7/11/2017 The Collaborative Way: A Framework for Scale and Spread Presented by Chad Glenn and Dr. Kirk Jensen What are we trying to accomplish? The aim of this meeting: • A better understanding of what to expect over the course of the next 9 months as we embark on this national process improvement journey. • Helping you, your teams and your patients get the most out of the 2017 Envision ED Patient Flow Breakthrough (BTS) Collaborative. Topics of discussion : • What exactly is a BTS Collaborative? • What is the focus and purpose of a BTS Collaborative? • What can it do for you, your team, and your patients…. • The 3 levels of improvement efforts • Forming an Effective Team • The Model for Improvement Chad Glenn, Innovation Group 2 1
7/11/2017 What’s in it for you… • Empowering you , the on-site expert in emergency department patient flow, operational excellence, and change management. • Providing you, your team, and your Emergency Department/ Hospital with everything you need – the knowledge, tools and techniques – to successfully execute the changes you want to see happen in your emergency department. • Giving you access to patient flow tools, content, experts and colleagues • Defining and developing the necessary support structure to rapidly deploy best practices at your site Chad Glenn, Innovation Group 3 Why you are here…Leader of the pack… • Respected opinion leaders amongst your peers • Judicious, wise innovative decision makers • Change agents with a passion for improvement and strong leadership skills Chad Glenn, Innovation Group 4 2
7/11/2017 What exactly is an Envision Breakthrough Series Collaborative? An Envision Breakthrough Collaborative is… • A cross-divisional effort to make rapid, measurable improvements in a targeted area of focus where • Interdisciplinary teams can leverage the science of continuous improvement and a theory of knowledge about Emergency Medicine Operations and flow through • A series of learning sessions and action periods designed to allow professionals to design, collaborate, share, and help hold one another accountable for improvement and change… Chad Glenn, Innovation Group 5 Charles Kilo, A Framework for Collaborative Improvement The 2017 Envision Breakthrough Series Collaborative Model and Timeline 3
7/11/2017 Envision Breakthrough Series Collaborative Model (9 Month Time Frame) Participants (25-100 teams) Select Topic (develop Spread mission) Prework Centers of Excellence P P P Develop A D A D Framework A D Expert & Changes S S S Meeting Holding LS 1 LS 2 LS 3 Planning the Gains AP1 AP2 AP3 Group Supports Acronyms: DCM Kaizen Events LS – Learning Session AP – Action Period Office Hours Individual Meetings Monthly Team Reports Chad Glenn, Innovation Group 7 BTS Collaborative Team Project Timeline ( 9 Month Time Frame with Series of Learning Sessions and Action Periods) Prework Execution Testing, Implementation, and Spread Team meetings, aim statement, Intake Tool, and team intro Action Period 1 Action Period 2 Action Period 3 S T E LS1 LS2 LS3 A N R D 1 month 3 months 3 months 3 months T Jun Jul Oct Jan Mar 2017 2017 2017 2017 2017 Chad Glenn, Innovation Group 8 4
7/11/2017 Overview of Envision BTS Collaborative Prework • Meet with your team and develop an aim statement and focus for team’s work. • Fill out and submit Intake Tool. • Complete “team introduction” PowerPoint template Learning Get ideas for improvement. Refine aim and measures. Develop plans for tests of changes for Action Period 1. Begin collaboration. Session 1 Action Test changes through PDSA cycles and get feedback from results. Establish monthly reporting. Period 1 More ideas for change. Deeper understanding of using PDSA cycles for Learning testing and implementation. Overcoming barriers and project fatigue. More Session 2 collaboration. Action Test changes in all areas of change package. Collaborate with colleagues. “Become faculty.” Begin discussing plans beyond pilot project Period 2 Learning Celebrate results. Develop detailed plan for holding the gains and spreading improvements. Session 3 Continue testing and implementation remaining changes. Monitor measures Action to sustain results. Participate in spread. Period 3 Chad Glenn, Innovation Group 9 The Three Levels of BTS Collaborative Improvement Effort Mission, Aims, Objectives 5
7/11/2017 Levels of Breakthrough Collaborative Series Improvement Effort Collaborative MISSION Individual Team AIMS PDSA Cycle OBJECTIVES Chad Glenn, Innovation Group 11 Levels of Breakthrough Collaborative Series Improvement Effort Example Collaborative Reducing wait times and delays in your MISSION emergency department Individual Team AIMS PDSA Cycle OBJECTIVES Chad Glenn, Innovation Group 12 6
7/11/2017 Levels of Breakthrough Collaborative Series Improvement Effort Example Collaborative Reducing wait times and delays in your MISSION emergency department Decrease Median “Door-to-doc” Individual Team time from 45 min to 15 min by AIMS March 1 st 2017 PDSA Cycle OBJECTIVES Chad Glenn, Innovation Group 13 Levels of Breakthrough Collaborative Series Improvement Effort Example Collaborative Reducing wait times and delays in your MISSION emergency department Decrease Median “Door-to-doc” Individual Team time from 45 min to 15 min by AIMS March 1 st 2017 PDSA Cycle OBJECTIVES Week 1: PDSA #1 – Process Map Front End Processes Week 2-3: PDSA # 2 - Test Immediate Bedding Chad Glenn, Innovation Group 14 7
7/11/2017 Collaborative MISSION The MISSION of the Envision ED BTS collaborative is to provide key staff and teams from each division with the tactics, tools and implementation skills necessary to optimize flow and staffing within their respective Emergency Departments. Envisions’ OBJECTIVE is action leading to improvement. This will be an undertaking focused on results. Participants should be able to achieve results for their sites and patients such as: • Improve patient flow in the Emergency Department to reduce operational cycle times. • Reduce the clinical cycle time while reliably delivering proper care. • Improve patient satisfaction by reducing waits and delays to improve service times and by managing perceptions and expectations. Chad Glenn, Innovation Group 15 Individual Site/ Team AIMS Each team’s AIMS will be aligned to the MISSION of the Envision BTS Collaborative, which is to enhance emergency department patient flow, optimize staffing, increase patient safety, and boost patient and staff satisfaction. Each team will develop their own aim statement/ project plan based on their individual site’s objectives, opportunities and targets. Teams will collaborate with other teams to problem solve, share success stories and harvest ideas Chad Glenn, Innovation Group 16 8
7/11/2017 Forming an Effective Team Three different kinds of expertise Forming an Effective Team The three different kinds of expertise Effective teams include members representing three different kinds of expertise 1. Clinical Leadership, Clinical 2. Technical (Subject Matter) Leader Expertise, and 3. Day-to-Day Leadership Day-to- Technical Day Expertise Leader * There may be one or more individuals on the team with each kind of expertise, or one individual may have expertise in more than one area, but all three areas should be represented in order to drive improvement successfully Chad Glenn, Innovation Group 18 Courtesy of IHI 9
7/11/2017 The Model for Improvement A framework for accelerating improvements Essential elements of systems improvement 1. Will. One must have the will to improve 3. Execution. 2. Ideas. One must have ideas about alternatives to Then one must the status quo make it real. Essential elements for systems improvement Courtesy of IHI Chad Glenn, Innovation Group 20 10
7/11/2017 Essential elements of systems improvement 1. Will. You must have the will to improve 3. Execution. 2. Ideas. You must have ideas about alternatives to Then you must the status quo make it real. Essential elements for systems improvement Courtesy of IHI Chad Glenn, Innovation Group 21 Execution - a Focus on The Model for Improvement The Model for Improvement (MFI), serves as a tool/ framework for: Developing Testing Implementing and Spreading changes Chad Glenn, Innovation Group 22 11
7/11/2017 Model for Continuous Improvement AIMS What are we trying to accomplish? How will we know that a MEASURES change is an improvement? What changes can we make that will result CHANGES in an improvement? Courtesy of IHI Chad Glenn, Innovation Group 23 Developing Your Teams Project Plan 1 2 3 Test and adapt Chad Glenn, Innovation Group 24 12
7/11/2017 Chad Glenn, Innovation Group Chad Glenn, Innovation Group 25 Model for Continuous Improvement AIMS What are we trying to accomplish? MEASURES How will we know that a change is an improvement? What changes can we make that will result CHANGES in an improvement? Courtesy of IHI Chad Glenn, Innovation Group 26 13
7/11/2017 1 2 3 Test and adapt Chad Glenn, Innovation Group 27 Fundamental Question #1: What are we trying to accomplish? 1 Chad Glenn, Innovation Group 28 14
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