20 Day Challenge Day 2 – San Francisco Advanced Measurement

in Health Care

It’s just day two of my 20-day blog challenge and it’s easy to see why people fail at process change. I’m whipped, still have work to do to prepare for tomorrow, and it was very tempting to skip a post (kind a like cheating on healthy eating or skipping the gym). Reminds me of the many times improvement teams have shared with me the challenge of getting started with PDSA testing and following through with rapid, sequential tests. It’s hard.

This morning, I awoke at the Hyatt San Francisco Airport at 5am to review my slides agin. I was opening day two, of the 2nd wave of the Hospital Engagement Network (HEN) led by the Health Research & Educational Trust (HRET), an affiliate of the American Hospital Association (AHA). The program is sponsored by a grant from the Center for Medicare and Medicaid Services (CMS) as part of the Partnership for Patients PfP campaign. The aim of the project is to assist hospitals with reducing patient harm by 40% and readmissions by 20%. My job….a two hour session on Advanced Measurement for Improvement.

So, I was a little anxious going into the session. Two hours, first thing in the morning, on day two of a meeting, and presenting on someones else’s slide deck posed some challenges. It wasn’t long before the fun of working with participants washed away any concerns. It helps that most people come into a measurement session with low expectations and prepared to be bored. So, my more consumer style approach, blended with examples and stories from real work or actual life experiences struck a cord and we had fun. It was great to have an engaged audience who asked great questions, shared freely from their own work experience, and want to learn more. More than 100 slides and I finished only 2 minutes late, but had a great time and was pleased to get some positive feedback and a small crowd of folks with questions.

One reflection that struck me during the session, but that I’ve encountered in other venues, is the sense that organizations have been exposed to improvement tools and may be “using” them in their work, but they have yet to completely realize their potential. People tell me stories of Shewhart control charts being used to display data, but the data going in is imperfect. PDSAs where people do a lot of planning and doing, but don’t get to the Study and Act. Experiences where leaders still react to common cause variation as if it’s special cause. Talking about measurement for improvement in the way we did today resonated with many, but reminds me there’s still opportunity for improving our skills and our cultures.

I had a great time with the group and felt very welcome and supported by the wonderful staff. I know they’ll do great work. It was also fun to run into Dr. Bruce Spurlock from Convergence Health. Bruce and I worked together on a project a few years ago it’s wonderful when we get to cross paths in our journeys.

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Ok, 2 days into the challenge and two posts. This reminds me of exercise. Sometimes you’re tempted to skip, but if you don’t, you usually discover that it wasn’t that hard to do and you feel better afterwards.

I had several observations today.

  1. It’s easy to think you can’t do it and I have to push through.
  2. I delayed working on a post until I had an internet connection at the end of the day, but I could have typed this out in an offline format throughout the day.
  3. I struggled with content. Do I just write diary format or do I focus on one lesson of the day that’s applicable to the work? I don’t know which you would prefer.
  4. I started typing and changed direction a few times. See #3.
  5. I perceived it would take a long time and I feel like it has taken more time then I should have spent, but I failed to time myself (no measurement).

On to day 3.