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Rapidly get your process management activities underway and under control

Patient Safety Quality Monthly, April 21, 2009

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Last month, we talked about three key areas to consider adding to your plan for improving quality and patient safety. These areas included:

• Rapidly get your process management activities underway and under control
• Become best friends with your CFO
• Make safety, quality and performance improvement a profit stream through reducing COPQ.

So, how can we rapidly get our process management activities underway and under control? Virtually all our facilities have a quality and/or performance improvement function, and we are all doing improvement projects to improve outcomes and meet specific measures that have been proposed (or mandated) by the outside world. The real question is, "Do we have a well-structured approach to process management?" Remember, that's management – not just improvement. A key test I like to use is summed up in the question, "Do you manage your processes as robustly as you manage your people?" We have a complete and comprehensive list of all employees that includes their performance and details of what they do, as well as a clear understanding about how they fit into the overall success of the organization. Can you say the same for your processes? Often, we can't even list them, let alone know how well they are performing. If you want to implement a comprehensive process management approach, you may be interested in the Greeley 7-Step process management framework. This framework includes the following steps:

1. Understand and map your process. If we don't know all our processes by name and don't have them documented, we will have a hard time managing them. (Process mapping)
2. Evaluate and manage the process risks. It doesn't make sense to try and improve the efficiency of a process that is inherently flawed and unsafe, so our next step is to evaluate the process for safety and risk. (FMEA, HAZWOP, probabilistic risk assessment, etc.)
3. Evaluate and manage the process efficiency. If the process has acceptable risks, then we move on to improve the efficiency and cost-effectiveness of the process. (Lean, 6 Sigma, visual process analysis, value analysis, etc.)
4. Perform formal change management. One of the riskiest places in the process management cycle is when we decide to change a process. It is essential that a formal change management process is used to ensure that we do not introduce unintended consequences. (Change management checklist, management risk assessment reviews, off ramps, FMEA, etc.)
5. Develop safe and effective policies and procedures. Once the redesigned process is approved, it is essential that the interfaces with the end user are clearly and safely defined. Typically, this is done through our policies, procedures and job aides. If we do not do this step well, we can negate all the good efforts to change our process, because the new process is not performed correctly and reliably. (Policy and procedure content review, policy and procedure writing guidelines, etc.)
6. Integrate your process with the workplace. The process and the physical workplace need to work well together. A comprehensive process management approach will help ensure that they do. (Visual Factory, 5S, etc.)
7. Manage process exceptions and breakdowns. Process management is an ongoing task. Just as we monitor the performance of our employees on a daily basis, we need to monitor our processes on a continuous basis. This allows us to identify breakdowns or trends that need to be addressed and collect the information that is needed to support all the other steps. (Problem identification and resolution, reporting, screening, cause analysis, etc.)

If you want to make significant improvements in your organization's safety and performance, make sure that your process management approach addresses these key areas in an integrated fashion. We work on a daily basis with our healthcare clients to assist them in improving their process management approaches. Please feel free to contact us if you are interested in the Greeley 7-Step approach.

Next month we will look at how we can better integrate our quality and safety activities with the CFO.

Ken Rohde 4-20-09

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