Nicole Harmon, MBA, PCMH CCE Senior Director HANYS Solutions Practice Advancement Strategies
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1 Nicole Harmon, MBA, PCMH CCE Senior Director HANYS Solutions Practice Advancement Strategies HANYS Healthcare Solutions Association Practice of Advancement New York State Strategies 9/28/2017 Slide 1
2 This webinar is provided with the support of the American College of Physicians Support and Alignment Network (ACPSAN) Healthcare Association of New York State 9/28/2017 Slide 2
3 Overview Importance of practice transformation Transformation alphabet soup Key redesign components Positioning for success Q&A 9/28/2017 Slide 3
4 Importance of Practice Transformation Healthcare Association of New York State 9/28/2017 Slide 4
5 CARE WITHOUT COORDINATION MEALS/ NUTRITION SOCIAL SERVICES NURSING HOME HOUSING/ HOME SUPPORT HOME HEALTH CARE TRANSPORTATION/ MOBILITY COMMUNITY INFORMAL CHURCH CARE FRIENDS HEALTH FINANCIAL INSURANCE SERVICES MEDICARE MEDICAID PART D LTC INSURANCE HEALTH SERVICES DOCTORS HOSPITALS CLINICS Rx FAMILY CARE GRANDCHILDREN CHILDREN SPOUSE 5
6 Medical Neighborhood Source:
7 NCBI Working Definition The deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient's care to facilitate the appropriate delivery of health care services. Organizing care involves the marshaling of personnel and other resources needed to carry out all required patient care activities, and is often managed by the exchange of information among participants responsible for different aspects of care. Source:
8 Impact of Coordinated Care More efficient use of services Lab, imaging, ER, hospitalization Improved patient experience Access, coordination, clinician collaboration, involvement in care Improved outcomes CQI, evidence-based guidelines, medication management
9 Transformation Alphabet Soup Healthcare Association of New York State 9/28/2017 Slide 9
10
11 Alphabet Soup of Redesign PCMH ACO MU APC DSRIP TCPI VBP PQRS
12
13 Key Redesign Components Healthcare Association of New York State 9/28/2017 Slide 13
14
15 Change isn t Easy Don t assume that all will embrace change - I m already overworked. Now you want me to do what? The transformation process can be a long and difficult journey Recognize that change doesn't occur overnight Teamwork Hate Change
16 Key Transformation Components Leadership Awareness Desire and urgency Communicate Engage the team Educate Measure progress Coach and manage resistance Celebrate successes Continuous improvement
17 Transformation is not a Project
18 Project vs. Change Management Project Management Task-Focused Project Plan and Milestones Transformation Process Change Management People-Focused Education and Coaching Sustainability of Change
19 Current State vs. Goal Policies and procedures Culture and environment Team structure HIT functionality Reporting capability Quality improvement 19
20 Transformation Team Leadership Define roles and responsibilities Decision making process
21 Team Roles and Responsibilities Project Manager Physician Champion Administrative Lead Clinical Lead HIT Lead Quality Lead Documentation Lead Scribe
22 Transformation Team Engaged Dedicated Focused on the goal Support efforts Set the standard
23 Why is Culture Important? 23
24 Awareness Building Specific and clear Timing Expectations
25 Creating Awareness Readiness to recognize the need to change depends on: A person s view of the current state How a person perceives the problems Credibility of the sender Misinformation or rumors Belief in the reasons for change
26 Must Have Message - WIIFM
27 The Practice Team What Makes the staff tick? Motivates him/her? Is his/her learning style? Barriers to learning new work styles need to be considered?
28 Communication Strategy Bulletin board Staff meetings Huddles Retreat s?
29 Communication Strategy
30 What To Do Communicate Clearly, consistently, and frequently Honest, open, transparent, and safe Ways for team to provide feedback Consider WIIFM Understand your team member s motivations Impact on daily activities of each team member Impact of the change on job security
31 Engaging the Team Be inclusive Communicate Identify necessary skills Provide training Consistently monitor progress and compliance
32 Engaging the Team Encourage transparency Invite to transformation team meeting(s) Subject matter experts Workflow redesign
33 Health Information Technology An important part of the equation, but not the solution Redesigned workflows Understand data and reporting 33
34 Education Skills People Process Technology Expectations Performance Measurement Audiences Physicians and Mid-Levels Clinical Staff Clerical Staff Administration Patients 34
35 Education Topics Healthcare reform Policies and procedures Care coordination Care management Care planning Motivational interviewing Team-based care Population health Vulnerable populations Behavioral health Health literacy Social determinants of health Workflow redesign Quality improvement 35
36 Ability Transfer training to daily activities Shadowing and mentoring Performance in new reality Performance evaluation updates 36
37 Reinforcement Analyze audit results and diagnose gaps Implement corrective action
38 Preparing for Resistance What type of resistance can be anticipated? Who is likely to be resistant to change? How will we approach resistance? 38
39 Overcoming Resistance Revisit steps of change Awareness WIIFM Knowledge and ability Continue to reinforce 39
40 Coaching and Feedback Seek to understand Lack of information Disagreement Personal reasons Emotional reasons Source: 40
41 Improvement Cycles
42 Celebrate Successes Why is this important? How will you celebrate even the smallest of successes? 42
43 Sustainability = Adaptability A willingness to adapt to the needs of patients and their family members, and to meet those needs in an objective, non-judgmental way
44 Recap - Lessons Learned Transformation team Culture Change management Leverage and involve HIT Celebrate small wins Train, reinforce, coach Accountability
45 Resources 9/28/2017 Slide 45
46
47 Questions Nicole Harmon, MBA, PCMH CCE Phone:
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