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Eastside Clinic Case Study

Anita Roberts, RN, is the nurse program manager for Denver Health’s Eastside Pediatric-Teen Clinic and a 2017 recipient of the state’s highest nursing honor, the Colorado Nightingale Luminaries Award.

Anita Roberts was part of a lean-guided effort over the past year to create dyad visits for moms and babies to improve the percentage of moms showing up for their postpartum visits. The mothers were more likely to bring their babies in for their 2-month checkups and vaccines than they were to come in for their own postpartum screenings. Committed to treating the whole family, Roberts and the Eastside Pediatric-Teen Clinic initiated dyad visits and also conducted a time study to find ways to reduce waiting times for busy mothers, who often had other children at home. A visual system for spotting system bottlenecks and allowing other team members to step up alleviated delays and provided even more care and time well spent for mothers and babies.

Roberts says the lean process, with its emphasis on the engagement of all participants, made it possible to transform the clinic from a number of silos (women’s care, pediatric care, primary care, internal medicine) to a whole-team approach that worked better for patients and providers.

“The attitude is: ‘If you have an idea, let’s try it.’ It’s OK to experiment and even make a mistake, if you learn from it. It sparks creativity,” Roberts said.

Whenever a new process is introduced, it can be difficult to get buy-in from all staff.

“One more thing is always hard,” Roberts said. “But the lean process provides settings where everyone can converse about how and why the process is changing. Everyone can speak up.”

Roberts said lean principles of staff engagement help managers to patiently listen — and not ask leading questions.

“You have to be comfortable with waiting. It allows the staff to be more open,” Roberts says, “and then they are more open to your leadership, too. The team appreciates getting feedback from supervisors.

“With our staff, it’s really changed the culture, creating a collaborative approach — with us owning patient care as a team. We share challenges.”

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