Accelerating the Pace and S cale of I mprovement

1. April9, 2014 Amy Compton-Phillips Kaiser Permanente Goran Henriks Qulturum Pedro Delgado IHI Acceleratingthe Pace and Scale of Improvement Session M11 2014 IHI/BMJ International Forum, Paris

2. Aims • Understand the concept of Quality and Innovation Centres and think critically about how it might take shape in different contexts • Develop ideas about supporting quality improvement and innovation in your own region or system • Understand how to begin to develop a quality and innovation centre to serve your region or area

3. Our time together 1.30 - 1:45 Intro & Structure 1.45 - 2.30 Qulturum 2.30 - 2.45 Reflections 3.00 - 3.15Break 3.20 - 4.20 KP 4.20 - 4.30 Closing

4. A global trend

8. IHI’s Triple Aim Populationhealth Per Capita Cost Experience of Care

9. Whatis a Quality and Innovation Center? A leading resource and driving force for system-wide, transformative health and healthcare improvement in a system or region (intentionality; commitment; infrastructure)

10. Role of a QIC • Leadership and resources in a system or region for focused and sustained attention to improving quality • Discover, test, and spread innovations and best practices • Build QI capacity and scientific thinking • Spark & support (system/regional/national) initiatives & demonstrate impact • Build relationships, establish links, and connect people (physically and virtually) to learn, improve and innovate • Offer technical and content expertise • Identify and coordinate disparate improvement activities • Influence policy and practice in their context

11. Quality and Innovation Center Driver Diagram Primary Drivers Secondary Drivers Aim • Ability to identify and measure gaps • Editorial and publishing skills and/or resources • Ability to convene a wide array of stakeholders Generating will for improvement in a region To support a system or region to achieve transformative health and healthcare improvement • Methods for harvesting innovations • Methods for developing innovations Innovating in quality improvement • Methods to build improvement capacity / capability • Process to test new ideas • Capabilities in spread and scale-up • Capabilities in data management and measurement • Process for evaluating improvement ideas Executing quality improvement ideas Fostering a robust organizational infrastructure • Staffing and operations plans to facilitate QI work • IT to support QI work • Structures and strategies for internal and external communications • The mission, vision, values and strategic plan all guide the work of the organization

12. Where are you as a QIC? A developmenttool WILL IDEAS EXECUTION

13. 10 Lessons (1-5) • Constancy of purpose • Ambitious aims and pace of change • Transparency and pursuit of reliability • Measurement for improvement • Skills, time and space for improving

14. What Improvement Skills are Needed for Each Role? Change Agents (Middle Managers, Stewards, project leads) Everyone (Staff, Supervisors, UBT lead triad) Operational Leaders (Executives) Experts • Analysis, prioritization of portfolios • Deep statistical process control • Deep improvement methods • Leadership team advisory re portfolio selection, process • Effective plans for implementation and spread • Setting direction and big goals • Execution leadership • Portfolio selection and management • Managing oversight of improvement • Being a champion and sponsor • Understanding variation to lead • Managing implementation and spread • Setting goals and measures • Identifying problems • Mapping process • Sequencing tests of change • Simple understanding variation • Implementation and spread • Simple waste reduction • Simple standardization • Setting goals and measures • Identifying problems • Mapping process • Testing change • Simple waste reduction • Simple standardization • Team behaviors

15. 10 Lessons (6-10) • Co-design and co-production(patients) • Exploration beyond healthcare for ideas • Behave their way to a culture change • Measure financial impact of initiatives • Celebratesuccess—and rewardit

16. “Based on our performance, we can confidently and conservatively expect to harvest at least a 5:1 return on investment for value creation work”

17. A mobile, transparent world 2m per min; x3 in 3 years Every 9.6 min

18. Ref: ILN’s Care Anywhere

19. O + A = R L = T + P

20. “There are painters who transform the sun into a yellow spot, but there are others who with the help of their art and their intelligence, transform a yellow spot into sun”