Utilizing Lean Leadership Principles to Build an Academic Primary Care Practice of the Future.
Lean
academic transformation
burnout
change management
continuous improvement
leadership behaviors
Journal
Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
28
08
2019
accepted:
14
09
2020
pubmed:
30
9
2020
medline:
15
5
2021
entrez:
29
9
2020
Statut:
ppublish
Résumé
This Perspective presents a case study of multidimensional clinical transformation in an academic general internal medicine practice. In the face of increasing internal and external pressures, health systems and individual medical practices have pursued multiple strategies to improve quality, patient experience, and efficiency, while reducing staff and provider stress and burnout. We describe a Lean-informed approach that emphasizes the importance of organizational alignment in goals, evidence-based problem solving, and leadership behaviors to support a culture of continuous improvement. Our aim in this Perspective is to provide a real-world example of a feasible process for the planning, preparation, and execution of effective transformation, and to present lessons that may be useful to other academic health center practices seeking to develop innovative models to achieve the quadruple aim.
Identifiants
pubmed: 32989712
doi: 10.1007/s11606-020-06246-7
pii: 10.1007/s11606-020-06246-7
pmc: PMC7728967
doi:
Types de publication
Editorial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3650-3655Références
Bodenheimer T, Sinsky C. From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider. Ann Fam Med 2014;12(6):573-576.
doi: 10.1370/afm.1713
Linzer M, Poplau S, Babbott S, et al. Worklife and Wellness in Academic General Internal Medicine: Results from a National Survey. J Gen Intern Med 2016;31(9):1004-1010.
doi: 10.1007/s11606-016-3720-4
American Medical Association Steps Forward. Physician Burnout. https://edhub.ama-assn.org/steps-forward . Accessed 21 Sept 2020.
Lee JS, Karliner LS, Julian KA, Linzer M, Feldman MD. Change in Faculty Perceptions of Burnout and Work Life in an Academic General Medicine Clinic: A Pre-Post Study. J Gen Intern Med 2019;34(10):1973-1974.
doi: 10.1007/s11606-019-05083-7
Shortell SM, Blodgett JC, Rundall TG, Kralovec P. Use of Lean and Related Transformational Performance Improvement Systems in Hospitals in the United States: Results from a National Survey. Jt Comm J Qual Patient Saf 2018;44(10):574-582.
pubmed: 30243359
Al-Balushi S, Sohal AS, Singh PJ, Al Hajri A, Al Farsi YM, Al Abri R. Readiness Factors for Lean Implementation in Healthcare Settings--a Literature Review. J Health Organ Manag 2014;28(2):135-153.
doi: 10.1108/JHOM-04-2013-0083
Grove AL, Meredith JO, Macintyre M, Angelis J, Neailey K. Lean Implementation in Primary Care Health Visiting Services in National Health Service Uk. Qual Saf Health Care 2010;19(5):e43.
pubmed: 20511600
Hung D, Gray C, Martinez M, Schmittdiel J, Harrison MI. Acceptance of Lean Redesigns in Primary Care: A Contextual Analysis. Health Care Manag Rev 2017;42(3):203-212.
doi: 10.1097/HMR.0000000000000106
Utah State University Shingo Institute. Shingo Model Handbook. 2014. http://sapartners.com/wp-content/uploads/2014/04/ShingoModelHandbook.pdf . Accessed June 18, 2020.
Institute for Healthcare Improvement. The Breakthrough Series: IHI’s Collaborative Model for Achieving Breakthrough Improvement. IHI Innovation Series White Paper. 2003. www.IHI.org . Accessed 21 Sept 2020.
Scoville R, Little K. Comparing Lean and Quality Improvement. IHI White Paper. 2014. www.IHI.org . Accessed 21 Sept 2020.
Hung DY, Gray CP, Truong QA, Harrison MI. Sustainment of Lean Redesigns for Primary Care Teams. Qual Manag Health Care 2019;28(1):15-24.
doi: 10.1097/QMH.0000000000000200
Hung DY, Harrison MI, Truong Q, Du X. Experiences of Primary Care Physicians and Staff Following Lean Workflow Redesign. BMC Health Serv Res 2018;18(1):274.
doi: 10.1186/s12913-018-3062-5
Clack L, Zingg W, Saint S, et al. Implementing Infection Prevention Practices across European Hospitals: An in-Depth Qualitative Assessment. BMJ Qual Saf 2018;27(10):771-780.
doi: 10.1136/bmjqs-2017-007675
Wagner EH, Gupta R, Coleman K. Practice Transformation in the Safety Net Medical Home Initiative: A Qualitative Look. Med Care 2014;52(11 Suppl 4):S18-22.
doi: 10.1097/MLR.0000000000000196