A New Context for Health A New Context for Health An Invitation to the journey… May we look upon this time with new eyes; With hindsight for what was; Insight for what is; Foresight for what can be. Kathy Orland, RN
From Evidence to Innovation Nursing in a Transforming Health System Tim Porter-O’Grady, DM, EdD, ScD (h) , APRN, FAAN, FACCWS
Rule # 1 If you don’t have a sense of humor….. Why bother?
NEW RESOURCE FROM THE NATION’S LEADING VISIONARIES Evidence To Innovation A Textbook of New Leadership “Leadership of innovation is essentially a work in progress—a never-ending journey with facets and elements that add up to a broad and complex mosaic” -From the Preface Order easily from Davidson, Weberg, Porter-O’Grady, Malloch, Jones and Bartlett website 2017, Jones and Bartlett Learning, Boston, MA.
A Culture of Value-based Health Practices • “The greatest difficulty in the world is not for people to accept new ideas but to get them to forget their old ones.” John Maynard Keynes John Maynard Keynes
Credit to Don Berwick
Building the Accountable Care Building the Accountable Care Infrastructure Infrastructure
The 5 Themes (undercurrents) of The 5 Themes (undercurrents) of Health Transformation Health Transformation • • From volume to value economics From volume to value economics Models of accountable care • • Models of accountable care Trans-disciplinary team decision/action Trans-disciplinary team decision/action • • User-driven technology User-driven technology • • • • Triple Aim (Service, Quality, Price) Triple Aim (Service, Quality, Price)
Value-driven Practice Good infrastructure Fit process - outcome Know your user(s) Evidentiary Excellence Care Ownership Integration Engagement Fiscal fit Knowledge capital Resource Partnership Value equation Engine Validation of value
“Value” vs. “Volume” Measures of Work Volume ( Industrial) Value (Post-digital) Focus on process Focus on results Numbers Synthesis Job enlarging Evidence Function payment Impact Task load Paying for Quality Amount of work Meaning Busy, (work for its own sake) E 3 Repetitive Mobility-driven Activity-based Sustainable Duke
Future Realities for Practice From Evidence to Innovation From the Floor to the Ceiling Of Practice
Capacity for Innovation Imagination Mental Models Passion Dissonance Creative Rewards Emergent Patterns Processing Outcomes Collective wisdom Skills Environment Knowledge Technical Expertise Motivation Value-based Conceptual
New Language Of the New New Language Of the New Age Age Accountability based processes Accountability based processes • • Focus on evidence (impact) Focus on evidence (impact) • • Technology drives everything, (creating “fit”) Technology drives everything, (creating “fit”) • • “Users” drive the relationship “Users” drive the relationship • • Transdisciplinary is now the unit of service Transdisciplinary is now the unit of service • • • • Building “bundles” from point-of-service Building “bundles” from point-of-service • • Now “one price” Now “one price”
Into the Age of Evidence And Innovation Value not volume • Pay for performance not process • Must have evidence of impact • “Best-practices” drive quality/payment • EMR / Digital is non-negotiable • • Excellence is driven from P-O-S (are at the center) • Evidence is not unilateral
Leading In The 21 st Century Professional Best Environment Practices Innovation New Age Movement Advancement Models Value-based Quality Quantum Driving Forces Leadership Reform Economics Triple Aim
New Model of 21 st Century Health Capacity Tools 21 st Century Connection “User” Control Practice Mobility/Synthesis/Access Centered Inter-disciplinary Competence Early Engage/Facilitate Techno-Clinical Genomics Health Virtual / Telecom Pharma/Nano Population-based Mobile Health Prescriptive Sustained / Safe Resource Sensitive Socio-political Priority
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