Covid Testing, Treatment, and Vaccination at Cleveland Clinic: Nate Hurle

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My guest for Episode #404 is Nate Hurle, a Senior Director of Enterprise Continuous Improvement at Cleveland Clinic. He was previously a guest on Episode 282. He was also recently a virtual keynote speaker for the Society for Health Systems annual conference.

Today, Nate shares stories and reflections from the past year — the pandemic year — and how Cleveland Clinic quickly stood up drive-thru testing, how they built a 1000-bed hospital (that thankfully wasn't needed), and how they've been ramping up Covid vaccination.

What happened when Nate got a surprise phone call about the need for testing to be up and running “in a few days.” Why was the approach of “get it up and running… then make it better” a useful one and how were mockups and other methods used to put safety first, given the cars and people on foot.

How did they utilize effective standardized work and training methods, huddles, and continuous improvement methods? Why was the question of “What's the most important problem to solve?” such a useful one?

How are they balancing the need for higher throughput with having a patient experience that's not too rushed? How did Cleveland Clinic get so much done in such a short period of time, and what were the lessons learned that could be applied in more normal times? Why is Cleveland Clinic now looking to continuously improve (again) their Cleveland Clinic Improvement Model?

We also chat a bit about their adoption of “Process Behavior Charts” (as I have written about) and we'll talk about that more in a future episode.

Here is the Dolly Parton video I mentioned — Please go get vaccinated when you can!

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You can listen to the audio or watch the video, below. I hope you enjoy it like I did.



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Mark Graban is an internationally-recognized consultant, author, and professional speaker who has worked in healthcare, manufacturing, and startups. His latest book is Measures of Success: React Less, Lead Better, Improve More. He is author of the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, as well as The Executive Guide to Healthcare Kaizen. He also published the anthology Practicing Lean that benefits the Louise H. Batz Patient Safety Foundation, where Mark is a board member. Mark is also a Senior Advisor to the technology company KaiNexus.

3 Comments
  1. Josh Jimenez says

    I’ve noticed that there have been numerous issues regarding vaccines. Some are unavoidable like getting cut in winter storms but there are also just a lack of people showing up to take them. Is there a Lean solution that would encourage people to take the vaccines that places like Walgreens and CVS offer? Or do you think those companies should offer an hour the the people who aren’t qualified to receive the vaccine to come in and receive them instead of throwing them away?

  2. Mark Graban says

    Thanks for your comment, Josh. The main battle right now is not enough vaccine supply. I visited a clinic on Saturday (to see their process, a “gemba visit”) and they have the capacity to do 5,000 shots a day. They were only able to book 1,500 appointments because they aren’t getting enough vaccine.

    Once the supply chain issue is resolved, then “vaccine hesitancy” (a.k.a. people who don’t want to take the vaccine) becomes a challenge. We need to convince enough people to do it so we can get herd immunity.

    Rather than finding people last minute to take extra doses before they expire, I think we should be solving the problem of “why do we have leftover doses?” That’s a solvable problem and some hospitals have done it.

    I posted on LinkedIn about this today:

  3. Nate Hurle says

    I think this also comes back to what is the most important problem to solve…today. In the vaccine world that still seems to be supply (vs people wanting it or not having the capacity to administer). Soon enough the problem will shift though.

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