Transcript The Ishakawa Diagram From the Perspective of the Fish

The Ishikawa Diagram From
the Perspective of the Fish
Celeste Chamberlain, BSN, MS
Director, Clinical Quality Improvement
St. Christopher’s Hospital for Children
February 23, 2011
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This Evening’s Journey
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Review shared professional
experiences
Apply a quality methodology to my
professional growth and development
Offer insights for application to help
you develop a personal strategy for
accessorizing your fish
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Cynthia Wollman
ParenteBeard LLC
Sharyn Mlinar
Celia Berry
The Boeing Company
Milton Roy Company
American Society
of Quality
February 23, 2011
Celeste Chamberlain
St. Christopher’s
Hospital for Children
ASQ
ASQ
ASQ
ASQ
Professional
Experience
Education
American Society
of Quality
February 23, 2011
Teaching
Certifications
Leadership
Quality Training
Attitude/Philosophy
What if the Ishikawa
fish could speak?
What would she say about you….
about your company?
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In my world…..
www.hospitalcompare.gov
IBC Pay for
Performance
Back to the Future
Celeste Chamberlain, 1971 - 2011
Fill in your name, ???? – 2011 and beyond
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Little Known Quality Formula
SC3
Self-Confidence
Content Competence
Keep this in mind as you accessorize your fish…
0
4 degrees
below zero
B.A.
A.D.
B.S.N.
M.S.
PhD
(2012) 5 degrees
below zero!!!
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Education
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B.A. Liberal Arts: Boston University 1971
– French teacher
– No jobs (worked in ED as ward clerk)
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A.D. Nursing: Lasell Jr. College 1975
– Aspiration: Emergency Department nursing
– No jobs
– Moved to Baltimore to work at Johns Hopkins
Hospital (they had jobs!)
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Education
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B.S. Nursing: University of Maryland 1979
– This one was a “gotta”
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M.S. Emergency Health Services: University
of Maryland 1986
– Found this in the white pages
– How’s that for a thoughtful decision?!

PhD. Candidate, Management: Walden
University (online) 2008 - ??
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Clinical Experience
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Staff nurse: 1975 - 1986
– Emergency department
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Level 1 trauma center
– Critical care
Intensive care, coronary care
 Cardiothoracic surgery intensive care
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– Post anesthesia care (recovery room)
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Clinical Nurse Specialist (1986 – 1989)
– Emergency and Critical Care nursing
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Leadership Experience
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Nurse manager, Emergency Department
(1977 – 1979)
Director Emergency Department/Level 1
Trauma Center (1990 – 1998)
– AHERF system bankruptcy, 1997
– 8 hospitals “on the auction block”
– Tenet purchase/rescue of the Philadelphia health
system
– “Opportunity” in quality language
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Leadership Experience
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Director Quality Improvement (1999 – 2011)
– Major change
– Adrenalin driven ED to “desk job”
– Quality experience: ED process data/analysis
– Able to stay at MCP
– Challenges
IS systems gone (with bankruptcy)
 Needed to rebuild the program
 New to the formal quality role (low on SC3)

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Leadership Experience
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More “opportunities”
– Reorganizations and staff reductions
– Assumed other organizational responsibilities
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Director Medical Staff Office (2001 – 2007;
2009 - 2011)
Director Regulatory and Accreditation
Compliance (2003 – 2011)
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Leadership Experience
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Still more “opportunities”
– Hospital closure announcement 2003
– Hospital changed hands, 2004, then closed for
good, March, 2005
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Director Risk Management (2004 – 2007)
Enough “opportunity” already
– Reorganizations and staff reductions
– Hospital sold
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Strike
Rat,
2003
Teaching 1986 - 2011
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CPR, ACLS, PALS, NALS
– Provider and Instructor courses
– Affiliate faculty, American Heart Association

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Critical Care Course (developed and taught)
Adjunct Faculty
– Thomas Jefferson University
– Hahnemann University
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Teaching 1984 - 2011
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Guest Speaker
– Holy Family University
– Acadia University
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National and Local Lectures
– American Healthcare Institute
– American Association of Critical Care Nurses
– American Association of Post Anesthesia Care
Nurses
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Related Experience
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Medical/legal expert witness (1995 – 2011)
Textbook reviewer: Emergency Nursing
Article publication: case study Tetanus
All measures of SC3
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Certifications
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Emergency Nursing (1980…)
Critical Care Nursing (1990….)
Six Sigma (2007)
Certified Professional in Healthcare
Quality (2008)
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Awards/Recognition
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Nurse Manager of the Year, 1996
– Emergency Nurses Association
Instructor Excellence, Advanced Cardiac Life Support
– National Institute of Emergency Care
Meritorious Service
– Second Alarmers Association and Rescue Squad
Volunteer of the Year
– Medical Education Care Associates
Honor Society of Nursing
– Hahnemann University Hospital
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Role Models/Mentors
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When you are young – align yourself with
older, smarter people
When you are old – associate yourself with
young, smart, motivated people
– Energy
– New ways, perspectives
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Be a mentor for others
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Thomas Jefferson University
School of General Studies
Emerging Alumni Award, 2010
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Mentor
Colleague
Sounding Board
Gentle Critic
Oh yeah……Husband!
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Mom and Dad
Thanks to my Mentors for:
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Mom and Dad: paying for a college degree
I never used
Cheryl: Learn from the Hamster of
Happiness
Susan: Always know the name of the
person that cleans your office
John: SC3; The technique of tact
They are all “ceiling dwellers”
So..How To Accessorize Your Fish
It’s About Decisions

Prospect theory of decision making
 V=Σ(IIi vi)
– V = The overall value
– II = Decision weights
– v = Consequence values
– i = Outcomes
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Shared Decision Challenges
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Which graduate degree is right for me?
Strategic career decisions
Professional goals and personal
philosophy
Promote quality
Drive social change
Expand your scope of influence
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Decision Points
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Initial aspiration: ED nurse – save lives!
Reasons for change/graduate school
– Burnout
– Shift work, weekends, holidays
– Narrow focus versus expanding experience
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Expanded clinical/organizational scope
Retirement “jobs”
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Develop a Personal
Methodology/Strategy
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Create your personal Ishikawa diagram
– Accessorize your fish with experiences that will
help you achieve your goals
– Develop your own SC3 factor
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Conduct a personal SWOT, PEST
Plan for contingencies
– What ifs, now what?
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Recognize Signs of
“Opportunity”
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Those within your control
– Current trajectory
Ceiling of growth
 Possible stagnation
 Possible burnout
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Those beyond your control
– Layoffs, closures, restructuring, etc.
– Better to be the one left behind?
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Final Thoughts
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Accessorize your fish
Influence your own future even if your
cannot always control it
Be ready for unsolicited “opportunities”
Take advantage of great resources like ASQ
Professional support network
Expand your horizons and……
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Soar to New Heights!!
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Thank You!