SIP Team Charters
SIP 1 – Pre-Op
Schedule to 00:01 on the Day of Surgery
Leader: Judy Canfield & Laurie Amundsen
Start Date: 2/3/05
Roles:
Suggested Members:
End Date:
Clinic Manager
Nancy Eberhardt
Milestones:
Dates:
Pre-Surgery Clinic
S. Deatrick/S. Mossing
Current State
2/23/05
PCC Manager
Kathy Herigstad
Proposal of Future State
PCC
Suzanne Hoehne
Best Practices
OR Scheduler
Susan Tracy
Identify and Eliminate Waste
Patient Data Services/ORCA Sally Beahan
Implementation
Charge RN OR
Donna Anderson
OR RN3
Jackie Walker
Surgeon
Ben Greer
Surgeon
Brandt Oelschlager
PL’s & Implants
Bill Anton
Patient Representative
Maria Hall
Anesthesiology
Alan Artru
Materials Management
Sal Ramirez
Financial Counselor
Becky Mounce
Support Staff: Kati Koszegvari
Consultant Roles:
Suggested Members:
IT Services
Trina Marsh
206-598-6991
Interpreter Services
Linda Golley
katibell@u.washington.edu
Med Consult
Cardiology Consult
Donna Nyenhuis
Radiology
Bill Shuman/Dawn Vincic
Radiology Tech
Dan Lane/Mario Ramos
Interventional Radiology
Patrick Willis
Lab Medicine
Paul Henderson
Pharmacy
Jim Velez
OR Manager
Mary Claire Cook
Surgeon
Ben Anderson
Stakeholders: Surgeons, PCC, Pre-Anesthesia Clinic, Scheduling, Med Consult, Lab, Radiology, SCCA,
Pathology, Patient Registration (Sally Beahan – director), Pharmacy
Scope: From patient’s decision of having surgery until 00:01 on the day of surgery.
In Scope: Patient scheduling of surgery; Pre-Anesthesia, Lab – including day of surgery; Discharge
Planning; Financial Clearance; patient packet; interface to: Med Consult, Radiology,
Pathology, Cardiology, Lab appointments; Scheduling Systems: scheduling coordination
with PL’s; Communication of special needs – implants, ICU beds, bariatric equipment,
etc.; In-patient preparation
Out of Scope: Preparing instruments, supplies, and equipments;
Methodology:
 Lean
o Optimize for Patient Experience
o PASCO
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SIP Team Charters
Outcome Characteristics
1. Safe and patient-centered care
2. Scientific modeling for case accuracy
3. Collect accurate patient data once, retain and disseminate
4. Universally accessible patient data
5. Staff, equipment, OR, ready for patient on arrival
6. Patient ready on arrival
7. Scheduling by code or code group that delivers time estimate, equipment, special
staffing, and essential service resource needs
8. Robust and flexible yet highly efficient
Outcome Deliverables
1. Document current state process(es)
2. Document best industry practices
3. Value analysis using LEAN methodology
a. Identification of optimal patient flow (patient experience)
b. Identification of optimal information flow
c. Identification of essential variability
4. Design future state process(es)
5. Develop project plan and timeline
a. Identify short and long term projects
6. Develop metrics and key indicators
7. Short and long term project completion
8. Strategy for ongoing Performance Improvement
Essential Metrics
 Patient ready upon arrival
 All resources ready upon arrival
 Block time utilization
 Planned schedule same as actual schedule
Project Support
Lean Expert; EPIC Expert
Resources
687302980
2/5/2016
SIP Team Charters
SIP 2 – First Case
Day of Surgery: 00:02 to Incision First Case
Leader: Kevin Smith
Roles:
PL’s/Equipment & C-Core
Anesthesiology
Anesthesiology
RN
Pavilion Pre-OP RN
Main Pre-OP RN
OR RN3
Patient Representative
Ambulatory Surgery Manager
Surgical Tech
Instrument Room
Hospital Assistant E
Surgeon (Ortho)
Surgical Resident (Ortho)
Consultant Roles:
Suggested Members:
Jason Jio
Karen Domino
Karen Souter
Susan Grant
Dori Nelmark
Vicki Sandeen
Sonja Borthen
Terry Way
Renae Burchiel-Battie
Mike Amos
George Davis
Abdul Ramzan
Kevin Smith
TBD
Suggested Members:
Start Date: 2/2/05
End Date:
Milestones:
Dates:
Current State
2/23/05
Proposal of Future State
Best Practices
Identify and Eliminate Waste
Implementation
Staff Support: Ruth Oskolkoff
Materials Management
Kathy Ritter
206-598-6300
Surgeon (CV)
Gabe Aldea
rosk@u.washington.edu
Surgeon (Ophthalmology)
D. Sapperstein
R2 OR Charge Nurse
Janet Link
Otolaryngology
Kevin Kiemele
Pharmacy
Shabir Somani
Admitting
Jason Metcalf
Stakeholders: Pavilion Pre-op, Main Pre-op, Admitting, Anesthesia, Materials Management,
Surgeons, Main OR RN, Pavilion OR RN, Registration
Scope: All support activities needed to prepare the resources necessary for surgery before the 1st
patient enters the OR at 7:25 am.
In Scope: Day ahead prep; Patient check-in; Preparing instruments, supplies, equipments;
Room setup; Preparing the 1st patients for surgery; Transport; Anesthesia;
documentation compliance and regulatory issues
Out of Scope: All labs or patient centered activities except patient check-in and flow on the day of
surgery
Methodology:
 Lean
o Optimize for Patient Experience
o PASCO
Outcome Characteristics
1. Safe and patient centered care
2. Compliant with all regulatory requirements
3. All cases start on time
a. Zone concept or evolutionary equivalent
4. Minimal unanticipated schedule changes
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SIP Team Charters
5. Management plan for schedule changes
6. Plan for transplant and emergent cases
Outcome Deliverables
1. Document current state process(es)
2. Document best industry practices
3. Value analysis using LEAN methodology
a. Identification of optimal patient flow (patient experience)
b. Identification of optimal information flow
c. Identification of essential variability
4. Design future state process(es)
5. Develop project plan and timeline
a. Identify short and long term projects
6. Develop metrics and key indicators
7. Short and long term project completion
8. Strategy for ongoing Performance Improvement
Essential Metrics:
 More accurate delay codes
 Resource checklist
Project Support:
Lean Expert;
Resources:
687302980
2/5/2016
SIP Team Charters
SIP 3 – Last Case
Day of Surgery: After Incision for First Case to Midnight
Leader: Peter Buckley & Mary Claire Cook
Start Date: 2/2/05
Roles
Suggested Members:
End Date:
OR Manager
Mary Claire Cook
Milestones:
Dates:
OR Charge Nurse
Jim Henkleman
Current State
2/23/05
Frontline OR Nurse
Proposal of Future State
PACU Main Charge RN
Mary Mentele
Best Practices
R2 PACU RN
Kim Owen
Identify and Eliminate Waste
R2 OR MA
Kenneth Marbury
Implementation
PACU Manager
Shelley Deatrick
Surgeon (Plastic)
Jana Cole
Surgeon
Al Hillel
Hospital Assistant PACU
Jason Dela Cruz
Pavilion RN3
Loretta Stesco
Materials Management
Leslie Bahr
Anesthesiology
Karen Domino
Patient Representative
Mike Smith
Main Pre Op RN
Gale Uhlenkott
Staff Support: Virginia McClure
Consultant Roles:
Suggested Members:
Radiology
B. Shuman/Dawn Vincic 206-598-4260
Pharmacy
Steve Bird
vmcclure@u.washington.edu
IP Unit Manager, 6SE
Judi Hubbard
PCS Director
Sherri Del Bene
Pathology
Melissa Upton
Environmental Services
Craig Saran
Patient Flow Supervisor
Shauna Andrus
Pavilion C-Core
Stakeholders: Pavilion Pre-op, Main Pre-op, Admitting, Anesthesia, Materials Management,
Surgeons, Main OR RN, Pavilion OR RN, Registration, HA, ES, PACU
Scope: Logistics for all non-first cases
In Scope: Patient check-in through holding; Documents/results ready; Procedure time;
Turnover; Non-black case management (TBA, Urgent/Emergent); Coordination of
rooms, instruments, supplies, and equipments between cases; Bed utilization;
Surgeon/patient availability; Transport of patients; hours of staffing coverage;
staffing; Family debriefing; Patient arrival time; team incentives;
Out of Scope: 1st cases
Methodology:
 Lean
o Optimize for Patient Experience
o PASCO
Outcome Characteristics
1. Patient and family centered, safe
a. No rescheduling of elective scheduled cases
2. Scheduled and case time approximate & appropriate
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3.
4.
5.
6.
7.
8.
Minimal "turnover time"
Manage educational experience to maintain efficiency and productivity
End of the day plan in place by the end of the first case or 9 am
Available resources for throughput from OR to inpatient or DC
Optimal strategy for urgent elective and emergent cases
Highly efficient use of resources
a. Efficient and consistent performance 24/7
Outcome Deliverables
1. Document current state process(es)
2. Document best industry practices
3. Value analysis using LEAN methodology
a. Identification of optimal patient flow (patient experience)
b. Identification of optimal information flow - staff, patient, AND family
c. Identification of essential variability
4. Design future state process(es)
5. Develop project plan and timeline
a. Identify short and long term projects
6. Develop metrics and key indicators
7. Short and long term project completion
8. Strategy for ongoing Performance Improvement
Essential Metrics:
 Number of overhead pages lowered
 Patient Satisfaction Survey
Project Support:
Lean Expert;
Resources:
687302980
2/5/2016
SIP Team Charters
SIP 4 – Leadership/Culture
Leadership and Culture
Leader: Alan Artru & Dan Kaiser
Start Date: 2/1/05
Roles:
Suggested Members:
End Date:
Administration
Lisa Brandenburg
Milestones:
Dates:
Surgeon
Doug Wood
Current State
2/23/05
Surgeon
Chris Wahl
Proposal of Future State
Surgery Resident
Fred Cobey
Best Practices
CCE & Anesthesiology
Gene Peterson
Identify and Eliminate Waste
Anesthesiology
Peter Buckley/ E Kharasch
Implementation
Anesthesiology
Karen Domino
Anesthesia Tech/Hospital Assistant Joe Fitzgerald/Abdul Ramzan
CRNA
Gail Weiner
RN Management
Susan Grant
Surgical Tech
Neil Kovacs
Frontline OR RN
Melissa Marshburn
Patient Representative
Laura Gerber
PACU
Cindy Riplinger
Inpatient Nursing
Janice Cherin
OD&T
Kurt O’Brien
Staff Support: Virginia McClure
Consultant Roles:
Suggested Members:
HR Consultant
Jennifer Petritz
206-598-4260
SOM Representative
Julie Reid
vmcclure@u.washington.edu
Stakeholders: Surgeon; RN; Anesthesiologist; HA; ES; CRNA; Anesthesia Tech; C-Core; Surgical Tech; PreOp; PACU
Scope: Activities within the Surgical Services
In Scope: All cultural & leadership aspects within the walls of Surgical Services; Performance
incentives;
Out of Scope: Pre-Anesthesia Clinic; Surgical Clinics; Support Organizations;
Methodology:
 Lean
o Optimize for Patient Experience
o PASCO
Outcome Characteristics
1. Safe and patient and family centered care
2. Specific responsibilities and accountabilities 24x7
3. Inspired, accessible, knowledgeable leadership at all levels
4. Incentives for team development and participation
5. "Can do" attitude - for our patients and ALL of our customers
6. Consistent across all of surgical services, all day, every day
7. Interdisciplinary
8. Transparent
9. Professionalism
Outcome Deliverables
1. Document current leadership and governance structure
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SIP Team Charters
2. Document best industry practices
3. Value analysis using LEAN and formal leadership evaluations
4. Design future state. Recommendations regarding future state: effective
governance structure and VALUE
a. Front line contributions, interdisciplinary and by consensus
b. Rules, protocols, guidelines for recurring operational/staffing/culture
issues
5. Ongoing leadership training
6. Strategy for ongoing optimization of Culture and Leadership - survival and
succession strategy
Essential Metrics:
 No bumps- every case finds a docking gate
 Same answer same question- any leader
 Patient Centered
Project Support:
Lean Expert
Resources:
687302980
2/5/2016
SIP Team Charters
SIP 5 – Strategic Planning
Strategy/Strategic Planning
Leader: Ed Walker & Ernie Weymuller
Start Date: 1/31/05
Roles:
Suggested Members:
End Date:
Administration
Judy Canfield
Milestones:
Dates:
Surgeon
Dave Flum
Current State
2/23/05
RN
Susanne Loven-Skolnik
Proposal of Future State
Anesthesiology
Peter Buckley
Best Practices
CRNA
Mark Schierenbeck
Identify and Eliminate Waste
Finance
Lisa Brandenburg
Implementation
Clinical Oversight
Susan Grant
Transplant
Jorges Reyes
Ambulatory Surgery Mgr Renae Burchiel-Battie
Electronic Patient Record Andy Bowdle
PACU RN
Shelley Deatrick
Patient Representative
TBD
Staff Support: Kimberly Knight
Consultant Roles:
Suggested Members:
Quality Consultant
Jim Perkins/Dave Flum
206-598-6090
Planning Con
Helen Shawcroft
kknight@u.washington.edu
Baldridge Consultant
Preston Simmons
IT Services
Tom Martin
SOM Representative
Julie Reid
Stakeholders: Everyone in Surgical Services; Administration, UW Medicine
Scope: All surgical patients through the continuum of the surgical process
In Scope: Core services of the OR, future projections in coordination with or development of the
current strategic planning (number of OR’s, sites, growth of business, business plan
development, specialty growth); Capacity planning and impact analysis of all essential
organizations; All evening and weekend cases; Marketing
Out of Scope: Governance; Daily operations
Methodology:
 Lean
o Optimize for Patient Experience
o PASCO
Outcome Characteristics
1. Safe patient and family-centered care
2. Alignment of performance vs. incentives
3. Right sizing of ambulatory and complex case capacity for current and projected
UW strategic planning goals
4. Graceful integration with hospital workflow that transcends traditional boundaries
a. Optimal utilization of Pavilion resources
b. IT infrastructure
(e.g.) Electronic patient record in OR
(e.g.) System-wide wireless patient tracking system
5. System for coordination with other UWMC strategic planning around capacity
and specific program development
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6. Standardized process for transplant cases
7. Standardized process for evening and weekend urgent-elective and emergent
cases
8. Policy for allocation and reallocation of block time
9. Sufficient beds for all cases
Outcome Deliverables
1. Environmental Scan, OR capacity, actual delivery of surgical services
a. UW and UW Medicine
b. Locally and regionally (Seattle, WA, WWAMI)
c. Nationally
2. Identify best practices for strategic planning in surgical services
3. Document current processes for strategic planning, where they exist
a. Document other strategic initiatives that affect the OR in UW Medicine
and UWMC
4. Strategic planning process evaluation using LEAN principles
5. Coordinated incentive system for all team members aligned with UWMC
principles and best industry practice
6. Proposal for optimized strategic planning process
a. Baseline strategic plan (including Marketing)
7. Coordination of PI in surgical services with Center for Clinical Excellence
Essential Metrics:
 Pt. Satisfaction feedback - after a number of surgeries get detailed patient
feedback
 Use of OR space
 Lower manipulation of day-to-day work
Project Support:
Lean Expert
Resources:
687302980
2/5/2016