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Ajit Abraham MS, MA ( Medical Ethics & Law), FRCS, FRCS ( General Surgery)

QUALITY COLLABORATIVE. Ajit Abraham MS, MA ( Medical Ethics & Law), FRCS, FRCS ( General Surgery) Consultant HPB Surgeon, Barts Health Health Foundation Quality Improvement IHI Fellow 2011-12.

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Ajit Abraham MS, MA ( Medical Ethics & Law), FRCS, FRCS ( General Surgery)

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  1. QUALITY COLLABORATIVE Ajit Abraham MS, MA ( Medical Ethics & Law), FRCS, FRCS ( General Surgery) Consultant HPB Surgeon, Barts Health Health Foundation Quality Improvement IHI Fellow 2011-12

  2. “Everyone in healthcare really has two jobs when they come to work everyday: to do their work and to improve it.” Paul Batalden

  3. The High Reliability - High Performance Opportunity “The journey to becoming a world-class healthcare organization isn’t quick or easy, or for the impatient or faint of heart” John Black - The Toyota Way to Healthcare Excellence

  4. The Ethics of Value Concentric to Linear - Patient-Centeredness Necessary paradigm shifts! The Triple Aim Measurement for Improvement The Idea of Complexity

  5. Complexity demands a Learning Organization

  6. Build Capability Within

  7. EXECUTIVE Vision, Strategy 1.FOCUS 6. HIGH PERFORMANCE CULTURE SYSTEM OF CARE Integrated Care Bundles 2. PLATFORM SYSTEM OF MEASUREMENT Metrics for Improvement STAFF OD 3. KNOWLEDGE SYSTEM OF IMPROVEMENT Improvement, Innovation, Safety 4. ACTION PATIENTS AND FAMILIES Outcomes & Experience 5. RESULTS

  8. Change Change Organization Individual Culture Attitudes Change Behavior Structure & Methods Structure & Methods Transformation: Changing Culture

  9. Making the future attractive Changing the old Framework: Leadership for Improvement Setting Direction: Mission, Vision and Strategy PULL PUSH Ideas Execution Will Establish the Foundation

  10. Framework: Leadership for Improvement 1. Set Direction: Mission, Vision and Strategy PULL Make the future attractive Make the status quo uncomfortable PUSH • 3. Build Will • Plan for Improvement • Set Aims/Allocate Resources • Measure System Performance • Provide Encouragement • Make Financial Linkages • Learn Subject Matter • 4. Generate Ideas • Understand Organization as a System • Read and Scan Widely, Learning from other Industries & Disciplines • Benchmark to Find Ideas • Listen to Patients • Invest in Research & Development • Manage Knowledge • 5. Execute Change • Use Model for Improvement for • Design and Redesign • Review and Guide Key Initiatives • Spread Ideas • Communicate results • Sustain improved levels of • performance 2. Establish the Foundation • Reframe Operating Values • Build Improvement Capability • Build Relationships • Develop Future Leaders • Prepare Personally • Choose and Align the Senior Team

  11. “Systems awareness and systems design are important for health professionals, but are not enough. They are enabling mechanisms only. It is the ethical dimension of individuals that is essential to a system’s success. Ultimately, the secret of quality is love.” AvedisDonabedian

  12. Go See, Ask Why, Show Respect!

  13. Meta-Leadership ! Self Transforming Leads to Learn Multiframe Ambiguity Tolerant Problem-finding Interdependent Self Authoring Own Frame Agenda Driven Problem-solving Independent Robert Kegan, Lisa LaskowLahey – Immunity to Change

  14. “The courage to persevere comes through the service of others” Eric Greitens, US Navy Seal, Humanitarian & Author ‘The Heart & The Fist’

  15. Quality as a core goal Use information to guide improvement Develop organizational skills to support performance improvement Have learning strategies to test improvement and scale it up when it succeeds Ross Baker 2011

  16. “We must be the change we wish to see in the world” Mahatma Gandhi

  17. Plan for change Execution of planned change

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