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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 l.jpg

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


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AIM of today

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


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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


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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


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Introductions & Why we are here

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


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Overview of Materials

  • Handouts

  • Specialty Practice Workbook

  • Microsystem Wall Models

  • Envelopes on the table

  • Masking tape

  • Action step worksheet to take home


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Introduction to Microsystem thinking

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

Outpatient

Minor

OR


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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


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Current reality


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

The Economist


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  • 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


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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


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The Inpatient Unit Workbook

  • Assess, Diagnose and Treat your clinical microsystem

  • Know YOUR 5 Ps

    • Purpose

    • Patients

    • Professionals

    • Processes

    • Patterns


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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.


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Patients

Purpose

Processes

Patterns

Professionals


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♦ 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


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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


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REPORT OUTS

  • What did you learn?

  • What can you apply at home?


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Dartmouth-Hitchcock Medical CenterPlastic SurgeryCarolyn Kerrigan, MD


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  • 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


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Wrap up

  • What might you do?

  • Evaluation of session

  • Evaluation and feedback on workbooks

  • www.clinicalmicrosystem.org


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WWW.CLINICALMICROSYSTEM.ORG


  • Login