Western CollaborativesWestern CollaborativesMed Rec/SSI callMed Rec/SSI call

September 12, 2006September 12, 2006“Three weeks to go!”“Three weeks to go!”

Dr. Robin Ensom, co-chair Med Rec CollaborativeDr. Robin Ensom, co-chair Med Rec CollaborativeShirley Gobelle, SSI FacultyShirley Gobelle, SSI Faculty

Safer Healthcare Now! Western Node

Seven Leadership Leverage Seven Leadership Leverage PointsPoints

For organization-level Improvement in For organization-level Improvement in Health CareHealth Care

Authors:Authors:

Reinertsen, Pugh, and BisognanoReinertsen, Pugh, and Bisognano

Source: Institute for Healthcare Improvement, ExtranetSource: Institute for Healthcare Improvement, Extranet

1: Establish and Oversee 1: Establish and Oversee System-Level Aims for System-Level Aims for

Improvement at the Highest Improvement at the Highest Board and Leadership LevelBoard and Leadership Level

Solid system level performanceSolid system level performance Establish aims for improvementEstablish aims for improvement Establish oversight at the highest level of Establish oversight at the highest level of

governance and leadershipgovernance and leadership Personal commitmentPersonal commitment SHN! Example: How can you ensure your work is SHN! Example: How can you ensure your work is

shared at a board committee meeting? (aims and shared at a board committee meeting? (aims and achievements)achievements)

2: Align Measures, Strategy 2: Align Measures, Strategy and Projects in a Leadership and Projects in a Leadership

Learning SystemLearning System

QI often not seen as strategicQI often not seen as strategic Results in project by project basis without Results in project by project basis without

making a clear direction to the overall aims making a clear direction to the overall aims and performance metrics of the organizationand performance metrics of the organization

SHN! Example: Build you QI initiative aims SHN! Example: Build you QI initiative aims into the balanced score card at the into the balanced score card at the department level – encourage your senior department level – encourage your senior leader to have it in his/her balanced score leader to have it in his/her balanced score card … etc. card … etc.

3: Channel Leadership 3: Channel Leadership Attention to System Level Attention to System Level

ImprovementImprovement The currency of leadership is attention. To The currency of leadership is attention. To

achieve system-level aims, leaders must achieve system-level aims, leaders must actually pay attention to them. actually pay attention to them.

Formal and informalFormal and informal Personal agendas, meeting agenda, Personal agendas, meeting agenda,

project team reviews, executive project team reviews, executive performance feedback, hiring, performance feedback, hiring, membership of design teamsmembership of design teams

SHN! Example: Have your team story be SHN! Example: Have your team story be profiled in a local newspaper with the help profiled in a local newspaper with the help of your region communication departmentof your region communication department

4: Get the Right Team on the 4: Get the Right Team on the BusBus

Most common reason for failure of large Most common reason for failure of large systems to change is the failure of the systems to change is the failure of the senior leadership team to function as an senior leadership team to function as an effective teameffective team

Get patients and family members onto the Get patients and family members onto the teamsteams

We simply must make it a routine matter We simply must make it a routine matter to bring patients’ ideas, perspectives and to bring patients’ ideas, perspectives and insights into the roominsights into the room

SHN! Example: Pick your high functioning SHN! Example: Pick your high functioning leaders as your promoter and navigator leaders as your promoter and navigator through your health regionthrough your health region

5: Make the Chief Financial 5: Make the Chief Financial Officer a Quality ChampionOfficer a Quality Champion

The connection between QI and business The connection between QI and business performance is weakly made in most performance is weakly made in most health care organizations.health care organizations.

In other industries, CFO’s spend more time In other industries, CFO’s spend more time on reducing waste and improving core on reducing waste and improving core processes.processes.

SHN! Example: Present a cost benefit SHN! Example: Present a cost benefit analysis of your initiative to your CFO. ie., analysis of your initiative to your CFO. ie., bed days saved by preventing a surgical bed days saved by preventing a surgical site infection/increased length of stays site infection/increased length of stays avoided by reconciling meds avoided by reconciling meds

6: Engage Physicians6: Engage Physicians

Physicians are in a powerful position to Physicians are in a powerful position to stop it from moving forward, and therefor stop it from moving forward, and therefor their engagement is criticaltheir engagement is critical

Leaders are not likely to achieve system Leaders are not likely to achieve system level improvement without enthusiasm, level improvement without enthusiasm, knowledge, cultural clout, and personal knowledge, cultural clout, and personal leadership of physiciansleadership of physicians

SHN! Example: Find your champion doc SHN! Example: Find your champion doc who will present at departmental head who will present at departmental head meetings, grand rounds and his colleaguesmeetings, grand rounds and his colleagues

7: Build Improvement 7: Build Improvement CapabilityCapability

Senior leaders must have the ability to know, use Senior leaders must have the ability to know, use and teach:and teach:

The model for improvementThe model for improvement A coherent improvement strategy such as the A coherent improvement strategy such as the

Toyota Production SystemToyota Production System Concepts and practices of high-reliability Concepts and practices of high-reliability

organizationsorganizations Sophisticated practices in flow managementSophisticated practices in flow management Concepts and practices in scale and spreadConcepts and practices in scale and spread SHN! Example: How knowledgeable are your SHN! Example: How knowledgeable are your

Senior Leaders? Invite them to LS 3 or other Senior Leaders? Invite them to LS 3 or other opportunitiesopportunities

DiscussionDiscussion

What have you done locally to work What have you done locally to work with your Senior Leader?with your Senior Leader?

How has your Senior Leader How has your Senior Leader promoted your project and its promoted your project and its sustainability?sustainability?

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