SRM 1/5/08

In Pursuit of ExcellenceImplementing Across AHA and Beyond

Opportunities to Lead

SRM 1/5/08

Opportunities for Leadership: Hospitals

SafeMake effective use of information and clinical technology

designed to improve safety.Implement specific practices shown effective in improving

safety.Redesign care processes to eliminate defects.Collect and report errors in care to patient safety

organizations.Support patients, their families, doctors and other caregivers

when patient harm occurs. TimelyReduce emergency department wait times.Reduce the time between scheduling an appointment and

seeing a health care practitioner.Speed procedures, test results, patient diagnosis and

treatment.Smooth the movement of patients throughout their care

delivery experience. EffectiveEnsure the use of current best evidence in patient care.Share information with clinicians on how their clinical

practice compares to "best practices" or "benchmarks”. Ban unhealthy products on hospital campuses, such as

tobacco, use of trans fats, or availability of unhealthy foods.Promote better nutrition and fitness among our own hospital

employees and within the broader community.Lead community based initiatives to reduce obesity,

diabetes, HIV or other local needs. EfficientEmploy techniques to optimize performance.Reduce process variation to improve reliability of care.Manage organizational variability to streamline processes.Adopt health information technology to eliminate duplication

of effort and reduce administrative costs.

Efficient (cont.)Participate in payment approaches that reward

efficiency and quality.Track patients with chronic conditions and provide them

with effective chronic care management to avoid hospitalization.

EquitableCollect patient data on race, ethnicity and language to

look more closely at hospital quality and patient satisfaction.

Make translation services available for patients and their families.

Strengthen the diversity of hospital governance, management teams and workforce.

Provide employees training in cultural competence.Work with community leaders and organizations that

serve racial or ethnic minorities or other groups to reduce care disparities.

Patient-centeredEncourage active patient and family involvement in

care delivery and decision-making.Customize care to meet each individual patient’s needs

and preferences.Educate patients and families on palliative care and

end-of-life care options.Embrace transparency in the reporting of quality and

pricing information to help people be better educated patients.

Ensure the protection of patient privacy and the confidentiality of medical information.

Expand the health care literacy of communities and patients served.

Integrate the care delivered by physicians, nurses and others to create a coordinated, seamless continuum of care for patients.

Examples of ways to reach the goal:

SRM 1/5/08

In Pursuit of Excellence: What Is It?

• WHAT: A field-wide focus on performance excellence in hospitals and health systems to accelerate performance improvement and enhance hospitals’ ability to deliver safe, timely, effective, efficient, equitable and patient-focused care

• WHO: Executive, trustee and physician leadership as well as other clinical and non-clinical leaders and managers in America’s hospitals and health systems

• WHERE: Local, Regional and National • WHEN: Starting NOW.• HOW: (1) engage leaders, (2) align our efforts, (3)

provide services and resources, and (4) measure performance and progress etc. Collect and spread proven innovations—spanning the Boardroom to the Bedside—across the hospital field

SRM 1/5/08

1. Hospitals become clinically, operationally and financially more capable, effective and efficient. 

2. Patients gain equal access to safer, higher quality and more affordable care.  

3. Hospitals become better connected to their patients and the communities they serve.

Goals

Focused on 3 Main Goals

SRM 1/5/08

Engage Leaders

-Systemness

-Culture

-Structure

-Strategy

-Process environment

-Process Excellence

-Competencies

-Team

-Training

In Pursuit of Excellence Requires Collaborative Leadership

Context Leaders(executive, trustee, physician leaders)

Content Leaders(clinical and non-

clinical)

Information From:Proven Performers/

Proven Practices

Case Studies

-Better Practices

-Etc.

Information To:The Field

-Create initiatives

-Adopt Better Practices

-Etc.

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Co

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SRM 1/5/08

In Pursuit of Excellence COMMUNICATION

Communication Planning•Key messages•Branding•Channel selection/usage•Integration with H4L

Channels•Web (QC, etc.)•Publications •Journals and magazines•Presentations•A2•State Associations•National Partners•Etc.

CONSULTATION/COLLABORATION

Stakeholders•CEOs/C-suite•State Assoc•Physician Leaders•QI Leaders•Change Management Experts•Consumer Voice•Business •Insurer/Payer•Disparity Leaders•Other

Internal Alignment•Incorporation of POE in business unit plans•Consistent messaging•Consistent Identity

MEASUREMENT AND REPORTING

Internal Measurement•Member satisfaction•Focus groups

External Measurement•HCAHPS•Hospital Compare•Other•In conjunction with Data and Research Strategy Team

“In Our Hands” Resource Guide

Leadership Education

Consistent Identity and Presence

National Advisory Group

Hospital Performance Measurement Tool

CONTENTEngage Leaders: system thinking for process excellence

Principles of Performance Excellence•Patient focus for everything•Create Culture of Reliability•Manage organizational variation (smooth census)•Remove waste•Eliminate defects•Reduce process variability

Achieve IOM Six AimsSafe EfficientTimely EquitableEffective Patient-Focused

Initial Areas of Focus•Throughput/flow (efficiency)E.D. waitsElective surgery•Hospital-acquired infections•Medication management (prescribing, dispensing, administering)

ADEs•Patient safety (ulcers, falls, etc.)•Patient & Provider Communication