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Specialty Practice Improvement and Redesign L3. Marjorie Godfrey Carolyn Kerrigan, MD 6 th Annual International Summit on Redesigning the Clinical Office Practice Washington, DC March 31, 2005 9:15am-12:15. www.clinicalmicrosystem.org. AIM of today.

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Specialty Practice Improvement and Redesign L3

Marjorie Godfrey

Carolyn Kerrigan, MD

6th Annual International Summit on Redesigning the Clinical Office Practice

Washington, DC

March 31, 2005

9:15am-12:15

www.clinicalmicrosystem.org


AIM of today

  • Review complexities of redesign and improving care, services and outcomes for patients requesting specialty services.


After this session you will be able to…

  • Describe method of observation to improve and standardize clinical practice in specialty practice

  • List steps to adapt shared medical appointments in specialty practice

  • Design strategies to improve access in specialty practice


Agenda for the Day

9:15amWelcome, Introductions, OverviewMargie

9:30-10:30Assessing Your Specialty PracticeMargie

The 5 Ps

10:30-10:45Break

10:45-12:00Plastic surgery case studyCarolyn

Connecting 5 Ps to improvement

-Shared Medical Appointments

-Improving OR flow and volume

-Standardizing Carpal Tunnel surgery

(Observation techniques)

-Access Improvement (Key Changes)

-Huddles, Weekly lead team meetings,

monthly all staff meetings, annual retreats

12:00-12:15Wrap up/next steps/evaluationsMargie


Introductions & Why we are here

♦ How many nurses, support staff, physicians, improvement specialists, administrators, clerical staff?


Overview of Materials

  • Handouts

  • Specialty Practice Workbook

  • Microsystem Wall Models

  • Envelopes on the table

  • Masking tape

  • Action step worksheet to take home


Introduction to Microsystem thinking

♦ “Every system is perfectly designed to get the results it gets.”

Outpatient

Minor

OR


Which system is the unit of practice, intervention, measurement?

Community, Market, Social Policy System

Self-care System

Macro-organization System

Microsystem

Individual care-giver & patient System


Current reality


When we connect things that don’t match...

The Economist


  • Staff

  • Staff focus

  • Education &

  • Training

  • Interdependence

  • of care team

  • Leadership

  • Leadership

  • Organizational

    • support

Information

&

Information

Technology

  • Performance

    • Performance

    • results

    • Process

    • improvement

  • Patients

  • Patient Focus

  • Community &

  • Market Focus

High performing clinical microsystems


What is a “Clinical Microsystem?”

♦ Small group of doctors, nurses, other clinicians

♦ Some administrative support

♦ Some information, information technology

♦ A small population of patients

♦ Interdependent for a common aim, purpose


The Inpatient Unit Workbook

  • Assess, Diagnose and Treat your clinical microsystem

  • Know YOUR 5 Ps

    • Purpose

    • Patients

    • Professionals

    • Processes

    • Patterns


Assessing your microsystem

Use the Assess, Diagnose & Treat Your Specialty Practice Workbook to diagnose the strengths of your microsystem and to start identifying improvement opportunities.


Patients

Purpose

Processes

Patterns

Professionals


♦ PATIENTS …

Assess

Diagnose

Treat

Involving the patient & family in the process

♦ MICROSYSTEMS…

Assess

Diagnose

Treat

Involving the microsystem players in the process

Caring for Patients & Growing Microsystems


EXERCISE “Discovery of 5 Ps”

Aim: Practice “Assessing Your Specialty Practice.”

  • Chose roles

  • Set up your agenda

  • Review instruction sheet

  • Prepare a 5 minute report out


REPORT OUTS

  • What did you learn?

  • What can you apply at home?


Dartmouth-Hitchcock Medical CenterPlastic SurgeryCarolyn Kerrigan, MD


  • Carolyn,

  • You have 75” to cover:

    Connecting 5 Ps to improvement

    -Shared Medical Appointments

    -Improving OR flow and volume

    -Standardizing Carpal Tunnel surgery

    (Observation techniques)

    -Access Improvement (Key Changes)

    -Huddles, Weekly lead team meetings,

    monthly all staff meetings, annual retreats


Wrap up

  • What might you do?

  • Evaluation of session

  • Evaluation and feedback on workbooks

  • www.clinicalmicrosystem.org


WWW.CLINICALMICROSYSTEM.ORG


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