Innovation, Quality & Accountability in Alberta Health Services National Health Leadership Conference Halifax, Nova Scotia Dr Tom Noseworthy June 4, 2012 1
Formation & first three years of AHS Pre-April 1995: ~ 200 individual hospital/facility boards April 1, 1995: Seventeen regional health authorities 2003: Nine RHAs & three provincial boards 2008: Alberta Health Services- one provincial health delivery organization formed 2011: New administration & five Zones introduced 2012: Strategic Clinical Networks launched 2
Top 20 characteristics of high performing health systems 1. Success is defined & terminology clear for all stakeholders. Quality is defined. 2. Physicians are engaged at all levels. 3. Innovation is defined and embraced: people, processes, and systems. Not just devices/drugs. 4. People in teams and networks - that lead a culture of innovation across boundaries (people, processes, systems, services). 5. People test innovation; it s OK to fail. 6. Champions of change (and leaders) are identified, developed and supported. 7. There is an engaged and empowered public (the public is actively involved). 8. Evidence-based treatments and approaches are used wherever possible and/or are pursued through research. 9. There is fusion of health, environment and education in a planned way: the health system addresses broader determinants. 10. The system improves value (and value for money) for all as a major goal. 3
Top 20 characteristics of high performing health systems 11.Good information for decisions is essential: real time evidence is key. 12.Prevention is part of doing business (it is somebody s job). 13.The system invests to buy positive changes. 14.There is a good human resource system. 15.Careful (avoid perverse) incentives are used to incent all stakeholders. 16.Careful (avoid perverse) on-line measurement with feedback to those who need it. Measure for goals and beware of what is not measured. 17.Strong and engaged primary care and strong community care. 18.Planning models with embedded research. 19.Be patient but always keep the patient in mind. Meet or exceed patient expectations as a top priority. 20. Top down meets bottom up in all ways (structures, programs, goals). 4
What is the Provincial Mandate of AHS? Improve population health Ensure continuous quality improvement Incorporate research that impacts patients Focus on patient outcomes and equity Design more accessible care Develop appropriate clinical practices Make patient safety a priority Ensure value for money 5
How will the Provincial Mandate be Accomplished? Clinically-driven change Strategic Clinical Networks Measurement, research & evidence drive practice Clinical care pathways Clinical variance management 6
Why Networks? Early experience with clinical networks in AHS- 2010 to present The need to connect top-down & bottom-up Strategy for clinical engagement Success elsewhere (Scotland, UK, Australia, OCCN) 7
Why Clinical Networks? Networks have proven to be an effective mechanism to ensure collaboration, joint decision-making and shared learning. Networks are a proven model to promote the use/uptake of clinical experience, knowledge and research to reduce variation and improve care. Networks are a positive way for all partners along a broad continuum to be involved in planning and improving healthcare service delivery. 8
What are Strategic Clinical Networks (SCNs)? Collaborative clinical teams with a strategic mandate Led by clinicians and driven by clinical needs Comprised of: Front-line physicians and clinicians from all professions (including primary care and community-based providers) Zone/ clinical operations/ clinical support service leaders Content experts Public/patients Researchers AHW & other external partners 9
What are Strategic Clinical Networks (SCNs)? Broad mandate: Specific populations, i.e. seniors Diseases with high impact, i.e. vascular disease Scope encompasses entire continuum of care From population health & prevention to primary care to acute care to chronic disease management to palliation Activities better aligned with AHS and AH priorities Integrated with and into organizational priority-setting and decision-making Resourced and supported to achieve improved clinical outcomes 10
Planned Support and Resources for SCNs Dedicated Business Intelligence Unit: Project management, clinical analytics, case costing, quality improvement, pathway development, patient safety, knowledge management, health technology assessment Embedded research capability and expertise Education & skills development for leaders Funding including: Seed money for innovation, initiatives, and research Remuneration of core members Opportunities to retain savings that are realized 11
First Six SCNs- Launch June 12-13 Diabetes, Obesity and Nutrition Bone and Joint Health Cardiovascular Health and Stroke Seniors Health Addiction and Mental Health Cancer Care 12
Next Six SCNs- Autumn 2012 Population Health and Health Promotion Primary Care & Chronic Disease Management Maternal Health Newborn, Child, and Youth Health Neurological Disease, ENT, and Vision Complex Medicine (GI, Kidney & Respiratory) 13
Accountability & Governance of SCNs Strategic Clinical Executive Committee (subcommittee of AHS Executive Committee) Executive Sponsors / Dyad: EVP & Chief Development Officer and EVP & CMO Senior Leadership Dyad: VP, SCNs & Clinical Care Pathways and Associate CMO, SCNs & Clinical Care Pathways Each SCN led by a Dyad: Clinical Co-Director and Administrative / Strategy Co-Director Each SCN to include a Research / Scientific Director 14
Core Committee Members SCN Clinical and Strategy Dyad SCN Executive Director Patient/Family Lead Communities/Public Lead Research and innovation Physicians Primary Care, specialty care and others Other Clinicians (Nurses, Physiotherapists, Psychology, OT, etc.) Zone & Clinical Operational/Clinical Support Services Leaders Alberta Health Policy Lead Strategic Partners (e.g. Alberta Heart & Stroke Foundation, Alberta Bone & Joint institute, etc. SCN dependent). 15
Next Steps Basic orientation and leadership training for SCN Co- Directors completed February 10, 2012 Launch the first six SCNs June 12, 2012 SCNs appoint Scientific Director & begin the process to build & strengthen provincial-level research networks Each SCN works with Zones to develop a Signature & Reassessment project 16