1/25/2012 Session Two Foundational Element: Leadership Kelly McCutcheon Adams, MSW, LICSW, IHI Director Barbara Balik, RN, EdD, IHI Faculty January 25, 2012 2:00 – 3:00pm EST David Kim David Kim , Institute for Healthcare Improvement (IHI), is responsible for managing and coordinating a variety of programs based on Key Processes on the IHI Improvement Map. Mr. Kim is a graduate of Boston University. He has been with the IHI for 2 years. He enjoys sports, food, and travel. 2 1
1/25/2012 WebEx Quick Reference • Welcome to today’s session! • Please use Chat to “All Raise your hand Participants” for questions • For technology issues only, please Chat to “Host” • WebEx Technical Support: 866-569-3239 • Dial-in Info: Communicate / Join Teleconference (in menu) Select Chat recipient Enter Text 3 When Chatting… Please send your message to All Participants 4 2
1/25/2012 Kelly McCutcheon Adams, MSW, LICSW Kelly McCutcheon Adams, MSW, LICSW, Director, Institute for Healthcare Improvement (IHI), has served in this capacity for eight years for a variety of IHI Collaboratives and programs, particularly those focused on critical care. She is a medical social worker with experience in hospice, nursing home, sub-acute rehabilitation, emergency department, and ICU settings. She has also served as faculty for the US Department of Health and Human Services Organ Donation Collaborative and for the Gift of Life Institute. 5 Barbara Balik, RN, EdD Barbara Balik, RN, EdD, Principal, Common Fire Healthcare Consulting, is also Senior Faculty at the Institute of Healthcare Improvement. Her areas of expertise include leadership and systems for a culture of quality and safety, including patient- and family- centered care, patient experience, systems to improve transitions in care, and transforming care prior to or with optimization of an electronic health record implementation. She works with leaders to develop adaptive systems to excel and innovate in complex organizations, and to ensure sustained improvement and innovation every day. Ms. Balik's publications include the book, The Heart of Leadership , and the IHI white paper on “Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care,” among others. Previously, she served in senior leadership roles at Allina Hospitals and Clinics, United Hospital, and Minneapolis Children's Medical Center. 6 3
1/25/2012 Overall Objectives At the end of this program, participants would be able to: • Articulate key foundational elements in support of all domains of patient experience improvement • Share specific testable ideas for improving nurse communication, pain management, and cleanliness • Plan small tests of change to try during the Expedition 7 Session Agenda • Homework – We did you learn? • Patient Experience Change Package o Our focus today • Leadership learning from the Patient Experience Collaborative • Hear from successful leaders o Kris White, VP of Innovation and Patient Affairs, Spectrum Health o Mitch Mongell, CEO, Colleton • Time for Q&A 8 4
1/25/2012 Pre-work 1. Read the IHI White Paper: Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care 2. Self Assessment •The Patient and Family Centered Care Organizational Self - Assessment Tool •Observation 3. Observation Exercise •Understand a Patient Journey 4. WIHI: Health Literacy: New Skills for Health Professionals 9 Homework Options • Before Call 2 January 25, 2012 o Identify 3 lessons learned from the teams on the call; compare your current activities to theirs; what is similar or different? o Review your patient experience data; where is your greatest opportunity? Areas to celebrate? o Do another patient/family shadowing activity; what did you learn that helps explain some of your patient experience data results? o Assure senior leaders are on the 1/25/12 call 10 5
1/25/2012 Patient Experience Change Package • Overview o Original work: Patient Experience White Paper and Driver Diagram o Focused content – 48 hospital collaborative Nurse Communication Pain Management Cleanliness 11 In words and actions leaders IHI Patient Governance and communicate that the patient’s safety and well being is the critical decision executive leaders guiding all decision making demonstrate that EVERYTHING in the Patients and families are treated as Experience partners in care at every level: on culture is focused on decision making bodies to team patient and family members with individual care centered care, PFCC is publicly verifiable, rewarded, Driver practiced and celebrated with relentless focus everywhere in the on measurement, learning, and improvement with transparent hospital (individual, patient feedback microsystem, Diagram Sufficient staff are available with the organization) tools and skills to deliver the care the patient needs when they need it Staff and providers are recruited for values and talent, supported for The hearts and minds success, and accountable individually of staff and providers and collectively for results are fully engaged Compassionate communication and Exceptional patient teamwork are essential competencies and family inpatient Every care hospital experience interaction is (safe, effective, anchored in a Patients and families are part of care patient centered, respectful team and participate at the level the patient chooses timely, efficient, partnership equitable) as anticipating and Care for each patient is based on a customized interdisciplinary shared measured by responding to care plan with patients educated, HCAHPS willingness enabled and confident to carry out patient and family their care plans to recommend needs (physical Communication uses words and comfort, emotional, phrases that the patient understands informational, and meets their emotional needs cultural, spiritual, and learning) The physical environment supports care and healing Hospital systems Patients are able to access care and deliver reliable say that there were not long and quality care 24/7 unreasonable waits and delays Patients say “there were staff available to give the care I needed” Care is safe, concerns are addressed and if things go wrong, there is open communication and apology The care team instills The Patient always means confidence by Care is coordinated and integrated patient and those they through use of a shared can plan and providing everyone on the patient’s care team, choose to call family collaborative, including the patient, has the information they need evidenced based care Patients get the outcomes of care they expect 6
1/25/2012 Patient Experience Change Package • Faculty, exemplars, teams experience: o Foundational cross-cutting work – address all domains Leadership commitment and behaviors Engaging patients in their definition of: – family, pain management, cleanliness o Successful use of the Driver Diagram and White Paper to assess current state and develop implementation plans 13 Patient Experience Change Package: Overview Key areas for improving specific domains of patient experience: Nurse Communication, Cleanliness, and Pain Management Staff and Physicians Connection Patient and Family Today’s Session Improvement/ Leadership Engagement Infrastructure Foundational Elements for Improving Patient Experience 7
1/25/2012 Foundational Elements for Improving Patient Experience Today’s Session Improvement/ Leadership Engagement Infrastructure Leaders take ownership of defining Staff, leaders, and physicians engage Improvement teams are solidly purpose of work and modeling patients and families so that efforts to grounded in skills to effect reliable desired behaviors. improve patient experience reflect change and gain meaningful actual patient experience. understanding of data Leadership – Key Change Ideas • Purpose • Leadership Behaviors • “All In” Behaviors • Leadership Rounding • Label and Link • Storytelling • Champions 16 8
1/25/2012 Leadership – Key Change Ideas Purpose • Define and communicate philosophy, intention, and plan for optimal patient experience. Include purpose of work in every leadership meeting, leadership rounding, etc. Include “impact on patients” in discussion of each topic at every meeting. 17 Leadership – Key Change Ideas Purpose • Impact on patients – sample questions o “How does this improve patient care?” o “What patients have we asked about this?” o “What value does this add to patient care and patient experience?” o “What patients/family members do we have on teams?” 18 9
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