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University of Utah Healthcare Value Management System Bob Pendleton MD FACP Chief Medical Quality Officer. Goal: Exceptional Value. UUHC: Becoming the Provider of Choice. INPATIENT: Rate this Hospital 1-10 (% total patients choosing 9-10) UHC National %tile Rank. UHC National %tile Rank.

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Goal exceptional value

University of Utah HealthcareValue Management SystemBob Pendleton MD FACPChief Medical Quality Officer


Goal exceptional value

Goal: Exceptional Value


Uuhc becoming the provider of choice

UUHC: Becoming the Provider of Choice

INPATIENT: Rate this Hospital 1-10 (% total patients choosing 9-10)

UHC National %tile Rank

UHC National %tile Rank


Goal exceptional value

UUHC: Nationally Ranked Outcomes

1

*Ranking out

of >98 National Academic

Medical Centers

4

7

9

37

50

20082009 2010 2011 2012 2013

* UHC Quality & Accountability Annual Scorecard


Goal exceptional value

Use of Color

Payers of Healthcare & a sample of Value related Initiatives

Government

Insurers (e.g. Regence, etc.)

Employers

Public

Medicare

(CMS)

Medicaid

HEDIS

Direct Contract

Direct &

Rankings

ACO

IPPS

OPPS

CMMI

PQRI

OQR

MU

IQR

VBP

HAC

HRRP

MU

PQRS

MU


Goal exceptional value

Growth of National Value Metrics

700

Measures

& counting…

614 measures

464 measures

402 measures

277 measures


Value management system

Value Management System:

System Management

Resource Management

Measure, Analyze, Improve

Service Delivery

Service Delivery

Service Delivery

Inputs

Outputs


Goal exceptional value

Clinical Services

Safety Committee (QM.8)

HCEC

QMOC (QM7)

Hospital Board

Document Control Cmt

Value Core (QM.7)

Value Council (GB.1)

Management Review:

Audit results

Corrective actions

Measurement

Analysis

Governing Body:

Operational oversight of clinical delivery system

Value Creation Team

Medical Board

Support Services

Basic Structure of our VMS


Goal exceptional value

Clinical Services

Chief Value Officers

Rob Glasgow - Surgery

Peter Yarbrough - Medicine

Chris Pelt- Orthopedics

Susan Baggaley - Neurology

Meic Schmidt - Neurosurgery

John Bohnsack -Pediatrics

Jerry Hussong- Pathology

Howard Sharp – OB GYN

Bernadette Kiraly – Family Medicine

Mark Eliason - Dermatology

Jim Ashworth- Psychiatry

Dave Gaffney- Rad Oncology

Value Council (GB.1)

GME

Value Council


Goal exceptional value

  • System alignment

  • System goals

  • System mgt.


Measure analyze at the department level

Measure & Analyze at the Department level…


Goal exceptional value

Entitlement

  • Typical approach to system performance & improvement:

  • BUT- isn't every patient entitled to optimal performance?

Poor value

Average value

Optimal value

Standard value


Goal exceptional value

Value Management System: Focus on Improving Processes

  • Focus on Results  Problem Solving (Reaction)

  • Focus on Process  Problem Prevention

Fix Problem 1

Fix Problem 2

Fix Problem 3

Redesign Process to Prevent Problem 1

Redesign Process to Prevent Problem 2

Redesign Process to Prevent Problem 3

Build Standard Work & Forcing Functions

Build Standard Work & Forcing Functions

Build Standard Work & Forcing Functions

Monitor Results

Monitor Results

Monitor Results

Improve Process Further

Improve Process Further

Improve Process Further


Goal exceptional value

How?

Value Improvement Methodology:

(re-)Define

Problem & Goals

Analyze & Investigate

Design & Implement

Impact

1

Improve Value

2

5

1

Improve Value

2

5

4

3

1

Improve Value

2

5

4

3

1

Improve Value

4

2

5

3

4

3


Goal exceptional value

VALUE SUMMARY


You your residents voice input is critical

YOU (& your residents) voice & input is critical:

  • GMEC sponsored group to facilitate two-way input on UUHC value efforts

  • Coordination with the CVO in your Departments

  • Should CRIT (empowered CMRs) remain a vehicle?

  • System use of Value Summary

  • Core training from Value U

  • Safety event reporting & subsequent management


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