He has been with the Kaiser Permanente since 1997, in various roles from implementing population care tools and electronic health records to redesigning the perinatal and shift change experiences. In his innovation work, Chris has partnered with IDEO to learn and import methods of “design thinking” into Kaiser Permanente. He led the innovation nurse shift change project, called Nurse Knowledge Exchange (NKE) from inception to full-implementation in the pilot sites. NKE was chosen for a KP-wide hospital rollout, and for this phase Chris moved into a content expert and coaching role. Other innovation work includes medication administration, bed management and transitions in care.
Chris McCarthy is the director of the Innovation Learning Network (ILN), which brings together the most innovative health care organizations in the country to share the joys and pains of innovation. The purpose of the ILN is to foster discussion on the methods and application of innovation/diffusion, ignite the transfer of ideas, and provide opportunities for inter-organizational collaboration”
Chris probably has one of the most interesting positions in healthcare that I could imagine, and gratifying with creating solutions for others. Chris stated he worked for Kaiser, left and went to further his education in a join program in New York and Copenhagen and came back.
One of the big focuses with innovation is unifying –space, technologies/tool, and workflow into a wholistic design, in other words use workspaces and patient spaces wisely and have the areas function be patient and clinician oriented.
There were a number of projects to be addressed. The first program enjoying success was the perinatal project. The second innovative project that enjoyed huge success was nurse communications, the Nurse Knowledge Exchange. The innovation spread across Kaiser Permanente. The next big hit was in medication administration; One area where Chris and the IC team focused was on the “sash.” It may not seem as a big issue but in fact it was. Nurses administering medications needed the ability to focus on their work with patients without disruption, thus the sash designating a “do not disturb” focus was created, simple but yet effective and understood by all. The following items were the outcomes of the Medication Administration project, and were dubbed “KP MedRite:”
1. Sash - nurse wears this when working with patient medications
2. New way to deliver medication - user/patient involvement
3. Sacred Space – an area marked off where nobody else can enter
With combining the 3 areas above, it made for an improved working experience for the nurses. Chris also stated that the nurses were all very much involved in the innovative process. They were involved from the beginning, submitting and creating ideas of what they thought it would take to create a safer and productive medication pass.
I asked Chris if there were some projects that had perhaps not experienced as much success. Bed management was the answer and he said it sounded simple in thought, but unlike the nurse communication project where the answers were similar from nurses, the responses on this project were all very different and varied when the call was put out for suggestions. Chris stated that this new innovation team was still in the development stage, and hadn’t realized how large the design challenge was. This failed project taught the team how to scope projects more effectively, and help, management focus the design methods on clearer opportunities.
I asked Chris a little about the process of his group and what expectations they had when starting each project. Chris stated that when they release a project for testing, it is only “half baked”, in other words they anticipate about a 50% change once the individuals involved begin working the processes through simulation and participation.
So where does all the field testing happen I inquired? At this point Chris spoke a bit about the Kaiser Permanente Sidney R. Garfield Health Care Innovation Center. He said it is a warehouse consisting of 37,000 square feet where they do the work and testing. In this warehouse they not only test current projects, but also have some interesting concepts working on how healthcare will be done in the future. The center is a mock up of a hospital, an outpatient clinic and a home. Why the home I inquired? The home he stated is moving toward becoming a major focus in healthcare as time is moving on with technology. In the home setting the mock up can be used to test and create scenarios for home monitoring devices as an example.
He said it is job one to stay keenly aware of what are the expectations and needs of Kaiser Permanente members. They also have some options to just go wild with concept designs and keep the Garfield Center as a special place for simulation and inspiration for the doctors, nurses and pharmacists. When creating a simulation process they even have housekeepers present, as that is what you see in the real hospital. Field tests are done over and over at the center and in the pilot hospitals until the IC group and the clinical workers feel they have answered the call for solutions.
I thought this would be great to be able to share with other healthcare facilities and Chris said “we do”. KP MedRite has been rolled out to 75% of Kaiser Permanente’s facilities, and Capitol Health Group in Ontario, Canada has rolled the system out in 11 of their hospitals. The Innovation group delivers the package with minimum specifications, and there is room to improve upon the system as well, in other words it may need a few additions/changes and tweaks to meet their specific environment.
Also Chris stated that the NHS in the UK has requested information on the Nursing Communication program where he recently spoke and presented some valuable information. The website has a video that goes into additional detail about “Innovating Physician Spaces.
To further sharing of ideas and creating solutions, Chris and Kaiser Permanente are also members of the ILN, the Innovation Learning Network which consists of Kaiser and other healthcare institutions, all again working in the same directions on the same and similar types of projects. The ILN Group meets every 6 months and the meeting is scheduled at one of the member’s innovation space areas. Chris stated that the more organizations that join and commit to “design thinking”, the better it gets and smart organizations allow for continuous innovation to happen.
If you take a look at the website you can see the membership on the left hand side of the site to include Partners Health, Via Christie Healthcare, the Department of Veterans Affairs and more.
In going further into some of the scenarios that are discussed, Chris mentioned one that was something they were pondering, “How to deliver care when you can’t interact with people”. In the future we may perhaps see some of this, but again looking at the potential issue today will give knowledge down the road. He called it the “Care Anywhere Concept.”
Chris continued to again mention that the human-centered design is a primary focus in much of this; this ensures that the innovations are truly designed for the people in the system, meaning both the patients and the people who work in the system.
The groups talk about receiving care via cell phones as well. Chris said their job is to “put together all the bits and pieces of telemedicine and identify the gaps.”
Overall the conversation with Chris McCarthy was very informative and shared a side of healthcare that we may not otherwise know exists and be aware of. Innovation also requires a dedicated group to provide research and development within these parameters to ensure successful implementation.
With the rapid move of technology today this was great to see Kaiser Permanente, Chris, and the ideas of innovation creating solutions that come to fruition and grow with time and I thank Chris for taking a few minutes today to talk about what is happening, it makes me feel much safer as a patient and happy to know these areas are addressed for providing better healthcare for patients and better space utilization for those who work in hospitals today.
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