Current State of Health Care & Building a High Reliability Organization. Jeff Korsmo Kansas Respiratory Care Society State Meeting April 11, 2013

Transcription

1 Current State of Health Care & Building a High Reliability Organization Jeff Korsmo Kansas Respiratory Care Society State Meeting April 11, 2013 Introduction Objectives Explain the concept of the Triple Aim initiative Provide examples of how Via Christi is implementing initiatives to achieve the Triple Aim Discuss how interdisciplinary leadership is necessary to achieve the Triple Aim Outline Via Christi s journey to become a highreliability organization 1

2 Introduction About Via Christi Serves Kansas and northeast Oklahoma through a system of physicians, hospitals, senior villages and other health services Co-founded by the Sisters of the Sorrowful Mother and the Sisters of St. Joseph of Wichita in1995 Contributed $90.5 million in community benefit in 2012 Hays Garden City Dodge City Manhattan Wamego Salina McPherson Wichita Ponca City, OK Pittsburg Hospitals (owned) Hospitals (partially owned) Hospitals (managed) Via Christi Villages Health Partners Physician Clinics Why Triple Aim? 2

3 New Goal of Health Care: Triple Aim The National Issue: Poor Health Care Value Per Capita Health Care Expenditure $8,000 $7,000 $6,000 $5,000 $4,000 $3,000 $2,000 $1,000 $0 Life Expectancy at Birth Health Care Expenditures by Country 2008 per capita Healthcare Expenditures and as a % of GDP HC Expenditures % of GDP Canada France Germany Italy Japan Switzerland UK US Among the above developed nations, the U.S. is the highest cost (on both a per capita and a % of GDP basis), yet has the lowest life expectancy at birth 18% 16% 14% 12% 10% 8% 6% 4% 2% 0% Healthcare as a % GDP Source: Organization for Economic Co-operation and Development, Health Data 2005: Statistics and Indicators for 30 Countries 3

4 The National Issue: Poor Outcome Consistency Deaths before age 75 that are potentially preventable with timely and appropriate medical care (International data , State data ) Deaths per 100,000 population *Top 5 states: MN, UT, VT, CO, NE; Bottom 5 states: LA, MS, AR, TN, AL; excludes District of Columbia data Sources: Commonwealth Fund National Scorecard on U.S. Health System Performance, 2009; Nolte and McKee: Measuring The Health Of Nations: Updating An Earlier Analysis, Health Affairs, Jan-Feb 2008 How does Wichita compare? Grand Junction, CO Proving better, safer, lower-cost care is within reach Wichita, KS How does it compare? McAllen, TX One of the most overutilized and costliest health care markets Price-Adjusted Medicare Reimbursements per Enrollee Source: and Dartmouth Atlas of Health Care 4

5 Environmental Drivers Aging population More than 10,000 baby boomers become Medicare-eligible every day Evolving relationships between hospitals and physician practices Health care work force Healthier communities Achieving Triple Aim: Moving from Volume to Value 5

6 Achieving Triple Aim: Moving to Population Health Determinants of Implementing Triple Aim 6

7 Creating a new Via Christi Vision 2020 Planning process, begun in January, to develop a shared vision and strategic plan for the future of Via Christi Transparent, Collaborative Process, Involving: Via Christi Leaders (Planning Task Force/Retreats) Employees (over 500 message board postings) Patients, Community and Business Leaders Vision 2020 Vision Elements Person-centered We place the needs of those we serve at the heart of all we do. Clinician-led We are led by clinicians who are willing, prepared and engaged in partnering with all colleagues in achieving patient-centered, team-based care. Clinical integration We coordinate, integrate and innovate care delivery to create a seamless experience. Best quality/best value We achieve improved quality, care experience, population health and cost outcomes by providing the right care at the right time in the right setting. Best place to practice and to work We respect and trust one another, share a passion and commitment for doing meaningful work, and demonstrate a genuine interest in each person s well-being. Healthier communities We are a model and catalyst for building healthier communities. 14 7

8 Hospital Safety Issues: Examples Hospital-acquired infections, e.g., C. difficile Ventilator-associated pneumonia Surgical site infections Patient falls 15 Setting a Big Aim Quality & Safety Safety Score Hospital C Via Christi Hospitals Wichita C Via Christi Hospital Pittsburg A Mercy Regional Health Center C, D Other Wichita hospitals 8

9 Setting a Big Aim Quality & Safety Safety Score Hospital C A C A A Via Christi Hospitals Wichita Via Christi Hospital Pittsburg Mercy Regional Health Center C, D Other Wichita hospitals Achieving High Reliability Leadership 18 9

10 Achieving High Reliability Culture eats strategy Key Performance Indicators Example Decrease patient falls to below state and national rates from 3.5 to 2.8 per 1,000 patient days Near miss, good catch - a just culture which values a safe environment Difference Makers Leadership 10

11 Leadership Interdisciplinary Leadership Dyad & Triad Leadership Clinical Practice Committee Center for Clinical Excellence Leadership Structure Clinical Practice Committee Clinical Practice Committee Quality Committee Physician Chair Randall Morgan, MD ACCREDITATION Physician open Administration - S. Nesbit, DO Staff Support - Erin Erb OUTCOMES Physician open Administration - S. Nesbit, DO Staff Support - G. Blake SERVICE Physician L. Ebersole, DO Administration C. Lafleur Staff Support- Jenn Bowman SAFETY Physician open Administration S. Nesbit, DO Staff Support - Jessica Pereira ACCREDITATION TEAM JOINT COMMISSION COMPLIANCE AMI / CHF PN CORE MEASURES SERVICE TEAM NET PROMOTER SCORES SAFETY TEAM LEAPFROG SAFETY SCORES Quality Sub-Committees Measurement SCIP HAIs BIG AIM HCAHPS BIG AIM SSE RATE PIT Teams NPSG Future PIT Teams 11

12 Resources to Support Leverage aviation industry experts Lean, Six Sigma black belts High-reliability organization Rapid-Cycle Improvement Create Performance Improvement teams Leapfrog Ascension Health Center for Clinical Excellence Organizational Chart Via Christi Hospitals Wichita, Inc. Executive Director, Quality and Process Improvement Al Miller Chief Medical Officer Dr. Stephen Nesbit Department Assistant Dianne Bingenheimer Scope: Patient safety, Just Culture, clinical quality, CMS reporting, NDNQI, Leapfrog, infection prevention/control Scope: Patient satisfaction, service, HCHAPS, and patient advocacy Scope: Regulatory preparedness with Authorities Having Jurisdiction (i.e. CMS, TJC, KDHE) Scope: Lean, Six Sigma, AP/WO, Process Improvement Teams Director, Quality/Patient Safety Gretchen Blake Patient Service Coordinator Jenn Bowman HC Accreditation Coordinator Erin Erb Director, Process Improvement Laura Thompson Focus: Clinical Quality Outcomes, Core Measures, readmission rates Focus: Patient Safety, Just Culture, High Reliability Science Focus: Specialty Hospitals (RH / BH) (Home Health) PI Specialist Black Belt Rob Dreiling PI Specialist Black Belt Zachery Lewis PI Specialist Black Belt Michelle Casados Manager Quality and Patient Safety Sandy Schremmer Manager Quality and Patient Safety (Open) Manager Quality and Patient Safety Jessica Pereira Manager Quality and Patient Safety Nancy Koftan Infection Prevention and Control Manager (Open) Black Belt Quality Analyst Marsha Healy Quality Analyst Shelley Kinder Quality Analyst (Open) Quality Analyst Diana Chipas IC Coordinator Kären Bally Green Belt Quality Analyst Shelly Berland Quality Analyst (Hold RH Budget) IC Coordinator Sandy Johnson Yellow Belt IC Coordinator John Kephart Revision Date : 1/7/2013 Quality Analyst Jessica Henning 12

13 Community Transparency Community Forum, Feb. 5 Well attended 94 community leaders, board members, physician and administrative colleagues, news media Nearly 200 watched live-stream video Commitment to improve and be accountable 25 Where To Find More Information Visit to find links to: The full 60-minute Community Forum as it was broadcast via livestream on our website Interview with KWCH Kloseup News Show (5 minutes) Stories about the forum and Via Christi s quality improvement efforts in The Wichita Eagle and the Wichita Business Journal A story and video by our Communications staff about our quality black belts and performance improvement teams 13

14 Achieving High Reliability Leadership 27 14