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Western Collaboratives Med Rec/SSI call September 12, 2006 “Three weeks to go!” Dr. Robin Ensom, co-chair Med Rec Collaborative Shirley Gobelle, SSI Faculty. Safer Healthcare Now! Western Node. Seven Leadership Leverage Points For organization-level Improvement in Health Care Authors:
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Western CollaborativesMed Rec/SSI callSeptember 12, 2006“Three weeks to go!”Dr. Robin Ensom, co-chair Med Rec CollaborativeShirley Gobelle, SSI Faculty Safer Healthcare Now! Western Node
Seven Leadership Leverage Points For organization-level Improvement in Health Care Authors: Reinertsen, Pugh, and Bisognano Source: Institute for Healthcare Improvement, Extranet
1: Establish and Oversee System-Level Aims for Improvement at the Highest Board and Leadership Level • Solid system level performance • Establish aims for improvement • Establish oversight at the highest level of governance and leadership • Personal commitment • SHN! Example: How can you ensure your work is shared at a board committee meeting? (aims and achievements)
2: Align Measures, Strategy and Projects in a Leadership Learning System • QI often not seen as strategic • Results in project by project basis without making a clear direction to the overall aims and performance metrics of the organization • SHN! Example: Build you QI initiative aims into the balanced score card at the department level – encourage your senior leader to have it in his/her balanced score card … etc.
3: Channel Leadership Attention to System Level Improvement • The currency of leadership is attention. To achieve system-level aims, leaders must actually pay attention to them. • Formal and informal • Personal agendas, meeting agenda, project team reviews, executive performance feedback, hiring, membership of design teams • SHN! Example: Have your team story be profiled in a local newspaper with the help of your region communication department
4: Get the Right Team on the Bus • Most common reason for failure of large systems to change is the failure of the senior leadership team to function as an effective team • Get patients and family members onto the teams • We simply must make it a routine matter to bring patients’ ideas, perspectives and insights into the room • SHN! Example: Pick your high functioning leaders as your promoter and navigator through your health region
5: Make the Chief Financial Officer a Quality Champion • The connection between QI and business performance is weakly made in most health care organizations. • In other industries, CFO’s spend more time on reducing waste and improving core processes. • SHN! Example: Present a cost benefit analysis of your initiative to your CFO. ie., bed days saved by preventing a surgical site infection/increased length of stays avoided by reconciling meds
6: Engage Physicians • Physicians are in a powerful position to stop it from moving forward, and therefor their engagement is critical • Leaders are not likely to achieve system level improvement without enthusiasm, knowledge, cultural clout, and personal leadership of physicians • SHN! Example: Find your champion doc who will present at departmental head meetings, grand rounds and his colleagues
7: Build Improvement Capability Senior leaders must have the ability to know, use and teach: • The model for improvement • A coherent improvement strategy such as the Toyota Production System • Concepts and practices of high-reliability organizations • Sophisticated practices in flow management • Concepts and practices in scale and spread • SHN! Example: How knowledgeable are your Senior Leaders? Invite them to LS 3 or other opportunities
Discussion • What have you done locally to work with your Senior Leader? • How has your Senior Leader promoted your project and its sustainability? • …