A process improvement team from Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine was recognized by the Florida Sterling Council for achieving a significant improvement in a key performance indicator, First Case On Time Starts (FCOTS).
The team proposed to improve FCOTS in the operating room from an average 25 percent rate to 70 percent or better by May 31. They exceeded their own expectations and achieved a 78 percent rate, edging out a number of other groups from across the state.
The FCOTS improvement project emerged from a Lean Six Sigma Green Belt Certification awarded in December 2018. As part of the certification process, Gladys Garcia-Greenberg, M.B.A., director of surgical scheduling and business operations, and Jennifer Mendez, project manager, were required to prepare, present, and submit a process improvement project using Lean Six Sigma tools. They presented their project at the 27th Annual Florida Sterling Conference and Team Showcase Competition, held in Orlando in May.
The Bascom Palmer team developed the initiative with input from a multidisciplinary team and with the support of their sponsor, Joanne Martin, Bascom Palmer’s chief operations officer.
A 12-minute presentation of their project, “First Case Busters: Improving First Case On Time Starts,” featured a comedy skit and dance performance with a Ghostbusters theme. The presentation was a collaboration among surgical scheduling, surgical services, nursing, patient access, and imaging.
The performance earned the team the prestigious first-place award in the Team Showcase Competition. The project also was honored with the “Use of Best Tools” award.
“It felt great – the road to that win was a long one,” Garcia-Greenberg said. “We were humbled and honored that our hard work provided a win for us and for Bascom Palmer.”
Focusing on improving FCOTS was important because when a first case is delayed, it affects all other cases.
“Delays impact all facets of care – surgeon, staff, patient, family members, and revenue,” Garcia-Greenberg said. “Not meeting this measure can lead to dissatisfaction at many levels, and at Bascom Palmer we strive to exceed our customers’ expectations.”
Garcia-Greenberg said the team wouldn’t have been able to accomplish such dramatic improvements in the all-important FCOTS metric without support from Bascom Palmer’s leadership, including Martin; Eduardo Alfonso, M.D., chair of the Department of Ophthalmology and the Kathleen and Stanley J. Glaser Endowed Professor in Ophthalmology; Steven Gayer, M.D., M.B.A., medical director of surgical services and professor of clinical anesthesiology; Sonia Yoo, M.D., chair of the OR Committee and professor of ophthalmology; and Michael Gittelman, CEO of Bascom Palmer Eye Institute and the Anne Bates Leach Eye Center.
“It’s not a one-man show – it’s all about the team,” Garcia-Greenberg said. “It requires teamwork and interdisciplinary participation to drive and maintain improvements.”
Another essential element is organizational commitment to continuous improvement. To illustrate this, Garcia-Greenberg quoted American industrialist and businessman Henry Ford, who said, “If everyone is moving forward together, then success takes care of itself.”
The Florida Sterling Council, established in 1992, is supported by the Executive Office of the Governor of Florida and recognizes organizations that set standards of excellence throughout their industries, including health care.