A Rare Second Chance

This clinic redesign profile features a women's health clinic in a major hospital that had previously redesigned, but then saw the results deteriorate over time. The clinic then engaged Coleman Associates to do RealTime Redesign™. This is the story of that effort.

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RealTime Redesign™

Implement radical change within four days? Yes. RealTime Redesign™ interventions are brief and intense. Over the course of four days, a Coleman Associates training team works closely with your staff, on your own site, shoulder-to-shoulder, radically redesigning work processes while seeing patients. Staff are coached and inspired to work in new ways.

By lunch on the second day, staff are re-energized as they realize that dramatically improved outcomes—such as lower cycle times, better teamwork, and ending the clinic session on time—are utterly possible. Patients notice too and appreciate the change. One patient remarked: "I loved my visit today—it was so fast! If all my visits were like this, I'd keep all my appointments!"

In RealTime Redesign™, we don't have the luxury of months to change obsolete work processes. Minutes count. Hours are considerable chunks of time. Each clinic session is an opportunity to make radical changes. Each day must be transformative.

Here's what happens when you commit to RealTime Redesign™:

• Managers' Orientation Workshop. Coleman Associate trainers introduce managers to the RealTime Redesign™ methodology, the principles of redesign, and preparation for the on-site work.
• Day One. Trainers are on-site in the afternoon only. RealTime trainers and clinic managers huddle. Trainers then observe staff on the job, to understand the current process and build rapport. Trainers and managers implement QuickStart methodology to ensure an on-time start to the next morning's clinic session. By the end of the day, managers have selected and organized Patient Care Teams.
• Day Two. Managers and Trainers work together to implement QuickStart and create a real time data flow for cycle time. Managers evolve into Patient Care Team coaches. Patient Care Teams huddle prior to the beginning of the clinic session. "Start All Visits on Time" is the mantra and the sole order of business. After staff have successfully gotten the day off to a clean start managers continue to coach Patient Care Teams, while the RealTime team troubleshoots patient and staff schedule issues. By day's end, the nursing express line or flowmaster function has often been implemented (if appropriate).
• Day Three. Managers continue to coach Patient Care Teams to achieve optimal teamwork. Trainers troubleshoot problems with individual Patient Care Teams. Each clinic session is managed in three phases—Start Up, Momentum, and Soft Landing—so staff go to lunch and go home on time. Patient comments are captured; data flow is public and well established. By the end of the day, Patient Visit Redesign™ is fully implemented.
• Day Four. Trainers are onsite for the morning only. The RealTime training team monitors progress and troubleshoots outstanding problems. Managers have assumed ownership for the redesign. The morning ends with a huddle of the RealTime trainers and managers.
• Follow Up Program. A trainer coaches the management team during the follow up period. The Patient Care Teams increasingly assume ownership of the redesigned process; the managers are no longer involved in daily coaching. During the first two weeks, the trainer and management team have daily end-of-day phone calls. For the next four weeks, these telephonic huddles decrease in length and frequency as the redesign model becomes an ingrained habit.

The cost of RealTime Redesign™ starts at $39,000, and varies according to size and complexity of the site. The cost includes all travel expenses and training materials. Please call or email for more information.

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