You have probably all heard the expression: “A picture is worth a thousand words”. As I followed the London Olympics, I was struck by how often a single image captured the focus, effort and results of amazing athletes. Their hard work and dedication was measured and displayed for the world to see, with success often determined by less than seconds.

The Workforce Planning team from People and Partnerships regularly review their wall, which lists their department’s three priorities and questions for staff to indicate if they feel they made a positive contribution this week or were able to influence how their work is done.

This phrase is also used to describe how a complex idea can be conveyed in just a single image. The concept of visibly capturing complex information and reporting results using simple, graphic images is powerfully illustrated in our visibility walls, which are part of Saskatoon Health Region’s new way of doing business.

Saskatoon Health Region has been a leader in measuring and reporting key performance indicators, such as immunization rates, surgical wait times, infection rates and staff overtime. For several years we have had a “balanced scorecard” which has been reported to the Authority and posted on our public website.

The scorecard was intended to focus our attention and improve accountability and key performance indicators. We are now taking this approach to a whole new level as we
adopt the Lean-based Saskatchewan healthcare management system.

The largest visibility wall is located in room 1911 at City Hospital. I encourage you to drop by and see it. The visibility wall is used to track selected performance indicators related to quality, safety, cost, service delivery, and morale. We are also tracking progress on our results related to seven strategic priorities (hoshins): sooner, safer, smarter surgery, primary health care, development of our continuous improvement system (Lean), safety culture, shared services, planning for the Children’s Hospital, and improving flow for patients with complex care needs.

The Region’s main visibility wall in SCH 1911 focuses on quality, safety, delivery, cost and morale, as well as this year’s four main service lines.

In addition to reporting Region-wide results, we are reporting selected performance indicators for four service lines: surgery, maternal/child care, emergency and supply chain (which includes services such as materials management and housekeeping). Over time, we will add more service lines to reflect all our care and service areas.

But our new way of doing business is not just about measuring and displaying our results. It involves a whole new level of accountability. Every Thursday morning at 0830, the senior leadership team conducts what is called a wall walk. Standing in front of the visibility wall, the vice presidents responsible for the measures we examine that week report on their results. If the results are not on track to meet our target, the vice president must provide a written corrective action plan, which outlines the steps he or she will take to get back on track. Excuses aren’t enough. Leaders are held accountable for meeting their targets.

Acute Medicine and Complex Care based their wall and metrics on better health, better care, better value and better teams, as well as a
spot for their rapid process improvement workshops.

The wall walks are very structured, with each presentation timed to the minute. Frankly, the process can feel pretty uncomfortable when the person reporting must explain why targets are not being met and what will be done about it. But there is also a strong sense of team as the participants problem solve together. On the weeks when we review progress on our strategic priorities, our entire leadership community, including directors and clinical (physician) department heads, are expected to attend and participate. This process is now part of the standard work for leaders.

Another piece of the Region’s main visibility wall in SCH 1911.

The wall walk is very powerful. It is part of the Saskatchewan healthcare management system being adopted across the entire province. There are now visibility walls in every region, the Cancer Agency, Health Quality Council and Ministry of Health. Every three months, a provincial wall walk is conducted at the Ministry of Health, where each CEO must report on selected regional and provincial results, including provision of a written corrective action plan (called an A3) if results are off target.

Over time, everyone will establish visibility walls and wall walks in every unit and department. Some areas have already started. We will learn as we go, part of our commitment to continuous improvement. Just as elite athletes improve by measuring their results and continuously striving to do better, our Health Region will use this new approach to measurement and accountability to help us achieve better health, better care, better value and better teams.

Maura Davies
President and CEO
Saskatoon Health Region