sutures newsletter

PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY January 2018 | Archived Issues

Streamlining Without Cookie Cutters

By Thomas M. Priselac, President and CEO

As part of our collective goal to make Cedars-Sinai care more affordable, many different departments have started re-examining how they do things. They’re finding opportunities to streamline processes, making things simpler and easier for our patients and each other, and in turn reducing unnecessary costs.

Although each area has different challenges and specific solutions, we’re starting to see a common thread throughout the institution. Like many organizations, as we have grown over the past decade, we have developed a lot of one-off, customized processes and solutions in almost every part of the organization. Many of these have greatly increased the complexity and time it takes to get things done, without necessarily providing a significant benefit for patients—hindering our ability to be more streamlined and efficient.

As our departments now take a step back to examine their processes, they are finding that one of the greatest opportunities is to increase consistency and simplicity in how we do things, where appropriate. A few examples: assessing usage of OR instrument trays to reduce the number of unused instruments; optimizing patient flow in Medical Network primary care practices; and standardizing guidelines for use of inpatient telemetry beds.

Certainly, standardizing and simplifying processes, undertaken without a thoughtful approach, can go too far and turn well-intended ideas into a mindless cookie-cutter experience. And healthcare in particular is not a "one-size-fits-all" endeavor. So how do we keep a sense of balance as we seek to increase the ways we standardize and streamline our practices and procedures?

We need to listen carefully to each other as we engage in this examination of processes together. While there will be many opportunities for standardization, there also will be situations where this approach doesn’t optimize our work or the clinical care of our patients. We need to continue to examine all aspects of our processes before making decisions about what and where to streamline. In some cases, a customized process may turn out to be the best solution.

We also need to be open to tweaking processes after they have undergone initial change. What seems to work perfectly in theory usually has a few wrinkles to iron out after it has been piloted.

Cedars-Sinai’s "test of change" culture and our openness to continual adaptation will be great reference points as we work together to streamline and optimize, and look for opportunities where standardization makes sense for our patients and for each other.