100 - 7S Model: Advancing Health and Patient Outcomes Using Lean Methodology and Interprofessional Continuing Education

Health Care Problem
Healthcare is changing its landscape at a very fast pace. There is a critical need for continuing education providers to create and deliver team-based education that is timely and relevant as well as measure its impact on patient outcomes. In an effort to realign our healthcare system’s continuing education program with a new strategic direction focused on interprofessional continuing education (IPCE), we made changes in rapid cycles and phases. Our continuing education program needed a structural framework to guide us in our journey of continuous improvement. The objective of this quality improvement project is to describe a novel model, grounded in lean methodology, that was derived from the critical processes involved during this transformation. Qualitative data was collected through interviews, feedback, review of committee documentation and our institution's patient safety and quality data.

Educational Strategy
During the annual program review, the critical processes used to improve our continuing education program designed by and for the healthcare team were categorized and transformed into a novel structural framework using a hybrid inductive and deductive content analysis approach. Seven key critical processes emerged as the pillars of the structural framework. The pillars can overlap but are intertwined so that one change can bring a change in the other element. Adopted from the 5S lean system, a Six Sigma tool, two more elements were added to create the 7S model which captures the rapid cycle of changes that continue to be implemented in our overall continuing education program. The basic elements of the seven pillars (S’s) are: (1) Sort-Identify strengths, weaknesses, opportunities, threats and overall needs of the CE program; (2) Set-Establish strategic priorities, alliances and goals based on the mission of the organization and the CE program; (3) Shine-Modify existing policies, procedures and processes; (4) Standardize-Synchronize processes and use of technology across the system to reduce redundancy, improve workflow and learner experience; (5) Sustain-Strengthen and support the CE program through meaningful collaboration, professional development and upholding accreditation; (6) Share- Promote IPCE by sharing pearls, pitfalls and best practices with internal and external stakeholders; (7) Safety- Patient safety is an attribute of healthcare systems and a key driver of our educational initiatives. At the core of these 7 pillars is the "patient", which forms the inner hub of the model. The basic premise of the 7S model is that the pillars need to be aligned as they are interrelated and have to be considered jointly to achieve continuous and successful improvement of the program. It shows how everything is linked and how effective change can be brought as we "create-deliver-measure" meaningful continuing education, which is the outer hub of the 7S model.

Patient-Level Outcome(s) Measured
As a healthcare system, we are committed to respond to the changing healthcare landscape and needs of our learners by delivering continuing education that is timely and relevant as well as support our healthcare team in providing patient-centered care. The 7S model is helpful in communicating how we identify, plan and implement the needed or desired changes to our overall program. It serves as a dynamic framework for overall program-based analysis. Since the implementation of this project, we have noted the following outcomes: (1) improved ability to deliver system-wide education based on strategic priorities; (2) increased collaboration with more stakeholders including patient advocates; (2) increased IPCE activities across the system focused on improving patient safety and population health; (3) improved ability to identify barriers to practice and provide system solutions; (4) improved learner and provider satisfaction due to decrease in redundancy through streamlining of processes and procedures and (5) improved ability to track our patient safety and quality data to determine the impact of our educational programs on patient experience and outcomes. The 7S model could serve as a tool for other healthcare institutions to assess and review the effectiveness of the needed changes of their existing continuing education programs with the goal of ultimately improving patient outcomes.

Cynthia Pineda

Associate Medical Director, Continuing Professional Education
MedStar Health
Washington, District of Columbia

Cynthia Pineda, MD is currently the Associate Medical Director of CME at MedStar Health and Chair of the CME Committee at MedStar Montgomery Medical Center. Dr. Pineda is a board certified Physical Medicine and Rehabilitation specialist and an Associate Professor of Clinical Rehabilitation Medicine at Georgetown University School of Medicine. She is a member of the Alliance for Continuing Education in the Health Professions, Society for Academic Continuing Medical Education and Society for Simulation in Healthcare. Dr. Pineda is a Diplomate of the American Board of Physical Medicine and Rehabilitation and a Fellow of the American Academy of Physical Medicine and Rehabilitation.