Clinic Sprints remove barriers, enhancing joy and patient care

OHSU President Danny Jacobs joined the huddle in Peds Dermatology, the latest ambulatory clinic to undergo a clinical Sprint to improve workflow and wellness.

Clinical informatics team also expanded

The concept of improving wellness often conjures images of meditation or yoga. Yet it is often the day-to-day frustrations, inefficiencies and hassles that erode joy and contribute to burnout.

That’s why the OHSU Practice Plan, the largest clinical practice group in Oregon, launched clinic Sprints, a two-week, rapid-cycle process improvement experience for ambulatory clinics. A year in to the pilot, the Sprints team has completed eight Sprints and is now inviting clinics to get in touch if they want to sign up.

“Our clinicians and their teams are on the run most of the day, and they struggle to come up for air and address the things that cause significant stress,” said Cort Garrison, M.D., chief health information officer for OHSU. “It is really gratifying to be able to go in, create a space for them to articulate those barriers and then remove them. And the more Sprints we do, the better we are at making them the most effective that they can be.”

Each Sprint team consists of a clinical informatics fellow, a process improvement consultant, an Epic analyst and the Sprints Master – Garrison – who is the “barrier remover in chief,” fast-tracking Epic edits or other requested changes.

A great opportunity 

The Sprints begin with eliciting the clinic’s challenges from all members of the care team, allowing for anonymous submissions if needed. Then, for the two weeks, the Sprints team convenes a 30-minute huddle first to prioritize and then to attack what the team calls “the pebbles in their shoes.”

While sometimes the issues the team encounters are larger, systemic problems that take time to resolve, more commonly the issues are basic workflow challenges:

  • Supply carts that never have what the clinicians really need.
  • Epic headaches where looking up one thing requires a dozen steps.
  • Scheduling practices that create delays.
  • Staff task assignments that are out of synch with clinician priorities.

“I really appreciated the opportunity to have a team of experts in workflow, Epic and leadership at our clinic every day during the Sprint,” said Mohamed Alyajouri, practice manager at Orenco Station Family Medicine Clinic. “It allowed my team to ask real-time questions and in many cases get an immediate answer or a fix.”

Shilpa Kasukurthi, lead performance improvement consultant for the Sprints, said the best Sprints are when the full care team, especially the clinicians, can engage. “And,” she said, “the relief they experience makes everyone feel better, and it translates into better patient care.”

The expanded OHSU clinical informatics team. Front, left to right: Meredith Kato, M.D.; LP Riccelle, M.D.; Tammy Wagner, M.D. Middle: Brian Tran, M.D.; Scott Sallay, M.D.; Steve Kassakian, M.D.;Julia Durrant, M.D. Back: Reid Muller, M.D.; Cort Garrison, M.D.; Thomas Hwang, M.D.; Amanda Miller, P.A. Not pictured: Tom Gregory, M.D.; Daniel Seifer, M.D.;Ben Orwoll, M.D.;Will Loker M.D.;andCatherine Wong, M.D.

‘Eyes and ears’ team expands to help

The Sprints teams are also making improvements. OHSU has greatly expanded its clinical informatics team to increase Epic problem-solving capacity for both inpatient and ambulatory areas, which means more heads and hands to support the Sprints teams.

“The clinical informatics team is the ‘eyes and ears’ about Epic strategy, issues, training and efficiency,” said Steven Kassakian, M.D., associate chief health information officer. “We are so pleased to expand this vital team and know the tremendous value they will bring.”

Perhaps the biggest value of the Sprints is what it teaches clinic team members:

“This is a collaborative process,” Kasukurthi said.” We attempt to give you that improvement mindset so that you can solve problems after we’re gone.”

To sign up for a Sprint, email Shilpa Kasukurthi at kasukurt@ohsu.edu .

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