In assessing its HealthCare Partners markets, DaVita HealthCare Partners Inc. realized it lacked a systematic approach to continuous improvement and needed to develop a standard approach to problem solving, both at the clinic level and across markets.
In response, DaVita created the PEAK program, a systematic approach to problem solving that was developed based off the Lean, Six Sigma, and Plan-Do-Check-Act (PDCA) continuous improvement methodologies of adding value and reducing variation. PEAK’s three-part aim is: leadership, systemic problem solving, and daily problem solving. PEAK provides the training, tools, and coaching for teammates to excel in these areas and ultimately get to enterprise goal alignment.
Program Details
PEAK encompasses three training courses, which emphasize understanding of the PEAK objectives, huddles, and teammate engagement. PEAK is designed specifically for site administrators, whose primary duty is to oversee the daily operational and clinical tasks of a center.
The crux of each course is breaking down silos to encourage teammate collaboration and problem solving. As such, huddles are emphasized heavily in all three trainings. Huddles allow for clinicians and all front-line staff to gather and review metrics from the prior day, discuss pain points and areas of improvement, and brainstorm solutions. Huddles give each teammate—no matter what role—a voice and chance to add value, be heard, and make a change. Huddles also recognize teammates who make a difference and, thus, encourage teamamates to communicate and share ideas. Huddles are limited to 15 minutes and move rapidly, so teammates must learn to be crisp, clear, and concise with their communication.
The PEAK program begins with Basecamp training, a one-day instructor-lead session teaching site administrators the mechanics and importance of huddles, metrics to track, how to foster clinician and non-clinician involvement and contributions, and problem-solving techniques.
Alpine training further reinforces and elaborates on Basecamp training by introducing the STARS Storyboard problem-solving methology, various process improvement tools and techniques, and how to lead change management. Teammates who go through Alpine training are assigned individual projects where they must work together and apply the learned tools and techniques. Sherpas (those who complete Alpine training) also are kept on track with the help of coaching sessions and weekly group calls. Successful completion of projects requires collaboration, which builds on clear communiation skills.
Including Basecamp training, site administrators are mentored and coached, receive one-on-one training, participate on weekly calls, and have access to their coaches/mentors around the clock.
Results
Since its beginning in 2014, PEAK has rolled out in three of DaVita’s six HealthCare Partners markets. More than 200 teammates have successfully completed Basecamp training; more than 50 doctors have successfully completed Clinician training; and 33 teammates have successfully completed Alpine training.
Each site’s huddle boards include metrics that are crucial to the clinic’s success. Each teammate contributes and the site works together as a team to meet (and sometimes exceed) its goals. In less than one year, DaVita’s Florida clinic’s triage calls improved by 12 percent; average patient visit times decreased by 11 to 20 percent (across clinics); and patient volume increased by 9 percent. Nevada’s average patient visit times decreased by 12 percent and patient volume increased by 20 percent. In DaVita’s California offices, patient no-shows were reduced by 40 percent and patient visit time was decreased by 15 percent by reducing wait times.
