team, and separate from our innovation team. So we really focus on capacity challenges. We focus on broader clinical implementation and our innovation team is separate from us, and they focus more on technology and really piloting quick things, not necessarily developing something to be a long-term sustainable but trialing it and then kinda gets handed to the operations team to figure out long term sustainable.

And so that is a great question and actually I am just starting this new approach with the team.

We've had some discussions about it.

And so with that discharge initiative, we actually started backing it up and trying to take this approach, and the engagement already has been a little bit better, and so really hopeful that taking this approach will get more buy into the team.

And, I think, again, the big key to it is really understanding that feeling, when you think about the feeling of a gym membership And you think about the feeling of a new process, they're the same. And so, what you need to get the team to do is to really see it that way and to meet their emotional needs, as well as their, you know, workflow or physical needs.

That's right. That's right. So, some of the comments are around the fact that we all know the behavior change is incredibly difficult to achieve and the sustainable behavior change is even more difficult. The question is, How does Cove in 19 in the And while we have been through, there's a lot of stress in the system right now, operationally, emotionally. How does that impact what you're trying to do here? Do you think that because of what's happening?

It's, it's, it's a force against or it's a force, you know, for what direction you're trying to move.

I think both, I think it's been a direction for, because I think it has helped the teams, to see the benefit of rapid change.

But I think it's also been against because anything that's not deemed a priority, and obviously in a global pandemic, a lot of like true process improvement for efficiency or for optimization is really not a priority. So that's really what highlighted the underlying cultural view of process improvement in our organization. As I mentioned, we really do get rapid results.

But as problems get so much more complex and you know we're a 789 that hospital. And we're getting ready to open up another 504 beds across the street in October to be one, you know, 1100 bed, bed, hospital. So that's not gonna work for us anymore. And I think that's what we realized is during the Global Pandemic is this structure we have of these, you know where it is a quick turn and we have that charge and we have that buy in. It doesn't always work and it's not going to work as we get into these bigger more complex. And we expand to 1100 beds.

So, I'd say both.

I'm hoping that, you know, we can get a little bit more of help towards the longer term and we're looking to restructure right now how we approach process improvement initiatives. So, versus us being external consultants that just come in for, you know, 3 to 6 months, we're really looking to embed ourselves and longer initiatives as well.

Screenshot (4)So we're looking to change the way that we operate in order to help support the teams a little more because we identified that in the global pandemic of that, we need to be longer support, instead of just a shorter term. Coming up with a solution, giving them the operational plan, we need to be able to support them more.

That's terrific cat. But we're out of time right now. But when I thank you so much, this is such an interesting presentation to go front, They appeal to a gym membership approach. I love the, I love the, the framework that you're deriving here for, for discipline, for long term sustainable solutions.

So thank you for taking the time to share with us, and they have of our global community I want to say thank you for, for sharing your wisdom and expertise with us today.

Thank you very much.

Ladies and gentlemen, that was, get the link, who is leading, gym memberships and sustainable process improvement at the University of Pennsylvania Hospital. What are, what out, What a fantastic view on the challenges of behavior change that we all know as practitioners of excellence and innovation acceleration, and in the context of that, of a hospital.

And the, I think, get, did a fantastic job showing that there is the most people look at process improvements, specifically as some sort of diet pill or they expect that. And the reality is, that we have to give them a little bit of, both. We gotta give them what they want.

But we have to engage the organization in, the, in, the, in the behavior pattern that will ensure sustainable implementation of solutions, you know. We all know, that when it comes to improvement and innovation, when we're 95% done, we're only halfway there. The last 5%, the sustainable implementation. It's like sticking the land on an aircraft. Cannot say you have a successful flight. Until you stick the landing. And sticking the landing is, is not easy. And This is a great insights, great perspectives. So, please do do connect with Cat. You know, go into the link in on LinkedIn. We have the connections for all the speakers in there. If you look at the posting, connect with them, If you want to do with the speaker directly. If you want to know more, post your question on the LinkedIn Posts that we have there on speakers will check the posting and will provide feedback.

So, that's a direct way that you can connect with Cat and find out what's happening, with their journey of improvement at the hospital in in, in the years to come.

Now, we're going to wrap up the session, and we're going to start, back up at the top of the session, bringing on the Artificial Intelligence Expert directly from Toronto, Canada. I'm going to have Bill Wong here with us from Dell.

And Bill is a leader of artificial intelligence applications in healthcare. He's going to discuss industry trends. He's going to discuss applications of artificial intelligence. I mean, he's, Every time I listened to Bill, I'm, I learned so much. So, I know that he will provide some very, very, good insights for all of us on the pace of artificial intelligence applications, into different types of artificial intelligence applications, that we're seeing right now. In healthcare, he is a true, he's not only a researcher, researcher, he's a true practitioner. So I look forward to seeing you back at the top of the hour with belong, coming directly from Toronto. Thank you.


About the Author

more (8)-Mar-31-2021-10-13-42-32-AMBill Wong,
AI and Data Analytics Leader,
Dell Technologies.

I have had the opportunity to work with customers around the world implementing strategic and analytical-based solutions leveraging data as a corporate asset. Experience with data-centric and cloud technologies from my tenure at IBM, Microsoft, Oracle, and Dell.  Previous roles have included cloud and enterprise architect, consultant, product and performance benchmarking manager.

Currently, I lead AI and Data Analytics initiatives at Dell Technologies and spend most of my time supporting customers from the financial services, retail, public sector, healthcare, and higher education industries. Customer AI projects have included: jointly developing the customer’s AI strategy, assessing AI accelerators, developing AI and data best practices, benchmarking deep learning algorithms, and jointly developing the technology roadmap with C-level executives, data scientists, and/or enterprise architects.

I have authored a number of articles, whitepapers, books on strategic data-technologies, and a currently the author and editor for a quarterly AI newsletter. Courses taught have included database management systems, systems analysis and design, accounting information systems, and strategic IT planning.


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