QI Microsystems Symposium – Sheffield Teaching Hospitals

Below is a piece written by Jackie Wang, a HealthCorps Navigator at the Community Health Center, Inc. serving in Quality Improvement. She recently took part in a symposium put on by CHC’s QI department which featured representatives from Sheffield Teaching Hospitals of the UK.

When I arrived at CHC in August, I remember being impressed by so many aspects of the organization. From the comprehensive care it provides, to its statewide presence, to the beautiful rooftop garden in Middletown, I was blown away. I spent my first few days wandering around star-struck…

But I was especially impressed – surprised, even – by CHC’s commitment to high-quality, innovative care. Before moving to Connecticut, I worked at a free clinic, and resources were so tight that quality improvement and systems-level transformation never even entered the conversation. But here at CHC, everyone – from the frontline clinical staff to senior leadership – has dedicated themselves to constantly, relentlessly improving the care we provide. This is why I came to CHC, and I feel lucky to be a small piece of this process.

Much of what the Quality Improvement department does is driven by the work of our Clinical Microsystem teams. These are small interdisciplinary groups, composed of our frontline staff and a trained coach, that work together to identify areas of change, design potential improvements, and test them in the clinical setting. I support a few teams in my role as QI Healthcorps Navigator, but I had a wonderful opportunity to learn even more about Microsystems and coaching last Thursday when we hosted five guests from Sheffield Teaching Hospitals (STH). STH has started its own Microsystem Coaching Academy to train new coaches, and wanted to see real live Microsystems in action within a large organization. CHC fit the bill perfectly! Steve Harrison, Tracy Jackson, Beccy McGeehan, Nick Miller, and Jude Stone joined us for a day of sharing ideas and exploring future collaboration.

Our English guests gave us an overview of their hospital, the UK health system, and their experience working with Microsystems so far. Sheffield Teaching Hospitals is the largest in the UK, employing 15,000 staff and serving a million patients each year. I never thought I’d say that CHC, with its 600 employees, seemed small! It was interesting to hear about how Microsystems function in a hospital setting that provides not only primary, but secondary and tertiary care as well. And even though Sheffield Microsystems are still in the early stages, they have already produced great results. The hospital has reduced its outpatient cycle times – the time between a patient walking in and walking out – from 6 to 2 hours; its length of inpatient stays in the hematology department from 25 days to 6 days; its wait time for a cystic fibrosis appointment from 40 min to 10 min; the list goes on. I especially liked their usage of a mock patient, “Evie,” as a tool to target areas of improvement. “What would Evie want from us? What would Evie want to change?”

I found myself learning just as much about CHC’s quality improvement efforts as I did about Sheffield’s. A Microsystems poster session, as well as a presentation by Mary Blankson on New London’s success care coordination, showcased just how much our teams have accomplished: reduced diagnostic imaging cycle times in Danbury, the implementation of warm handoffs between a medical and behavioral health provider, improved hypertension control rates across the agency, and much more. We also heard from Shanti Carter about the integral role that our IT department has played. I can’t imagine CHC without eCW, but our electronic health record was introduced just in 2006! And look how far we’ve come.

We ended by discussing future collaboration between Sheffield and CHC. Ideas flew back and forth throughout the day: shared coaching support, collaborative development of a practical curriculum for Microsystem teams, trading QI tools. One of my roles this year is to coordinate the efforts of multiple Microsystems, so I’m personally excited to hear about how Sheffield’s different teams end up interacting and working together: what’s the best way for teams to feed off each other’s good ideas? How can they spread their success to the rest of the organization?

It was a whirlwind of a day, but a smashing success! I’m excited to see what the future holds for both of our organizations, and I’m so glad that I get to be part of our transformation.

Next week, CHC’s QI department will welcome a delegation from Jönköping, Sweden, for another symposium on Microsystems. Stay tuned for more information on these exciting opportunities for CHC!