We all know the major challenges of leading a healthcare delivery system in 2023. Most health systems have huge fiscal challenges despite great patient demand, commonly attributed to an inability to hang onto their workforce or adequately recruit new replacements. To cite another, high levels of patient and staff harm continue to be inflicted during medical care, with adverse events affecting one-fourth of hospitalized Medicare patients. One contributor to these related crises is how ineffectively and inefficiently health systems have tried to improve. We typically just don’t get the results we need from a lot of disconnected efforts to get better.
What if an approach to operations leadership and rapid organizational improvement (dubbed the “pancake syrup” approach by its creator, Mike Bundy) offered a path to escape these vicious cycles to instead both stabilize health systems and create a path to sustainable excellence?
Mike Bundy is CEO of the Prisma Health Richland campus (teaching hospital, heart hospital, and children’s hospital) and has led many other hospitals during his career, always turning around their varied deep challenges with astonishing speed and sustainable results. In his most recent assignments, at the Prisma Baptist and Parkridge sites, their Leapfrog Safety Grades, profitability, employee engagement, and patient satisfaction scores have shot up all at the same time, with Prisma Parkridge winning a Leapfrog Top Hospital honor in 2020 and again in 2021, beginning just two years after Mike took the helm, during COVID.
On June 12th and 13th 2023, he and his colleagues will host a two-day seminar for healthcare CEOs and other C-suite operating leaders called “Leading with Safety.” The Leapfrog Group and Value Capture are the co-sponsors, and other leaders of astonishing accomplishments in healthcare and other industries will also share their allied approaches.
Bundy comes to us from the army rangers and has a knack for helping those he leads organize their work and support each other in a crystal-clear, easy-to-understand method based on a commitment to meeting the needs of patients and to meeting each other’s needs using clearly linked customer-supplier pathways. And there is no question about the purpose being to meet the needs of the human being served.
He also has a way of turning a phrase, that keeps everyone “locked in” and enthusiastic and gaining skill with the method. He will start his tenure by telling a medical staff and the rest of a health care operation that in every root cause about things gone wrong. you always hear about time – the lack of time to do what is known, needed, and right. The answer? The path to excellence lies with pancake syrup. When Bundy responds to the question, “What do you mean?” he explains that doctors and nurses (the front-line clinical teams) are “special operators” akin to the special forces. And that what makes groups of special operators, and those that support them, great is the ability to do the routine things routinely, without fail. Such as making sure the pancake syrup ordered by a patient is on the tray at the right time, every time. So that the patient doesn’t ring their call bell, taking the nurse away from doing a CAUTI bundle (or whatever it is that is the nurse's doing-the-routine-things-routinely) to keep patients safe, healing and moving through the hospital so they can get back to the safety of home as quickly as possible.
To get there, everyone in Mike’s organization learns what he calls “micro PI” (process improvement) and with coaching, each unit uses it to identify one or two key process metrics that indicate whether they are delivering perfectly to their customers, every time. There is complete transparency across Bundy’s organizations, so each day starts with what he calls the “first cup stack” (named for everyone’s first cup of coffee and the “stack” of metrics clearly aligned in value streams) in which the whole team reviews the performance of the customer-supplier flows from the previous 24 hours and, crucially, any failures are being solved to root cause and worked on immediately to prevent recurrence. Not just safety failures. Everything. And it is all animated by a crystal-clear purpose – to take care of patients to the highest possible standard, starting with keeping them safe, and to treat each other the same. From there, Mike is off into operations, literally, with his feet, modeling for other leaders, checking on units and people by name, always with their latest performance and praise for their efforts to be measurably great on his lips.
Using this method Mike has seen steady performance improvement on cost, safety, throughput, employee engagement and retention, and outside measures such as Leapfrog grades, all come much faster and more sustainably than is typical in healthcare. My theory is the results come because the method is simple, fully integrated, and followed with great discipline. There is not “how the place is run” on the one hand, and lots of disconnected hard-to-grasp improvement projects or activities on the other hand. The place is led one way, for repeatable greatness, one pancake syrup on one tray at a time.
To find out what Mike means by “Rake Your Own Leaves” and his approach to ensuring quality was built into parachute packing in the Army Rangers, you are going to have to attend the seminar. Participation is limited to 20.
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