Outcomes Improvement: Our process works.

 

The Behavioral Excellence Platform provides an easy way to improve both the practice of medicine as well as the business of medicine.

The essential Behavioral mechanisms That underpin the system have been used to:

· Improve safety, quality, and the patient experience
· Execute and sustain process improvements
· Achieve operational goals
· Enhance teamwork and communications among staff
· Improve collaboration among senior leadership on decision making

We can confidently guarantee improved outcomes because Drs. Julie Smith and Joe Layng have extensive experience in producing superior results in other industries. Julie and her colleagues at CLG, a company she co-founded in 1993, pioneered the development of a behavior-based strategy execution process that led to the achievement of unprecedented results for their global clients.

Dr. Joe Layng, who specializes in combining behavior science and technology to produce revolutionary breakthroughs, most recently used his patented reading program to teach one million children to read without the aid of teachers or parents!

While Julie and Joe have focused their consulting efforts mainly in non-healthcare related industries, the following sample projects prove that their behavior-based performance improvement methodologies work in healthcare too, even without the use of technology.

 
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Order Entry System Implementation in an Academic Medical Center

•  100% of 1200 physicians adopted system within 10 days of cutover.

•  Vendor’s previous best-in-class—3 years to achieve 100% adherence.

Performance Turnaround in a Long-term Care Facility

• Multiple performance improvement targets set.

• Checklists, observation, feedback, measurement and continuous improvement processes implemented.

• 90%+ adherence rates to checklists related to housekeeping, safety, call bells, shift hand-­offs, etc.

•  Results improved dramatically within 6 months and sustained for over 10 years (e.g., 70% fewer medication errors; 45% decrease in agency costs; 15% more private pay beds; 21 point increase on employee engagement).

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Hospital Preparedness at an Ebola Treatment Center

• Behavior-based Ebola checklists developed and training simulations completed using our prototype robust, mobile web app.

• Feedback from NIOSH/CDC’s site reviewers stated this hospital was the best prepared in the country and the web-app’s capabilities should be expanded to all 55 national Ebola Treatment Centers. 

 
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Order Entry System Implementation

Dr. Joe Layng, Chief Science Officer, helped a large academic medical center implement an order entry system. A cost/benefit analysis showed that the system would result in savings only if physicians did direct data entry. The medical center conducted best practice visits arranged by the vendor. At that time, the two most successful system installations achieved 100% usage by physicians within three years.

Layng used the science of Behavior Analysis to identify and implement True Motivators™ for physicians. The hospital and vendor made several small, but significant changes to motivate the physicians to use the system. Examples of these changes included:

•  Placing the computers in locations that supported the physicians’ work flow.

•  Personalizing the initial screen physicians saw after logging in to include information they said they needed —the status of their orders.

•  Having the charge nurses, rather than the Information Technology team, serve as trainers/coaches to the physicians.

•  Rewarding charge nurses for ensuring physicians were confident and competent in using the system unassisted.

•  Allowing physicians to order equipment for their unit based on cost savings achieved by their speedy adoption of the system.

•  Using data from the pharmaceutical ordering module to evaluate which drugs were most used on a floor and then setting up pharmacies on each floor to fulfill drug orders more quickly.

Outcomes: 100% of 1200 physicians adopted system within 10 days of cutover.

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Performance Turnaround in a Long-term Care Facility

Dr. Julie Smith, Chief Executive Officer, assisted a large long­term care facility in turning around its culture and performance. Major problems had accumulated over the years: medical errors, absenteeism and turnover, low patient/family satisfaction, poor process adherence, and low employee engagement. The Medical Director was worried about quality of care and ready to resign. The Board thought that leadership lacked basic management skills and that some people needed to be replaced. Smith and her team helped implement a high-engagement process to implement basic checklists, observation, measurement, and performance feedback. The results were immediate and astounding. Within six months, sample results included:

•  70% fewer medication errors
•  25% fewer call-­offs
•  45% decrease in agency costs
•  15% more private pay beds
•  90%+ adherence rates to behavior-based checklists related to housekeeping, safety, call bells, shift hand-­offs, etc.

The system has since been in place for 10+ years and the management team continues to use the science of Behavior Analysis to improve and sustain all clinical and operational outcomes. They are extremely proud of being awarded the Employer of the Year in their large metropolitan area.

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Hospital Preparedness at an Ebola Treatment Center

ChangePartner worked with one of the 55 designated Ebola Treatment Centers in the US to design and test a robust mobile web-app prototype that allows for large-scale development, deployment, training in, and sampling of correct checklist usage during practice and real-time events. The first project undertaken was in the Emergency Department, where behavior-based Ebola checklists were developed and training simulations completed using the web-app. Formal feedback from NIOSH/CDC’s site reviewers stated that this hospital was the best prepared Ebola Treatment Center in the country.

The reviewers recommended that the web-app’s capabilities be expanded to provide a technology-supported, national emergency preparedness system that continuously ensures health care workers and other targeted professionals are confident and behaviorally competent to handle Ebola and other highly infectious diseases.