Seven leadership leverage points for organization level improvement in health care
Download
1 / 30

Seven Leadership Leverage Points for Organization-Level Improvement in Health Care - PowerPoint PPT Presentation


  • 116 Views
  • Uploaded on

Seven Leadership Leverage Points for Organization-Level Improvement in Health Care. Presented by: Robert L. Colones, MBA President and Chief Executive Officer Florence, South Carolina. A Quality Leadership Challenge.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Seven Leadership Leverage Points for Organization-Level Improvement in Health Care' - phyllis-filia


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Seven leadership leverage points for organization level improvement in health care
Seven Leadership Leverage Points for Organization-Level Improvement in Health Care

Presented by:

Robert L. Colones, MBA

President and Chief Executive Officer

Florence, South Carolina


Seven leadership leverage points for organization level improvement in health care1

A Quality

Leadership

Challenge

We have become good at making improvement happen for one condition, on one unit, for a while.

We have not learned how to get measuredresults, quickly, and ‘sustainably’, across many conditions for the whole organization.

Seven Leadership Leverage Points for Organization-Level Improvement in Health Care


Seven leadership leverage points for organization level improvement in health care2

Give me a lever long enough, and I shall move the world.’

ARCHIMEDES

The leverage points are offered as a sort of hypothesis …

If leaders are to bring about system-level performance improvement, they must channel attention to and take action on these points.

Seven Leadership Leverage Points for Organization-Level Improvement in Health Care


Seven leadership leverage points for organization level improvement in health care3

1

Establish and Oversee System-Level Aims for Improvement at the Highest Board and Leadership Level

Seven Leadership Leverage Points for Organization-Level Improvement in Health Care




Seven leadership leverage points for organization level improvement in health care4

2

Develop an Executable Strategy to Achieve System Level Aims at Highest Level of Leadership

Seven Leadership Leverage Points for Organization-Level Improvement in Health Care


2 executable strategy four critical steps
2 – Executable Strategy: Four Critical Steps

  • A few, focused breakthrough quality and safety aims

  • Senior Team develops a ‘rational portfolio of projects’ with scale and pace to achieve breakthrough aims

  • Key projects are resourced with leaders and infrastructure

  • Senior Team monitors and responds


2 executable strategy
2 – Executable Strategy

Reliability

Theory

Quality as a

Core Value

Core

Success

Factors

Physician &

Executive

Engagement

Prioritization

Change

Theory

Improvement

Methodology


2 executable strategy quality is a core value
2 – Executable Strategy: Quality is a Core Value

Service

Science

Safety

Executive Team

Engagement

Physician

Leadership

“Just Culture”


2 executable strategy prioritization a few focused breakthrough quality and safety aims
2 – Executable Strategy: PrioritizationA few, focused breakthrough quality and safety aims


2 executable strategy ce prioritization a few focused breakthrough quality and safety aims
2 – Executable Strategy: CEPrioritizationA few, focused breakthrough quality and safety aims


2 executable strategy ce prioritization a few focused breakthrough quality and safety aims1
2 – Executable Strategy: CEPrioritizationA few, focused breakthrough quality and safety aims

The total potentially avoidable days are distributed across numerous DRGs,

but 45% of days are in the top twenty DRGs.

High Opportunity DRGs: Potentially Avoidable Days

422 2.12 DRG 106 CABG with Cath

732 0.61 DRG 116 PTCA with Stent/Pacemaker

174 1.96 DRG 107 CABG without Cath

112 2.63 DRG 144 Other Circulatory Dx

588 0.43 DRG 143 Chest Pain

82 2.98 DRG 075 Major Chest Procedures

296 0.75 DRG 209 Major Joint and Limb Procedures

132 1.63 DRG 475 Resp. System with Vent

206 0.97 DRG 174 GI Hemorrhage

114 1.69 DRG 122 Circulatory Disorder with AMI

78 2.34 DRG 493 Laparoscopic Cholecystectomy

232 0.75 DRG 121 Circulatory disorder AMI

42 4.03 DRG 385 Neonates

56 2.88 DRG 239 Path Fx and MS Malignancy

130 1.21 DRG 005 Extracanial Vascular Procedures

170 0.84 DRG 298 Nutritional and Metabolic-Peds

320 0.41 DRG 088 COPD

156 0.81 DRG 316 Renal Failures

96 1.23 DRG 026 Seizures and Headache-Peds

84 1.4 DRG 110 Major Cardiovascular Procedure

Example Data

Total Days Opportunity:

10,543 days


2 executable strategy ce prioritization a few focused breakthrough quality and safety aims2
2 – Executable Strategy: CEPrioritizationA few, focused breakthrough quality and safety aims

EXAMPLE


2 executable strategy oe prioritization a few focused breakthrough quality and safety aims
2 – Executable Strategy: OE PrioritizationA few, focused breakthrough quality and safety aims

Creating Efficiency of Work:

Operational Effectiveness

  • Deployment of “Lean” methodology

  • Eliminate waste or non-value added work

  • Make processes flow smoothly

  • Involve staff in redesign of work


2 executable strategy oe prioritization a few focused breakthrough quality and safety aims1
2 – Executable Strategy: OEPrioritizationA few, focused breakthrough quality and safety aims


2 executable strategy oe
2 – Executable Strategy: OE

RIE Results from Cardiac Value Stream –

Nursing Documentation Time Saved

fromto

Pre-population of fields 60.0 minutes 12.0

Electronic documentation 40.0 12.0

Peds Questions 10.0 0.5

ED TBA paperwork 40.0 0.0

Room orientation 20.0 0.0

Speech screens 10.0 3.0

Diabetic bundle/flow sheet 4.4 1.4

Plans of care 24.0 8.0

Plus other …

Total Time Savings: Admission History, 60 minutes per patient

admitted to 27 minutes; Plan of care, 24 minutes to 8 minutes


2 executable strategy four critical steps1
2 – Executable Strategy: Four Critical Steps

  • A few, focused breakthrough quality and safety aims

  • Senior Team develops a ‘rational portfolio of projects’ with scale and pace to achieve breakthrough aims

  • Key projects are resourced with leaders and infrastructure

  • Senior Team monitors and responds


2 executable strategy key projects resourced with leaders infrastructure

Clinical Effectiveness

-Teams are Physician-Led

-Work for 3 months at 2 week intervals

-4 to 5 Physicians

-Care Manager RN, MSN

-Educator

-Implementer

-Multi-disciplinary Team

-VP Champion

Operational Effectiveness

Team Leader

Work for 6 to 12 months in VSA, @ 1 RIE/month

OE Facilitator with certification in ‘lean’

9 members with 3 in the area of focus, 3 up/downstream, and 3 ‘fresh eyes’

VP Champion

2 – Executable Strategy:Key Projects Resourced with Leaders, Infrastructure


2 executable strategy key projects resourced with leaders infrastructure1
2 – Executable Strategy: Key Projects Resourced with Leaders, Infrastructure

1. Establishing a Sense of Urgency

2. Forming a Powerful Guiding Coalition

3. Creating a Vision

4. Communicating the Vision

5. Empowering Others to Act on the Vision

6. Planning and Creating Short-Term Wins

7. Consolidating Improvements and Producing Still More Change

8. Institutionalizing New Approaches

  • John Kotter, Leading Change


2 executable strategy monitor and respond

‘The currency of leadership is attention.’ Leaders, Infrastructure

J. Reinertsen, MD

Formal & Informal resources focus on the aims

Inside: calendars, meeting agendas, project reviews, performance feedback and compensation systems

External: Transparency

2 – Executable Strategy:Monitor and Respond


2 executable strategy monitor and respond1
2 – Executable Strategy: Leaders, InfrastructureMonitor and Respond


STOP Leaders, Infrastructure

START

Focus on “Ideal” & rate of improvement

Focus on benchmarks

Rely on people/Process Technology serves P&P

Relying on technology

Running the organization on “principles”

Thinking “tools” &

“best practices”

Leading from the front, constant reinforcement

Delegating leadership


STOP Leaders, Infrastructure

START

Few, visual, focused metrics that matter

Dozens of metrics

Internal focus (specialty, unit, role…)

Patient centered, Value Steam focus

Lead through Principles, Standard work.

Managing by Control

Improving what we know …greater complexity

Lead transformation …start with simple


STOP Leaders, Infrastructure

START

Experts collect data, Design/manage projects

Access knowledge & Creativity of workforce

Double digit gains in vital areas

Incremental improvement

Bottom up execution Agile and adaptive

Top down execution Rigid command & Control

The “fitness” mentality

The “fix” mentality


ad