Leading Health Care Transformation: A Primer for Clinical Leaders, 1st Edition (Hardback) book cover

Leading Health Care Transformation

A Primer for Clinical Leaders, 1st Edition

By Maulik Joshi, DrPH, Natalie Erb, MPH, Sonia Zhang, MPH, Rishi Sikka, MD

CRC Press

232 pages | 24 B/W Illus.

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pub: 2015-07-06
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Description

A succinct and practical primer on healthcare transformation, Leading Healthcare Transformation is a key resource for all clinicians in leadership positions. It summarizes high-profile healthcare topics and includes a synopsis of the evidence, examples, lessons learned, and key action steps for each topic covered.

Providing cutting-edge insights from the quality and physician perspectives, the book focuses on the most critical topics in the field today, including the issues of quality, cost, value, and new models of care.

The book includes discussions on various quality improvement processes including Lean and Six Sigma. Detailing specific strategies and tools to help you achieve and sustain improvement, it explains how to build a culture of safety and identifies proven principles and practices for creating a high reliability organization.

Blending the perspectives of administrators, nurses, and physicians, this insightful and practical resource provides the understanding you need to leverage health information technology for clinical improvement and to improve care coordination to reduce readmissions.

The book includes a Foreword by Jonathan B. Perlin, MD, PhD, MSHA, FACP, FACMI.

Reviews

Leading Healthcare Transformation provides a handbook of essential tools for defining transformational opportunities, leading high-functioning teams, being a good team player, and using evidence, measurement, and narrative for effectively communicating and fostering a change agenda. The book is punctuated by salient case studies that offer valuable insight into deploying change tools in real-world situations, illustrating not only technique, but the context of their application. In that regard, this is really much more than a ‘primer;’ it offers both expert knowledge, as well as the wisdom borne of colleagues’ experience and lessons learned.

—Jonathan B. Perlin, MD, PhD, MSHA, FACP, FACMI, President, Clinical Services and Chief Medical Officer, Hospital Corporation of America

Table of Contents

The Health Care Landscape

Introduction

First Curve to Second Curve

Leading Transformation

Key Factors Driving Transformation

High Cost of Care

Shifting Demographics: Patients and Workforce

Transition to Value-Based Reimbursement

Variable Quality Outcomes

Expansion of Coverage under the Affordable Care Act

Advances in Health Information Technology

Shift from Defined Benefit to Defined Contribution Health Plans

The Role of a Clinical Leader

Conclusion

References

Effectively Implementing Quality and Safety Improvement

The Evidence

The Model for Improvement

Lean

Six Sigma

International Standards Organization 9001

Lessons Learned

Case Studies

NCH Healthcare System: Improving Medication Communication with Patients

Memorial Health System: Hourly Nurse Rounds Reduce Patient Harm and Improve Patient Satisfaction

Action Steps to Lead

References

Spreading Improvement

Evidence

Preparing for Spread

Establishing an Aim for Spread

Developing a Spread Plan

Effective Strategies for Executing and Monitoring Spread

Case Study: On the CUSP

Lessons Learned

Action Steps

References

Physician Champions

The Evidence

Case Study

Lessons Learned

Action Steps and Strategies to Lead

References

Building a Culture of Safety

The Evidence

Transparency around Safety Events

AHRQ Surveys on Patient Safety Culture

Safety Attitudes Questionnaire

Case Study

Lessons Learned

Action Steps and Strategies to Lead

References

Principles and Practices of High Reliability Organizations

The Evidence

Preoccupation with Failure

Reluctance to Simplify

Sensitivity to Operations

Commitment to Resilience

Deference to Expertise

Case Study

Preoccupation with Failure: Investigating Near Misses and Good Saves

Reluctance to Simplify: Thorough Root Cause Analysis and Event Investigation

Sensitivity to Operations: Daily Organization Huddle

Commitment to Resilience: Simulation

Deference to Expertise: Executive Rounding

Lessons Learned

Action Steps and Strategies to Lead

References

Key Quality and Safety Measures

The Evidence

Data for Performance Measurement: The Basics

Types and Dimensions of Measures

Criteria and Standards

Data Sources

Metrics of the Future

Effective Strategies: Using Data to Drive Performance Improvement

Selecting Measures

Lessons Learned

Case Study: Tracking Total Harm

Action Steps to Lead

References

Using Data for Feedback and Improvement

Evidence

Step 1: Data Collection: Objectives, Sources, and Methods

Step 2: Displaying the Data

Physician Profiling

Dashboards

Run Charts

Step 3: Analyzing the Data

Step 4: Implementing Improvement Cycles

Lessons Learned

Interview: Tina Esposito, Vice President, Center for Health Information Services at Advocate Health Care

Action Steps and Strategies to Lead

References

Leading Effective Teams: For Clinical Care and for Performance Improvement

Evidence

Clinical Care Teams

Performance Improvement Teams

Strategies for Success

Effective Strategy: TeamSTEPPS

Effective Strategy: Patient and Family Engagement

Case Study: Building an Improvement Team

Voice from the Field: Ken Anderson, MD, Chief Operating Officer, Health Research & Educational Trust

Lessons Learned

Action Steps to Lead

References

Engaging Patients and Families

The Evidence

Prevalence of Patient and Family Engagement Practices

Effective Strategies for Patient and Family Engagement

Strategies at the Direct Care Level

Strategies to Engage Patients in Organizational Design and Governance

Working with Patients/FamilyAdvisor

Case Studies

Developing a Patient and Family Council

Partnering with Patients and Families to Achieve High Reliability

Lessons Learned

Beyond the Bedside

Engage Patients as Partners

Provide Meaningful Opportunities for Patients and Families to Contribute

Patient and Family Engagement as a Strategy to Eliminate Harm

Barriers to Engagement

Action Steps and Strategies to Lead

References

Improving Care Coordination and Reducing Readmissions

Evidence

Boston Medical Center Re-Engineered Discharge

Care Transitions Program

Evercare™ Care Model

Transitional Care Model (TCM)

Strategies for Success

Identify Patients at High Risk for Readmission

Build Self-Management Skills

Discharge Planning

Follow-Up and Community Resources

Case Study—Collaborative Effort to Reduce Readmissions at Griffin Hospital

Lessons Learned

Action Steps to Lead

References

Addressing Variation in Utilization

Evidence

Understanding Warranted vs. Unwarranted Variation

Choosing Wisely®

American Hospital Association: Appropriate Use of Medical Resources

Strategies for Success

Interview: Dr. Debra O’Connor, Vice President of Clinical Effectiveness, Advocate Health Care

Lessons Learned

Action Steps and Strategies to Lead

References

Physician Alignment and Clinical Integration

The Evidence

Case Study

Physician Hospital Organization Field Support Team

Clinical Programs

IT Solutions

Lessons Learned

Action Steps and Strategies to Lead

New Payment Models

The Evidence

Pay-for-Performance

Accountable Care Organizations and Shared Savings

Identifying an Attributed Patient Population

Structure of Risk Sharing

Bundled Payments

Capitation

Case Study—Advocate Health Care

Lessons Learned

Information Technology

Data and Analytics

Care Management

Action Steps and Strategies to Lead

References

The Clinical Leader Role in Emerging Models of Care

Retail Medicine

Population Health

Mobile Health

Case Study

Lessons Learned

Action Steps and Strategies to Lead

References

Compendium of Action Steps

Chapter 1: The Health Care Landscape

Chapter 2: Effectively Implementing Quality and Safety Improvement

Chapter 3: Spreading Improvement

Chapter 4: Physician Champions

Chapter 5: Building a Culture of Safety

Chapter 6: Principles and Practices of High Reliability Organizations

Chapter 7: Key Quality and Safety Measures

Chapter 8: Using Data for Feedback and Improvement

Chapter 9: Leading Effective Teams: For Clinical Care and for Performance Improvement

Chapter 10: Engaging Patients and Families

Chapter 11: Improving Care Coordination and Reducing Readmissions

Chapter 12: Addressing Variation in Utilization

Chapter 13: Physician Alignment and Clinical Integration

Chapter 14: New Payment Models

Chapter 15: The Clinical Leader Role in Emerging Models of Care

Index

Subject Categories

BISAC Subject Codes/Headings:
BUS053000
BUSINESS & ECONOMICS / Quality Control
BUS070080
BUSINESS & ECONOMICS / Industries / Service Industries
MED000000
MEDICAL / General
MED002000
MEDICAL / Administration