Transforming Healthcare via Continuous Performance Improvement (CPI)
Seattle Children’s Hospital is one of the first medical centers in the country to apply the methods and scientific rigor of the Toyota Production System to healthcare. Children’s adaptation of this method is an organization-wide philosophy and improvement approach called Continuous Performance Improvement (CPI).
This improvement program is a transformative way to remove waste from systems and processes, thereby improving quality and safety to deliver the best healthcare to patients and families. Importantly, when we improve quality and safety we reduce costs. Children’s is dedicated to making ongoing improvements to the basic building blocks of healthcare: Quality, Safety, Delivery, Cost, and Engagement.
Over the last decade, adoption of CPI with active involvement of our expert caregivers has yielded tremendous results. Through CPI, physicians, nurses, residents, administrators, and hospital staff are actively engaged in a culture of continuous performance improvement. CPI allows us to evaluate and improve healthcare from a patient and family perspective, better support our people, adopt new practices, and respond to economic challenges. It is also proving to be a reliable means to advance core clinical, education and research programs. Ultimately, this work helps support our ambitious mission to prevent, treat and eliminate pediatric disease. In summary, CPI has been transformative at Seattle Children’s, and we believe it can transform our national health care system as well.
Key aspects of CPI
It's about putting patients and families first — we view the uniqueness of our patients as our only variation in applying consistent, reliable methods in delivery of our services.
Reducing costs is a by-product of improved safety, quality and outcomes — we know that if we focus on better care first, cost savings will follow.
Empowering and engaging employees is key — we seek to transform our culture by empowering our physicians, nurses and employees with the tools they need and removing barriers allowing them to identify and eliminate waste and spend more time with patients.
Taking the long-term view — CPI is an ongoing, iterative process that is continuous. It is not a short-term, "flavor-of-the-month," cost-cutting program.
Results achieved
Patients remained on ventilators 20% fewer days
Total parenteral nutrition (TPN) medication error rates reduced by 66%
Reduced patient time in hospital from 20 to 10 days in the Inpatient Psychiatric Unit (can now accommodate 650 children vs. 400 a year)
Patients spent 20% fewer days in the Intensive Care Unit
Patients see doctors sooner: appointment scheduling times dropped 50%
Fewer Emergency Department patients leave without being seen at peak times (achieving a 0.7% rate, compared to a 2.4% national rate)
Savings
3.7% reduction in cost per patient, resulting in $23 million in annualized savings*
30,000-square-foot space reduction in design and construction of new ambulatory services clinic, achieving $20 million cost avoidance
$180 million in capital cost avoidance by not building new patient rooms
$2.5 million reduction in supply-related costs
* Adjusted for inflation
CPI in the news
Children's CPI approach is receiving interest from healthcare peers, policymakers and the public from around the country. Children's is committed to sharing advances about ways to remove waste from healthcare and inform the healthcare-reform process. Here are a few examples of our recent national media coverage on CPI:
The New York Times
New York Times reporter Julie Weed visited Children's to observe how we apply CPI methods, and talked with our physicians, nurses and administrators. Read her July 2010 story, "Factory Efficiency Comes to the Hospital."
The Washington Post
In October 2009, The Washington Post published a guest opinion piece about applying CPI in healthcare by Pat Hagan, Children's president and COO. Read "Waste Not, Want Not: The Key to Reducing Costs."
Seattle Children's CPI Consulting
Pat Hagan, President and COO, teaching CPI methods.
As the news of Children's progress with Continuous Performance Improvement in healthcare began to spread, we received increasing requests from healthcare organizations around the country and abroad who wanted to learn about what we were doing and how we did it.
To better serve these requests, and as part of Children's role as an academic institution, we developed Seattle Children's CPI Consulting to share details of our CPI journey with others.
CPI Consulting brings together experts with more than a decade of experience to demonstrate how to improve all aspects of the practice and delivery of medicine. The consulting team can offer you insights about their experiences with this method and provide interactive courses and tools to help you begin your own performance improvement journey.
Children’s staff using CPI methods
Seattle Children’s invites you to join us for innovative, highly interactive training programs that will teach you the strategy and approach to apply Continuous Performance Improvement techniques at your organization.
Download our brochure (PDF) for more information on results and outcomes, and details about our two-day CPI showcase seminar. You may also be interested in comments from CPI showcase attendees (PDF).
Courses
Two-Day CPI Showcase Seminar
Staff involvement in CPI
This two-day showcase focuses on Seattle Children’s adoption of CPI as its primary method for achieving our strategic goals and as the means to continuously improve the efficiency and flow of pediatric health care delivery.
Learn how Children’s applies the CPI philosophy to improve operational performance and the patient experience, including key progress in five areas: quality, cost, delivery, safety and engagement.
Instruction includes tours, discussions and breakout sessions focused on implementing CPI.
The fee is $1,800 — breakfast, lunch and breaks are included.
Half-Day Seattle Children's Hospital CPI Tour
This on-site tour provides a way to see key CPI advances and learn about Seattle Children's CPI philosophy and methods applied across hospital, research and foundations settings. Talk with experts — physicians, administrators and clinicians — in a variety of areas to gain an overview of this transformative approach to advancing healthcare.
Participants will observe and learn about basic CPI concepts. The tour is designed to provide education and direct access to seasoned professionals using CPI in healthcare. Tours can be customized to suit participants' needs, including a choice of tour stops in locations such as the Laboratory, Heart Center, Orthopedics Clinic, Operating Room, Supply Management and more.
The tour takes place on September 30, 2010, from 1:00 p.m. to 4:30 p.m. The fee is $600, and there is a minimum participant number of 10 for each tour.
Two-Day Operating Room CPI Showcase
This innovative showcase demonstrates how to use proven methods and tools based on the Toyota Production System to address challenging issues facing operative services teams today. This course will highlight ways to enhance efficiency and improve quality while reducing operating room delays for patients and providers, lessening access challenges, addressing supply and provider needs to ease safety concerns and much more.
Seattle Children's Hospital offers a unique opportunity for OR professionals to learn about the CPI method applied to the daily operations of an academic medical center to accelerate advances in quality, safety, cost, engagement and delivery.
Talk with surgeons, anesthesiologists, nurses and directors about the benefits of using CPI methods to eliminate waste and improve the OR working environment and, ultimately, the patient experience.
The showcase takes place on September 16 and 17, 2010, from 7:30 a.m. to 5 p.m. Thursday and from 8 a.m. to 4 p.m. Friday. The fee is $1,800. There is a minimum participant number of 10 and a maximum of 24.
One-Day CPI Showcase
We also offer a specialized, one-day CPI Showcase for a minimum of 10 team members from the same organization. Please call 206-987-2003 or email cpiconsulting@seattlechildrens.org for details.
Joan Wellman and Associates
Seattle Children’s has a longtime partner in our CPI efforts, Joan Wellman and Associates, Inc. (JWA). CPI experts from JWA have been constant collaborators in our quest to implement Continuous Performance Improvement and to support transforming our staff, practices and culture.
Lean Leader Training (Offered by JWA)
This week-long training equips executives, managers and internal consultants with basic knowledge of the core Toyota System principles and how they apply to healthcare. Instruction includes lecture, exercises, simulation, application case studies in local hospitals and a trip to a local manufacturing site that uses the Toyota Motor Company's improvement methods.
Contact Us
Sue Cowan
Seattle Children's
4800 Sand Point Way NE
Seattle, WA 98105
206-987-2003
cpiconsulting@seattlechildrens.org