{"id":5832,"date":"2010-11-24T09:55:18","date_gmt":"2010-11-24T08:55:18","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=5832"},"modified":"2010-11-24T09:56:37","modified_gmt":"2010-11-24T08:56:37","slug":"liz-thiebe-lessons-from-seattle-dealing-with-the-challenge-ahead","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2010\/11\/24\/liz-thiebe-lessons-from-seattle-dealing-with-the-challenge-ahead\/","title":{"rendered":"Liz Thiebe: Lessons from Seattle: dealing with the challenge ahead"},"content":{"rendered":"

\"\"Every year I lead a group of health care leaders on a study trip of medical and other organisations in Seattle, an American\u00a0city with a rich and diverse health care economy. This year the trip threw up some interesting comparisons between our two nations\u2019 health systems, and helped to shed light on the current situation facing the NHS.<\/p>\n

Our multinational group \u2013 five doctors and a mix of senior NHS leaders \u2013 were all looking for ways to apply learning from the exemplar sites in Seattle to their own organisations.<\/p>\n

On the trip we spent half a day at Group Health, a member-owned, integrated care organisation similar to Kaiser Permanente that successfully commissions and provides services for 600,000 members. We learned how the organisation uses transparency together with strong leadership and support structures to focus on the four \u2018pillars\u2019 of patient experience, staff satisfaction, quality of care and financial balance.<\/p>\n

Here we learned the value of the daily \u2018huddle\u2018, in which key staff come together for a five minute focus on the goals of the day. This was done every day \u2013 and on some wards, every hour. It was amazing to see such a complex organisation manage itself so successfully with very simple routine processes.<\/p>\n

At the Everett Clinic, which employs more than 300 primary care and specialty care doctors, we explored how to give feedback and manage clinicians\u2019 variation in practice. The Clinic\u2019s annual appraisal system taught us valuable lessons to take forward with our own GP consortia around feedback to peers. This included peer feedback on working relationships with colleagues, patient satisfaction, and productivity measures based on individual performance and compared to agreed performance targets.<\/p>\n

It seems that Seattle has embraced the concept of improving productivity and quality through these austere times. At three different medical centres \u2013 the Virginia Mason Medical Center (VMI), the Veterans\u2019 Affairs, and the Harborview Medical Center \u2013 we witnessed lean practices being introduced to reduce tasks or remove steps that do not add value. In each case, frontline staff identified work processes that could be standardised across teams and organisations.<\/p>\n

For example, in the outpatient clinic at VMI, patients do not sit in waiting rooms, but are greeted by a receptionist, handed a clipboard with the consultation room location and then allowed to walk right in. This approach has enabled the clinic to reduce the time spent taking patients to rooms and to spend more time with the patients who needed treatment.
\nWe found it incredibly valuable to experience these health systems first-hand \u2013 and we could dive as deep as we wanted into the organisations, allowing us to test our assumptions and thinking.<\/p>\n

In particular, all the organisations we visited showed just how serious they were in keeping the patient at the centre of everything. It is a lesson we would do well to bring back into the UK.<\/p>\n

Liz Thiebe<\/strong> is the deputy head of leadership, King’s Fund.<\/em><\/p>\n

This blog also appears on the King’s Fund website at http:\/\/www.kingsfund.org.uk\/blog\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Every year I lead a group of health care leaders on a study trip of medical and other organisations in Seattle, an American\u00a0city with a rich and diverse health care […]<\/p>\n

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