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LDI: November 2017

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DEFINING MOMENTS

DAN LUNDERGAN, CHIEF OPERATING OFFICER

• Lead with trust

• Assuming good

intentions

• Cultivate relationships

• Recognize team

• Are you a role model

• Do you aspire

• Create safety –

Psychological safety

What type of leader are you ?

As a leader, what are your defining moments?

• What is your “True North”?

• Are you cultivating relationships?

Remember the long game: Make the work

personal, acknowledge and listen to your team, be

respectful, be kind.

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TOP 10: ADVICE ON LEADERSHIP

ALISON FLYNN GAFFNEY, EXECUTIVE DIRECTOR

1. BE KIND; GIVE AND EARN RESPECT

2. DON’T FORGET TO LAUGH

3. HAVE A PLAN/BUILD YOUR BRAND

4. BE OK WITH MAKING MISTAKES

• Ask questions

5. HAVE A LIFE

6. SEE THE SOLUTIONS IN THE CHALLENGES

• Any ideas?

– Pushing rock up a hill

– Bring positivity with challenge

7. GIVE BACK

• Contribute to someone else’s leadership journey

8. EXPAND YOUR CIRCLES OF INFLUENCE

9. TAKE RISKS

10. SAY THANK YOU

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FOUNDATIONS OF VALUE:

THE ROLE OF LEARNERS AND MEDICAL EDUCATION IN

ACHIEVING A HIGH VALUE HEALTHCARE SYSTEM

BRIGITTE SMITH, MD

ASSISTANT PROFESSOR OF VASCULAR SURGERY

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HEALTHCARE

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WHAT IS “HIGH VALUE” HEALTHCARE?

• The best patient

health outcomes

• At the lowest cost

Scheurer D, Crabtree E, et al. The Value Equation: enhancing patient outcomes while constraining costs.” Am J

Med Sciences. 2016.

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QUALITY

1.Safe

2.Timely

3.Effective

4.Efficient

5.Equitable

6.Patient-centered

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MEDICAL EDUCATION

Basic Science Clinical Science

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CURRICULUM

• Formal– planned sequence of instruction with defined

outcomes

• Informal or “Hidden”– unwritten, unofficial, and often unintended lessons

and values learners pick up from their environment

– may support or contradict the formal curriculum

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MY FORMAL EDUCATION

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• Systematic Review

• 31 curricula identified across GME

• 6 surgery-specific (19.4%)

• Each missing key concepts required for a comprehensive QI

curriculum

– Content: missing value, patient experience

– Instruction: limited to didactics

– Scope: elective or single-resident curricula

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MY INFORMAL EDUCATION

“everyone is trying to kill our patients”

“let’s get them before they get us”

“I blame myself”

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MY EDUCATION = CURRENT STATE

• Minimal formal education in value

– Core concepts: what is value?

– Methodology: how to achieve value?

– Importance of TEAMS within the system

• Negative informal education

– Us against the System…rather than part of it

– MD as Captain of the Ship…rather than teammate

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THE FUTURE OF VALUE EDUCATION

We can do better for our learners!

I know this because Utah educated me.

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HEALTHCARE ISN’T THIS…

The

Patient

Physicia

n

Physician

assistant

Patient

navigatorNurse

Care

coordinator

Physical

therapist

Social workerDietitian

Adapted from AMA Education Consortium, Health Systems Science, 1st Ed.

Coding &

Billing

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…IT’S THIS!

The

Patient

Physician

Physician

assistant

Patient

navigator

Nurse

Care coordinator

Physical

therapist

Social worker

Dietitian

Adapted from AMA Education Consortium, Health Systems Science, 1st Ed.

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Create Flow

Improve Quality

Eliminate Waste

Lean

PDSA

6s

D M A I C

PLAN

DO

ACT

STUDY

Value Improvement Methodology

1. Project Definition

2. Baseline Analysis

3. Investigation

4. Improvement Design

5. Improvement Implementation

6. Impact & Monitoring

Problem Solving at the University of Utah

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MY RE-EDUCATION

• Value Methodology

– Empowerment from Skills

• People

– Importance of Teams

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UTAH STRENGTHS FOR TEACHING VALUE

1. Clinical success delivering value

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UTAH STRENGTHS FOR TEACHING VALUE

2. Shared purpose

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UTAH STRENGTHS FOR TEACHING VALUE

3. Strong and growing infrastructure

uofuhealth.utah.edu/accelerate

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UTAH STRENGTHS FOR TEACHING VALUE

4. People

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WHAT YOU CAN DO TODAY

• Provide positive, authentic experiences with

value improvement

• Create a positive informal curriculum

• Respect learners as valued members of the

healthcare team

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THANK YOU!

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WHEN PRACTICAL FEELS

IMPOSSIBLECARISSA CHRISTENSEN, RD

NUTRITION CARE SERVICES

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START END

identify the real problemadding to the team

find a sponsormake adjustmentsassemble the team

implement

keep going!

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THE NEW YOU PROGRAM

• 12 months, 22 visits, cover of

book

– Academy of Nutrition and Dietetics’

“Real Solutions Weight Loss

Workbook”

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LESSONS LEARNED

• Have a vision

• Good leaders are humble

• Patience, perseverance, and flexibility

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broccoli

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HOW TO CREATE A CULTURE OF

CIVILITYSUSAN CHILDRESS, RN

DIRECTOR OF NURSING, HUNTSMAN CANCER INSTITUTE

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MELISSA AND WHITNEY: COMPASSION

FATIGUE

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Compassion Fatigue is a normal response to

being a caregiver which can contribute to burnout.

Take care of yourself and your employees.

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2015 LEADERSHIP RETREAT: BURNOUT

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Burnout can happen to anyone – it is the result of

too much work and not enough support from your

team or manager.

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BEN: MEANINGFUL WORK

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Everyone in our organization is blessed with

meaningful work.

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2017 LEADERSHIP MEETING

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We needed to create a

culture of civility

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Clearly communicate expectations around

behavior standards

1

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Help employees understand the difference

between incivility and constructive criticism

2

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Encourage staff to speak up if they feel they are

being bullied

3

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Address uncivil behavior immediately

4

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Be kind and be selfless

5

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HOW TO CREATE A TEAM THAT IS MILES

APARTJESSICA RIVERA, MANAGER

COMMUNITY CLINICS ENVIRONMENTAL SERVICES

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Sometimes I’m like:

“Why aren’t I more successful?”

Then it takes me three tries to get my

arm into my coat sleeve and I’m like:

“Ah, right”

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BUILD TRUST – WALK THE WALK

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LEADERS TAKE CARE OF THEIR PEOPLE

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LEARNING IS IMPORTANT

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WHAT’S ESSENTIAL FOR OUR TEAMS:

BEING PRESENT

TRACY FARLEY, NURSE MANAGER

UNIVERSITY NEUROPSYCHIATRIC HOSPITAL

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CODE LAVENDER

INHALEEXHAL

E

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What’s essential as a leader?

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Acceptance Commitment

Therapy (ACT)

Increases psychological flexibility in the

present moment

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Tell me the color of their eyes.

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RECOGNIZING A WINNING TEAM

BOB PENDLETON, MD, CHIEF MEDICAL QUALITY

OFFICER

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TOP 10 QUALITY– EIGHT YEARS IN A ROW!

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74

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