ajit abraham ms, ma ( medical ethics & law), frcs, frcs ( general surgery)
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QUALITY COLLABORATIVE. Ajit Abraham MS, MA ( Medical Ethics & Law), FRCS, FRCS ( General Surgery) Consultant HPB Surgeon, Barts Health Health Foundation Quality Improvement IHI Fellow 2011-12. - PowerPoint PPT PresentationTRANSCRIPT
Ajit Abraham MS, MA ( Medical Ethics & Law), FRCS, FRCS ( General Surgery)
Consultant HPB Surgeon, Barts HealthHealth Foundation Quality Improvement IHI Fellow 2011-12
QUALITY COLLABORATIVE
“Everyone in healthcare really has two jobs when they come to work everyday: to do their work and to improve it.”
Paul Batalden
The High Reliability - High PerformanceOpportunity
“The journey to becoming a world-class healthcare organization isn’t quick or easy, or for the impatient or faint of heart”
John Black - The Toyota Way to Healthcare Excellence
Necessary paradigm shifts!
The Ethics of Value Concentric to Linear - Patient-Centeredness
The Triple Aim Measurement for Improvement
The Idea of Complexity
Complexity demands
a
Learning Organization
Build Capability Within
EXECUTIVE Vision, Strategy
SYSTEM OF CAREIntegrated Care Bundles
SYSTEM OF MEASUREMENTMetrics for Improvement
SYSTEM OF IMPROVEMENTImprovement, Innovation, Safety
PATIENTS AND FAMILIESOutcomes & Experience
6. HIGH PERFORMANCE
CULTURE
STAFF OD
1.FOCUS
2. PLATFORM
3. KNOWLEDGE
4. ACTION
5. RESULTS
ChangeOrganization Culture
ChangeIndividualAttitudes
ChangeBehavior
Structure & MethodsStructure & Methods
Transformation: Changing Culture
Changing the old
Making the future attractive
Framework: Leadership for Improvement
WillIdeas
Execution
Establish the Foundation
Setting Direction: Mission, Vision and Strategy
PULL
PUSH
PULL
PUSH
1. Set Direction: Mission, Vision and Strategy
Make the status quo uncomfortable
Make the future attractive
3. Build Will• Plan for Improvement• Set Aims/Allocate Resources• Measure System Performance• Provide Encouragement• Make Financial Linkages• Learn Subject Matter
5. Execute Change• Use Model for Improvement for Design and Redesign• Review and Guide Key Initiatives• Spread Ideas• Communicate results• Sustain improved levels of performance
4. Generate Ideas• Understand Organization as a
System• Read and Scan Widely, Learning
from other Industries & Disciplines• Benchmark to Find Ideas• Listen to Patients• Invest in Research & Development• Manage Knowledge
Framework: Leadership for Improvement
2. Establish the Foundation• Prepare Personally• Choose and Align the Senior Team
• Build Relationships• Develop Future Leaders
• Reframe Operating Values• Build Improvement Capability
“Systems awareness and systems design are important for health professionals, but are not enough. They are enabling mechanisms only. It is the ethical dimension of individuals that is essential to a system’s success. Ultimately, the secret of quality is love.”
Avedis Donabedian
Go See, Ask Why, Show Respect!
Meta-Leadership !
Self AuthoringOwn FrameAgenda DrivenProblem-solvingIndependent
Self TransformingLeads to LearnMultiframeAmbiguity TolerantProblem-findingInterdependent
Robert Kegan, Lisa Laskow Lahey – Immunity to Change
“The courage to persevere comes through the service of others”
Eric Greitens, US Navy Seal, Humanitarian & Author ‘The Heart & The Fist’
1. Quality as a core goal
2. Use information to guide improvement
3. Develop organizational skills to support performance improvement
4. Have learning strategies to test improvement and scale it up when it succeeds
Ross Baker 2011
“We must be the change we wish to see in the world”
Mahatma Gandhi
Plan for change Execution of planned change