March 11, 2019

Jackie Medland: Highlands-Cashiers Hospital Takes Inclusive Approach to Improving Efficiency

By Jackie Medland
President/Chief Nursing Officer, Highlands-Cashiers Hospital

At Highlands-Cashiers Hospital (HCH), we are engaged in a constant quest for quality. In fact, our clinical care team plays a critical role in guiding us to solutions for overall improvement in the patient care experience. To that end, 10 of our clinical leaders, including nursing, lab, therapy and facility leaders, are currently participating in five full days of LEAN training. LEAN is an organizational systems approach that focuses on increasing efficiency, streamlining processes and eliminating waste – whether time, effort, task redundancy or supplies (both materials and human energy).

One particularly valuable component of LEAN training is the Kaizen event. “Kaizen” means “improvement” in Japanese, and a typical meeting employs a progressive, solution-oriented approach to break down a problem methodically, analyze every component of it from every conceivable angle and reconstruct the process in which it originated to formulate a superior process.

A recent example of a process that needed enhancement emerged from both community feedback and a desire by our emergency department nurses, including Rosalie Lindecamp and Hollis Whitehead, to improve the rapid transport of our sickest patients off the mountain. While our commitment to finding practical solutions to improving the speed and efficiency of the transport process is unwavering, arriving at workable solutions is neither simple nor easy.

HCH recently held a day-long mini-Kaizen performance improvement forum in which we solicited input from members of every stakeholder group involved in the rapid transport process including physicians, nurses, local community partners such as Macon County EMS, and colleagues within the Mission Health system. Led by our Quality Manager Karen Hendricks and our Performance Improvement Specialist Vivian Trudell, the group immersed themselves in a robust conversation that yielded some immediate solutions as well as long-term ideas for improving the process. Participants mapped out our current transfer process, identified inefficiencies as a team where every voice and idea was valued and considered, and carefully painted a detailed portrait of what they want patient transport to look like in the future. While there is much work yet to be done, the team identified immediate solutions such as refinement of the “estimated time of arrival” notification from the field, radio enhancements, a resource alert and revised documentation.

Our mini-Kaizen event illustrates that HCH cares for the community in so many ways, in addition to direct patient care, and that lasting change can result from this type of coming together. The relatively short day-long time investment in training is reaping immediate, significant dividends. We owe it to our patients to huddle – literally and figuratively – with our community partners to find inspired solutions to any barrier to the best care.

We gave our stakeholders the appropriate time and space to begin making real traction on this pivotal community issue. Collaboration is the key to a clear path forward for sharpening our efficiency, increasing safety and overall care quality, and making our community stronger and healthier.

Jacqueline Medland, PhD, RN, is the President/Chief Nursing Officer (CNO) of Highlands-Cashiers Hospital. Jackie has enjoyed a career as a healthcare leader for over 30 years, including positions in direct patient care, advanced practice nursing, nursing management and hospital administration. Jackie received her MSN from the University of Illinois, College of Nursing, and her PhD in Organization Development from Benedictine University. She is a member of the American Association of Critical Care Nurses, the American Organization of Nurses Executives, the Illinois Organization of Nursing Leaders and Sigma Theta Tau. Jackie’s unique leadership and mentorship was recognized by the University of Illinois, College of Nursing with the Sage Award.

Highlands-Cashiers Hospital