II Quality International Symposium

Lean Six Sigma approach to improve e ciency and quality of care

October30th,2019 Palazzo dei Normanni - Sala Mattarella Palermo, Italy

www.ismettquality2019.it

Hosted by Assemblea Regionale Siciliana and Fondazione Federico II UPMCItaly.it ismett.edu Dear Colleagues, Hospitals today face complex and challenging problems. Healthcare in contemporary society is recognized as one of the highest risk industry. The need to implement ways to improve quality and patient safety and to manage resources in e ective and ecient ways is pressing and, to do so, learning from other high risk industries new competencies and approaches is crucial. Lean Six Sigma principles are used in a range of industries to improve process eciency by eliminating waste and reducing defects in every process, procedure, and activities through an ongoing system of improve- ment and the use of a set of tools and techniques. When applied correctly, these methodologies can lead to higher customer satisfaction and increa- sed revenue. Use of Lean Six Sigma methodologies is critically important in healthcare because they can be a determining factor not only for revenue and customer satisfaction. Given that in healthcare poor quality (“defects”) may range from long waiting time to wrong diagnosis, wrong prescriptions and medication errors, robust improvement methodologies can greatly a ect patient. The II Quality Symposium will present the state of the art of Lean Six Sigma programs in healthcare facilities. Sharing of International and National expe- riences will facilitate identification of key elements of successful implemen- tation of Lean Six Sigma methodology. Some institutions and advanced health care centers, including the University of Pittsburgh Medical Center and Virginia Mason Institute, together with European and Italian quality experts, will present their programs to reduce wastes and variability in processes and will share key factors for successful implementation. Target audiences are all healthcare professionals, including those who have a coor- dinating and managing role. The event will be CME accredited. During the event, ISMETT will present its three best Lean projects. A “spe- cial” jury will vote the best project. The objective of this event is to share tools and modalities used by the most advanced health care organizations to add value to healthcare processes, eliminating wastes and improving eciency and e ectiveness towards the ultimate goals of achieving zero defects in patient care. We look forward to welcoming you to the conference.

Angelo Luca Barbara Ragonese Chief Executive Ocer Director of Quality and Patient Safety IRCCS ISMETT IRCCS ISMETT - UPMC Italy SCIENTIFIC PROGRAMME

08.30|09.00 Registration of participants 13.10|14.00 Lunch 09.00|09.30 Greetings Regional Healthcare O cer and President 14.00|14.30 Reducing Hospital Mortality by Reducing of ARS Variability DAVID L. BURWELL MD, MBA - VP OF CLINICAL 09.30|10.00 Welcome and opening remarks QUALITY AND C OMPLIANCE, CHIEF MEDICAL INFORMATION OFFICER- UPMC ALTOONA BRUNO GRIDELLI AD UPMC ITA LY AND EXECUTIVE VICE PRESIDENT UPMC INTERNATIONAL SESSION III E ciency of processes in healthcare ANGELO LUCA CEO ISMETT organizations: experiences in the Region 10.00|10.30 Lecture: Pursuit of the Perfect Patient Experience: MODERATORS: ANTONIO CAPODICASA, AMEDEO CASIGLIA, Twenty Years of Applying Lean At Virginia Mason GIANGAETANO D’ALEO Medical Center 14.30|14.50 National Healthcare System: New financing levels HENRY OTERO MD, EXECUTIVE SENSEI, VIRGINIA MASON INSTITUTE to improve e ciency of processes e cient and 10.30|10.50 Coffee break e cacy of care BARBARA CITTADINI PRESIDENT OF AIOP - ASSOCIAZIONE ITALIANA OSPEDALITÀ PRIVATA SESSION I Use of Lean six sigma in healthcare to improve quality of care and patient satisfaction 14.50|15.10 Will the Choosing Wisely campaign be eective MODERATORS: FILIPPO AZZALI, TOMMASO MANNONE, GIUSEPPE MUROLO in Sicily? DOMENICO COLIMBERTI REGIONAL REFERENCE FOR SLOW MEDICINE 10.50|11.10 Using Value stream mapping and discrete event simulation to improve e ciency of oncology 15.10|15.30 Results of implementation of IHI Global Trigger department SERGIO FICHERA FULL PROFESSOR OF MANUFACTURING Tool in the Regions of Sicily: much ado about AND PRODUCTION SYSTEMS, UNIVERSITY OF CATANIA nothing? VINCENZO PARRINELLO QUALITY DIRECTOR VITTORIO 11.10|11.30 Leanthinking: the experience of usl Toscana South EMANUELE HOSPITAL, CATANIA East division SILVIA BELLUCCI USL TOSCANA SUD-EST 15.30|15.40 Q&A 11.30|11.50 Lean Program in Humanitas: a journey towards a SESSION IV ISMETT Quality Award Lean Hospital MODERATORS: GIUSEPPE ARENA, GIUSEPPE ALONGI, CINZIA DI BENEDETTO GIULIA GORETTI CLINICAL PROCESS IMPROVEMENT AND LEAN MANAGER 15.40|16.00 ISMETT Quality Award 11.50|12.00 Q&A BARBARA RAGONESE DIRECTOR OF QUALITY AND PATIENT SAFETY, UPMC ITA LY-ISMETT SESSION II Implementation of Lean Programs: ingredients for 16.00|16.30 Presentation of the best three projects success MODERATORS: ANTONELLA CAMPO, ALBERTO FIORE, ALBERTO FIRENZE 1. How can we optimize antifungal use in Solid Organ Transplant recipients? The ISMETT experience (10’) 12.00|12.20 “L’EANsieme vincente”: Experience of Poliambulanza ALESSANDRA MULARONI INFECTIOUS DISEASE AND INFECTION WALTER GOMARASCA HEALTH DIRECTOR POLIAMBULANZA CONTROL SERVICE DIRECTOR 12.20|12.40 Designing for Zero Defects, Creating a Sustainable 2. Assessing the appropriateness in prescription of Lean Six Sigma Program ERIC D. BAKOW PROJECT DIRECTOR, urine culture: a new protocol for bacteriuria screening LEAN SIX SIGMA, UPMC HEALTH PLAN (10’) MARIA CONCETTA SORRENTINO CLINICAL PATHOLOGY BIOLOGIST 12.40|13.00 Lean management: between strategy and operativity ALESSANDRO BACCI PROFESSOR OF ECONOMICS AND BUSINESS 3. Digital Management of the local Radiology warehouse ADMINISTRATION AND LEAN MANAGEMENT, UNIVERSITY OF SIENA (10’) GIUSEPPE GALLO RADIOLOGY TECHNICIAN NICOLÒ PESTELLI MANAGEMENT CONSULTANT IN HEALTHCARE,UNIVERSITY OF FLORENCE 16.30|16.45 Prize award ceremony 16.45|17.00 Closing Remarks ANGELO LUCA - BARBARA RAGONESE 13.00|13.10 Q&A II Quality International Symposium Lean Six Sigma approach to improve e ciency and quality of care

08.30|09.00 Registration of participants 13.10|14.00 Lunch 09.00|09.30 Greetings Regional Healthcare O cer and President 14.00|14.30 Reducing Hospital Mortality by Reducing of ARS Variability DAVID L. BURWELL MD, MBA - VP OF CLINICAL 09.30|10.00 Welcome and opening remarks QUALITY AND C OMPLIANCE, CHIEF MEDICAL INFORMATION OFFICER- UPMC ALTOONA BRUNO GRIDELLI AD UPMC ITA LY AND EXECUTIVE VICE PRESIDENT UPMC INTERNATIONAL SESSION III E ciency of processes in healthcare ANGELO LUCA CEO ISMETT organizations: experiences in the Region 10.00|10.30 Lecture: Pursuit of the Perfect Patient Experience: MODERATORS: ANTONIO CAPODICASA, AMEDEO CASIGLIA, Twenty Years of Applying Lean At Virginia Mason GIANGAETANO D’ALEO Medical Center 14.30|14.50 National Healthcare System: New financing levels HENRY OTERO MD, EXECUTIVE SENSEI, VIRGINIA MASON INSTITUTE to improve e ciency of processes e cient and 10.30|10.50 Coffee break e cacy of care BARBARA CITTADINI PRESIDENT OF AIOP - ASSOCIAZIONE ITALIANA OSPEDALITÀ PRIVATA SESSION I Use of Lean six sigma in healthcare to improve quality of care and patient satisfaction 14.50|15.10 Will the Choosing Wisely campaign be eective MODERATORS: FILIPPO AZZALI, TOMMASO MANNONE, GIUSEPPE MUROLO in Sicily? DOMENICO COLIMBERTI REGIONAL REFERENCE FOR SLOW MEDICINE 10.50|11.10 Using Value stream mapping and discrete event simulation to improve e ciency of oncology 15.10|15.30 Results of implementation of IHI Global Trigger department SERGIO FICHERA FULL PROFESSOR OF MANUFACTURING Tool in the Regions of Sicily: much ado about AND PRODUCTION SYSTEMS, UNIVERSITY OF CATANIA nothing? VINCENZO PARRINELLO QUALITY DIRECTOR VITTORIO 11.10|11.30 Leanthinking: the experience of usl Toscana South EMANUELE HOSPITAL, CATANIA East division SILVIA BELLUCCI USL TOSCANA SUD-EST 15.30|15.40 Q&A 11.30|11.50 Lean Program in Humanitas: a journey towards a SESSION IV ISMETT Quality Award Lean Hospital MODERATORS: GIUSEPPE ARENA, GIUSEPPE ALONGI, CINZIA DI BENEDETTO GIULIA GORETTI CLINICAL PROCESS IMPROVEMENT AND LEAN MANAGER 15.40|16.00 ISMETT Quality Award 11.50|12.00 Q&A BARBARA RAGONESE DIRECTOR OF QUALITY AND PATIENT SAFETY, UPMC ITA LY-ISMETT SESSION II Implementation of Lean Programs: ingredients for 16.00|16.30 Presentation of the best three projects success MODERATORS: ANTONELLA CAMPO, ALBERTO FIORE, ALBERTO FIRENZE 1. How can we optimize antifungal use in Solid Organ Transplant recipients? The ISMETT experience (10’) 12.00|12.20 “L’EANsieme vincente”: Experience of Poliambulanza ALESSANDRA MULARONI INFECTIOUS DISEASE AND INFECTION WALTER GOMARASCA HEALTH DIRECTOR POLIAMBULANZA CONTROL SERVICE DIRECTOR 12.20|12.40 Designing for Zero Defects, Creating a Sustainable 2. Assessing the appropriateness in prescription of Lean Six Sigma Program ERIC D. BAKOW PROJECT DIRECTOR, urine culture: a new protocol for bacteriuria screening LEAN SIX SIGMA, UPMC HEALTH PLAN (10’) MARIA CONCETTA SORRENTINO CLINICAL PATHOLOGY BIOLOGIST 12.40|13.00 Lean management: between strategy and operativity ALESSANDRO BACCI PROFESSOR OF ECONOMICS AND BUSINESS 3. Digital Management of the local Radiology warehouse ADMINISTRATION AND LEAN MANAGEMENT, UNIVERSITY OF SIENA (10’) GIUSEPPE GALLO RADIOLOGY TECHNICIAN NICOLÒ PESTELLI MANAGEMENT CONSULTANT IN HEALTHCARE,UNIVERSITY OF FLORENCE 16.30|16.45 Prize award ceremony 16.45|17.00 Closing Remarks ANGELO LUCA - BARBARA RAGONESE 13.00|13.10 Q&A SCIENTIFIC DIRECTORS Bruno Gridelli AD UPMC Italy and Executive Vice President UPMC International Angelo Luca Chief Executive Ocer - IRCCS ISMETT Tami Minnier Chief Quality Ocer, UPMC Barbara Ragonese Director of Quality and Patient Safety - IRCCS ISMETT – UPMC Italy Giovanni Vizzini Chief Operating Ocer UPMC

FACULTY Giuseppe Alongi Palermo - Italy Giuseppe Arena Palermo - Italy Filippo Azzali Milan - Italy Alessandro Bacci Siena - Italy Eric D. Bakow Pittsburgh - USA Silvia Bellucci Grosseto - Italy David L. Burwell Altoona - USA Antonella Campo Caltanissetta - Italy Antonio Capodicasa Palermo - Italy Amedeo Claudio Casiglia Palermo - Italy Barbara Cittadini Palermo - Italy Domenico Colimberti Palermo - Italy Giangaetano D’Aleo Messina - Italy Cinzia Di Benedetto Palermo - Italy Sergio Fichera Catania - Italy Alberto Fiore Palermo - Italy Alberto Firenze Palermo - Italy Walter Gomarasca Brescia - Italy Giulia Goretti Milan - Italy Tommaso Mannone Palermo - Italy Giuseppe Murolo Palermo - Italy Henry Orlando Otero Seattle - USA Vincenzo Parrinello Catania - Italy Nicolò Pestelli Florence - Italy

ISMETT ORGANIZING COMMITTEE: Maria Angela Barone Dipartimento Accreditamento e Qualità ISMETT Maria Luisa Fazzina Dipartimento Accreditamento e Qualità ISMETT Rosario Lombardo Nurse Educator Coordinator Marilena Lorito Direttore Ucio Formazione ISMETT Alessandra Sansone Ucio Formazione ISMETT General Information

MEETING VENUE Palazzo dei Normanni - Sala Mattarella - Piazza del Parlamento, 1 - 90129 Palermo (Italy)

OFFICIAL LANGUAGE The ocial language of the meeting will be English. Simultaneous translation will be provided.

C.M.E. CONTINUING MEDICAL EDUCATION ISMETT (provider 505) has included the meeting in the educational plan 2019. C.M.E REF.: 505-6362 The Symposium will be suited for Physicians (all branches of medicine) and Nurses and it provides 4,2 C.M.E. credits

IN ORDER TO OBTAIN C.M.E. CREDITS, PARTICIPANTS MUST:

• Attend the 90% of the meeting • Fill-in the C.M.E. evaluation questionnaire (credits will be granted to those who will answer 75% correctly) • Belong to the accredited medical profession and specializations related to this symposium • Submit the required documentation, sign in and sign out at the registration desk at the beginning/end of the symposium

C.M.E. CERTIFICATION The certificate of attendance with the number of C.M.E. assigned credits can be downloaded after 91 days from the date of the meeting directly through the website http://www.ismettquality2019.it/

CERTIFICATE OF ATTENDANCE Certificate of attendance will be issued at the registration desk at the end of the meeting

REGISTRATION The Meeting is free to attend. On-line registration is mandatory and possible until October 25th 2019 or until the predetermined limit is reached. Please confirm your participation to the Organizing Secretariat by registering online at www.ismettquality2019.it. On-site registration will be possible until the predetermined limit is reached. SECRETARIAT/REGISTRATION DESK During the meeting the secretariat/registration desk will be open at the following hours: • Wednesday, October 30th 2019, from 8.30am to 5.30pm Under the patronage of

C.M.E. Provider Organizing Secretariat

Istituto di Ricovero e Cura a Carattere ISMETT Scientifico Via U. Giordano, 55 - 90144 Palermo Tel. 091 6867.401 - Fax 091 9889354 e-mail: [email protected]