Leadership link & learn webinar what is leadership in healthcare today

Leadership Link & Learn Series

What is Leadership in Healthcare Today?

Presenter: David M. Williams, PhD, TrueSimple

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HealthHIV Core Capabilities Capacity Building

Health Services Research & Evaluation

Advocacy

Education & Training

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Diverse staff of professionals with HIV, HCV, and LGBT clinical, global, cultural competency, prevention, and other experience – particularly within LGBT and other underserved communities

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Numerous strategic partnerships with national and local organizations (non-profit, clinical, behavioral, political, and technological)

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HealthHIV CBA Programs

ASO/CBO Capacity Building

HIV Prevention Technical Assistance

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Health Department Capacity Building

Health Center Capacity Building

Workforce Capacity Building

Retention in Care Institute

PatientCentered HIV Care Model

Municipal Leadership Capacity Building

Why Three D HIV Prevention?

The Three D Program enhances the ability of TA recipients to conduct enhanced data collection and analysis to make betterinformed programmatic decisions that impact the delivery of quality HIV prevention services.

Approach of Three D HIV Prevention Program • Facilitate community infrastructure development and systems coordination to ensure sustainability along the HIV care continuum • Expand care team integration through partnership development to include non-clinical HIV prevention partners • Demonstrate cost effectiveness and outcomes monitoring of programs to maximize strengths and efficiencies and impact of health outcomes • Promote workforce development, including training the next generation of leaders in HIV prevention

HealthHIV’s ASO/CBO Leadership Initiative

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ASO/CBO Leadership Training & Certificate Program Leadership Link & Learn monthly webinar series Mentor/ mentee program Online portal that links ASO & CBO leaders around the country to engage with one another, share information and best practices, and participate in online education and training

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Become a Certified ASO Leader!

HealthHIV’s ASO/CBO Leadership Training and Certificate ProgramTM http://tinyurl.com/pa5jo6t © 2015 HealthHIV

Certified ASO Leaders Across the US HIV Prevalence-Certified ASO Leaders

Key HIV Prevalence 2812.4 481.8 - 782.0 269.5 - 391.0 149.4 - 237.0 34.6 - 119.0

Certified Leaders within County 1 2 3-4 5-6

Prevalence Rates are per 100,000 population Data source: CDC HIV Surveillance Report 2013

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Total Number of Certified Leaders = 94

Launching the Series!

HealthHIV’s new “Leadership Link & Learn” 2015 Webinar Series will include monthly webinars as part of the ASO Leadership Initiative.

Topics will address crucial issues in healthcare leadership and ASO/CBO development.

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Available for Download Guide to HealthHIV’s ASO/CBO Leadership Training & Certificate Program: http://tinyurl.com/pbbl4c2 Also Available for Download: • Slide Deck • Webinar Recording HealthHIV.org

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What is Leadership in Healthcare Today?: Quality as a Strategy with David M. Williams, Ph.D.

HealthHIV – Leadership Link and Learn Webinar Series 1:00PM EST March 18, 2015

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David M. Williams, Ph.D. David M. Williams, PhD, is an Improvement Advisor. He founded and leads a consulting practice based in Austin, Texas, called TrueSimple Improvement. He is also an improvement advisor and faculty for the Institute for Healthcare Improvement (IHI).

He advises education, emergency medical services (EMS), and health care organizations in the US, Europe, & Middle East on applying the science of improvement and integrating quality as a business strategy.

Dr. Williams started his career as a volunteer firefighter in high school, worked as a paramedic in several cities, and is a subject matter expert on emergency medical services systems and improvement. He is also the Vice Chairman of the Board of CommUnityCare, a large FQHC serving Austin, Texas.

He earned a Bachelor's degree in EMS Management, a Master's degree in Emergency Health Services Management, and a PhD in Organizational Systems with a research focus on the obstacles to patientcentric EMS system design. Š 2015 HealthHIV

WebEx Quick Reference

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Where are you?

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Learning Objectives • Describe five activities for leaders including: • Purpose, Mission, Vision, Beliefs • Viewing your Agency as an Organizational System • System for Obtaining Information (Customer Focus) • Planning for Improvement • Managing Improvement Efforts

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The Science of Improvement

Deming’s System of Profound Knowledge

Key Improvement Methods:

Combi nes wit h

Theory of Knowledge

Understanding Varia8on

Subject MaVer Knowledge drives

Psychology

Model for Improvement with PDSA Shewhart charts Opera;onal Defini;ons Analy;c Studies Graphical Data Analysis Intrinsic mo;va;on Mul;-­‐disciplinary teams

Are used with

Apprecia8on of a System

Improvement Provides the Philosophical and Theoretical Base for

Seven Proposi8ons:

1. Grounded in the Scien8fic Method 2. Founda8on of conceptualis8c pragma8sm 3. Embraces a weak form of psychologism 4. Considers context of jus8fica8on and discovery 5. Recognizes value of opera8onism 6. Varia8on is defined by chance-­‐cause system 7. Systems theory © 2015 HealthHIV

Characteris8cs of the Applied Science of Improvement: 1. Bias toward ac8on learning 2. Focus on predic8on of future outcomes 3. Mul8ple tes8ng cycles before implementa8on 4. Visual display to learn from data 5. Learning from special and common causes 6. Simple and complex study designs 7. Ongoing interac8on of scien8sts and prac88oners Provost, Perla, Parry, 2013

Deming’s Production Viewed as a System

Source: The Improvement Guide, p. 265; Adapted with permission from Deming, W. Out of the Crisis. Cambridge, Massachusetts, USA: Institute of Technology, 1986, p.4. © 2015 HealthHIV

QBS - Five Activities for System Improvement

1

2

Purpose Mission Vision Vision

Beliefs

System for forObtaining Obtaining System Information Information 3

(CustomerFocus) Focus) (Customer

Operations Employee Perspective Perspective

Organization Viewed as a System The Improvement Guide p..260

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• Strategic Objectives • Improvement Efforts • Resources

4

2A Business Customer Perspective Perspective

Products, Services, Tools

Planning

Three 5 Basic 5 Questions ACT

PLAN

STUDY

DO

Managing Improvement Efforts

QBS - Five Activities for Leaders

1

Purpose Mission Vision Vision

Beliefs

Our Vision Improve the health of the community by increasing access to the best care possible.

Our Mission We will work with the community as peers with open eyes and a responsive attitude to provide the right care, at the right time, at the right place. Š 2015 HealthHIV

The Improvement Guide p..260

Values Respect: We treat patients and peers with dignity and embrace diversity.

Integrity: We are honest and sincere, doing what is right, not what is expedient.

Dependability: We are accountable and strive to exceed expectations.

Teamwork: We work together, promote cooperation, and value the opinions of patients and peers.

Quality: We strive for excellence in all that we do.

Chat Time!

Please type into the chat box how your mission, vision, and values are embedded in how your organization leads and works?

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QBS - Five Activities for Leaders

1

2

Purpose Mission Vision Vision

Beliefs

Inputs and Transformation of Inputs (Elements of the System and 4 the Process Changes) 5 5

Products, Services, Tools

Support processes: e.g., IT, HR…

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Traditional View of an Organization President Grant

Planning Meade

VP Marketing

VP Distribution and Service

VP Research & Development

Services

Butler

Haupt

Halleck

Sheridan

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VP

Region 1

Region 2

Buford

Grierson

VP Administration and Support Porter

Region 3 Handcock

Source: API-Austin, Quality as a Business Strategy

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What does an organizational chart tell us about how organizations work?

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Deming’s Production Viewed as a System

Source: The Improvement Guide, p. 265; Adapted with permission from Deming, W. Out of the Crisis. Cambridge, Massachusetts, USA: Institute of Technology, 1986, p.4. © 2015 HealthHIV

Defining the Organiza;on Viewed as a System Three Classifica-ons of Processes to View a System

Design & Redesign of Process & Products

Driver Process

Plan to Improve

Market Purpose of the Research Organization Measurement & Feedback

Suppliers

Mainstay Process

Customers

A B

Production of Product or Service

C Support Process

D E

Support Process

F G

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Need

Source: API-Austin, Quality as a Business Strategy

Distribution

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Medic OVS Map February 6, 2014

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Manage Employee & Patient Safety

Administer Benefits

Process Payroll

Develop Employees

Select Employees

On-Board New Employees

Manage Employee Performance

Forecast Demand

Produce Resources

Distribute Resources

Manage Inventory

Maintain Fleet

Maintain Equiment

Manage Risk

Manage Compliance

Conduct Quality Assurance

Develop Plans

Maintain Facilities

Understand Need

Manage Data

Conduct Research

Perform Analytics

Receive Request for Service

Respond to Request

Provide Clinical Care

Close Out Call

Purpose

Manage Revenue Cycle

Communicate Information

Customers

QBS - Five Activities for Leaders

1

Purpose Mission Vision Vision

Beliefs

3

2

Products, Services, Tools

Organization Viewed as a System

2A: Outputs: Improved Safety: - ADE - CAUTI - CLABSI - Falls - OAE - HAPUs - Readmissions - SSI - VTE - VAP/VAE

The Improvement Guide p..260

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4 5 5

Outputs: Dashboard Key Performance Measures • Patient Experience • Clinical Care & Patient Safety • Strategic • Financial • Compliance • Workforce

Source: Provost & Murray (2010), The Healthcare Data Guide © 2015 HealthHIV

Chat Time!

Please type into the chat box… some of the metrics you measure regularly!

Do you report data in visual displays that support understanding variation and building knowledge (e.g. run charts, Shewhart statistical process control charts)?

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QBS - Five Activities for Leaders

1

2

Products, Services, Tools

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Purpose Mission Vision Vision

Beliefs

System for forObtaining Obtaining System Information Information (Customer Focus) 3 (Customer Focus)

2A: Outputs: Improved Safety: - ADE - CAUTI - CLABSI - Falls - OAE - HAPUs - Readmissions - SSI - VTE - VAP/VAE

4 5 5

System for Obtaining Information (Customer Focus)

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Chat Time!

Please type into the chat box… how you scan your customers and the environment to understand their needs?

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QBS - Five Activities for Leaders

1

2

Purpose Mission Vision Vision

Beliefs

System for forObtaining Obtaining System Information Information 3

(CustomerFocus) Focus) (Customer

2A

Planning • Strategic Objectives • Improvement Efforts • Resources

4 5 5

Products, Services, Tools

Organization Viewed as a System The Improvement Guide p..260

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Strategic Objectives

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How often does your organization develop strategic objectives?

What data do you use to guide your planning?

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QBS - Five Activities for Leaders

1

2

Purpose Mission Vision Vision

Beliefs

System for forObtaining Obtaining System Information Information 3

(CustomerFocus) Focus) (Customer

Planning • Strategic Objectives • Improvement Efforts • Resources

4

2A

Three 5 Basic 5 Questions

Products, Services, Tools

Organization Viewed as a System The Improvement Guide p..260

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ACT

PLAN

STUDY

DO

Managing Improvement Efforts

Aim Statement:

Increase the percentage of neurologically intact, non-traumatic, out-of-hospital Ventricular Fibrillation (VF) cardiac arrest (OHCA) adult patient survivals by 10% by June 30, 2013 by: • Increasing the number of OHCA patients who receive dispatcher assisted CPR to 50% of cases • Increasing bystander/layperson CPR to 50% of witnessed arrests • Implementing team-based resuscitation for on 80% of OCHA patients with resuscitations attempted.

• High quality CPR with minimum interruptions is performed for 85% of all OHCA cases.

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Repeated Use of the PDSA Cycle 1) What are we trying to accomplish?

2) How will we know that a change is an improvement?

3) What change can we make that will result in improvement?

D S P A

Hunches Theories Ideas

Very Small Scale Test Š 2015 HealthHIV

A P S D

Implementation of Change

Wide-Scale Tests of Change

A P S D

Changes That Result in Improvement

Follow-up Tests

Sequential building of knowledge under a wide range of conditions

Source: Institute for Healthcare Improvement

Chat Time!

Please type into the chat box…. if you have a method for continuous improvement in your organization?

What is it?

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QBS - Five Activities for Leaders

1

2

Purpose Mission Vision Vision

Beliefs

System for forObtaining Obtaining System Information Information 3

(CustomerFocus) Focus) (Customer

Planning • Strategic Objectives • Improvement Efforts • Resources

4

2A

Three 5 Basic 5 Questions

Products, Services, Tools

Organization Viewed as a System The Improvement Guide p..260

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ACT

PLAN

STUDY

DO

Managing Improvement Efforts

QBS Evaluation Grid

Source: Š2014 IHI Improvement Advisor Professional Development Program and Associates in Process Improvement Area Purpose

Score=0 No written statements

Score=2 Statement exists

Planning for improvement

No formal planning; reactive culture

Planning for improvement is done on an informal basis

Managing improvement efforts

No system exists to manage improvements

Model for improvement

No standard approach to improvement efforts

Management system

Structure does not exist to make improvement key a focus of daily work

System

Whole System Measures

Information

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Score=4 Score=6 Score=8 Score=10 Mission and tenets Communicated and Used to align and Fully integrated into the defined and visible understood by guide the business structure employees Work as a process is Major processes Relationships Systems thinking Systems diagrams are Management systems not understood and products between and language is used in business. have integrated the have been processes are common systems view documented documented Financial data is Financial and Family of Balances set of Set of measures Measures are integrated viewed periodically other operational measures is measures reported aligned and variation into management measures are assembled graphically understood systems used Information is System is based System is well Information is Comprehensive Marketing leads and gathered on ad hoc, on passive documented and documented and system with analysis/ integrates information reactive basis information includes active communicated synthesis for decision system sources making A formal, Integrated process All other planning documented identifies objectives, processes are defined process exists for efforts, and and linked planning resources improvement Improvements Leaders provide Improvements are The impact of recognized on an formal guidance for guided by planning; improvement is as-needed basis individuals and leaders are learning understood and & resources teams managed assigned Various Training on the Theory behind the Improvements are approaches are Model and Model is managed as PDSA used for expectation of its understood cycles improvement use The need for A formal system for Top management Improvement is linked improvement is improvement is assumes to planning and other recognized and defined responsibility for key business responsibility integrating activities assigned improvement

Planning system is improved and integrated in all areas

Improvement system is integrated in business and regularly improved

Model is routinely used by all levels of the Organisation Improvement is completely integrated into all aspects of operating & developing the business

Thank You @TrueSimpleATX

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Upcoming HealthHIV Webinars National Coalition for LGBT Health Time for Trusting Relationships--LGBT Health Awareness Week Wednesday, March 25, 2015 4:00 PM EST http://tinyurl.com/mde5r9s © 2015 HealthHIV

Upcoming HealthHIV Webinars Leadership Link & Learn Webinar Series Closing the Deal: When is it Time for a Strategic Partnership?

Wednesday, April 22, 2015 1:00 PM EST http://tinyurl.com/kgcdzx7 © 2015 HealthHIV

HealthHIV Capacity Building The webinar is presented as part of HealthHIV’s Three D Program and it’s National Center for Healthcare Capacity Building.

For more information contact: Marissa Tonelli Senior Capacity Building Manager marissa@healthHIV.org 202-507-4726

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