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Lunch & Learn Featured Program/Organization: Oregon State Hospital

Becoming a World Class Inpatient Public Psychiatric Facility

You probably know that the Oregon State Hospital (OSH) serves adults needing intensive psychiatric treatment for severe mental illness. And you may not be surprised to learn that OSH has two campuses: one in Salem and a smaller one in Junction City where 24-hour, on-site nursing and psychiatric care is provided.

You may not realize that treatment planning, pharmacy, laboratory, food and nutritional services, and vocational and educational services are also provided to help patients achieve a level of functioning that allows them to successfully transition back to the community. Or that OSH’s long-term goal is to become a world class public psychiatric hospital. One element of that strategy is the OSH Performance System.

Foundations, Key Goals, & Outcome Measures

The OSH Performance System focuses on the organization’s fundamental work processes and desired outcomes, while forcing discipline around measurement and metrics. The performance system helps the hospital generate targeted breakthrough initiatives and use problem-solving techniques to address areas where performance is poor. The Office of Performance Improvement is intimately involved in all aspects of this process and owns the development and upkeep of breakthrough initiatives, improvement projects and metric alignment with its implementation of the Lean Daily Management System.

OSH Fundamentals Map

How it Works

The Performance System works by addressing the two major components of running an organization.

The first component is the Fundamentals (all the routine work and core processes that drive key goals). Since the Fundamentals represent 90-95% of all resource utilization and have the greatest opportunity for improving patient outcomes and reducing costs, OSH started with creating a Fundamentals Map and Scorecard.

The second component is the Breakthroughs, new competencies and major function improvements in existing work processes.

Section of the OSH Fundamentals MAP

These two components have been built by, and are governed by, the Superintendent/CEO’s Cabinet. Performance reviews are held each quarter to check the pulse of the organizational health using scorecards.

The scorecard monitors the organization’s outcome measures, which are the lagging indicators of success in achieving its key goals. Also, the scorecard monitors all the process measures, which are the leading indicators of success. In essence, the scorecard is a way for OSH to manage its data, monitor progress and to identify achievements. Having this data available enables the organization to proactively assignresources to continuous improvement teams early enough to make vital improvements that impact patient outcomes and the customer experience.

OSH Scorecard

Regular Reviews Focus on Results

Quarterly Performance Reviews (QPRs) create the discipline to review status of the routine work (Fundamentals) and initiatives (Breakthroughs), and to drive problem-solving as needed to achieve the goals of the organization.

Purpose of QPRs:

  • Frequent reminder of what is most important to the hospital

  • Performance becomes visible in a safe environment

  • Enables people involved to share accomplishments

  • Sets the stage for addressing problems (not solving them during the QPR)

  • Keeps everyone focused on results and outcomes, not just activity

  • Creates the heartbeat for “Plan – Do – Check – Act”

  • Helps hospital leadership assess and pursue organizational health (like checking the organization’s vital signs”)

Not only is the Hospital’s Performance System a key element of its long-term strategy, the standardized, disciplined approach supports the organization in reaching its vision of Hope, Safety and Recovery for the patients it serves.

For more information about Oregon State Hospital’s Performance System, contact Kim Ross, Director of Performance Improvement at

[Article written by: Camille Clark Wallin, Certified Lean Practitioner, Oregon State Hospital.]

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