What is Adaptive Design?

Translating the success factors of highly resilient companies to healthcare, Adaptive Design® empowers management, physician, staff and patient interdisciplinary teams to create systemic solutions to problems as they happen on the frontline. It is an integrated set of methods, skills and tools that uses evidence-based shared decision-making create a new mindset: everyone is accountable for patient-centered innovation as part of their everyday work.

Why Adaptive Design? Unlike Lean and other project-based, process-reengineering approaches, Adaptive Design is a self-sustaining system for developing, doing and improving complex, patient-centered care within and across disciplines and organizations. For organizations, management, physicians, staff and patient populations that means success in 21st Century healthcare: more access, to more Ideal Patient Care®, all at continually lower cost.

Who has used it? Clients have ranged from large, national health systems (Mayo Health System) to tiny, Critical Access Hospitals (Harbor Beach Community Hospital, Harbor Beach, MI).

How does it work? In all those environments, collaborative doctor, nurse, staff and management teams have applied Adaptive Design to surgery and medicine, nursing and support services, outpatient services and independent clinics to create more care for less cost. It is rapid, predictable, replicable, scalable way to create horizontal integration across the silos. For example, UnityPoint Healthcare used Adaptive Design in more than 200 rural and urban outpatient clinics to prepare for Patient-Centered Medical Home.

Here’s the process:

  1. Leadership sets a meaningful, clear, consistent direction toward Ideal Patient Care. Then, when a patient doesn’t receive Ideal Patient Care, those close to the problem alert the unit’s Adaptive Design team.
  2. The team uses standard Adaptive Design methods, skills and tools to clarify the problem and identify its Root Cause.
  3. With the problem clarified, the team identifies solutions by eliminating waste and adapting current resources to create more value. If a solution can be identified at the frontline, that’s where the solution should be created.
  4. Team members then test and refine solutions as close in time and place to the problem as possible until it is proven safe, reliable, stable and effective.
  5. In summary, Adaptive Design links information to action to verifiable results for patients using only the resources needed as close to the patient and opportunity as possible.

What happens? Adaptive Design changes minds by rapidly building self-sustaining systems of care from the patient up, instead of the top-down. Positive results generated in real-time develop everyone’s trust, optimism, high performance, and innovation. In Adaptive Design, Improvement is not a project, and Quality is not a department, they are everyone’s work, everyday.

The evidence is clear; you and your organization can build integrity, financial strength and lead the U.S. in creating more care for less cost in about one-year. Adaptive Design is a “systems” approach to creating new value: patient-centered, predictable, low risk, high reward, and fast. For example:

  1. Minnesota Medical-Surgical Unit met all IOM safety recommendations in 6 months with no task forces, committee meetings, quality improvement projects, or new technology.
  2. Colorado hospital pharmacy lowered volume-adjusted drug costs (VADC) by 2.3% while the other hospital system pharmacies’ VADC rose 11%. This improvement translated to $1.9 million in savings — directly to the bottom line.
  3. Massachusetts hospital OR saved $625,000 directly to the bottom line in improved charge capture and supply chain management in six months while they simultaneously increased surgical volume by 16% and decreased overtime by 14%.
  4. Indiana materials management team increased their productivity by 233% while simultaneously almost eliminating stock-outs and decreasing inventory by 21%.
  5. Adaptive Design outpatient clinics in a large, national health system improved diabetic population health results by 123% compared to all other system clinics using traditional improvement methods.
  6. Hospital inpatient nursing units have consistently produce stellar results:
    • Most improved patient satisfaction in an 18-hospital system
    • Highest staff engagement scores in a 12-hospital system
    • Staff turnover decreased 51% at the same time RN productivity increased 14%
    • $1,700,000 in decreased waste and cost savings in one year
  7. Wyoming small community hospital found solving 52 problems in the course of work generated more than $200,000 in savings.

Dr. Kenagy has made Adaptive Design his life’s work because it’s the most effective way to create a healthcare system that works for everyone – that’s more access to more Ideal Patient Care at continually lower cost.