OAHHS Hospital Voice Spring/Summer 2021

8 » A magazine for and about Oregon Community Hospitals. They would have to come up with a viable location, one where, for example, the traffic generated by hundreds of vaccine seekers at a time could be made to flow smoothly, and not become an off- putting barrier to vaccination— not to mention a bane to the surrounding community. And then there were the logistics, both those they could foresee, and those they’d have to discover along the way. “It wouldn’t be perfect, but we are an organization that has adopted ‘ lean’ as our management system here, and we’re comfortable with things not being, quote unquote, perfect,” Nester Wolfe said. Salem Health’s lean approach, aimed at eliminating waste, increasing productivity, and add- ing value for the patient, fits right in with Kaizen, the Japanese busi- ness philosophy of continuous improvement that’s been central to Salem’s management system since 2010. Kaizen, made famous by the Toyota Motor Corp., has been adopted by companies such as Ford Motor Co. and Trader Joe’s, as well as healthcare provid- ers like Salem Health, the Mayo Clinic, and Los Angeles County- Harbor UCLA Medical Center. Variations on core Kaizen princi- ples revolve around the idea that it’s always possible to do things better, even if everything seems to work well at a particular moment. “We’re OK to bring something up the best we can and to adjust it quickly as we go, so I knew that culturally we could do that,” Nester Wolfe said. “Quickly” is perhaps an understate- ment, considering the short time- line between that first shot given in mid-December, to the full open- ing of the fairgrounds as a mass vaccination site on January 7—a true all-hands-on-deck effort, Nester Wolfe said. Not only that, but the deckhands came from all over, not just Salem Health, mak- ing the effort more like coordinat- ing an international fleet, with ships from different navies, each with its own customs, consider- ations, and constraints—think city, county, state, and federal agencies, health departments, civic organiza- tions, property owners, businesses, ambulance companies, and the Oregon National Guard. Besides having to act quickly, the fleet has to be maneuverable enough to navigate the pandem- ic’s shifting currents, like surges and lulls in the public demand for vaccinations, and ripples in the supply and delivery of the vaccine itself, as with the recent pause in distribution of the Johnson & Johnson vaccine. Major changes in rules and policies can rock the entire fleet—like the FDA’s May 10 decision to authorize emer- gency use of the Pfizer vaccine in adolescents aged 12 to 15. But in the beginning, it was loca- tion, location, location. Applicable models of mass vacci- nation sites were hard to come by Nester Wolfe said, and many took a drive-through approach, with shots being administered through car windows. But especially in the middle of an Oregon winter, the prospect of posting crews in park- ing lots, their shifts inevitably complicated by cold, rain, and an early dusk, the Salem Health planners steered toward finding a suitable indoor venue, or one that could handle some combination of indoor and outdoor setups. Salem Health’s lean approach, aimed at eliminating waste, increasing productivity, and adding value for the patient, fits right in with Kaizen, the Japanese business philosophy of continuous improvement that’s been central to Salem’s management system since 2010. Variations on core Kaizen principles revolve around the idea that it’s always possible to do things better, even if everything seems to work well at a particular moment.