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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


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    1. 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

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

    3. 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

    4. Agenda for the Day 9:15am Welcome, Introductions, Overview Margie 9:30-10:30 Assessing Your Specialty Practice Margie The 5 Ps 10:30-10:45 Break 10:45-12:00 Plastic surgery case study Carolyn 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 12:00-12:15 Wrap up/next steps/evaluations Margie

    5. Introductions & Why we are here ♦ How many nurses, support staff, physicians, improvement specialists, administrators, clerical staff?

    6. Overview of Materials • Handouts • Specialty Practice Workbook • Microsystem Wall Models • Envelopes on the table • Masking tape • Action step worksheet to take home

    7. Introduction to Microsystem thinking ♦ “Every system is perfectly designed to get the results it gets.” Outpatient Minor OR

    8. 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

    9. Current reality

    10. When we connect things that don’t match... The Economist

    11. 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

    12. 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

    13. The Inpatient Unit Workbook • Assess, Diagnose and Treat your clinical microsystem • Know YOUR 5 Ps • Purpose • Patients • Professionals • Processes • Patterns

    14. 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.

    15. Patients Purpose Processes Patterns Professionals

    16. ♦ 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

    17. 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

    18. REPORT OUTS • What did you learn? • What can you apply at home?

    19. Dartmouth-Hitchcock Medical CenterPlastic SurgeryCarolyn Kerrigan, MD

    20. 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

    21. Wrap up • What might you do? • Evaluation of session • Evaluation and feedback on workbooks • www.clinicalmicrosystem.org

    22. WWW.CLINICALMICROSYSTEM.ORG