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    Katie Castree

    Katie Castree, Career Healthcare Process Improvement Connoisseur

    Global Impact: Rebecca Rock, RN and SABM CFO talks with HPI about two roles across two countries

    From Lab Trend Visionary to Dark Group CEO: HPI connects with the Founder and Editor of the Dark Report, Robert Michel

    Two Imaging Leaders, Two Systems, One Outcome: Communication

    From Communication Strength to Just in Time Reopening at MGH A conversation with Dr. James Brink, Chief of Radiology at Massachusetts General Hospital

    From Time Magazine to PBM Influencer: Sherri Ozawa's Mission to Define the Value of Blood

    Buried Blessings: Pandemic perspective from Tom Strauss, CEO at Sisters of Charity Health System

    Katie Castree, Career Healthcare Process Improvement Connoisseur

    Solving Lab Challenges through Recruiting Innovation: HPI connects with Lighthouse Lab Services President, Jon Harol

    Providing Value-Based Care in a Pandemic through Telehealth and Data Resources: An HPI exclusive with Dr. Darrel Weaver

    From Supply Chain Crisis to Innovation in a Pandemic

    From Navy Medic to running a Clinical Laboratory . . . during a pandemic

    Planning for Blood Shortages in a Pandemic with Dr. Claudia Cohn

    Blood Banking is more complex today than ever before. Rob Van Tuyle, President of Vitalant's Blood Division, tells us why.

    Profoundly Impacting Healthcare with Breakthrough Anemia Management

    Supporting Imaging Precisely Where You Need It

    Working Together Makes End of Life Conversations Easier to Have

    The Future of Imaging: Assessing the early impacts of COVID-19 and the path to innovation through Artificial Intelligence (AI) A conversation with Dr. Geoff Rubin

    Pivoting in a Pandemic: How a U.S. 3D printing manufacturer is helping healthcare in its time of need

    Mara G. Aspinall: Diagnostic evangelist educating the world on the power of diagnostics today

    How The Joint Commission is addressing the COVID-19 Pandemic

    CHI Nebraska’s Laboratory Director Connie Wilkins, describes How To Manage a Clinical Laboratory During the pandemic

    Former Commercial Lab Leader Highlights the Hospital Lab as the Solution to Community Sustainability in a Healthcare Crisis

    Three Phases Essential to Crisis Preparedness in Patient Blood Management with Anne Burkey of St. Luke's Health in Boise, ID

    The Importance of Agility in Your Lab

    Dr. Paul Biddinger Shares Three Ways to Prepare for COVID-19

    Bringing Clinical Skills to Operational Leadership During a Time of Crisis; Dr. Blanton, Chief Medical Officer at Peterson Health

    7 Team Attributes to Teams that Work in Challenging Times & Through Rapid Innovation

    From Finding Problems to Saving Lives: The Evolution of Interventional Radiology

    Identifying the Potential with AI in Radiology with Dr. Chung

    Communication in the C-Suite with Cliff Robertson of Catholic Health Initiatives

    Reviewing Your Patient Financial Journey with Melody W. Mulaik, President of Revenue Cycle Coding Strategies

    Ask An Accumen Expert: Carolyn Burns, MD, a Patient Blood Management Advocate

    Linda DeVee, Leads Radiology Services at Edward-Elmhurst Health

    Theresa Mouton, Market Chief Financial Officer with Steward Health

    PELITAS President and CEO Steven Huddleston Wants Patients to Have a Great Experience – Both Clinically and Financially

    How Do You Deal with 2 Billion Forms a Year? Ask Randy Campbell

    Medical Director of Telehealth for UAB Knocks Barriers Down to Treat Patients on Their Terms

    C-Suite Spotlight: Wayne Bohenek Chief Ancillary Services Officer, Bon Secours Mercy Health

    A Leader in the Laboratory Service Line : Pierre Mouawad

    Healthcare Partner: Autumn Farmer, Chief Laboratory Officer, Bon Secours Mercy Health

    How Imbio is using AI to close the gap of missed diagnosis with Mike Hostetler

    Spit Matters with Bill Phillips from Spectrum Solutions

    How COVID-19 inspired TeraRecon to accelerate their imaging solutions to the point of care with Jeff Sorensen

    Katie Castree always wanted to work in the healthcare industry. Finding a passion for business and process improvement, she set her sights on a master’s degree in health administration followed by a Six Sigma Black Belt certification. Katie then found success in the simplicity of making things run smoothly, as a Senior Performance Improvement Specialist, and recently as an Operations Excellence Manager focused on the hospital laboratory. HPI met up with Katie to talk about the application of process improvement principles in healthcare and the impact of her work in the midst of the current healthcare crisis.

    Process in Practice
    Today Katie focuses on delivering measurable improvement for the laboratory in three areas – productivity, quality, and service – by implementing Lean Six Sigma practices, identifying opportunities for improvement, and leading initiatives to deliver the improvements. This involves a lot of facilitating and coaching clients, sharing tools and methods, defining, and measuring new metrics, and analyzing data to improve and also sustain the improvements made. There’s a lot of communication involved as I serve as a change agent, influencing teams and driving results.

    Katie manages projects over multiple years beginning with an extensive assessment of each lab department. Over the initial few months of an engagement, there is an intense review of all workflows, including observation of all three shifts. There are some pretty long, odd hours but it’s essential to identify what strengths and best practices are already in place. A dozen or more opportunities might also be noted in the assessment of a single department, varying from easy changes to larger scale initiatives. We prioritize opportunities by the effort required to make a change as well as the impact it will have on the lab. Of course, as new opportunities come to light post-assessment, those can be prioritized and added to the improvement plan as well.

    The unique part of Katie’s work is her team’s support of implementation through “boots on the ground” and project management. If we’re going to implement a new process to complete the inpatient morning blood draws in a different way, for example, I’m going to be the one working hand-in-hand with the supervisor – training the staff, making sure that the lab team is collaborating with nursing on the changes, creating communications for the hospital, getting new supplies that they may need, writing Standard Work, and collecting and analyzing data before and after the change. Then, during the implementation week of a new process, I’ll be going with the team on their collections. Day or night.

    Katie continues: It’s really important to monitor sustainment after making a process change and initial improvement. To accomplish that, we create a Control Plan. We try to avoid any process deterioration among the team. We identify any of the tasks that need to be completed, who is going to own them, and the timeline for that to be completed. Asking regularly for feedback, doing daily huddles, and celebrating with staff following implementation are also best practices. This consistent review and course correction is the missing link more often than not in project success, and the reason why so many health system labs haven’t been successful in some of these improvements yet.

    Process Improvement Meets COVID
    Katie has participated in several efforts in response to the current healthcare crisis. We asked her to share some examples and takeaways from these experiences to-date. She quickly reflected on two.

    One area we have assisted has been avoiding getting to critical levels of staffing due to the virus. We have developed a lab scheduling proposal to minimize opportunity for the spread of COVID-19 among staff, while still allowing hospitals to staff the lab appropriately. Similar staffing models have actually been used in other industries for years, where coworkers are assigned to team A or team B and each team has their assigned three eight-hour shifts – day, evening, and overnight. Each team works seven days on, seven days off, so they’re not interacting with each other.

    Another example was development an emergency response plan should a lab get to a critical level of staffing. This included an emergency response test menu that maintains quality and critical care services while providing high value testing onsite and moving other testing to another location. One lab could function as the centralized core hub, still having complex COVID-19 negative patients who require a lot of specialized testing. A second lab could function as an alternate core hub, but smaller satellite sites would only perform tests on the emergency menu and would send everything else to the core hub. A change like this requires administrative approval and input from the Med Exec Committee, as well as a notification system to alert all sites when the emergency response test menu has been activated.

    We CAN
    Katie continues to reflect on her COVID work to-date, recognizing that clients have been struck by just how quickly they can move things that would have normally taken months to implement. In an environment where things have had to be done out of necessity, the healthcare system has pulled together to move quickly. The pandemic has also forced the industry to finally recognize the vital role of the medical lab professional and that the hospital laboratory can provide financial stewardship and quality improvement opportunities, leading to better patient care.

    Don’t Stop Now
    Katie doubles down on the “we can” thought process circulating today as she observes healthcare organizations wrestling with pausing current quality, process improvement, or cost-saving efforts while they continue to deal with the pandemic. This might appear to provide focus in the short-term, but these needs are not going away. The Institute for Healthcare Improvement (IHI) recently weighed in as well, stating that the healthcare institutions who are doing the best job of handling COVID-19 are using not only epidemiology, but also quality improvement principles and methods. At critical times like this, (hospital labs) can’t afford to be spending time on wasteful processes or practices that produce defects or low quality. The time is now to implement change, one step at a time. Sharing a favorite quote, Katie leaves us with a final, impactful thought.

    The revolution is not an apple that falls when it is ripe. You have to make it fall.”

    We cannot wait for change to happen naturally because it might not, or for someone else to bring about change because they might not. We must take on change ourselves.

    We have to be proactive about improvement.

    Mic drop.

     
    Katie Castree

    Katie Castree

    Operations Excellence Manager, Accumen