Leading health care transformation: a primer for clinical leaders Joshi, Maulik

Table of Contents

• The Health Care Landscape
Introduction
First Curve to Second Curve
Leading Transformation
Key Factors Driving Transformation
High Cost of Care
Shifting Demographics: Patients and Workforce
Transition to Value-Based Reimbursement
Variable Quality Outcomes
Expansion of Coverage under the Affordable Care Act
Advances in Health Information Technology
Shift from Defined Benefit to Defined Contribution Health Plans
The Role of a Clinical Leader
Conclusion
References
• Effectively Implementing Quality and Safety Improvement
The Evidence
The Model for Improvement
Lean
Six Sigma
International Standards Organization 9001
Lessons Learned
Case Studies
NCH Healthcare System: Improving Medication Communication with Patients
Memorial Health System: Hourly Nurse Rounds Reduce Patient Harm and Improve Patient Satisfaction
Action Steps to Lead
References
• Spreading Improvement
Evidence
Preparing for Spread
Establishing an Aim for Spread
Developing a Spread Plan
Effective Strategies for Executing and Monitoring Spread
Case Study: On the CUSP
Lessons Learned
Action Steps
References
• Physician Champions
The Evidence
Case Study
Lessons Learned
Action Steps and Strategies to Lead
References
• Building a Culture of Safety
The Evidence
Transparency around Safety Events
AHRQ Surveys on Patient Safety Culture
Safety Attitudes Questionnaire
Case Study
Lessons Learned
Action Steps and Strategies to Lead
References
• Principles and Practices of High Reliability Organizations
The Evidence
Preoccupation with Failure
Reluctance to Simplify
Sensitivity to Operations
Commitment to Resilience
Deference to Expertise
Case Study
Preoccupation with Failure: Investigating Near Misses and Good Saves
Reluctance to Simplify: Thorough Root Cause Analysis and Event Investigation
Sensitivity to Operations: Daily Organization Huddle
Commitment to Resilience: Simulation
Deference to Expertise: Executive Rounding
Lessons Learned
Action Steps and Strategies to Lead
References
• Key Quality and Safety Measures
The Evidence
Data for Performance Measurement: The Basics
Types and Dimensions of Measures
Criteria and Standards
Data Sources
Metrics of the Future
Effective Strategies: Using Data to Drive Performance Improvement
Selecting Measures
Lessons Learned
Case Study: Tracking Total Harm
Action Steps to Lead
References
• Using Data for Feedback and Improvement
Evidence
Step 1: Data Collection: Objectives, Sources, and Methods
Step 2: Displaying the Data
Physician Profiling
Dashboards
Run Charts
Step 3: Analyzing the Data
Step 4: Implementing Improvement Cycles
Lessons Learned
Interview: Tina Esposito, Vice President, Center for Health Information Services at Advocate Health Care
Action Steps and Strategies to Lead
References
• Leading Effective Teams: For Clinical Care and for Performance Improvement
Evidence
Clinical Care Teams
Performance Improvement Teams
Strategies for Success
Effective Strategy: TeamSTEPPS
Effective Strategy: Patient and Family Engagement
Case Study: Building an Improvement Team
Voice from the Field: Ken Anderson, MD, Chief Operating Officer, Health Research & Educational Trust
Lessons Learned
Action Steps to Lead
References
• Engaging Patients and Families
The Evidence
Prevalence of Patient and Family Engagement Practices
Effective Strategies for Patient and Family Engagement
Strategies at the Direct Care Level
Strategies to Engage Patients in Organizational Design and Governance
Working with Patients/FamilyAdvisor
Case Studies
Developing a Patient and Family Council
Partnering with Patients and Families to Achieve High Reliability
Lessons Learned
Beyond the Bedside
Engage Patients as Partners
Provide Meaningful Opportunities for Patients and Families to Contribute
Patient and Family Engagement as a Strategy to Eliminate Harm
Barriers to Engagement
Action Steps and Strategies to Lead
References
• Improving Care Coordination and Reducing Readmissions
Evidence
Boston Medical Center Re-Engineered Discharge
Care Transitions Program
Evercare™ Care Model
Transitional Care Model (TCM)
Strategies for Success
Identify Patients at High Risk for Readmission
Build Self-Management Skills
Discharge Planning
Follow-Up and Community Resources
Case Study—Collaborative Effort to Reduce Readmissions at Griffin Hospital
Lessons Learned
Action Steps to Lead
References
• Addressing Variation in Utilization
Evidence
Understanding Warranted vs. Unwarranted Variation
Choosing Wisely®
American Hospital Association: Appropriate Use of Medical Resources
Strategies for Success
Interview: Dr. Debra O’Connor, Vice President of Clinical Effectiveness, Advocate Health Care
Lessons Learned
Action Steps and Strategies to Lead
References
• Physician Alignment and Clinical Integration
The Evidence
Case Study
Physician Hospital Organization Field Support Team
Clinical Programs
IT Solutions
Lessons Learned
Action Steps and Strategies to Lead
• New Payment Models
The Evidence
Pay-for-Performance
Accountable Care Organizations and Shared Savings
Identifying an Attributed Patient Population
Structure of Risk Sharing
Bundled Payments
Capitation
Case Study—Advocate Health Care
Lessons Learned
Information Technology
Data and Analytics
Care Management
Action Steps and Strategies to Lead
References
• The Clinical Leader Role in Emerging Models of Care
Retail Medicine
Population Health
Mobile Health
Case Study
Lessons Learned
Action Steps and Strategies to Lead
References
• Compendium of Action Steps
Chapter 1: The Health Care Landscape
Chapter 2: Effectively Implementing Quality and Safety Improvement
Chapter 3: Spreading Improvement
Chapter 4: Physician Champions
Chapter 5: Building a Culture of Safety
Chapter 6: Principles and Practices of High Reliability Organizations
Chapter 7: Key Quality and Safety Measures
Chapter 8: Using Data for Feedback and Improvement
Chapter 9: Leading Effective Teams: For Clinical Care and for Performance Improvement
Chapter 10: Engaging Patients and Families
Chapter 11: Improving Care Coordination and Reducing Readmissions
Chapter 12: Addressing Variation in Utilization
Chapter 13: Physician Alignment and Clinical Integration
Chapter 14: New Payment Models
Chapter 15: The Clinical Leader Role in Emerging Models of Care

Index

Features

Summarizes high-profile healthcare topics and includes a synopsis of the evidence, examples, lessons learned, and action steps for each topic covered
Provides cutting-edge insights from both the quality improvement and physician perspectives
Focuses on the most critical topics in the field today, including the emerging issues of quality, cost, value, and new models of care
Blends the perspectives of administrators, nurses, and physicians to produce a text that is both insightful and practical
Includes a Foreword by Jonathan B. Perlin, MD, PhD, MSHA, FACP, FACMI
Summary

A succinct and practical primer on healthcare transformation, Leading Healthcare Transformation is a key resource for all clinicians in leadership positions. It summarizes high-profile healthcare topics and includes a synopsis of the evidence, examples, lessons learned, and key action steps for each topic covered.

Providing cutting-edge insights from the quality and physician perspectives, the book focuses on the most critical topics in the field today, including the issues of quality, cost, value, and new models of care.

The book includes discussions on various quality improvement processes including Lean and Six Sigma. Detailing specific strategies and tools to help you achieve and sustain improvement, it explains how to build a culture of safety and identifies proven principles and practices for creating a high reliability organization.

Blending the perspectives of administrators, nurses, and physicians, this insightful and practical resource provides the understanding you need to leverage health information technology for clinical improvement and to improve care coordination to reduce readmissions.

https://www.crcpress.com/Leading-Health-Care-Transformation-A-Primer-for-Clinical-Leaders/Joshi-DrPH-Erb-MPH-Zhang-MPH-Sikka-MD/p/book/9781498700184