Taking Charge of Team Based Care: Lessons Learned and Results Attained. Susan D. Douglass Paul H. Keckley, PhD.

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1 Taking Charge of Team Based Care: Lessons Learned and Results Attained Susan D. Douglass Paul H. Keckley, PhD. 1

2 Discussion Overview In the New Normal Healthcare Landscape, The Rules Are Changing. The Evolving Role of the Physician. As Providers, Our Ultimate Goal is Illustrative Examples: Results and Barriers. Building Momentum. Questions.

3 The Transition from Old Rules to The New Normal For Physicians From healthcare being local to most healthcare is viewed as local. From quality, safety and costs being perceived to quality, safety & costs being transparent and accessible. From incentives to do more...to incentives to do the right thing in a coordinated care model. From a member of a medical staff to a member/ provider within narrow networks that share risk. From employers as observers to employers as value activists for employees. From patients as healthcare users to purchasers as consumers.

4 The Transition from Old Rules to The New Normal For Physicians Success in the new healthcare environment, which means increased demand for healthcare services and looming talent shortages, will require a team based approach to quality, cost effective patient care. The transition will be a challenging one and will require investment in: New technologies Predictive analytics and workflow analysis New protocols Human Resource (HR) business processes; learning, compensation, communication etc. Change management.

5 Physicians Will Play A Key Role But A Different Role Administrators/Watchdogs Employers Insurers Infomediaries Disruptors Medi a Pharma Innovators Service Providers BIOTECH Hospitals Long Term Care Retail Pharmacy Alternative Health Over The Counter (OTC) Allied Health Professionals Physicians Consumers Regulators BioTech Outpatient Facilities Disease Management Devic e Professional Societies/ Special Interests Accrediting Agencies

6 Our Ultimate Goal To thrive, healthcare providers must: Deliver the right care, in the right setting, at the lowest cost possible. Infuse standardization and develop evidence based care protocols. Reduce the variation in outcomes and mitigate risk. Continually work to improve HCAHPS and patient satisfaction scores. Build brand loyalty Inspire physicians to be champions. Develop dynamic care teams who can consistently share this purpose and can deliver the above.

7 The Ultimate Goal A dynamic care team which demonstrates: Professionalism and respect among gifted health care professionals Harnessing of group dynamics Focusing on top of license contributions Exemplary patient handoff across the care continuum.

8 The Ultimate Goal To develop highly functioning care teams across the care continuum. Shared purpose Focused on measurable goals Consistent, widely understood protocols. Effective leadership and communication Good cohesion, mutual respect. To form care teams using a consistent methodology: Forming : form relationships around task. Storming: establish policies, procedures and vet any power struggles. Norming: build upon small wins to gain momentum. Performing: attention is focused on achieving goals. To develop the technology and HR processes to sustain momentum. 8

9 Future Care Team: Illustrative Example Patient / Consumer Nurse Practitioner Acupuncturist Front Line Workers Pharmacist Self Diagnosis 9 ETC 9

10 Emerging Care Models Inter professional care teams across a wide continuum of care are entrenched at many locations and emerging at others to meet the physical, mental and social needs of a patient. Significant work effort occurring across the country. To date, the most successful models share several elements. Re engineering care models has been a driving strategy for some time. All involve realize this transition will be disruptive and not easy. Physician champions are inspired to embrace team based care. Clinical professionals and front line workers are involved in care model development. Patient Centered Medical Home ( PCMH) and Accountable Care Organization (ACO) experience is favorable. Predictive analytics and electronic tools to manage specific populations are widely used. Having the funding to invest in re engineering care models is a must.

11 Illustrative Results and Barriers Results: In general, most are involved in a transition from the Dyad care model (Physician Nurse) to the Triad care model (Physician, Nurse, Case Manager) and Beyond (Physician, Nurse, Social Workers, Others etc.) to be better equipped to deliver patient centered, coordinated and cost effective care. Initiatives include: Tackle the inefficiencies in the case management model. Focus on a specific service line to start ( i.e. cancer). Improve HCAHPS Doctor Communication by focused triad rounding. Create a service line on team based care and develop an ancillary network across the community to cost share the development of the organization wide team based care effort. Reduce readmissions by improving acute and post acute communication. Provide stipends to those involved for time in developing, launching and ongoing coordination of care models. Barriers: These include threatened stakeholders; limited funding; poor selection of team based care champions; non team oriented professionals and burnout.

12 Immediate Action: Making Some Tough HR Decisions 12

GGG Understand and prioritize Wherever the organization is. Adapt and apply Small wins first. Reorient and Up skill your team Invest in inspiring, skill development and technology.

13 GGG Understand and prioritize Wherever the organization is. Adapt and apply Small wins first. Reorient and Up skill your team Invest in inspiring, skill development and technology. Operationalize and sustain Reflect on what worked well; assess and remove barriers; use ongoing skills based training and HR processes to hardwire ability to sustain momentum. Source: The Disney Institute 13

14 US Air 1549 Emergency: A Team That Performed With Precision 14

15 Questions Additional questions after the Session, please contact: Susan Douglass

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