Problem-solving with structure increases referrals

Educators at the diabetes education program at Baylor Scott & White in Round Rock, TX, knew they had a problem getting referrals from the attached hospital for group classes.


Michael Baratz, BS, MBA, SSGB, CQE, CQA and Raynelle Shelley, MS, RD, LD, BC-ADM, CDE

The program found the answer to increasing referrals thanks to a specific problem-solving system, which two members of the Baylor Scott & White team will describe during Monday’s “Using Lean Problem Solving Methodology to Improve Diabetes Programs” session. Raynelle Shelley, MS, RD, LD, BC-ADM, CDE, a certified diabetes educator and Regional Diabetes Education Coordinator, and Michael Baratz, BS, MBA, SSGB, CQE, CQA, Vice President Operations Excellence, Baylor Scott and White Health, will detail the real-world experience of how Lean and the related A3 problem-solving tool helped boost referrals from the hospital significantly.

“It’s a scientific method that everybody at AADE can identify with,” Shelley said. “You plan, you do, you check, you act. You keep going through that process.”

Shelley asked Baratz, who leads training efforts for these structured problem-solving tools, for help in solving why the hospital had so few referrals when compared to outpatient physicians, primary care offices and endocrinology offices.

Shelley and her colleagues thought at first the problem was with in-patient doctors not knowing or caring about the program. But the structured problem-solving led them to realize the problem came at discharge.

Doctors wanted patients to participate in the diabetes group classes, but many times at discharge they were not the ones handling the discharge, or they would forget while trying to organize all aspects of go-home health. The answer was to have in-patient dietitians handle the orders for the ambulatory diabetes education, which meant the doctor just needed to sign off to start the ball rolling.

Today, group class enrollments are full, and about half of the patients complete all four sessions.

“If we hadn’t gone through the Lean process, we would have gone down a completely incorrect path,” Shelley said. “We had all of these ideas of things that might have been happening.”

Baratz said that Baylor Scott & White has been using the A3 tool since 2010 and have seen good results.

“A3 is a different way of thinking about problems,” he said. “It’s more than just the tool, and more than just putting it on the paper. It’s changing the way we think about problem solving.”

Even those with knowledge about Lean and A3 will get something out of Monday’s session, Baratz said, because of Baylor Scott & White’s unique way of teaching how to use these tools and concepts, focusing on engagement and understanding the root causes to solve problems at the source.

Classes are set up with multiple teams all working on different projects. Sessions include learning the basics and working in their individual groups and also meeting as a large group to ask questions and share ideas.

“We use it with all different problems, all different processes,” Baratz said. “In our clinics, our hospitals, everywhere across our system, we use A3 as the way to solve problems.”

Monday Session
Using Lean Problem Solving Methodology to Improve Diabetes Programs
11:45 am – 12:45 pm
Room 6A

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