UMass Memorial Health's transformation journey
THE KEY POINT: In 2013, when Dr. Eric Dickson became president and CEO of UMass Memorial Health, the large health system was facing serious financial problems, while patient and caregiver satisfaction was declining.
He then began implementing a management system that defined standard processes and behaviors across the organization, engaged everyone in improvement activities, and created mechanisms for frontline staff to put forward tens of thousands of innovation ideas – which led to substantial improvements for patients and staff, as well as a return to financial stability.
In this Catalysis white paper, learn how Dr. Dickson established a management system that defined standardized processes and behaviors throughout UMass Memorial — which today has more than 15,000 employees and 2,500 physicians — and engaged everyone in improvement activities.
Dr. Dickson began learning and applying lean thinking in healthcare when he was chair of the Emergency Medicine department and interim COO at University of Iowa Health Care. He was inspired by a presentation by John Toussaint, then CEO of ThedaCare in Wisconsin and now executive chairman of Catalysis. The two have maintained a professional relationship connected by lean for decades. “When he came up to talk to me after the presentation, I immediately realized he got it,” Toussaint recalled. “I didn't know exactly what path he would take, but he was one of the few people in the audience who really understood what I had just explained.”
After that, Dr. Dickson began visiting ThedaCare frequently, first while still in Iowa and later bringing teams from UMass Memorial. During these visits, he and his team realized that leadership does not mean telling people what to do — a trait deeply rooted in medical culture, especially among emergency physicians. Instead, he recognized that leading means treating everyone with respect and engaging those who do the work in improving that very work.
He stated that a lean transformation in a health system must begin by defining the True North, which must come from the CEO.
“Start by understanding where you are and where you want to go — your True North (the best place to give care, the best place to receive care).”
“Then organize and engage everyone, every day, to move from where you are now to that desired future. When I chaired a department, I could do that for the department. As a hospital CEO, I could do part of it. But there is no more powerful position from which to drive cultural change and lean transformation than that of a health system CEO.”
Dr. Dickson used UMass Memorial's success with clinical standardization as a starting point to convince managers across the organization to also standardize management processes and join frontline staff in daily continuous improvement.
He implemented the UMass Memorial Management System, a decisive step based on his realization that the role of leaders needed to be redefined: leading in healthcare means caring for those who care for patients, a fundamental principle built into UMass Memorial's management processes.
Today, the management system consists of nine standardized processes and three levels of organizational engagement: System (for example, the president and executive vice presidents), Entity (unit leaders), and Departments (managers and frontline staff) — with teams regularly using visual management and structured problem solving, while catchball (strategic dialogue for alignment) takes place continuously between the different levels of the organization.
Another fundamental element of UMass Memorial's lean transformation was setting the expectation that all employees take part in improvement initiatives and propose ideas, using a technology platform called “Innovation Station”. This system has resulted in 132,000 improvement ideas from the front line over the last decade, with 48% annual growth in idea generation.
The system-wide improvements would not have been possible without providers and employees embracing the UMass Memorial Management System — everyone, regardless of position, business unit, or department, working in alignment and at the same pace. Many of these systemic improvements have been documented by Catalysis, including:
- Redesign of an emergency department to optimize patient flow, which significantly reduced the length of time patients remained after discharge.
- Reduction of communication barriers and improved access to information between clinical teams and Radiology, which had been contributing to significant delays in hospital discharges.
- Setting up a field hospital during COVID-19 in just 11 days, with all the operational capabilities of a conventional hospital.
- Critical improvements in the follow-up of subacute, unexpected, and actionable radiology findings, ensuring that patients and their physicians are alerted in a timely manner about the care needed.
The improvements achieved at UMass Memorial under Dr. Dickson's leadership include gains in patient experience indicators, especially in the likelihood-to-recommend score, and financial stability, evidenced by the highest credit rating (bond rating) in the health system's 35-year history.
“What I really want is to know that this is becoming a better place for our people. And I know it is already better for our patients,” said Dr. Dickson.
“And, right now, the most important thing for me is to make sure I leave this organization in better shape than I found it and that I create the conditions for the next CEO to succeed.”
“And that means having a great team around that leadership, having a strong culture, and making sure we choose someone who is aligned with that culture.”
Learn more about lean leadership in healthcare and how to replicate this journey.
