Dr. Bruce Roe made an early morning visit to St. Paul’s Hospital on September 3 to talk about his hospital’s efforts to improve patient experience and safety.

Roe, Chief Medical Officer and Executive Director Clinical Programs at St. Boniface Hospital in Winnipeg, has championed his hospital’s strategic commitment to integrating transformative Lean practices throughout the organization, a journey his hospital has been on for about eight years.

RR-2015-09-09-Dr-Roe“We are on the road to perfect care, which is an endless journey,” Roe told the group of over 60 who gathered in Pylypchuk Hall to hear him speak. “However, we are seeing great staff engagement, we’ve seen improvements in our mortality rates, and patient satisfaction, and better financial performance. And we’ve found we can care for more patients, and sicker patients, with the resources we already have.”

Looking at hospital mortality rates will be a major focus for the upcoming Safer Every Day cycle on safety, and Roe spoke at length about how his hospital has moved to address those rates. All hospital deaths are reviewed within a week, he said, for evidence of harm and quality of care issues. In the review process, a committee of physicians is consulted and any problems that might have played a role in the death are reported back to the proper programs, so what occurred can be addressed.

Mortality rates are reported on a regular basis by the Canadian Institution for Health Information (CIHI), but often the occurrences that make up the report happened at least six months in the past, which makes any signals from them hard to understand.

“A more timely death review process will give us better information,” Roe believes.

Roe also had some suggestions for removing barriers to physician involvement in Lean work.

“Physicians have an intense interest in patient safety,” Roe noted, “but we don’t create opportunities for them to contribute to the conversation.”

The time commitment for Lean events like Rapid Process Improvement Workshops (RPIWs), which require at least an entire week of dedicated focus, is often too much for physicians, he indicated. Meetings after hours, strategic involvement of physicians for certain portions of RPIWs, or using other types of improvement methods, and using data and stories that show evidence that improvement initiatives have impact are ways to remove those barriers to their involvement, Roe believes.

“There’s no silver bullet,” he said, noting that word of mouth is the best way to entice physicians to get involved.

“You have to find the leaders, the champions and support those individuals. They will tell the stories about what their involvement was, how what they did made a difference for their patients, how valuable was the investment of time, and that will spread physician engagement. It’s slow, incremental. But there will be physicians who step up, and it will be very powerful.”