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The Deployment System: An Organizational Structure to Support Sustainable Change

The Deployment System: An Organizational Structure to Support Sustainable Change. John L. Haughom, MD July 2014. Implementing an Effective System of Production in Healthcare. Analytic system. Scalable and sustainable outcomes. Deployment system. Content system.

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The Deployment System: An Organizational Structure to Support Sustainable Change

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  1. The Deployment System:An Organizational Structure to Support Sustainable Change John L. Haughom, MD July 2014

  2. Implementing an Effective System of Production in Healthcare Analyticsystem Scalable and sustainable outcomes Deploymentsystem Contentsystem

  3. Deployment system components Analyticsystem Organize teams for scalable improvement ApplyAgile CombineLean and analytics Contentsystem

  4. A Demonstration… Foundational Applications Discovery Applications Advanced Applications` EDIT—Executive Dashboard Integration Tool (Key Performance Indicator editable collage from all app categories) CAFE—Comparative Analytics Framework and Exchange—across Healthcare Systems and National Benchmarks Key Process Analysis (KPA) Population Suitese.g., Ischemic Heart Disease Population Explorer Cohort Builder Patient Satisfaction Explorer Population Modules e.g., CABG, Stent, AMI Comorbidity Analyzer General Ledger Explorer Regulatory Explorer Readmission Explorer Workflow / Operational Suites e.g., Acute Medical Attribution Modeler Practice Management Explorer Suite Workflow/Operational Modules e.g., ICU, MedSurg, Emergency ACO Explorer Suite Patient Flow Explorer Readmission Predictor Financial Management Explorer Patient Injury Prevention Suites e.g., Infection Prevention Payment Model Analyzer Labor Management Explorer Metric Correlation Analyzer Patient Injury Prevention Modules e.g., CAUTI, CLABSI, SSI Patient Flight Plan Predictor Rev Cycle Explorer

  5. Improvement Methodology • A goal is a desired result the workgroup envisions, plans and commits to achieve an organizational desired end-point by a specified deadline. • AIM statements are written, measurable, and time-sensitive objectives that move the team toward achieving the goal .

  6. CV Heart Failure • Goal: Decrease 30 day readmission rates of heart failure patients AIM #1 Establish a baseline of all cause 30 day readmission rates for HF patients, create and validate 30 day and 90 day readmission rates for all HF patients. AIM #2 AIM #3

  7. CV Heart Failure • Goal: Decrease 30 day readmission rates of heart failure patients AIM #1 Identify high risk heart failure patients and extend the identification of these patients to a Risk Stratification Model to predict the likelihood of all cause 30-day readmission rates. AIM #2 AIM #3

  8. CV Heart Failure • Goal: Decrease 30 day readmission rates of heart failure patients AIM #1 Schedule a follow-up appointment for all HF patients within 24 hours of discharge with a focus on high risk patients being seen within 48-72 hours after discharge. AIM #2 AIM #3

  9. CV Heart Failure • Goal: Decrease 30 day readmission rates of heart failure patients AIM #1 Establish a medication reconciliation baseline and track compliance in order to achieve 75% compliance by X date. AIM #2 AIM #3 AIM #4

  10. CV Heart Failure • Goal: Decrease 30 day readmission rates of heart failure patients AIM #2 A follow-up phone call from a nurse post-discharge to assess whether the patient has obtained his/her medication and has no barriers to making their follow-up appointment. AIM #3 AIM #4 AIM #5

  11. Two Important Questions… • Why is a deployment system necessary? • What is the most important ingredient to make a deployment system successful?

  12. Why is a deployment system necessary? • To spread best practice… • …to sustain improvements.. • …and to support continuous learning and continuous improvement.

  13. For different results, something has to change… • “Insanity is doing the same thing over and over and expecting different results.” • Albert Einstein • "Every system is perfectly designed to get the results it gets." • Paul Batalden, MD

  14. Outcome of a Traditional Deployment System Baseline performance Improvement with focused project Inability to sustain gains over time

  15. Deployment System Team Structure Team interactions Guidance team Direction, prioritization of resources & remove barriers Clinical implementation team Fundamental knowledge of process Broad representation of stakeholders across the continuum of care • Work group • drafts: • Workflows • Measurements • Knowledge assets Content SME* Technical SME Analytic SME Nurse lead Physician lead *SME = Subject matter expert

  16. Two Important Questions… • Why is a deployment system necessary? • What is the most important ingredient to make a deployment system successful?

  17. Healthcare: The Way It Should Be Why? A handbook… …for transformation. engagement. Available for FREE download at: http://www.healthcatalyst.com/ebooks/healthcare-transformation-healthcare-a-better-way/

  18. Levels of Engagement Relatively • Engaged Disengaged ∧ Hungry for best practice Committed to continuous learning Less hungry “Do it my way” Traditional Craft of Medicine Traditional Craft of Medicine Accepting the need for change; more team oriented, data-driven profession style of practice Need to be convinced a new way is necessary; want to be shown it is necessary and that it works

  19. Engaging the “Smart Cogs”Focus on the opinion leaders Rogers’ diffusion of innovation model Tipping point at 15-20% adoption Innovations do not spread equally over different society segments (social groups),but through 5 stages with a particular profile of reaction. 2º • Many studies have looked at how these groups differ: • Innovators are highly cosmopolitan and open to new things. • Early adopters tend to be opinion leaders. • Early majority provide “legitimization” of the innovation. • Late majority are skeptical. • Laggards put trust in the status quo.

  20. Linking the three systemsClinical Integration hierarchy GUIDANCE TEAM CLINICALIMPLEMENTATIONTEAM WORKGROUP

  21. Two additional points… • We are never too old or too young We achieve the most when we get together and figure out best practice.

  22. Poll Questions • Does your organization have the necessary organizational structure that not only supports the spread of innovation and improvement, but also allows improvements to be sustained over time? • 79 Respondents • 5 – Definitely – 15% • 4 – 17% • 3 – 31% • 2 – 27% • 1 – Not at all – 11%

  23. Thank You Upcoming Educational Opportunities • Six Reasons Why Healthcare Data Warehouses Fail • Date: August 13, 1-2pm, EST • Presenter: Steve Barlow, Co-founder and former CEO, Health Catalyst • http://www.healthcatalyst.com/knowledge-center/webinars-presentations • Healthcare Analytics Summit • Join top healthcare professionals for a high-powered analytics summit using analytics to drive an engaging experience with renowned leaders who are on the cutting edge of healthcare using data-driven methods to improve care and reduce costs. • Date: September 24th-25th • Location: Salt Lake City, Utah • Save the Date: http://www.healthcatalyst.com/news/healthcare-analytics-summit-2014 For Information Contact: Dr. John Haughom: john.haughom@healthcatalyst.com

  24. Transforming Healthcare Through Analytics

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