Lisa Yerian, MD, joined Cleveland Clinic in anatomic pathology in 2004, and has held several pathology and enterprise leadership positions. After 10 years serving as Medical Director of Continuous Improvement, Dr. Yerian was named Cleveland Clinic’s first Chief Improvement Officer of Continuous Improvement in December 2019. Over the past decade, her passion for bettering healthcare and her drive for efficiency have changed the health system’s culture and led to development of the Cleveland Clinic Improvement Model.
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CQD sat down with Dr. Yerian to find out how continuous improvement (CI) works at Cleveland Clinic.
How is Continuous Improvement structured?
We have a Continuous Improvement Department that is made up of professionals with backgrounds in lean, Six Sigma and project management. In my role, I’m part of the health system Operations Council, which works to direct, coordinate and evaluate improvement strategies, methods and implementation across the enterprise. I am also a physician advocate and partner with hospital and institute leaders to build physician and executive support for expansion of improvement methods to all caregivers.
Over the past several years, our Continuous Improvement team has developed, tested and refined our improvement model with more than 5,000 caregivers across the Cleveland Clinic health system. It is now used throughout the enterprise, as well as outside organizations, and it directly supports our organizational goals, mission, vision and values. The application of this model enables us to focus on the following: patient safety, patient quality, patient experience, caregiver experience and affordability.
What is the basis of continuous improvement at Cleveland Clinic?
It is really about empowering every Cleveland Clinic caregiver to make improvements. Every day, we have an opportunity to make a positive impact on our patients and caregivers. That’s both challenging and exciting, because of the impact we can have for Cleveland Clinic and for healthcare at large. Our people are relentless in their efforts to improve our care and the way we deliver it, and I’m truly inspired every day by our caregivers all around the organization.
As a surgical pathologist, your work is behind the scenes. While you don’t meet patients, how does Patients First inform what you do?
I don’t distinguish between caregivers who do and do not have face-to-face time with patients. We share a common purpose – serving our patients and each other. There is a lot of work required to serve our patients – some of that work occurs physically in front of patients, some does not. Keeping patients first is about your commitment, not your location or role. In the face of other demands, pressures or distractions, this commitment helps us prioritize and stay focused on what matters most.
How do you build meaningful relationships with your colleagues?
I love to learn about people – who they are, how they think, what drives them. I have learned so much from my colleagues in my clinical work, and really enjoy working together on complex and difficult diagnostic questions. I also served on Cleveland Clinic’s Board of Governors, which gave me the opportunity to meet people in other departments, institutes and locations that I would never have encountered in my clinical role.
How do you decompress from work?
So, “5S” is one of the many CI tools we’ve utilized to build a culture of improvement at Cleveland Clinic. I love to cook, so think 5S as it might apply in the kitchen: Sort, Set in order, Shine, Standardize and Sustain. On a Saturday night there are few places I’d rather be than in the kitchen. I focus on dishes influenced by my travels. To minimize waste within the cooking process, I co-locate items used together, utilize labels and implement par levels and a Kanban system to ensure that I have the supplies needed to do the work. This sustainment is easy because my husband and family also value the system, which means they don’t like waste and want to ensure that they have what they need. I also do trail running. It’s a great way to clear the mind. When running, you have to focus on the trails to avoid tripping on a rock or root. This forces me to stop thinking about immediate concerns, and it frees up my mind to do some of my best, most creative thinking.
You travel all over the world. Do you have a favorite destination?
I love adventure and learning – so what I most enjoy is going new places! I don’t think I could choose a favorite – and I’m always debating whether to go back to a place I loved or go explore somewhere new. In 2019, I visited Peru (Amazon, Lima and Machu Picchu), Estonia and Finland and I loved them all!
Dr. Yerian has authored more than 150 manuscripts, articles and book chapters in the fields of pathology and continuous improvement, and she has achieved many awards. She is a member of the Lean Enterprise Institute Board of Directors and the Catalysis (formerly Healthcare Value Network) Board of Directors. She speaks nationally and internationally on pathology and on the pursuit of continuous improvement. See the Cleveland Clinic website to learn more about the Cleveland Clinic Improvement Model.