L2: Building Capacity and Capability: The Really Big Challenge Uma - PDF document

12/6/2013 James M. Anderson Center for Health Systems Excellence L2: Building Capacity and Capability: The Really Big Challenge Uma R. Kotagal, MBBS, MSc SVP, Quality, Safety and Transformation Executive Director, James M. Anderson Center for Health Systems Excellence Cincinnati Children’s Hospital Medical Center 1 James M. Anderson Center James M. Anderson Center for Health Systems Excellence for Health Systems Excellence Our Vision To be the leader in improving child health 2 1

12/6/2013 It ’ s all about the kids 3 Cincinnati Children’s At a Glance – Full service, pediatric academic medical center with annual 1,161,000 patient encounters* – 598 registered beds (549 in service) including inpatient and residential psychiatry beds* – Served patients from 53 countries and all 50 states* – Nationally ranked in all 10 subspecialty programs – 3 rd highest recipient of NIH grants for pediatric research – Ranked 3 rd best Department of Pediatrics among all University Colleges of Medicine – Total Employees of 12,873, with 11,799 full time equivalents* – Employees from 97 different countries – Over 790 volunteers contributed 72,806 hours* * For fiscal year ending June 30, 2013 2

12/6/2013 What Inspires Our Success… • Vision – to be the leader in improving child health • Mission – Cincinnati Children’s will improve child health and transform delivery of care through fully integrated, globally recognized research, education and innovation. For patients from our community, the nation and the world, the care we provide will achieve the best: - medical and quality of life outcomes - patient and family experience and - value today and in the future. • Values – Respect everyone. Tell the truth. Work as a team. Make a difference. What Guides Us…2015 Strategic Plan Focus Statement: We will deliver demonstrably superior outcomes and experience at the lowest possible cost and discover and apply better ways to improve the health of more children, here and around the world. Our Goals Safety To be the safest hospital Care Coordination & Outcomes To improve outcomes for our patients with complex and chronic diseases Community Care Delivery To strengthen our community’s system of care for children Community Health To measurably improve the health of local children Research & Infrastructure To accelerate the impact of our investment in discovery Leadership Development & To help employees reach their potential and Cincinnati Children’s Learning achieve its vision Reach & Revenue To leverage our unique expertise to serve more children Philanthropy To provide abundant resources for the care and cures for children Cost To be more affordable for patients and maintain our financial strength Productivity To improve the experience for patients and more effectively utilize our people and physical assets Respect & Professionalism To ensure that every employee feels valued and respected 3

12/6/2013 James M. Anderson Center James M. Anderson Center for Health Systems Excellence for Health Systems Excellence Our Mission Cincinnati Children’s will improve child health & transform delivery of care through fully integrated, globally recognized research, education & innovation. For patients from the community, the nation & the world, the care we provide will achieve the best: • Medical & quality of life outcomes • Patient & family experiences & • Value today & in the future. 7 James M. Anderson Center James M. Anderson Center for Health Systems Excellence for Health Systems Excellence IHI Execution Framework Achieve Strategic Goals Provide Leaders for Spread and Large System Projects Sustain Develop Manage Human Local Resources Improvement Provide Day to Day Leaders for Microsystems Strategic Execution 8 ������������������������ 4

12/6/2013 James M. Anderson Center James M. Anderson Center for Health Systems Excellence for Health Systems Excellence Context: Key Issues in Quality Education Development OVERALL CONTEXT • Degree of leadership support for both the overall quality effort & for quality education • Overall aim for the organizational quality improvement process – Organizational transformation vs – Incremental improvement 9 James M. Anderson Center for Health Systems Excellence Cincinnati Children’s Context • Organizational transformation implies radical changes in how members perceive, think and behave at work. • Transformational change must attend to the interests of multiple stakeholders and needs to occur at multiple levels of the organization if new strategies are to result in wide-spread and lasting changes in behavior. The competencies and strategies derive from this vision Context is key Source: Organization Development & Change, T.G. Cummings & C.G. Worley, South-Western, 2005. 10 5

12/6/2013 James M. Anderson Center James M. Anderson Center for Health Systems Excellence for Health Systems Excellence Capability vs Capacity • Improvement Capability – An individual’s knowledge & skill to to design improvement initiatives to achieve measurable results & the ability to execute (i.e. develop, test, measure & implement changes) improvement efforts & sustain results. • Improvement Capacity – An organization’s resources which enable it to initiate & sustain a transformation effort. This includes capable individuals but also structures, processes, infrastructure including quality experts & measurement experts. 11 James M. Anderson Center for Health Systems Excellence Operating Assumptions • Building improvement capability at CCHMC goes beyond acquisition of knowledge and skills to action-oriented improvement that achieves critical results and accelerates transformation. • As an Academic Medical Center, CCHMC’s strategy for building improvement capability focuses on engaging and developing faculty as improvement leaders, educating trainees and advancing the scholarship of health care improvement through rigorous methods and quality improvement research. • Different groups of people will have different levels of need for improvement knowledge and skill to achieve results, and each group should receive the training they need when they need it and in the appropriate amount. • All members of the organization should incorporate improvement into their daily work and have the ability to advance their improvement knowledge and skills to achieve critical results, and function at any level of the CCHMC improvement ladder. 12 6

12/6/2013 James M. Anderson Center James M. Anderson Center for Health Systems Excellence for Health Systems Excellence Our Thinking • We will target a diverse group of leaders including physicians, nurses, allied health professionals, clinical & nonclinical support services staff, executives, formal & informal leaders • The diversity of the cohort requires an instructional design which appeals to all of the learning styles • We are an academic medical center so the course must academically rigorous but practically oriented with support for all learners. 13 James M. Anderson Center James M. Anderson Center for Health Systems Excellence for Health Systems Excellence Our Thinking • Academic rigor requires data & measurement rigor. • Leadership for improvement must have a foundation in “hands-on” technical QI skills • Focus on leaders not all front-line people for this course with the expectation that leaders will coach & develop their staff • Use Deming’s System of Profound Knowledge as an integrating philosophy to develop a new way of thinking 14 7