As of today, Day 60, Saskatoon Health Region is two-thirds of the way through their first 90 day cycle of breakthrough improvements.

How are things going so far? We sat down with Petrina McGrath, Vice-President of People, Practice and Quality and the Process Lead for 90 Days of Innovation: Ready Every Day, to find out.

Petrina McGrath

Petrina McGrath

“There has been a tremendous amount of knowledge gained by these teams in the work they’ve been doing,” McGrath said. “And we are all starting to see the system differently because of that work. We’re gaining a more common understanding about issues across the system and how they affect patients, staff and physicians.”

The predictive model that has been developed by the team dedicated to Information and Decision Support has been a huge win, she feels.

“That has shown us that we can predict what our work will be like on a given day, and that gives us the opportunity to act in ways that prepare us to manage the changing demands.  It is changing the conversations. It’s also given us a better understanding of the variables involved, and which variables we actually control ourselves as a system,” McGrath noted.

The opportunities the Community Strategies team has identified which would help alleviate pressure on the acute care system are also significant, she feels.

“Their work is having us rethink about where people want to be and how we can shift our thinking about supports provided in the community,” she said.  “We’re better understanding and breaking down this concept of alternate levels of care, not all people that are waiting in the acute care setting have the same needs and this  work is helping us develop customized program to provide care outside of a hospital setting.”

The Transitions of Care team’s work on what is happening within acute care – things like repatriation and developing a dedicated stroke unit – has also led to a lot of knowledge gained, and breakthrough strategies.

Teams have been using the Lean tools they’ve been trained in, and are seeing the value of them.

“They’re taking what they’ve learned and are putting it into action,” she noted.

The teams have been great at moving and changing directions quickly, she added. “Whenever we learn something new, that leads to reprioritization, and that requires nimbleness.”

There is incredible value in focusing people on this important work for a condensed time, McGrath believes.

“Each piece of work impacts another, and sometimes it’s what another team is actually working on. To have focused work across the entire value stream at the same time is extremely beneficial,” she said. “I believe we are getting to the root issues, not just addressing the symptoms.”

What’s a value stream?

A value stream is essentially what constitutes the entire patient experience. Mapping the value stream is a Lean tool to help visualize the health care experience through the eyes of the patients. This map is essential to identifying gaps and waste, and for creating a road map for improvement from a patient’s perspective.

“I’m getting emails all the time from people who want to let us know the work they are doing to improve patient flow. They’re excited and want to profile what they’re doing,” McGrath said.  “ We’re at an exciting point because we are in the testing phase of the 90 day cycle, so there is lots of action happening.”Sixty days in, more and more people in the Region are getting involved in the work of the 90 Days of Innovation teams.

The most important thing to remember at this stage is that it’s okay if some actions don’t stick, if they don’t work, she advised.

“The key is for us to say, okay, that didn’t work, but what did we learn from that trial? It’s all about continual learning and improvements.”

Another level of learning in 90 Days of Innovation is how to set up a 90-day cycle.

“We’re really learning about the process to set up a 90-day cycle of improvement, and part of that is gaining a solid understanding about what’s needed in the data collection phase.”

Without data collection, she said, the Region runs the risk of jumping to action without knowing if the root issue is actually being addressed.

“Really, the first 30 days of this cycle was focused on collecting that data and learning the incredible value of that process,” she stated.

It’s a critical part of the improvement process for the teams involved to go out and experience the current state for patients and families, for clinicians and support staff, to understand the barriers they are facing, and really know what a day in their lives looks like.

“It is absolutely vital to understand current conditions, and you can only do that by going out and observing the process in action, then making those conditions visible to the others involved in the improvement work,” McGrath said.

This learning will be valuable for the next 90 day cycle, which is due to begin in September. McGrath believes some of that data collection and target setting can be done before the 90 days actually start, as the first of three phases for each cycle. Phase two would involve taking action, and phase three, the follow-on which focuses on sustaining the gains and ongoing improvements.

“As you solve problems, new issues are usually identified, so it’s an ongoing process. It doesn’t just stop when the 90 days are up,” she said.

See more stories about Region improvements at