Daily CIP Sustains Improvements at Sick Kids

February 05, 2015

​In early 2012, SickKids began piloting a strategy that would one day lead to process improvement becoming a daily occurrence across the entire hospital. It started with a pilot that focused on two inpatient units and has now spread out across all inpatient units and is even making its way into administrative areas.

The Daily Continuous Improvement Program (Daily CIP) is grounded in LEAN management principles and is guided by nearly 10 years of experience of ThedaCare, a hospital system in Wisconsin recognized globally for its gains in performance.

Building on the learnings from SickKids' SPEED initiative, in which frontline staff helped to significantly improve admission wait times from the Emergency Department, Daily CIP is the latest step in SickKids' process improvement journey, reinforcing the hospital's commitment to providing the highest quality family-centred care and to building process improvement capacity.

The Daily CIP strategy is helping SickKids sustain improvements and provide a structured methodology for frontline staff to identify and solve problems on a daily basis.

The outcomes from Daily CIP are improving the patient experience and helping SickKids meet many of its strategic objectives – hitting performance targets, being innovative, leading in world-class quality and creating a culture of service excellence.

The Daily CIP has armed senior management with the pivotal framework to achieve big-picture results. And it gives frontline staff an opportunity to bring opportunity to learn new skills and to make a measurable, positive impact on the unit for patients, families and their colleagues. Managers and frontline staff have enthusiastically embraced the program.

To date, more than 1,500 improvements have been made as a result of Daily CIP, ranging from the very small to large, cross-unit implementations. Examples include a standard approach to verify families over the phone, providing cell phone chargers for families, and printing pictures of the most commonly needed supplies on a supplies tray, reducing the risk of forgetting an item and cutting down on multiple trips between the supply room and patient rooms.

In terms of large strategic improvements, one of our units focused on chemotherapy start times. Recognizing the later they start, the longer the patient is required to stay at the hospital, the unit embarked on an eight-month project that moved the start time of chemotherapy to the beginning of the day, therefore reducing the need for patients to stay the night.

"Before joining this program at SickKids I worked at other hospitals using this sort of methodology for improvement projects, and I can say that the culture at SickKids is amazing," says Travis Beamish, a Process Improvement Program Manager involved with the project since its SickKids inception. "Everyone understands that the program is a great opportunity to improve how we work and deliver quality care to our patients."

While Daily CIP is still a relatively new program in hospitals across North America, the success of the program here has other organizations looking at SickKids as a model. This innovative approach to problem solving has captured the attention of hospitals across Ontario, with executives, directors, quality leaders and frontline staff visiting SickKids over the past year to observe Daily CIP in action. It wasn't long before Accreditation Canada added Daily CIP to its list of Leading Practices.  And in November 2013, SickKids was asked to present their success in LEAN health care at Health Achieve, the largest health-care industry conference in Canada.

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