In my first QReview post, I introduced myself using the “The Story of Self” and committed to following up with “The Story of Us” and “The Story of Now” as described in the Public Narrative Approach for community engagement and mobilization. For me, it’s a perfect time to reflect and think about the “Story of Us” and the “Story of Now” as we move into a new era of quality improvement through the provincial implementation of Hoshin Kanri (strategy deployment) and a Lean Management System.
For the last four years my work has been dedicated to supporting the implementation of the Releasing Time to Care™ (RTC) program across the province. My “Story of Us” is strongly connected to this experience. First as a QI consultant and then as a Program Director with the project, I have had the privilege of working with dedicated individuals and teams across the province to initiate one of the most wide-scale acute care quality improvement initiatives ever undertaken in Saskatchewan. There was a lot of concern and discussion about how we could implement RTC in the stressful and busy health care system. We were being pushed out of our comfort zone and it was a leap of faith for all of us.
But together, we worked hard to move the program forward. Those who were involved or contributed to the project are too numerous to name but each question asked, idea shared, and experience lived contributed to our learning as a system. RTC is not just HQC’s initiative, it has been “our” initiative – the health care system’s initiative – and it continues to move forward today with momentum that can only be generated from a deep commitment and dedication to improvement.
But this journey hasn’t been without some challenges. We’ve learned A LOT along the way and there are SO many things we could have done differently. But as Kierkegaard said “Life can only be understood backwards; but it must be lived forwards.”
So, let’s live forward. On May 18th I participated in my first RPIW report-out in the Saskatoon Health Region (http://www.saskatoonhealthregion.ca/lean/index.htm). I concluded this is our “Story of Now.” The report-out was very interesting and the results were great. But it wasn’t just the steps saved, efficiencies gained, or the waste eliminated that impressed me. We’ve seen many of those same kinds of improvements with RTC. The REAL difference I saw was in three key areas:
- The rapid organizational response to the improvement needs identified by the team (e.g., moving equipment, adjusting cart supplies, cleaning certain areas, etc. within a week).
- A strong leadership presence with on the improvement team and at the report out.
- The clear voice of the patient/family.
These 3 things move us forward in an important way. Soon, it will no longer be acceptable for frontline staff to wait months for a shelf to be installed to make the their work more efficient. We now know that work can be done within a week. Similarly, it will no longer be acceptable for leaders to lead from their offices, while frontline care providers struggle to break down the barriers that keep them from doing their job safely and efficiently. We’ve now seen the contribution leaders can make by being actively involved at the point of care. Finally, it will also no longer be acceptable to work on quality improvement without the voice of the patient/family being front and center as an equal member of the improvement team. The days of health care providers doing “to” and “for” rather than “with” are going the way of the dinosaur. This warms my QI heart.
I have to admit, I was holding on to the “Story of Us” and not sure if I was ready to start creating a new “Story of Now.” But seeing the RPIW report-out made me realize that this new era of improvement provides us with huge opportunities to take a step out of our comfort zone once again… like we did with RTC back in 2008.
I’m ready to create some new magic – are you?