Journeying with Lean Healthcare’s Best October 17, 2017 We in lean circles often use the word “journey” to describe an organization’s experience of learning, adopting, and applying lean thinking until it’s engrained in our cultures and how we work. The word resonates with my experience in healthcare CI. In our description of this event we said our experience of this journey is often an arduous climb. So maybe the photo here resonates with you – either the challenge, or the worthiness of the goal, or both. Personally, I wouldn’t ever attempt a world-class mountain climb without an expert who’s been there before, for safety, for the best chance at success in the shortest possible time. The lean transformation journey can be tricky, dangerous, certainly challenging. We’re fortunate this evening to learn about two of the best guides in lean healthcare – they’ve been there, and although they’ll say they’re still working at it, they are much further along in the climb than most. We’re going to learn about them through the eyes of 3 climbers – 3 New England health systems. Before we get going on that, let me first share the agenda, and some acknowledgements and introductions.

Tonight’s Topic Learning from Lean Healthcare’s Best 6:00 – 6:25 Food, networking, setup 6:25 – 6:35 Thanks! and Introductions, Needs and Offers 6:35 – 6:40 Virginia Mason Institute (VMI) – Melissa Lin, Sensei Catalysis – Helen Zak, Chief Development Officer 6:40 – 6:45 Interactive 6:45 – 7:25 Panel discussion: * Martin’s Point Healthcare (Catalysis) -- Bonnie Baker * North Shore Medical Center (VM Institute) – Lindsay Gainer * UMass Memorial Health Care (Catalysis) - Lori Pelletier, VP Performance Excellence - Jeffrey Smith, COO - Eric Dickson, CEO 7:25 – 7:55 Q & A – discussion with panel 7:55 – 8:00 Wrap-up First, on behalf of the MHLN, I want to express gratitude to the UMMHC system, CEO Eric D, COO Jeff S, and Lori P for the use of this wonderful space this evening. I’m fortunate to have gotten my start here at UMM, and even before that upon meeting Eric in the summer of 2009 when he spoke to a group at MIT learning about lean in healthcare. Without that connection and his support, I might not in front of you today. Also want to thank Ernest Byers, PI staff and Mgr of Education and Collaboration in UMM’s lean team, for his help arranging our use of the space tonite. We also like to share a bit on who / what the MHLN is, in case you’re unfamiliar, and I guess because we like talking about ourselves. The hardest job tonite, I promise, goes to our reps from vendors Catalayis and VMI who I’ve given only 2-3 minutes to introduce themselves and their organizations. They will be around all evening for Q&A, but we want to save most of our time for the panelists to share their experience working with those two. We have a short interactive exercise for you, then to the main feature – our panel. We’ll end with 30 minutes of Q&A, anticipating there will be lots of questions about the value and ways of working with them. If we finish early, we’ll use any remaining time for more networking with panelists, vendors. OK, allow me to say a few words about MHLN before we start on our topic.

Who We Are…and What We Do Learning – topical evening events (quarterly), gemba walks, links, surveys Networking – web site, job postings, LinkedIn group, affiliation (e.g. NHLN) Social – summer gathering 450+ Members 100+ organizations across Massachusetts Leadership Team Doug Alden, Jonathan Baum, Jeff Durney, Tom Gormley, Bruce Hamilton, Kae Santos The MHLN started 8 years ago with just a few lean practitioners in local hospitals, and has grown from there to 450+ members. I don’t think Doug and Jonathan ever envisioned their 3-person group growing to over 400. They like it if we bow down to them. Just kidding, but I do owe them for enriching my lean healthcare journey. Introduce the leadership team – JB, DA, JD, BH, KS. Make sure to meet them and hit them up with your ideas for future learning / networking opportunities. Founders Douglas Alden (Lahey) Jonathan Baum (Brigham) Andy Wurtzel (Newton-Wellesley)

Massachusetts Hospital LEAN Network (MHLN) founded 2009 Massachusetts Hospital LEAN Network (MHLN) MISSION To network with all Massachusetts hospitals' LEAN Performance Improvement (PI) practitioners involved in PI methodologies (Lean, Six Sigma, etc) to: Have fun -- This is the primary objective.. Let's face it, the type of people that choose Performance Improvement are usually very interesting ! Network (Promote learning and sharing) - within the Massachusetts healthcare quality improvement field…among both practitioners and those interested in the industry. Find other people who do what we do, to get ideas, to share, to see how others approach similar challenges. Currently have 450+ members across 100+ Massachusetts hospitals and other healthcare facilities 3) Exists for You -- This group exists purely to promote Lean PI learning and networking in Massachusetts hospitals. This is NOT the organizers' group; this is your group. We would not exist if it was not for you. Thus, anyone may provide ideas, comments, and/or offer help to improve how this network can better serve you. Our focus is on learning from each other, and hopefully adding some fun to our work through the social exchange. We measure our success by your satisfaction – so we’re always interested in hearing your input on topics of interest, potential speakers, venues – how to provide the best value. http://www.mhln.org/

Topics – Past and Present Fall, 2017 – Summer, 2018 Learning from Lean Healthcare’s Best (October, 2017) Learn about Virginia Mason Institute and Catalysis from a panel of New England health systems working with them. Lean Learning Lounge: Red-Hot Improvement Topics (by member vote) (Jan-Feb, 2018) Mini group discussions on topics chosen by members. Last year included Patient Access; ED Flow; and Lean Training Tip of the Spear: Training Clinicians in Lean – PI (May-June, 2018) Training busy clinicians to understand and lead PI is a challenge. Learn what Partners Healthcare is doing to address this gap. Launched in 2010, Partners CPIP is a 6-day experiential program conducted over 6 months. Lean Coach Training in Japan (February, 2017) Gerry Velasco, Vice President, Performance Improvement, Atrius Health Systems-Based Approach to End of Life Care (October 2016) Jo Paladino, MD , Palliative Care physician , Dana-Farber Cancer Institute and Ariadne Labs The Role of Executive Management in Improvement and Lean (Signature Healthcare) (May, 2016) Kim Hollon, CEO, Brockton Hospital Applying Lean Six Sigma to Patient Access (March, 2016) Howard Brightman, Director, Enterprise Project Management Office Kevin Pawl, Director, Patient Access; Eric Nathanson, Director, Contracting Sustaining Quality Improvement (November, 2015) Tom Gormley, South Shore Hospital, Senior Lean Advisor Summer Gemba Walk Series (July-August 2015) Mass General Hospital’s Center for Comparative Medicine Reducing medication errors at South Shore Hospital Shingo & Baldrige: Oper. Excellence Strategies (June, 2015) José Daniel Paredes, UL Associate Director, Continuous Improvement & Marta Nichols, Executive Director of Partners in Performance Excellence We’ve improved our Planning – first time ever I think that we’ve planned our next year’s worth of activities. These are described in more detail on our web site. Also, here are topics from our last 2 years’ events. http://www.mhln.org/ 5

Needs and Offers Looking for Lean – PI jobs in healthcare Have open positions for Lean – PI in healthcare (post on the MHLN site?) Happy Healthcare Quality Week Part of our networking approach includes mentioning during our events – any job openings, or people seeking jobs in this field. Is there anyone looking who wants to introduce theirself to this audience? Speak up now. Anyone who has jobs to fill? Feel free to send them to us for posting on our web site, at masshln2009@gmail.com. http://www.mhln.org/ Email: masshln2009@gmail.com

“Any improvement must be made … under the guidance of a teacher…” Decoding the DNA of the Toyota Production System. Stephen Spear, Kent Bowen Organization Presenter Melissa Lin, Sensei Helen Zak, Chief Development Officer Services Build organizational capability for embedding lean culture; assessments; Site visits; coaching, facilitation, training Educational programs, resources designed to transform healthcare value; Site visits; Peer Network; conferences; white papers Formation 2008 Non-profit Awards Leapfrog “Top Hospital of Decade” Lowest cost, high quality; Consumer Choice Located Seattle, Washington Appleton, WI Web site www.virginiamasoninstitute.org Createvalue.org While each of them and the health systems they’ve helped are highly accomplished experts in lean transformation, I can tell you from talking with them they each exemplify the humility needed to continue their pursuits of perfection. As you can read in their books, both looked outside to find experts they could learn from – including manufacturers Boeing, Ariens, and Toyota. They both realize they have a long way to go. Later in Q&A, you’ll have a chance to ask them questions about their organizations, their services and approach. But for now please hold questions so we can get to our panel on time. So let me now turn it over to these unique providers of lean healthcare education and consulting services. First, Melissa Lin, of VMI. Melissa is Transformation Sensei at VMI (2+ years; 7+ yrs consulting; Geisinger; and Dartmouth’s MS-HC Leadership). And next, Helen Zak, of Catalysis (7 yrs; LEI EVP / COO 10 yrs; prior Sr. Ops Mgr in manufacturing; Kettering MS-Ops Mgt).

Share a few of your thoughts Interactive Exercise Share with someone in a seat near you, not from your employer: How have you or your employer engaged outside experts from healthcare, other industries, consulting, or academia, for guidance on your lean journey? How did you choose them? What value or benefits were you seeking in engaging these experts? How did the experience compare with your expectations? With those vendor introductions in mind, we’d like to give you a quick opportunity to learn from someone else how they or their organization has engaged outside consultants, academics, training groups, or other experts. Are consultants “verboten”? Take 2-3 minutes now and ask someone not from your employer… first, rapid fire tell me what type of org you engaged – either of these 2; or traditional consultant; or academic; other? Raise hand if someone in your org has gone on lean-PI focused site visits? OK, tell me what industries – rapid fire. - How many have tried book clubs? Share a few of your thoughts http://www.mhln.org/ Email: masshln2009@gmail.com

Tonight’s Topic Learning from Lean Healthcare’s Best 6:00 – 6:25 Food, networking, setup 6:25 – 6:35 Introductions 6:35 – 6:40 Virginia Mason Institute – Melissa Lin, Sensei Catalysis – Helen Zak, Chief Development Officer 6:40 – 6:45 Interactive 6:45 – 7:25 Panel discussion: * Martin’s Point Health Care (Catalysis) -- Bonnie Baker * North Shore Medical Center (VM Institute) – Lindsay Gainer * UMass Memorial Health Care (Catalysis) - Lori Pelletier, VP Performance Excellence - Jeffrey Smith, COO - Eric Dickson, CEO 7:25 – 7:55 Q & A – discussion with panel 7:55 – 8:00 Wrap-up Moving to our main feature tonite – hearing from 3 New England health systems engaged in lean for improvement or transformation, which have enlisted support and services from one of our two lean healthcare service providers – either Catalysis or Virginia Mason Institute. Depending on time, we’ll allow 1-2 quick questions after each panelist. I’d like to start with Martin’s Point Health Care, located in Portland, Maine (thanks for coming down). Bonnie Baker is Director for the Martin’s Point Mgt System. Bonnie, please tell us about Martin’s Point, and your experience with Catalysis. Next, NSMC in Salem, MA. Lindsay Gainer is Exec Director of Innovation there. Lindsay will fill us in on NSMC and the relationship with VMI. Last but not least, UMMHC, our host. http://www.mhln.org/ Email: masshln2009@gmail.com

Q & A Our Panel: Suggested topics: Bonnie Baker Director, Martin's Point Management System (MPMS) Martins Point Health Care Lindsay Gainer, RN, MSN Senior Executive Director of Innovation North Shore Medical Center UMass Memorial Health Care Lori Pelletier, PhD VP, Performance Excellence Jeffrey Smith, MD, COO Eric Dickson, MD, CEO Suggested topics: Inspiring interest in learning about VMI and Catalysis within your organization Peer-to-peer networking between health systems Senior executive engagement in services provided by these two organizations Strategic vs. tactical engagement of VMI and Catalysis Using these providers vs. other experts Barriers to engaging outside experts like VMI or Catalysis Great overviews – thank you panel members for introducing us to some of your experiences and insights about working with these unique lean healthcare providers. They’ve summarized a tremendous amount of experience in a very short window, so it’s your opportunity now to delve deeper with your questions. Remember, no question is dumb; most likely others are thinking of the same question and will appreciate you asking it. I’ve made a list of suggested topics here that might help. Fire away – including if your question is to a particular panel member or one of our two vendors. http://www.mhln.org/ Email: masshln2009@gmail.com