Performance Improvement slides for career.pptx

Introduction of Performance Improvement slides for career

1. Leadership Training

2. Faculty Warren C. White, Jr., FACMPE     Vice President Physician Practices, Retired     Spectrum Health Lakeland Kenneth J. O’Neill, MD     Vice President Clinical Integration     Spectrum Health Lakeland     President Board of Directors     Lakeland Care Network

3. Performance Improvement 22 April 2021 Kenneth J. O’Neill, MD

4. Purpose Prepare participants to lead organizational Performance Improvement 4

5. Learning Objectives Participants will be able to: Articulate why performance improvement is a foundational attribute in modern healthcare institutions Establish a framework for organizational improvement  Implement an improvement process 5

6. Session's Agenda Define Performance Improvement (PI) including the purpose and scope Identify the key components of an institutional framework for PI Explore the Model for Improvement from the Institute for Healthcare Improvement (IHI) 6

7. Why Performance Improvement? Medical errors cause many deaths​ 98,000 people die annually from medical errors ​ Adverse events are common 44% of adverse events are preventable ​ To Err is Human:  Building a Safer Health System ​, Institute of Medicine (IOM)​ December 1, 1999 Department of HHS, Nov, 2010  Landrigan  et al, New England Journal of   Medicine, Nov, 2010 7  

8. Why Performance Improvement? Medical errors and adverse events are affecting our neighbors, friends and family Errors and adverse events can be prevented 1 July 2018 Elijah O’Neill died— He was my grandson 8

9. What is Performance Improvement? Definition— Performance Improvement (PI) is the continuous study and improvement of the processes of providing healthcare to meet peoples needs. 9

10. What is Performance Improvement? Purpose:  Medical care that is High quality Safe Efficient Cost effective Equitable 10

11. What is Performance Improvement? The scope of PI is very broad with many Activities Systems Fields of study 11

12. Framework for PI 12 Frontline Management Governance Culture Process Structure

13. Framework for PI 13 Frontline Management Governance Culture Process Structure Plan Plan Plan Plan Plan Plan Plan Plan Plan

14. Framework for PI Organizations with strong PI Nurture PI CULTURE Establish PI STRUCTURES Adopt effective PI PROCESSES 14

15. Framework for PI 15 Frontline Management Governance Culture Process Structure Plan Plan Plan Plan Plan Plan Plan Plan Plan

16. Nurture PI Culture Organizational culture  is the underlying beliefs, assumptions, values and ways of interacting that contribute to the unique environment of an organization. It is seen in behaviors that are encouraged and tolerated. 16

17. What is Performance Improvement? Purpose:  Medical care that is High quality Safe Efficient Cost effective Equitable 17

18. Nurture PI Culture--continued Board and senior management must set the tone Board and senior management must keep the tone by their actions 18

19. Nurture PI Culture--continued Empowering all team members to address safety concerns Training How to escalate safety concerns Barriers Authority or power gradient Bullying 19

20. Nurture PI Culture--continued Staff trained to escalate when they perceive a problem 1. Ask a question 2. Make a request 3. Voice a concern 4. Use chain of command 20

21. Framework for PI 21 Frontline Management Governance Culture Process Structure Plan Plan Plan Plan Plan Plan Plan Plan Plan

22. Establish Structures for PI Dedicated executive management (VP level) Quality committees Medical staff committees Hospital operations Dedicated staff 22

23. Structures for PI—continued Data collection systems Hardware Software Analytics staff to track and display Process improvement staff 23

24. Structures for PI—continued Clinical Practice Councils Physicians Data analysists Improvement specialists Defined responsibility Department Specialty 24

25. Framework for PI 25 Frontline Management Governance Culture Process Structure Plan Plan Plan Plan Plan Plan Plan Plan Plan

26. Model for Improvement From the Institute for Healthcare Improvement (IHI) Scenario 26

27. IHI Model for Improvement Design, implement and test small improvements Keeping doing this over and over Components Three questions PDSA cycle 27

28. IHI Model for Improvement 28

29. IHI Model for Improvement 3 questions What are we trying to accomplish? How will we know that change is an improvement? What changes can we make that will result in improvement? 29

30. IHI Model for Improvement PDSA cycle Plan Do Study Act 30

31. PDSA cycles—continued Plan State the objective of the change Develop a plan to test the change. (Who? What? When? Where? What data need to be collected?)   Make predictions about what will happen and why 31

32. PDSA cycles—continued Do Carry out the test on a small scale Document problems and unexpected observations Gather data 32

33. PDSA cycles—continued Study Complete the analysis of the data Compare to your predictions Summarize and reflect on what was learned 33

34. PDSA cycles—continued Act Refine the change Make modifications Plan for the next test 34

35. IHI Model for Improvement 35

36. Effective PI Process—continued Other PI process Huddles Dashboards MDI Boards Root cause analysis Daily safety checks Safety call-outs 36

37. Session Summary Define Performance Improvement (PI) including the purpose and scope Identify the key components of an institutional framework for PI Explore the Model for Improvement from the Institute for Healthcare Improvement (IHI) 37

38. Summary and Application What did you learn in this session? How does this information apply to your setting? What action will you take after attending this session? What barriers might block your action steps? 38

39. References Agency for Healthcare Research and Quality https://www.ahrq.gov/ncepcr/tools/pf-handbook Institute for Healthcare Improvement (IHI) http://www.ihi.org/resources/Pages/HowtoImprove/default.aspx Root Cause Analysis https://www.cms.gov/medicare/provider-enrollment-and-certification/qapi/downloads/guidanceforrca.pdf 39