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VUMC Quality Pillar Goal: Pioneer Program

VUMC Quality Pillar Goal: Pioneer Program. Michael Cull, PhD, MSN Director, Education and Dissemination Office of Quality and Patient Safety. Roadmap. Quality Pillar Organizational Culture Culture Change and Organizational Learning Pioneer Programs. FY2012 Goals. FY2012 Goals Continued.

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VUMC Quality Pillar Goal: Pioneer Program

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  1. VUMC Quality Pillar Goal: Pioneer Program Michael Cull, PhD, MSN Director, Education and Dissemination Office of Quality and Patient Safety

  2. Roadmap • Quality Pillar • Organizational Culture • Culture Change and Organizational Learning • Pioneer Programs

  3. FY2012 Goals

  4. FY2012 Goals Continued

  5. FY2012 Goals Continued

  6. FY2012 Goals Continued CULTURE

  7. Step 1: Sit downStep 2: Hold on for 8 seconds

  8. Landing a passenger jet on the Hudson

  9. A successful landing

  10. QPS Mission • Continuously inspire improvement for the health and safety of patients, families, faculty and staff; • Advance a culture of habitual excellence and high reliability; and • Champion discovery, innovation, and transformation in healthcare to high reliability and bring excellence to full-scale.

  11. Organizational Culture • What is organizational culture? • Should it be changed? • Can it be changed? • If so, what strategies are available?

  12. Culture “A pattern of shared basic assumptions that was learned by a group as it solved its problems of external adaptation and internal integration, that has worked well enough to be considered valid and, therefore, to be taught to new members as the correct way you perceive, think, and feel in relation to those problems“ Edgar Schein

  13. Why Change Culture? • Culture supports - or creates barriers for -systems' efforts to innovate and learn.1 • Cultures that emphasize affiliation, teamwork, and coordination implement and sustain more CQI initiatives.2 • By contrast, cultures that emphasize formal structure, regulations and reporting relationships.3

  14. What is Vanderbilt’s Culture?

  15. Subcultures

  16. Subcultures

  17. Types of change • Revolutionary • Sub-groups, targeted • Incremental

  18. Types of change • Revolutionary • Sub-groups, targeted • Incremental

  19. Types of change • Revolutionary • Sub-groups, targeted • Incremental

  20. Artifacts – Values – Assumptions - Beliefs How will we advance the Culture?

  21. Artifacts – Values – Assumptions - Beliefs How will we advance the Culture?

  22. CULTURE change vs SYSTEM change “Changing the system, will change what people do. Changing what people do, will NOT change the system.” Peter Scholtes

  23. What will change look like? …people in the organization identifying with new role model heroes… telling different stories to one another… spending their time differently on a day-to-day basis… asking different questions and carrying out different work rituals.4

  24. What is the Pioneer Program? An intensive, yearlong program designed to support service line level improvement goals and advance a culture of patient safety, quality, and reliability at VUMC.

  25. Vehicles for change

  26. Resistance to Planned Culture Change 5 • Lack of Ownership • Complexity • External Influences • Lack of Appropriate Leadership • Cultural diversity • Dysfunctional consequences

  27. Ownership and Cultural Diversity • Internal RFP process • Collaborative learning • Interdisciplinary involvement

  28. Pioneer Program

  29. Pioneer Program

  30. Complexity, External Influences and Dysfunctional Outcomes • Collaborative learning • Design and Scoping, goal alignment • QPS expertise

  31. Pioneer Program

  32. Leadership and Dysfunctional Outcomes • Stated strategic goal • Required Leadership involvement • Formal report-outs and celebration

  33. What did we expect? • What is the mission, make-up, and organizational structure of your program? • What are some examples of successes and challenges with improvement projects? • How will program leadership contribute to the Pioneer year? • What do you hope to accomplish and how will this advance VUMC’s goal of creating a culture of safety, quality, and reliability?

  34. Evaluation Criteria • Organizational readiness / maturity • Commitment to the process • Energy for change • Alignment with VUMC quality and patient safety goals • Leadership engagement

  35. Selection 10 Person selection committee 22 full proposals submitted for review

  36. Pioneer Year Design • Kick-off with Lucian Leape, MD • Comprehensive curriculum that encompasses both internal and external subject matter experts • Modified IHI Learning Collaborative model • Customized sessions with onsite technical assistance for project design, scope, implementation, and evaluation

  37. Learning Sessions • Safety Culture • Julie Morath, RN, MS • Leadership an promoting professional accountability • Gerald Hickson, MD • Ranja Ramanujam, PhD • Tim Vogus, PhD • Teamwork and Improvement Science • Allan Frankel, MD • Reliability and Safety Science • Tim Vogus, PhD • Allan Frankel, MD

  38. Between Sessions Plan • Bi-weekly collaborative calls: • Updates • Discussion of barriers • Interactive educational component with SME • Independent between-session team meetings • Ad-hoc training and consultations using supported coaching

  39. Wraparound model of support

  40. Threshold – Target - Reach

  41. Questions?

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