Captain James A. Lovell Federal Health Care Center. Institute of Medicine: Quality Mark Albrecht

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Jody Perry
5 years ago
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1 Institute of Medicine: Quality Mark Albrecht

2 Outline Welcome/Introduction Overview Quality: From Two to One FHCC Quality Program Structure Aligning, Integrating, Maximizing Building a Systematic Approach Going Forward: Challenges and Opportunities

Acronyms BUMED: Bureau of Medicine and Surgery CARF: Commission on Accreditation of Rehabilitation Facilities CLC: Community Living Center CPI: Continuous Process Improvement

3 Acronyms BUMED: Bureau of Medicine and Surgery CARF: Commission on Accreditation of Rehabilitation Facilities CLC: Community Living Center CPI: Continuous Process Improvement DoD: Department of Defense ED: Emergency Department FHCC: ICU: Intensive Care Unit LSS: Lean Six Sigma MH: Mental Health NCVAMC: North Chicago Veteran s Affairs Medical Center

4 Acronyms (cont d) NHCGL: Naval Health Clinic Great Lakes NME: Navy Medicine East OME: Home Care NAVOSH: Naval Occupational and Safety Health OSHA: Occupational and Safety Health Administration PACT: Patient Aligned Care Team SR: Systems Redesign VA-TAMMCS: Vision Analyze Team Aim Map Measure Change Sustain VHA: Veteran s Health Administration VHA CO: VHA Central Office

5 Quality: From Two to One Pre-Integration Different Operations NCVAMC: Inpatient and Outpatient, Surgery, ICU, Med Surg, ED, MH, OME, CLC, etc. NHCGL: Ambulatory only, focused on supporting Recruit Mission, Operational Readiness of Sailors at Great Lakes and healthcare for their families and retirees Post-Integration Quality infrastructures were already in place Challenges and opportunities to build upon to bring them together

6 NCVAMC and VHA Data rich Quality Approaches Focus on Performance Measures and Outcomes Improvement Projects from Central Office NHCGL and BUMED Mission-Focused data/productivity measures Outpatient focused/hedis Measures Fewer centralized improvement programs/priorities from above

7 All prior Performance Measures remain in place, to meet both Navy and VA monitoring requirements PO3 PO4 Access for Primary Care Patients (new and established): each Network will monitor the percent of unique Primary Care Patients on the Access List waiting more than 14 days from desired date for an appointment VA Primary Care DoD Primary Care Access for Specialty Care Patients (new and established): each Network will monitor the percent of unique Specialty Care Patients on the Access List waiting more than 14 days from desired date for an appointment

8 Organizational Cultures VHA CPI Approach BUMED/Navy CPI Approach Navy/DoD Pt FHCC BUMED Strategies Command Strategies Local CPI/LSS Improvements System-Wide Improvements Through VHA Strategic Priorities Command-Level Improvements in Alignment with Navy Strategic Priorities

9 Considerations for Quality VHA BUMED Performance Measures Systems Redesign: VA-TAMMCS (n=4 Belts) Lean Six Sigma (n=35 Belts)

10 The Way Forward for Quality Continue to successfully implement Centrally-Driven Impr0vement Projects While maximizing locally-driven systems/process improvements VHA Systems Redesign + Navy Lean Six Sigma

11 Combining our Strengths VHA Systems Redesign Structured SR Program required (this is new to VHA) VISN 12 Plans for program development are tracked BUMED LSS Mandated LSS CPI approach Navy-Wide Invested earlier in training staff across Navy FHCC Quality Structure Integration provides perfect opportunity for Aligning, Integrating, and Maximizing these strengths for FHCC

12 Executive Steering Strategic Vision Leadership Sub-Group: Assistant Directors Patient Safety Council Tactical Management/ Alignment with SP Goals SR/LSS Management Group LSS/SR Cadre Issue Vetting Directorates, Committees, Departments, and Staff Issues Identification

ESC - Mondays: One Hour. Director, Deputy Director, Six Associate Directors, Assistant Directors, Command Master Chief, Senior Enlisted Leaders, and OPI.

13 ESC - Mondays: One Hour. Director, Deputy Director, Six Associate Directors, Assistant Directors, Command Master Chief, Senior Enlisted Leaders, and OPI. Overall strategic coordination of FHCC according to annual list of topics; Calendar of reports from each Oversight Committee. Serves as Strategic Planning Board for FHCC. Monthly review of all Performance Measures. Leadership Council - Wednesdays: One Hour. Deputy Director, CMC, Six Associate Directors, OPI. Reviews issues and action items from Oversight Committees. Serves as Leadership body overseeing improvement priorities, coordinating project selection (Charters) and improvement projects oversight. Committee Process: The five standing Oversight Committees will meet monthly, receive feedback from the committees listed below them, and provide appropriate reports to the ESC. Unresolved issues or items needing action will be forwarded to the LC for analysis, prioritization, tracking, and resolution/management

14 Quality Program Structure: The System We re Building Unique approach to meet our needs: Engage trained staff throughout the organization Leadership: Assistant Directors driving improvement activities/priorities Designating LSS resources for each Directorate Hiring Full-Time LSS Black Belt to mentor and support projects and activities command-wide Enjoy support from both Navy and VA LSS/SR resources above us

15 Summary: Lessons Learned Tremendous Opportunities Integration provides many challenges amenable to structured process redesign Ample Resources Growing emphasis for structured quality program from both Navy and VA Support from both Navy and VA for continued expansion of LSS trained staff Quality infrastructure/tools available from both Navy and VA Building program structure to meet FHCC s needs Adapt from existing Navy and VA structures FHCC Quality program approach is new/potential is unlimited

16 Integration Impact: Quality VHA Quality Reporting and Monitoring BUMED VISN 12 NME FHCC Post-Integration, dual quality oversight remains

17 Integration Impact: Quality Whose Rules do we follow? Policy questions navigate differences in BUMED or VHA guidance/instructions Redundancies and/or differences in reporting requirements to higher authorities Great outside interest in FHCC Multiple (continual) visitors, inspections and reviews most requiring responses and follow-up Potential redundancies of inspection bodies Ex. Two Inspectors General; OSHA and NAVOSH; Joint Commission and CARF, etc.

19 Questions?

WHITEPAPER: PERSPECTIVES ON MILITARY HEALTHCARE QUALITY IMPROVEMENT Strategic Collaboration

WHITEPAPER: PERSPECTIVES ON MILITARY HEALTHCARE QUALITY IMPROVEMENT Strategic Collaboration LEVERAGING LEAN SIX SIGMA TO HARNESS THE BEST OF VA & MILITARY HEALTHCARE Introduction Continuous Process Improvement