Most webinars about virtual continuous improvement work focus on the adaptations — how to facilitate, how to run virtual mapping, how to handle camera-off participants. This session is something different. It's a look inside an actively operating transformation function at a large healthcare system, with the size, structure, scope, and integration to give a concrete answer to the question of what mature improvement infrastructure looks like in 2022 and beyond.
UMass Memorial Health is a 17,000-employee system serving Central Massachusetts — four owned hospitals across more than 10 campuses, a behavioral health entity (Community Healthlink) with addiction services, 70 ambulatory clinics, roughly 1,100 physicians in the medical group, and five urgent care facilities. The Center for Innovation and Transformational Change, known internally as CITC, sits at the center of how that system executes its strategy. CITC reports directly to the CEO, Dr. Eric Dickson. Penny Iannelli, the Chief Transformation Officer, runs the group.
The session walked through three integrated functions inside CITC — process engineering, enterprise analytics, and strategic program management — that together support the system's transformation work. It surfaced the trade-offs CITC has made about which methodologies to use when, how to prioritize incoming demand, how to handle accountability for project ownership, how to operate an idea system that has captured 108,000 frontline ideas to date, and how to keep frontline engagement growing through the disruption of the pandemic years and ongoing capacity pressure.
The conversation was practical throughout. Penny and Cliona answered specific questions about belt training, project ownership, prioritization, scaling huddles across shifts, integrating physical and virtual work, and the slow walk from idea counting toward impact measurement that mature systems eventually undertake. Anyone running or building a CI program at scale will find specific operational decisions in this session that they can either adopt directly or use as a comparison point against their own practice.
Cliona Archambeault is Senior Director of Process Improvement at UMass Memorial Health Care. She leads the process engineering team of Lean Six Sigma Black Belts and Master Black Belts in the Center for Innovation and Transformational Change. She has more than a decade of experience leading process improvement in healthcare. Prior to joining UMMH, she led a process improvement and health systems engineering team at the Veterans Health Administration in Boston. Earlier in her career, she worked as a process and industrial engineer at Intel Corporation, where she first learned about Lean and the Toyota Production System. She holds an MBA from Worcester Polytechnic Institute, a BS in Biomedical and Mechanical Engineering from Rensselaer Polytechnic Institute, and is a Lean Six Sigma Master Black Belt.
Penny Iannelli is the Chief Transformation Officer for UMass Memorial Health and runs the Center for Innovation and Transformational Change. Prior to joining UMMH she worked for Intel Corporation for 15 years in the areas of process engineering, portfolio-program-project management, Lean Six Sigma program management, manufacturing operations, and quality management. She holds a BS in Chemical Engineering from Rensselaer Polytechnic Institute, is a Lean Six Sigma Master Black Belt, holds a PMP, and has Lean certifications from various institutions.
Penny laid out the architecture early in the session because the rest of the conversation depends on understanding it.
CITC has three functional groups. Process engineering is the Black Belt and Master Black Belt team that leads transformational improvement work — A3s, kaizen events, and DMAIC projects. Cliona leads this team. Enterprise analytics and data warehouse integration is the IT-backed team responsible for the analytics platforms, the data warehouse, and all enterprise reporting. About half the CITC team sits in this group, and they're IT professionals and developers by background. Strategic transformation portfolio is the project and program management arm — program directors and program business analysts who lead strategic project work end-to-end.
The unusual structural decision is that these three groups don't operate as silos. Penny was specific: they work horizontally, in what she called tiger team fashion. A given strategic project will pull a data person, a project manager, and a process engineer onto the same team for the duration of the work. When the project completes, the team dissolves and the members move to other work. Multiple tiger teams are active simultaneously, and CITC was carrying about 80 to 85 active projects at the time of the webinar.
The integration matters because data flows continuously through the work. The data person on the tiger team is establishing baselines at the start of the project, supporting midpoint measurement, and building the sustain-the-gains measurement system at the end. Because the data team sits within CITC rather than within IT, there's no friction in getting data needs met. Project work doesn't stall waiting for an IT ticket. The data is already available and strategically aligned to the CEO's priorities.
The team is 42 people total. About half are in the data group. Process engineering has roughly nine people. Project management has roughly nine. Penny mentioned that she didn't build the team to its current size in one step — she grew it incrementally as demand and maturity supported it. Headcount additions happened through attrition replacement decisions, deciding where to add a person back when someone left, more than through net-new hiring.
The functional split inside process engineering: about 75 percent of the team's time is on transformational work (A3s, kaizens, DMAIC projects). The remaining 25 percent is on proliferating the process improvement culture — idea boards, visual management coaching, support for leaders, and a four-level belt training program (white, yellow, green, black). The split is deliberate. Project work produces breakthrough results. Culture work produces the conditions that make project work sustainable.
Mark asked how the team decides which approach to use for a given problem. Penny's answer was structural rather than ideological.
The decision depends on the outcome you're trying to produce. Some projects are heavily Lean-centric — flow, waste, process redesign — and the Lean tools fit. Some projects are more data-centric, focused on quality variation that requires statistical analysis, and the Six Sigma tools fit. The methodology choice follows the problem type.
Kaizen as a format is appropriate when speed matters and the team can be assembled together for a concentrated effort. Penny called kaizen events a fire starter culturally — the energy and engagement they produce is part of their value. They're particularly useful when the alternative would be a project that stretches over weeks and weeks of fragmented meetings.
A3 thinking is the organization's default improvement framework. The lean training program teaches A3 to green belt and black belt candidates. DMAIC sits alongside A3 for the data-intensive projects where the Six Sigma toolset is needed. Cliona was explicit that the team keeps A3 and DMAIC mostly separate — they have a different roadmap for DMAIC work than for A3 work — but both are part of the team's toolkit. The choice between them is project-specific.
Penny used a particular discipline around language that's worth pulling out. She described herself as a purist about Lean terminology. She uses the term "Lean" specifically to describe what Toyota did. She doesn't apply it loosely. When CITC has borrowed concepts from the Toyota Production System and adapted them to UMass's context, the result isn't called Lean — it's called UMass's management system. The distinction matters because mixing the imported vocabulary with the local adaptations dilutes both.
The same applies to Hoshin Kanri. CITC uses strategy deployment language. They don't run formal Hoshin Kanri practice with X matrices and the rest of the methodology. They've taken the learnings — cascading strategic priorities down to operational tactics, aligning daily work with longer-term direction — and built them into their own management system. The system is theirs. The borrowed concepts informed it without dictating it.
A question about turning strategy into execution produced one of the most concrete sequences in the session.
UMass has four strategic priorities: patients first, our people, our community, our future. Tactics flow from each. One of the tactics under "our people" at the time of the webinar was addressing the staffing crisis. The state of Massachusetts had a deficit of 5,100 RNs against open positions. The pressure was real and immediate.
CITC was tasked with a system-wide redesign of talent acquisition. The Chief Human Resources Officer became the executive sponsor. Master Black Belts from process engineering worked with the HR team. The work was structured around kaizen events — multiple kaizens running across different aspects of the talent acquisition process. The analytics team built dashboards for retention and recruitment metrics, which had been an under-developed area before the project. A strategic program manager oversaw the integrated effort.
The leave of absence program was a parallel example. A two-day visioning event surfaced the design challenges and set up five or six work groups. The work groups each owned a nested A3 underneath an umbrella project. Cliona described them as "baby A3s" — significant pieces of work, but each one bounded enough that a work group could own it end-to-end while the umbrella project tracked their collective progress. The structure made the relationship between the pieces visible to everyone involved.
The pattern across these examples is that strategic priority becomes tactic becomes project becomes set of nested A3s or kaizens, with the integrated team carrying the work and the executive sponsor accountable for the outcome.
A clear principle emerged when Mark asked about ownership of project work.
The operational lead owns the project. CITC team members are facilitators and methodology experts. The operational sponsor supports the operational lead. CITC doesn't take on new requests unless that ownership structure is in place.
Cliona was specific about why. When the project completes and the results get presented, the operational owner presents the results — not CITC. Mark noted that some teams might worry about not getting credit for the work. Cliona's response was direct. The whole point is that if the operational team owns the project, the culture of improvement perpetuates. CITC gets the team to the result and shows them how to do the work, but at the end of the day the operational team has to own the sustainment. Without that, the gains don't stick.
The ownership requirement also functions as a prioritization filter. Before CITC takes on a project, the leader has to be engaged and understand their role. The team members assigned have to be people who can dedicate time to the transformational work. If the leadership engagement isn't there, or the team members can't carve out the time, the project isn't ready. CITC will wait.
Penny was direct that she's good at saying no to things, a skill she credited to a previous role under the CIO that put her in charge of intake and prioritization for IT projects.
The principle CITC uses is mission alignment. The team's mission is to strategically execute the CEO's strategic plan. Requests that don't align to that plan don't get accepted as CITC projects. The rejection is rarely a flat no. It's usually a redirection — CITC offers to train someone in the requesting area to Green Belt or Black Belt level so they can lead the work themselves, or they share a list of consulting firms that could take it on. The mission discipline keeps CITC from being pulled in directions that would dilute their focus on the strategic plan.
When the strategic backlog is genuinely full, CITC tells the requester. They use their project management visibility to estimate when they can take the work on — three weeks, six weeks, whatever the realistic window is. The carrot of a near-term slot keeps the relationship intact even when the immediate answer is "not yet."
The training redirect is the part Cliona particularly likes. When the operational area has someone who wants to become Green Belt or Black Belt trained, CITC can develop that person while also coaching them through the project they brought in. The setup produces both a project result and a capability addition for the operational area. The win-win is real when the conditions align.
Sometimes the operational leader can't dedicate someone to belt training. In those cases, the conversation surfaces the underlying problem — the project requires someone's sustained attention and the area can't provide it. If that's true, the project isn't ready regardless of how CITC handles it. The prioritization discipline produces clarity about whether the work is actually ready to be done.
Cliona walked through the operational mechanics of Innovation Station — the internal name UMass uses for their idea system, powered by KaiNexus.
The naming itself came from caregivers. When CITC was selecting an electronic platform, an internal advisory group brainstormed name options, narrowed to five, and put the choice to a system-wide poll. Innovation Station won. The platform has expanded over time to cover the idea system, A3s, DMAIC projects, the level-one strategy deployment board, and several level-two boards. A user navigating Innovation Station can see the company's strategic priorities and tactics in one place and connect their own work to them.
The submission mechanics are simple. Every caregiver has single sign-on access. The platform sits on the intranet and on desktop icons. The minimum required fields when submitting an idea are the problem and the idea itself. Cliona was specific that the problem field matters as much as the idea field — submitters identify what they're trying to solve, not just what they want to do. Why the problem is happening and which team it belongs to are also captured but aren't required to submit.
Once submitted, the idea lands on the relevant team's board. The team has a board with cards for new ideas, ideas in progress, parking lot items, items needing help, items needing review, and so on. The team huddles around the board and decides what to work on next.
The idea volume Penny shared was substantial. As of the webinar, the system held 108,054 completed ideas across its history. The annual rate had peaked in pre-pandemic years and dropped during the pandemic and subsequent capacity pressure. CITC was actively working to rebuild momentum.
The metric the team has shifted focus to is participation. Of 17,000 caregivers, what percentage are connected to an idea — either as submitter or collaborator? The target at the time of the webinar was 75 percent. The current rate was around 60 percent. Participation matters more than raw idea count because participation captures the cultural shift CITC is actually trying to produce.
Cliona pulled a few examples from the honor roll system — the monthly review where a few ideas are selected for recognition.
A team installed bubble mirrors outside elevators where bumps with patients on stretchers had been a recurring problem. The mirrors made it possible to see around the corner before entering the elevator area.
The ECMO activation team — a critical care function where speed matters substantially — moved from pagers to secure chat for activations. The change produced more timely responses for what is a life-saving need.
A Community Healthlink team in behavioral health and substance abuse services created a "sponsor night" where clients needing a sponsor and community members willing to sponsor could meet over a potluck dinner. The pattern of work — bringing a structural problem to the level of the people closest to it — produced a different kind of intervention than top-down policy would have.
The range across the examples is wide. Some ideas are directly patient-impacting. Some are about communication between caregivers. Some are about the way work happens in non-patient-facing functions. Corporate services teams generate plenty of ideas about their own work — finance, HR, revenue cycle — that improve how those functions support the front lines. CITC encourages alignment to the true north and the team's metrics, but doesn't constrain the type of problem an idea can address.
One of the most consequential operational decisions Penny described was making participation in the management system a measured executive accountability.
Participation in the idea system is one of UMass's tier-one true north metrics — measured at the CEO level. Penny sends a scorecard weekly to senior leaders (the Core Team) showing how their entity is performing on white belt training completion and idea system participation. The goal for white belt training in the prior year was 90 percent of caregivers in each entity trained. The accountability sits with the entity leadership, not with CITC, because CITC can't make the caregivers participate. The entity leaders can.
The change Penny pushed for when she became Chief Transformation Officer was tying these metrics to executive performance reviews. The metrics of the management system became goals for executives and managers. The shift in accountability transformed how seriously the metrics were taken. The electronic platform made the data visible. The performance reviews made the data consequential.
The participation metric is gradually being supplemented with impact measurement. CITC is in what Penny called a tiptoe journey toward measuring impact more rigorously. The first step has been participation. The next steps involve attributing ideas to true north categories — patient experience, caregiver engagement, finance, safety — and then quantifying impact within those buckets. Penny was honest that the team is in the crawl-walk-run phase of this evolution. High-medium-low impact rating is a likely intermediate step. Specific financial measurement of cost savings is something CITC is considering but hasn't fully implemented as a primary metric. The team's current view is that idea counting is easy and impact measurement is hard, and that gaming becomes a risk when count is the only metric. The shift toward participation and impact reflects an intentional move away from countable activity toward meaningful outcomes.
Mark asked about the visible drop in annual idea volume starting in 2020 — roughly a 50 percent decline that persisted through the pandemic years.
Penny's response was that she had no problem with the chart. The drop coincided with CITC's intentional pivot from idea count to participation as the primary metric. The team didn't want the system to be gamed by individuals submitting many ideas of marginal value to hit a count target. They wanted real participation across the caregiver population, with ideas that actually mattered. A higher count of trivial ideas (the potluck idea, in Penny's example) is not better than a lower count of meaningful ones, and rewarding count can produce idea hoarding — people holding back ideas to make their own count look better, or treating ideas as personal property rather than team work.
The drop in raw volume during the pandemic was real and partially driven by the operational pressure caregivers were under. But the metric shift away from raw count was also real, and the participation focus is now where CITC measures progress. The team's confidence in the strategy comes from the clarity about what they're actually trying to produce.
Cliona walked through the belt training program because several questions came in about it.
White belt is part of new caregiver orientation. The session is about three hours. There's a virtual classroom version and a web-based training version. All new caregivers go through it.
Yellow belt is one day, delivered as a virtual classroom with live instruction.
Green belt is two and a half days of live in-person instruction. Candidates complete a real project with a CITC coach as part of the certification.
Black belt is four days of live classroom instruction, with two projects completed under coaching as part of the certification.
By the time someone reaches Black Belt, they've had multiple days of training and have completed at least two real projects. The projects are all tracked in Innovation Station with toll gates that candidates pass through electronically. The platform serves as both the work environment for the projects and the record of the candidate's training journey.
Certification is internal to UMass. The team encourages people who want to pursue external certifications like ASQ to do so, and they encourage further development beyond Black Belt for those interested. CITC has used multiple external institutions to develop their own Master Black Belts because they want the certification to be rich and not "the world according to Penny and Cliona," as Penny put it. The internal training is rigorous. The recognition that broader development matters is also rigorous.
Green and Black Belt candidates apply through rolling enrollments. CITC runs the classes five times per year, scaling up or down based on demand. Candidates need manager and sponsor approval and a project that fits their training window. The project requirement keeps the training oriented around real work rather than abstract learning.
Cliona described UMass's huddle practice as a mix of all three modes. The virtual huddles work well. The in-person huddles work well. The hybrid huddles are the hardest, which matches the general challenge of hybrid meetings of any kind.
CITC has been deploying TV screens and WebEx kits to teams that need them to make virtual or hybrid huddles work. The technology investment matters. Before the electronic platform, a team with members at different campuses had no real option for joining a huddle remotely. With the platform and the right hardware in the room, the huddle can include everyone who needs to be there regardless of where they're physically located.
The mechanics across shifts vary by team. CITC recommends weekly huddles as a default. Teams with shift-based work patterns may huddle every shift, with structural connections between shifts to keep continuity. Most teams in the system huddle either weekly or every other week. The team decides the rhythm.
One example Penny shared came from the urology clinic, where physicians are spread across multiple sites. The team installed monitors in the clinic and physicians call in via WebEx from wherever they're working. The setup makes the huddle possible across geographic distribution that would have prevented it entirely under a paper-board model.
Another integration Penny described was with the bed huddles nursing teams already run. CITC worked with IT to enable the same monitor used for bed huddles to switch between epic patient pass-down and Innovation Station. The teams huddle for idea system work in the same place they huddle for clinical handoff. The integration keeps idea system engagement from feeling like a second activity layered on top of clinical work. It bakes the practice into the existing rhythm.
Mark surfaced a question about whether UMass had a mechanism for spreading proven ideas from one team to others.
Cliona acknowledged the area as one where the system has opportunity to improve. The current mechanisms include the honor roll system, regular sharing of selected ideas through the company intranet and Communications Department newsletters, and the search function in Innovation Station itself. The team encourages users during training to use the search function to find ideas other teams have already implemented.
Penny added that the transparency of the platform helps. Caregivers can look at other teams' boards. Sharing happens organically when someone wonders what a particular unit is doing and goes to check. The annual "Innovators of the Year" event also surfaces the biggest ideas system-wide and recognizes the teams behind them, providing a once-yearly broad share.
Both Penny and Cliona were honest that systematic spreading is an area for continued improvement. The platform provides the infrastructure. The organizational practices around proactive replication are still developing.
A subtle question came in about what counts as participation in the idea system metric.
Cliona's answer: anyone whose name is attached to an idea counts as participating. Submitters count. Collaborators count. A3 leads count. The participation framing is intentionally broad because the goal is engaging caregivers in the practice of improvement, not just rewarding idea-submission behavior. Working on someone else's idea is participation. Leading an A3 is participation. The breadth of the definition is part of the cultural message.
The architecture Penny and Cliona described depends on infrastructure in ways that aren't always made explicit in CI conversations.
Innovation Station — KaiNexus, with UMass's branding — is the operational home for the idea system. The 108,000 completed ideas, the 700-plus team boards, the project portfolio of 80 to 85 active projects, the A3s and DMAIC projects, the belt training toll gates, the level-one and level-two strategy deployment boards, the participation metric tracked at the entity level — all of this lives in one platform. The integration is the point. The team's tiger-team approach to project work depends on the data person, the project manager, and the process engineer being able to see the same project state in real time. The cross-entity participation accountability that Penny built into executive performance reviews depends on entity leaders being able to see their own performance and their peers' performance at the system level. None of this is achievable on spreadsheets at the 17,000-caregiver scale.
The platform integration with bed huddles that Penny mentioned is a small example of a larger pattern. The team worked with IT to make the same monitor used for clinical bed huddles capable of switching between epic patient pass-down and Innovation Station. The integration kept the idea system from being a separate activity layered on top of clinical work. It became part of the workflow rather than a parallel workflow. The same integration logic applies elsewhere in the system — wherever caregivers are already gathering for operational reasons, the platform can be present so that improvement work happens in the same physical and temporal space as the operational work.
The visibility the platform provides is what makes the executive accountability work. Penny's weekly scorecard to the Core Team isn't generated manually. The platform makes the participation data, the white belt training data, and the project portfolio status visible in standard reports that surface meaningful patterns and drift. The accountability is operational because the data is operational.
The training and certification infrastructure rides on the same platform. Green and Black Belt projects live in Innovation Station with electronic toll gates marking progress. The platform is the work environment, the record of the work, and the artifact of the certification. The candidate doesn't have to manage projects in one system and document them in another. The same applies to A3s and DMAIC projects more broadly.
None of this changes what Penny and Cliona were teaching. The discipline of operational ownership for projects is the discipline. The training program is the program. The huddle practice is the practice. The mission-aligned prioritization is the prioritization. What infrastructure does is make the practices operational at the 17,000-employee scale where manual tracking and ad hoc visibility would have made them impossible. The team's success isn't because of the platform. It's because the platform allows the team's discipline to operate at the scale where the system needed it to work.
What is CITC and what does it do? CITC is the Center for Innovation and Transformational Change at UMass Memorial Health. It's the strategic execution arm for the CEO's strategic plan, reporting directly to Dr. Eric Dickson. The group has three integrated functions: process engineering (the Black Belt and Master Black Belt team that leads transformational improvement work), enterprise analytics and data warehouse integration (the IT-backed analytics platform team), and strategic transformation portfolio (the project and program management arm). The three groups work horizontally in tiger team fashion on strategic projects, with team members from each group pulled together for the duration of a project and then redistributed when it completes.
How does CITC decide whether to use an A3, a kaizen event, or DMAIC? By the outcome they're trying to produce and the nature of the problem. Lean-centric problems with flow, waste, and process redesign tend toward A3 or kaizen. Data-centric problems with quality variation that requires statistical analysis tend toward DMAIC. Kaizen events are appropriate when speed matters and the team can be assembled for concentrated focused effort — Penny called kaizen a fire starter culturally because of the energy and engagement it produces. A3 thinking is the organization's default improvement framework, taught to Green Belt and Black Belt candidates. DMAIC is reserved for data-intensive projects where the Six Sigma toolset is genuinely needed.
Who owns improvement projects at UMass? The operational lead. CITC team members are facilitators and methodology experts, not project owners. The operational sponsor supports the operational lead. CITC doesn't take on new requests unless that ownership structure is in place. When a project completes, the operational owner presents the results — not CITC. The reason is cultural: ownership by the operational team is what produces sustainment after the project ends. Without operational ownership, the gains drift.
How does CITC handle prioritization and saying no? Mission alignment is the filter. The team's mission is to strategically execute the CEO's plan, and requests that don't align to the plan don't get accepted as CITC projects. The rejection is usually a redirection — CITC offers belt training so the requesting area can lead the work themselves, or shares a list of consulting firms. When the strategic backlog is genuinely full, CITC tells the requester and uses their project portfolio visibility to estimate a near-term slot. The mission discipline keeps the team focused without becoming inaccessible.
What is Innovation Station? The internal name UMass uses for the KaiNexus platform that powers their idea system, project management, A3s, DMAIC projects, level-one strategy board, and level-two boards. The naming came from caregivers — an advisory group brainstormed options, narrowed to five, and put the choice to a system-wide poll. Innovation Station won. The platform is the single home for improvement work at UMass.
How many ideas are in Innovation Station? 108,054 completed ideas at the time of the webinar. The annual rate peaked in pre-pandemic years and dropped during the pandemic and subsequent capacity pressure. CITC was actively working to rebuild momentum. The primary metric has shifted from idea count to participation, measuring the percentage of the 17,000 caregivers connected to an idea as either submitter or collaborator. The target at the time of the webinar was 75 percent. The current rate was around 60 percent.
What kinds of ideas do caregivers submit? The range is wide. Direct patient impact: bubble mirrors outside elevators to prevent bumps with patients on stretchers, secure chat for ECMO activations replacing pagers for faster response, sponsor nights at the behavioral health entity bringing together clients needing sponsors with community members willing to sponsor. Indirect patient impact through corporate services: finance, HR, revenue cycle, and other functions improving how they support clinical operations. Safety, communication, equipment, workflow — the range of submitted problems reflects the range of work caregivers actually do. The honor roll system selects a few each month for recognition and broader sharing.
How is participation in the idea system measured, and what counts? Anyone whose name is attached to an idea counts as participating — submitters, collaborators, A3 leads. The breadth of the definition is intentional. The goal is engaging caregivers in the practice of improvement, not just rewarding submission behavior. Working on someone else's idea is participation. Leading an A3 is participation. The framing reflects the cultural message that improvement is a team practice, not an individual contribution metric.
How is the participation metric tied to executive accountability? Participation in the management system is one of UMass's tier-one true north metrics, measured at the CEO level. Penny sends a weekly scorecard to senior leaders showing how each entity is performing on white belt training completion and idea system participation. The accountability sits with entity leadership, not with CITC, because CITC can't make caregivers participate. The metrics are tied to executive performance reviews, which Penny pushed for when she became Chief Transformation Officer. The accountability is consequential because performance review is consequential.
Why did the annual idea volume drop during the pandemic? Partially because of operational pressure on caregivers — capacity issues, the pandemic, RSV, flu, ongoing capacity constraints. But also because CITC intentionally shifted the primary metric from idea count to participation. The team didn't want the system gamed by individuals submitting many trivial ideas to hit a count target. A higher count of trivial ideas isn't better than a lower count of meaningful ones. Rewarding count produces idea hoarding and gaming. The participation metric reflects what CITC actually wants to produce, and the team is confident in the strategy.
How does CITC measure impact beyond participation? The team is in the early stages of supplementing participation with impact measurement. Penny called it a "tiptoe journey." The current approach: ideas can be attributed to true north categories — patient experience, caregiver engagement, finance, safety — and the buckets become the basis for impact analysis. Future steps likely include high-medium-low impact ratings and gradual quantification of financial impact for the categories where that's meaningful. The team is in the crawl-walk-run phase of impact measurement and doesn't want to overstate where they are.
What does the belt training program look like? White belt is part of new caregiver orientation, three hours, with virtual classroom and web-based versions. Yellow belt is one day, virtual classroom with live instruction. Green belt is two and a half days of in-person live instruction with a real coached project. Black belt is four days of in-person live instruction with two coached projects. All Green and Black Belt projects are tracked in Innovation Station with electronic toll gates. Certification is internal to UMass. The team encourages further external certifications and broader development for those who want to pursue them.
How does UMass handle huddles across in-person, virtual, and hybrid teams? All three modes. Virtual huddles work well. In-person huddles work well. Hybrid huddles are the hardest, matching the general challenge of hybrid meetings of any kind. CITC has been deploying TV screens and WebEx kits to teams that need them to make virtual or hybrid huddles work. One specific integration: the same monitor used for clinical bed huddles can switch between epic patient pass-down and Innovation Station, so idea system work happens in the same physical and temporal space as the operational work. Most teams huddle weekly or every other week. Shift-based teams may huddle every shift with structural connections between shifts.
How does CITC spread good ideas across the system? Through the honor roll system, intranet and newsletter sharing, the search function in Innovation Station, the annual "Innovators of the Year" event, and the transparency of the platform itself (teams can see other teams' boards). Cliona was honest that systematic spreading is an area for continued improvement. The infrastructure provides the visibility. The proactive replication practices are still developing.
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