Collaborative Learning and Leadership Tom Evans, M.D. SCHA Transforming Health Symposium

1. Collaborative Learning and Leadership Tom Evans, M.D. SCHA Transforming Health Symposium April 7, 2016 100 E. Grand Ave., Ste. 360 • Des Moines, IA 50309-1835 Office: 515.283.9330 • Fax: 515.698.5130 www.ihconline.org

2. “Knowledge comes in two flavors – “knowledge that” and “knowledge how.” Knowing that a bicycle has two wheels, a seat, handlebars and a foot-pedal crank, for example, stands in sharp contrast to the practical knowledge of how to ride a bike. Brent James, MD

3. Saxaphone

4. Systems create aims, and measure results.

5. Aims & Results: a choice we make every day

6. A practical choice on Aims (ends)

7. Traditional Learning Traditional Model…to find truth • Formative concept or intervention with separate control population • Measure impact when done • Evaluation requires disproving the null hypothesis (That there is a significant difference between specified populations not due to sampling)

8. Systems don’t create aims. Aims create systems.

9. A leadership choice – Breakthrough Aims

10. How do I get from here to there?

11. Emergent Strategy: Stand For Them, Enroll Others, Persist, Learn, Evolve...Fast

12. Collaborative Learning Results Oriented Model…to do truth • Formative and impact merge • No clean intervention vs. control population • Evaluation focuses attention to change in historical patterns, alignment, change in human behavior, etc.

14. Aims create systems. Systems create results.

15. Aims of Partnership for Patients Aims Create Systems; Systems Create Results

16. IHC HEN Safety Across the Board HEN Baseline 2012

17. Impacts of Major Improvements in Patient Safety: Compared to 2010 Baseline • 17% Reduction in HACs 2010-2014 • from 145 per 1,000 discharges to 121 per 1,000 discharges in 2013 and 2014 • 39% reduction in preventable HACs – nearly at 40% goal • $19.8B in Estimated Associated Cost Savings2010-2014 • $4B for 2011 and 2012 combined • $15B for 2013 and 2014 combined • 87,000 Lives Saved 2010-2014 • ~15,000 lives saved for 2011 and 2012 combined • ~72,000 lives saved for 2013 and 2015 combined * Final MPSMS-based 2013 HACs, Preliminary 2013 NHSN-based HACs, and extrapolation of 2012 Data for 2013 PSI-based HACs; Partnership for Patients 12/1/14 press release

18. Leadership: The challenge is creating will… • Will • Ideas • Execution

19. Get comfortable with being uncomfortable.

20. Saxaphone

22. Characteristics of Collaborative Learning • Quantifiable Aims that all Participants share • Engaged Leadership that focuses on Removing Barriers • Thoughtful Use of Data • Rhythmic Testing and Adjustment (PDSA) • Facilitation of Tacit Knowledge Exchange • Regular Celebration of Progress

24. “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten.” --Bill Gates Jr.

25. “There has never been a better time to be an Innovator in health care.” --Don Berwick, former administrator, CMS Military Health System conference January 2011

26. “I don’t believe there’s any problem in this country, no matter how tough it is, that Americans, when they roll up their sleeves, can’t completely ignore.” The Late Comedian George Carlin

27. “The Americans always do the right thing…after they’ve exhausted all the other alternatives.” Sir Winston Churchill

28. “We always need to remember that behind almost every great moment in history, there are heroic people doing really boring and frustrating things for a prolonged period of time.” – Gail Collins, The New York Times, August 13, 2010

29. “Somebody has to do something, and it’s just incredibly pathetic that it has to be us.”--the late Jerry Garcia of the Grateful Dead