on Quality Improvement in Health Care Derek Feeley, DBA Institute for Healthcare Improvement Enrique Ruelas, MD, MPA, MHSc Tecnológico de Monterrey
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1 Welcome to the 2017 National Forum on Quality Improvement in Health Care December 10 13, 2017 Orlando, Florida A Committed Board of Directors Donald M. Berwick, MD, MPP Institute for Healthcare Improvement Ann Scott Blouin, RN, PhD, FACHE The Joint Commission Tom Chapman, MPH, EdD The HSC Foundation Michael Dowling Northwell Health Derek Feeley, DBA Institute for Healthcare Improvement Elliott Fisher, MD The Dartmouth Institute for Health Policy and Clinical Practice Jennie Chin Hansen American Geriatrics Society Helen Haskell, MA Mothers Against Medical Errors Gerald B. Hickson, MD Vanderbilt University Medical Center Brent James, MD, MStat Intermountain Healthcare Gary Kaplan, MD Virginia Mason Health System Arnold Milstein, MD, MPH Stanford University Mary Beth Navarra-Sirio, RN, MBA Sirio Healthcare Innovations Enrique Ruelas, MD, MPA, MHSc Tecnológico de Monterrey Mark D. Smith, MD, MPA Harvard T.H. Chan School of Public Health Nancy Snyderman, MD, FACS University of Pennsylvania Sam R. Watson, MSA, CPPS Michigan Health & Hospital Association (MHA) Keystone Center #IHIForum
2 Thank You IHI Staff (on a normal day) #IHIForum Thank You IHI Staff (this week) aka Blue Shirts
3 2017 National Forum Chairs NAVINA EVANS CEO, East London NHS Foundation Trust LISA SCHILLING, RN Vice President, Quality and Care Delivery Effectiveness, Kaiser Permanente RON WYATT, MD Chief Quality Officer and Director, Hamad Medical Corporation MICHAEL FISHER President and CEO, Cincinnati Children s Hospital Medical Center #IHIForum Welcome Groups of 25 and Up Kaiser Permanente Northwell Health Southcentral Foundation Orlando Health Gundersen Health System Mayo Clinic #IHIForum
4 Thank You IHI Strategic Partners #IHIForum Welcome to our Year 4 Leadership Alliance members: Air Force Medical Department Alberta Health Services Bellin Health CareSouth Carolina Charleston Area Medical Center Christiana Care Health System CHRISTUS Health Cincinnati Children's Hospital Medical Center Coastal Medical Consulate Health Care Duke University Hospital GBMC HealthCare System Genesis HealthCare Hackensack Meridian Health HealthPartners Henry Ford Health System Kansas Health Care Collaborative Keck Medicine of USC Memorial Hermann Health System MemorialCare Health System Missouri Hospital Association National Capital Region Medical Directorate North Country Healthcare Northwell Health Northwest Community Healthcare OCHIN Parkview Health System Providence St. Joseph Health Roanoke Chowan Community Health Center Samueli Integrative Health Programs SCAN Health Plan South Carolina Hospital Association Southcentral Foundation Tanana Chiefs Conference The Dartmouth Institute UMass Memorial Health Care University of Arkansas for Medical Sciences Virginia Mason #IHIForum Learn more at ihi.org/leadershipalliance
5 Thank You Diamond Sponsors #IHIForum
6 Thank You Platinum Sponsors #IHIForum Thank You Gold Sponsors #IHIForum
7 Forum Hall Hours Today 9:30 AM 10:30 AM (By appointment only) 10:30 AM 1:30 PM 4:15 PM 6:30 PM Tomorrow, 10:30 AM 1:30 PM See the Welcome Guide for a floor plan and list of Exhibitors. #IHIForum Join the use #IHIForum Visit Conference Information near the bookstore for more information. #IHIForum
8 The National Forum Celebration #IHIForum Tonight 6:30 PM 10:00 PM, Marriott Poolside Keynote Speakers RANA AWDISH, MD Director of Pulmonary Hypertension Program, Critical Care Physician, Henry Ford Hospital TIFFANY CHRISTENSEN Vice President for Experience Innovation, The Beryl Institute DEREK FEELEY President and CEO, #IHIForum
9 Keynote 1b #IHIForum December 12, 2017 Orlando, FL Mutuality 29 th Annual National Forum on Quality Improvement in Health Care Derek Feeley Tiffany Christensen Rana Awdish
10 Two Challenges 60% respondents of MD survey are considering leaving practice 70% knew at least one MD who left practice due to poor morale 37% of newly licensed RNs are thinking of leaving their job Lucian Leape Institute Through the eyes of the workforce: creating joy, meaning and safer health care. National Patient Safety Foundation. 20
11 Mutuality A win-win situation that is built on a foundation of trust Sharing things in common Seeking for things in common: Interests Goals Values SOURCE: Dr. Martha Reavley, Odette School of Business
12 Applied to Health Care Mutuality The optimal doctor-patient relationship model This model views neither the patient nor the physician as standing aside Each of participants brings strengths and resources to the relationship Based on the communication between doctors and patients SOURCE: Stewart M, Roter D. Communicating with Medical Patients. Sage: London Keys Purpose Partnership Power
13 Purpose The source of energy at work is in connection to purpose. How to Create a Joyful, Engaged Workforce Outcome: Patient experience Organizational performance Staff burnout 4. Use improvement science to test approaches to improving joy in your organization 3. Commit to making Joy in Work a shared responsibility at all levels 2. Identify unique impediments to Joy in Work in the local context 1. Ask staff what matters to you?
14 Critical Components for Ensuring a Joyful, Engaged Workforce Interlocking responsibilities at all levels Real Time Measurement: Contributing to regular feedback systems, radical candor in assessments Physical & Psychological Safety: Equitable environment, free from harm, Just Culture that is safe and respectful, support for the 2 nd Victim Wellness & Resilience: Health and wellness selfcare, cultivating resilience and stress management, role modeling values, system appreciation for whole person and family, understanding and appreciation for work life balance, mental health (depression and anxiety) support Daily Improvement: Employing knowledge of improvement science and critical eye to recognize opportunities to improve, regular, proactive learning from defects and successes Camaraderie & Teamwork: Commensality, social cohesion, productive teams, shared understanding, trusting relationships Wellness & Resilience Daily Improvement Real Time Measurement Camaraderie & Teamwork Happy Healthy Productive People Physical & Psychological Safety Participative Management Meaning & Purpose Recognition & Rewards Choice & Autonomy Participative Management: Co-production of Joy, leaders create space to hear, listen, and involve before acting. Clear communication and consensus building as a part of decision making Meaning & Purpose Daily work is connected to what called individuals to practice, line of site to mission/goals of the organization, constancy of purpose Autonomy & Choice: Environment supports choice and flexibility in daily lives and work, thoughtful EHR implementation Recognition & Rewards: Leaders understand daily work, recognizing what team members are doing, and celebrating outcomes Partnership ( Adapted from Comité sur les pratiques collaboratives et la formation interprofessionnelle 2013a
15 Power: Getting to the Third Curve Ceding power Outcomes Keeping power ASSURANCE Targets, sanctions, inspections Sharing power QUALITY IMPROVEMENT MOBILIZING PARTNERSHIPS CO-PRODUCING QUALITY IMPROVEMENT PERFORMANCE MANAGEMENT Time Mutuality: I will find it where?
16 December 2017 In Shock Rana Awdish MD
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21 Join the conversation Rana Awdish MD
22 IHI National Forum Orlando, Florida The Ripple Effect Tiffany Christensen VP Experience Innovation at The Beryl Institute December 12, 2017 Is illness really a gift?
23 Do your patients know what to expect? 45 Do you know what your patients expect? 46 Is it possible for patients to find joy at the end of life? How do we support that?
24 47 How could end of life be joyful but working life be so joy-less? 48 How do we find meaning in our work? What matters to you?
25 What would happen if we admired patients instead of pitied them? 49 How might that impact your joy at work? How did you answer my questions? Let me know! Tiffany Christensen Vice President of Experience Innovation The Beryl Institute
26 Scottish Government 2010
27 But START!
28 Heroism is out, humility is in
29 Listen to understand not to respond Two wide lugs an a short tongue is best -Scottish proverb
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31 Welcome to the 2017 National Forum on Quality Improvement in Health Care December 10 13, 2017 Orlando, Florida Don t miss out on these Keynotes Book Signings: Rana Awdish, Today, 9:00 AM 10:00 AM In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope Tiffany Christensen, Today, 10:45 AM 11:15 AM Sick Girl Speaks!: Lessons and Ponderings Along the Road to Acceptance National Forum Bookstore
32 Welcome to the 2017 National Forum on Quality Improvement in Health Care December 10 13, 2017 Orlando, Florida
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