Image of team beside bulletin board
The Learning community had the opportunity to see safety huddles in action, similar to the one depicted here on Toronto Western’s General Internal Medicine unit 8B. (Photo: UHN)​

Representatives from hospitals across Ontario converged at UHN this month where managers at Toronto Western Hospital (TWH) spoke frankly about safety successes and challenges on their units.

In the true spirit of Lean, managers gave the visitors and members of the Lean Learning Community an honest appraisal of how well their units are doing at preventing falls and pressure ulcers, and may have learned a thing or two in return.

This was the fifth such meeting of the Lean Learning Community: a group of more than 40 process improvement professionals from 16 hospitals across Ontario. The inaugural meeting took place last year at UHN's Toronto Rehab.

Since then, participants have come together every two months to visit each other's sites and see first-hand what they are doing to provide safer and higher quality patient care.

"Every hospital in Ontario is facing similar challenges," says Brenda Kenefick, Director, Lean Process Improvement at UHN.

"Lean is all about improving our patients' experiences, safety, quality and care delivery. It will take a lot longer if every organization tries to figure it out on its own. Bringing people together to go and see what's actually happening at other hospitals facilitates the sharing of ideas. It doesn't make sense for us all to reinvent the wheel on our own."

Safety achievements at UHN

The theme of the most recent event was safety. Participants heard about UHN's Lean journey from Kathy Sabo, Vice President, TWH, and spent most of the day touring units at TWH, before returning to tap into the group's combined knowledge and learn from one another.

On 5A, a spinal unit, Yvette Lashley, patient care coordinator (PCC), spoke about how the team has twice reached 60 days without a patient developing a pressure ulcer.

On 8B April Mick, PCC, shared the process improvements that have resulted in a 38 per cent reduction in falls on General Internal Medicine (GIM) units at TWH in the past six months.

Silvi Groe, nurse manager, 3B, walked the group through the evolution of her team's Do No Harm board, then show-cased the morning huddle.

Sylvia Blanchard, manager, surgical pre-admission clinic, displayed her team's Safety, Quality, Delivery and Efficiency board, and discussed how they are working to reduce post-operative delirium by screening patients before surgery, then working with post-operative data to learn and improve their processes.

Reinventing the wheel across the province

 All the teams highlighted some of the most interesting opportunities for improvement (OFIs) that they identified and subsequently resolved, in the pursuit of improved patient safety.

Previous meetings took the group to Quinte Healthcare Corporation, where the Physician-in-Chief discussed what he learned from days spent shadowing other doctors. St. Thomas Elgin Hospital showed what's possible when an entire organization aligned from top to bottom on just a few important goals.

At Mount Sinai Hospital, Lean methodology was on display in the redesign of the new, state-of-the-art neonatal intensive care unit. The applied lean process ensures the safest environment possible for patients, and provides staff with a workspace that minimizes unnecessary walking, supply searching, hallway congestion.

​"While this community is still young, we see interest growing among the Lean Healthcare community," says Brenda. "There is tremendous potential to accelerate positive change if we continue to openly share and learn from each other." 
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