Duke Rohe: Hi this is Duke Rohe and if you've been watching, we've been doing culture building pieces, first we did P4 where they made changes there that were very good. We went to Room Service where they do world class customer service showed how they get all their departments to do that and finally today we're gonna talk about a division that's using the PDCA process as far as making their culture to change. Welcome today I have both Frank Tortorella and I have Cory Helms and they're with Clinical Support Services and Frank tell our viewers a little bit about how you get started on this journey.

Frank Tororell: Yes several years ago I received training in the Baldrige framework for performance excellence which influenced my leadership philosophy. It heightened my appreciation for database decision making as well as continuous improvement. So when we received the 2002 institutional employee opinion survey results that showed that employees didn't see how they contributed to M. D. Anderson's goals and they wanted clearer expectations in developmental opportunities, I saw this as I developed the performance improvement model as a way to address these issues as well as to take our performance as individuals as well as a division to the next level.

Duke Rohe: Ok and how do you see this vision or this improvement model rolling out?

Frank Tororell: Well as you can see from the attached poster I'm responsible for a very large and diverse area with over 800 employees and 65 managers and supervisors spread throughout the hospital and in multiple buildings. Our vision is to exceed our customer's expectations through teams continuously working to improve our services in sharing of our best practices. When Cory joined my team as a Performance Improvement Specialist this past year I saw this as a great opportunity to leverage her performance improvement training and skills so we went to work and developed the performance improvement model.

Duke Rohe: Ok and what exactly is the performance improvement model?

Frank Tororell: With the introduction of Create Solutions which was very valuable for it encouraged front line, the creation of teams, the front line staff, I was concerned that my managers and supervisors did not have a common understanding and approach for performance improvement. So when Cory joined my team we developed the performance improvement model with two goals in mind and the first goal was to standardize the approach as well for performance improvement including a clear understanding of the PDCA cycle as well as to promote interdepartmental teamwork.

Duke Rohe: Before we talk about the details of the model Cory, could you tell a little bit more about your role?

Corey Helms: Sure, I worked here in Rehab at M. D. Anderson for about five years and after I finished the business degree I was looking for other opportunities in the institution and was accepted into the Transformation Specialist Program which is a one year residency with the Office of Performance Improvement. During that year I learned everything from data analysis to leading and launching teams to performance improvement tools so that when I finished that year I was able to return to Clinical Operations Support Services and be their actual internal performance improvement specialist.

Duke Rohe: Were you able to devote a lot of time working with them?

Corey Helms: I was, I developed three educational modules around PDCA concepts all based on the create solutions material, it's already available here in the institution, and each of Frank's managers and supervisors as they're required to go to the three educational modules, but also have a project identified they'll be able to apply the concepts they are learning towards.

They were also encouraged to work in departments with other departments so that they could address cross departmental issues. Prior to attending the first educational module all the managers and supervisors were asked to attend a one-hour kick off meeting that would introduce this performance improvement model.

The initial meeting also outlined the expectations in deliverables for the model by outlining the deliverables very clearly from the beginning and tying the completion of those deliverables to each manager and supervisor's performance evaluation, we are addressing the opportunities identified in the employee opinion survey, clearer expectations and development opportunities.

Duke Rohe: How do you ensure that the teams have the tools to work with as far as ensuring success?

Corey Helms: I do a couple of different things. There's just as I mentioned earlier, there's just in time training from March to June so that the modules are timed to work in conjunction with their projects. I also am available for any kinds of questions from anything from general questions to data analysis to technical assistance. I also look at the database, the create solutions database on a fairly regular basis, and look to make sure they're on the right track and if they're not I email them or call them just to clarify.

Duke Rohe: And what kind of specific questions have you received?

Corey Helms: I receive everything from can you review my aim statement to how does my baseline performance look to you know really anything, it runs the gamete.

Duke Rohe: Do they listen to what you say?

Corey Helms: Most of the time, I hope so.

Duke Rohe: Frank, how do you see this affecting Clinical Support Services in the future?

Frank Tororell: Now all my leaders have the tools that they need to improve their work environment and it ultimately benefit the patients and they will also to be able to serve as mentors for their employees. Another goal was the interdepartmental team work and we have several examples.

Duke Rohe: Can I go visit one of your project teams?

Frank Tororell: Absolutely.