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Building and Sustaining Momentum: Engaging Executives

Building and Sustaining Momentum: Engaging Executives. Chris Goeschel ScD RN FAAN cgoesch1@jhmi.edu October 12, 2012. Learning Objectives . Describe current pressures for Senior Teams to “engage” Define the differences between technical and adaptive work

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Building and Sustaining Momentum: Engaging Executives

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  1. Building and Sustaining Momentum: Engaging Executives Chris Goeschel ScD RN FAAN cgoesch1@jhmi.edu October 12, 2012

  2. Learning Objectives • Describe current pressures for Senior Teams to “engage” • Define the differences between technical and adaptive work • Delineate the role of senior leaders in addressing both types of work in QI efforts • Discuss tactics used successfully to engage senior leaders in this work

  3. CEO Checklist for Creating High Value Health Care 1. Foundational Elements • Governance Priority • Culture of Continuous Improvement 2. Infrastructure Fundamentals • IT best practices • Evidence Protocols • Resource utilization Armstrong Institute for Patient Safety and Quality

  4. CEO Checklist for Creating High Value Health Care 3.Care Delivery Priorities • Integrated care • Shared decision making • Targeted services 4. Reliability and Feedback • Embedded safeguards • Internal transparency Armstrong Institute for Patient Safety and Quality

  5. Leading Change Pronovost: Health Services Research 2006

  6. Technical Work • Addresses problems for which the definition is clear, the potential solutions are reasonably clear, and usually require little or minimal learning • Responsibility for implementing a solution is reasonably clear between leaders and followers.

  7. Adaptive Work • Addresses problems that require a change in attitudes, beliefs, and behaviors • Involves shared responsibility for change: leaders share responsibility with organizational staff and key stakeholders.

  8. The Work of Adaptive Change • Determining the direction – what must change • Determining the methods - how to change

  9. Most Common Leadership Error • Treating an adaptive problem as technical

  10. Create and Sustain Executive Partnership • Create a compelling case for participation • (4 Es) • Design structures and processes to support involvement • (meeting time, place, process) • Discuss potential barriers to effectiveness (awareness, agreement, ambiguity, ability) • Identify facilitators unique to your executive and leverage them

  11. Executive Partnership: Impact and Influence Executive partnership leverages four main functions of leadership to improve patient safety locally and globally: • Information search (staff safety assessment, executive safety rounds) • Problem solving (learning from defects) • Managing material resources (business case, pay for performance, public reporting) • Managing personnel resources (patient and employee satisfaction) Fleischman et al., 1991

  12. Is everyone clear on the goals, timelines, and mission? Is the necessary structure in place – people, roles, authority and responsibility? Are decision making, problem solving and conflict management processes clear? Are material resources in place – space, equipment, people, budgets? Are financial tracking mechanisms in place (CMS P4P implications) Leading Change:The Amazing Race to Eliminate VAP

  13. Action Items for Senior Leaders • Make certain an executive is assigned to each participating unit and meets regularly as a member of the project team . • let the staff know senior leaders are invested and will work as hard as they do to make it a success. • Set clear project goals and expectations for the leaders and staff in participating. • Provide opportunities for project teams to meet with senior leaders and the board to discuss the project • Provide the necessary resources – time to work on the Project, funds for travel, training, equipment, supplies, etc.

  14. Action Items for Senior Leaders 4. Support transparent communication • VAP rates • Process barriers and successes • Tell your own of a patient who suffered a VAP at your organization 5. Expect resistance and be prepared to address it 6. Celebrate wins and provide encouragement, support, attention, and resources if there are set backs.

  15. COURAGE “Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it’s the only thing that ever has.” Margaret Meade

  16. References Slide 5: PronovostPJ, Berenholtz SM, GoeschelCA, Needham DM, Sexton BJ, Hyzy, Thompson DA, Lubomski LH, Marsteller JA, Makary MA, Hunt E. Creating High Reliability in Health Care Organizations. HSR. 2006;41:1599-1617. Slide 11: Fleishman EA, Mumford MD, Zaccaro SJ, Levin KY, Korotkin AL, Hein MB.(1991). Taxonomic efforts in the description of leader behavior: A synthesis and functional interpretation. Leadership Quarterly, 2, 245–287. Armstrong Institute for Patient Safety and Quality

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