mobilizing rising leaders to reach the triple...

12/9/2014

1

Mobilizing Rising Leaders to Reach the Triple AimKate Hilton, Jessica Perlo, and IHI Open School I-CAN Scholars

Workshop A26/B26

The presenters have

nothing to disclose

Tuesday, December 9, 20149:30-10:45 am 11:15-12:30 pm

Agenda

Welcome & Introduction

Introduction to the IHI Open School and I-CAN

What is Organizing?

– Example from University of South Carolina

Introduction to Public Narrative

– Application / Practice

– Example from Portland State University/Oregon Health

and Sciences University

– Audience Example

Debrief & Next Steps

2

12/9/2014

2

Session Objectives

Understand the resources and opportunities

available through the IHI Open School & I-CAN

Describe what population health projects look

like and how they can help advance the Triple

Aim strategy

Gain narrative skills to motivate others

(including students!) to join you in action

P3

Pair and Share

1. Why did you come to the Forum this year?

2. What do you hope to get out of this session in

particular?

4

12/9/2014

3

“Advance health care improvement and patient safety competencies in the next generation of

health professionals worldwide.”

IHI Open School Mission

Content

ExperientialCommunity

Open School Strategy

12/9/2014

4

31 online courses

More than 1.5 Million courses completed

More than 200,000 learners have completed a

course

More than 45,000 learners have earned the

Basic Certificate

More than 1,000 universities and

organizations use the courses for training

700 Chapters in 70 countries

IHI Open School Growth

The IHI Open School Improvement Change Agent Network (I-CAN)

is a student-driven campaign to improve population health through project-based

leadership training

8

12/9/2014

5

RWJF: Health Care’s BLIND SIDEThe Overlooked Connection Between

Social Needs and Good Health

85% physicians surveyed say unmet social needs are directly leading to worse health.

85% physicians surveyed say patients’ needs are as important to address as their medical conditions. – Especially true (more than 9 in 10, or 95%) for patients in low-income,

urban communities.

76% would like the health care system to cover the costs associated with connecting patients to services that meet their social needs.

80% are not confident in their capacity to address their patients' social needs.

10

Robert Wood Johnson Foundation summary reviews key findings from an online survey of 1,000 American

physicians in the American Medical Masterfile who agreed to be invited to participate in the survey. The participation

rate was 5 percent (1,000 physicians completed the survey out of 20,000 invited to participate); 690 were primary

care physicians and 310 were pediatricians.

12/9/2014

6

What we’re testing

Change

Improvement Science

Organizing & Leadership

Training

Subject Matter

Knowledge

Agenda

Welcome& Introduction

Introduction to I-CAN

What is Organizing?– Example from University of South Carolina

Introduction to Public Narrative– Application / Practice

– Example from Portland State University/Oregon Health and Sciences University



12

12/9/2014

7

People:

Recruiting and

developing

leadership

Power:

Building a

community around

that leadership to

create power

Change:

Using this power to

address the challenge

the constituency is

called to face

Community Organizing

… people acting together

to change the status quo

Theory of Change

‘Leadership is accepting responsibility for

enabling others to achieve shared

purpose in the face of uncertainty.’

• A practice, not a position

• Authority is earned, not

bestowed

• Focus is on developing

others, not just yourself

What is leadership?

• Grounded in

values, interests

& assets

• Built through

relationships

12/9/2014

8

Interdependent Leadership

“Snowflake Structure”

What leads to effective action?

ORGANIZATION

Capacity

Created

INDIVIDUAL

Leadership

Developed

AIM

Problem

Solved

12/9/2014

9

Course Information

Eight-week semi-synchronous module 30-45 minutes of asynchronous video lectures

60-minute coaching call

1-3 hours applying leadership/organizing skills and tools

Participants learn community organizing and

leadership practices and apply them in field-

based projects aimed to improve the health of

their communities

Next course offering is February 2015

Shape Culture

Engage Across Boundaries

Create Vision

and Build Will

Deliver

Results

Develop

Capability

Driven by

Persons and

Community

12/9/2014

10

The Tummy Time Project

• Our aim is to educate expectant and new mothers on tummy time with a goal of 2000 signed pledges by July 2015.

• We have developed a brochure, practiced educating parents through supervised role play, and identified ways to educate future volunteers.

• Our team is going to an OB/GYN clinic in December 2014 to educate expectant mothers on how and why to perform tummy time.

• The 16 person leadership team is going to become IRB certified before January 1, 2015.

• We will apply for IRB approval in January 2015 for two research projects.

1. Measure compliance of parents three months after their education on tummy time.

2. Educate randomly selected second year medical students on tummy time prior to clinical rotations. Survey students one year later to determine if this additional training impacted their ability to teach families about tummy time.

Research planning

12/9/2014

11

Melissa

KelseySarah

Pooja

Charlie

Tiffany

Elizabeth

Jim

Erin Michael

Tiffany

Christina

Will

Alex

Simon

Simon

John

AlexCharlie

Nadya

Christina Will

12/9/2014

12

• The project proposal was shared in July 2014 with the USC IHI Open School steering committee membership.

• Dr. Rick Foster, Vice President for the South Carolina Hospital Association expressed an immediate interest.

• The IHI I-CAN curriculum has helped develop our leadership, identify our shared values, and promote vested interests among our leadership team.

• Project support recently gained from Dr. Caughman Taylor, Interim Dean of the USC School of Medicine and past Director of the Palmetto Health Children’s Hospital.

Project development steps

Agenda








24

12/9/2014

13

Public Narrative

A leadership practice through which we

motivate others to join us in action

Two Ways of Knowing26

12/9/2014

14

Values & Emotion

Values inspire

action through

emotion

Emotions inform us

of what we value

Decisions to act

are based on

judgments of value

27

Leaders Motivate Action28

12/9/2014

15

What makes a story?

Challenge – Choice – Outcome

29

Elements of Public Narrative30

WHY ME? WHY NOW?

WHY US?

CALL TO

ACTION

WHY US?

12/9/2014

16

Story of Us31

What is the urgent challenge?

– What is the intolerable condition that you want to

end or to avoid?

– Why is the action urgent now? What is at stake?

What is the motivating vision?

– What will happen if you don’t act?

– What could happen if you do?

What is a plausible path the offers hope?

– What would achieving success look like?

Story of Now

12/9/2014

17

Story of Now: Developing an Ask

The Story of Now

involves a specific

action you want your

people to join you in

taking: “THE ASK”

Tips: Crafting an Effective Narrative

Specific names

Specific images

Specific sounds

Specific smells

Specific

moments

34

12/9/2014

18

- Jayanti Ravi, public narrative student

It’s not about agloss from without,

but about a glow from within.

35

Learning the Practice of Narrative

12/9/2014

19

Coaching Narrative

When did you feel something in the story?

– “I felt something when…”

Did you hear a challenge? A choice? An outcome?

– When explicitly? How could each made clearer?

What values did the choice points demonstrate?

What images brought the story to life?

– How to “show” rather than “tell”?

How effective was the ask?

37

In Teams of Three

Silent reflection 0:00-0:05– What calls you to leadership? Why do you care about engaging

students in population health? What is a first step that you could pursue with a student(s)?

Person 1 0:05-0:10– 3 min narrative

– 2 min coaching


– 2 min coaching


– 2 min coaching

38

12/9/2014

20

Story of ChangeDecember 9, 2014

I-CAN Leadership Team

URGENT CHALLENGE

12/9/2014

21

HOPEFUL VISION

❏ Open, honest, and respectful patient-provider communication

❏ Health literacy

❏ Provider responsiveness

In order to improve patient-provider communication about unnecessary tests, treatments, and procedures, the PSU & OHSU IHI Open School Chapter is organizing with learners and providers to build capacity (4-7 leaders and clear snowflake structure) and to pilot a Choosing Wisely awareness campaign at PSU Student Health and Counseling Center (distribution of 5 Question cards and exposure to 5 Questions poster to 1000 students at point of care) by December 15, 2014.

Organizing Statement

12/9/2014

22

Pro

ject

Beg

inn

ings

12/9/2014

23

PSU & OHSU IHI OPEN

SCHOOL

I-CAN LEADERSHIP

TEAM

CHALLENGE: Change in

project scope;

mobilizing vs. organizing?

CHOICE: Hit pause on project to

build infrastructure

Moral: building capacity as leaders

OUTCOME: Organizing

Adapted from I-CAN Lesson 3, Lecture 3 - Kate Hilton JD, MTS

12/9/2014

24

Project Re-Launch

Reflection

● Personal Calling

● Leadership Transformation

● Organizing within my workplace

12/9/2014

25

Will you commit to:

● Be passionate

● Be authentic

● Recruit others to work with you to make meaningful change

To develop a motivating visionTo ground a group in a shared purpose – eliciting shared values around an urgent challenge and hopeful vision for a different future

To calls others to join you in action– In a one-to-one meeting

– Tell yours and elicit another person’s story of self

– Develop your story of us in the encounter

– End by using a story of now to ask for a commitment

– In a team setting

– As an exercise in a round to ground team in shared values

– At the end of a meeting to motivate others to take action

– In front of a large group

– As a call to collective action

– As part of every action

– As a way to sustain momentum and motivate volunteers to take action

When to use public narrative?50

12/9/2014

26

Agenda








51

I-CAN Scholar Experiences

52

12/9/2014

27

What is 100 Million Healthier Lives?53

An audacious goal for improving health: “100 Million People Living Healthier Lives by 2020”

A catalytic social movement whose purpose is to create a shift in culture, heart and mindset.

A unifying coalition that helps to bring together those who are working to improve health across sectors to accelerate change.

An improvement campaign designed to achieve a measurable goal of improving health and spark large-scale innovation about how to get there.

How will we do this?

• A Guiding Coalition: Align the people,

organizations, health systems, employers,

communities, and other key enablers who can

achieve an audacious goal for health.

• Guiding Principles: These principles will shape

how we work together as a group and with the

people and communities we hope to serve.

• Core Strategies: We have six core strategies as

part as our approach.

54

http://www.ihi.org/Engage/Initiatives/100MillionHealthierLives/Pages/GuidingCoalition.aspx

http://www.ihi.org/Engage/Initiatives/100MillionHealthierLives/Pages/GuidingPrinciples.aspx

http://www.ihi.org/Engage/Initiatives/100MillionHealthierLives/Pages/Approach.aspx

12/9/2014

28

Core Strategies

Creating a health care system that’s good at health and good at care

Building bridges between health care, community, and public health

Creating healthy communities

Promoting peer-to-peer supports to improve health

Creating enabling conditions, such as sustainable business models

Developing new mindsets — about partnership, co-design with the people we are hoping to serve, collaboration, and servant leadership

55

You’re invited to:

Share your story and elicit the stories of others

Pledge to support this community of improvers:

– www.ihi.org/ICAN

Mentor existing projects

– Projects will be listed on the website

Lead I-CAN projects at your institution by recruiting

students and enrolling in our second PDSA cycle

– Feb 2016

Join and learn with us in creating 100M Healthier

Lives

56

http://www.ihi.org/ICAN

12/9/2014

29

Thank you!

57

Nikos Karakashian, Medical Student

Shannen Whiddon, Nursing Student

University of South Florida

Organizing Project: We are organizing with

community members at the University of South

Florida to collaboratively design and distribute

materials promoting prevention and early

intervention in mental health by May 2015.

Progress: Strong student interest

demonstrated by two organizations (To Write

Love On Her Arms and Come Out of The

Dark). Currently assigning students to

leadership roles in the project.

Projected Outcomes: Cards designed and

printed by May 2015, and a committed

leadership network comprised of current

participants to continue the sustain the

distribution and outcome assessment next

year.

12/9/2014

30

Jennifer Berryman

Greater Binghamton Health

Center/Binghamton University

Organizing Project: We are organizing a

Greater Binghamton Health Center –

Binghamton University Suicide Prevention

Partnership. This will be an IHI Open School

and will have at least 50 members by March

1, 2015.

Outcomes: The partnership will include at

least 50 members, have at least 5

committees working on projects, and have

representatives from staff and students at

the university and staff and consumers at

the psychiatric center.

Jennifer Bailey, Sara Goldsby, Joseph Galloway, Purva Choudhari, PoojaChoudhari

Organizing Project: We are organizing health professional students, health-related student organizations, and professionals to encourage volunteer participation at Healthy Columbia health screenings by using public narrative and relationship-building tactics in order to increase engagement by December 2014.

Outcomes: Volunteer assessment developed, implemented, and data analyzed to

determine support for volunteers; University Interprofessional Education Committee

Faculty have agreed to encourage students to volunteer and to consider ways to

integrate volunteer opportunities in courses; reached out to different health

professional organizations, and students with previous experience with Healthy

Columbia (to provide a more personal introduction to Healthy Columbia)

12/9/2014

31

Erin Maggie Jones, PharmD Candidate 2015

University of New England Chapter – Portland, ME(Interprofessional Student Advisory Team)

Organizing Sentence: We are organizing interprofessional

students interested in oncology to increase the quality of life of

patients with cancer by 1) quality of life topic discussions

(internal student education); 2) creating a facilitator packet of

interprofessional discussion surrounding actual cancer patient

stories (external education); and 3) hosting a Delete Blood

Cancer bone marrow registry drive (external action) to directly

impact the quality of life of patients with cancer by the end of

the Fall 2014 academic semester.

Outcome: 15 students from pharmacy, nursing, and physical

therapy participated and volunteered through the UNE

Oncology Club, with 31 students registering as bone marrow

donors during our drive, held November 5, 2014. A second

drive is planned for January 2015 on our sister-campus.

Eric Schultz

Tulane University, School of Medicine

Organizing Project: We are organizing medical and other health

professions students to reduce uninsurance in patients visiting student-

run clinics by surveying patient insurance status, and providing

uninsured patients with referrals to enrollment assistance in order to

improve their access to health care, by the end of the open enrollment

period (February 2015).

Outcomes: We have created an interdisciplinary team to implement

this project.

12/9/2014

32

The Brock University Chapter of the IHI Open SchoolErica Bridge, Michelle Zahradnik, and Cameron Leveile

Organizing Project:

The Brock University Chapter ofthe Institute for HealthcareImprovement (IHI) Open School isorganizing students, faculty andstaff, and healthcare professionalsto increase awareness andidentification of non-medicalstimulant prescription drug misuseamong students by developingeducational material to provide abetter understanding of non-medical stimulant prescription drugmisuse among the studentpopulation in order to prevent useby April 2015.

Project Outcomes: a) development of a team, b) identification ofthe topic, and root cause, c) creation of an organizing sentence, d)the creation of a network, e) preliminary literature review anddata collection.

Cody Mullen

Organizing Sentence: I am organizing both patients and

clinicians of rural hospitals in Indiana to reduce inpatient

admissions and emergency department utilizations by 30%

within 6 months of the patient (diabetic and/or congestive heart

failure patients) being involved in this program by providing

health coaching services because individuals with chronic

conditions should be able to better manage their health outside

of a healthcare facility and at home, this project will work over

the next two and half years.

Outcomes: The outcome of this project was the development of

a team to work on this project, this was an interprofessional team

across the state. In addition, a plan was developed for

implementation to make the goals of this project a reality.

12/9/2014

33

CUIDATE

Juan Limo

Cayetano Heredia University Chapter

Organizing Project: We are organizing 70 health

professionals to improve the health of patients

with Diabetes by November 2015.

Outcome: 90 % patients with diabetes under

control involved in his own care and healthier.

“Educational Intervention to Improve Low Health Literacy at Primary Care.”

IHI OS “ Universidad Peruana Cayetano Heredia”

Coordinator: Diana Rodriguez Hurtado M.D.

The objective is to

improve low health literacy

.

To raise knowledge about

their diseases , healthy

styles of life and

adherence to the

treatment.

To diminish

hospitalizations

unnecessary.

To diminish costs.

Because we want to improve Low Health Literacy, to raise knowledge

about their diseases ,healthy styles of life and adherence to the

treatment, to diminish hospitalizations unnecessary and to diminish

costs. By November 2014 – May 2015

mobilizing rising leaders to reach the triple...

Documents