Realizing Improvement through Team Empowerment (RITE): A Team-based, Project-based Multidisciplinary Improvement Program.
Performance improvement in a complex health care environment depends on the cooperation of diverse individuals and groups, allocation of time and resources, and use of effective improvement methods. To address this challenge, we developed an 18-week multidisciplinary training program that would also provide a vehicle for effecting needed improvements, by using a team- and project-based model. The program began in the radiology department and subsequently expanded to include projects from throughout the medical center. Participants were taught a specific method for team-based problem solving, which included (a) articulating the problem, (b) observing the process, (c) analyzing possible causes of problems, (d) identifying key drivers, (e) testing and refining interventions, and (f) providing for sustainment of results. Progress was formally reviewed on a weekly basis. A total of 14 teams consisting of 78 participants completed the course in two cohorts; one project was discontinued. All completed projects resulted in at least modest improvement. Mean skill scores increased from 2.5/6 to 4.5/6 (P < .01), and the mean satisfaction score was 4.7/5. Identified keys to success include (a) engagement of frontline staff, (b) teams given authority to make process changes, (c) capable improvement coaches, (d) a physician-director with improvement expertise and organizational authority, (e) capable administrative direction, (f) supportive organizational leaders, (g) weekly progress reviews, (h) timely educational material, (i) structured problem-solving methods, and ( j ) multiple projects working simultaneously. The purpose of this article is to review the program, including the methods and results, and discuss perceived keys to program success.©RSNA, 2016.
From the Department of Radiology (D.B.L., L.J.M.) and the Department of Imaging Services, Stanford Hospital and Clinics (L.J.M., K.G.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105.
David B
DB
Larson
From the Department of Radiology (D.B.L., L.J.M.) and the Department of Imaging Services, Stanford Hospital and Clinics (L.J.M., K.G.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105.
L Jake
LJ
Mickelsen
From the Department of Radiology (D.B.L., L.J.M.) and the Department of Imaging Services, Stanford Hospital and Clinics (L.J.M., K.G.), Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5105.
Kandice
K
Garcia
D002140:California; D003657:Decision Making; D007857:Leadership; D017146:Models, Organizational; D009937:Organizational Objectives; D010348:Patient Care Team / Q000458:organization & administration*; D011209:Power, Psychological; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D058996:Quality Improvement / Q000458:organization & administration*; D000072177:Radiologists / Q000193:education / Q000458:organization & administration*; D011872:Radiology Department, Hospital / Q000458:organization & administration*