WINNIPEG REGIONALHEALTH AUTHORITY

2012 Supply Chain ForumInnovation in Health Care

Dan Skwarchuk, Executive Director,Health Services Integration and InnovationWinnipeg Regional Health Authority

November 21, 2012

Health Innovation as a Literary “Trend”

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

2003 2005 2007 2009

University of Manitoba Library search…

Found over 268,000 published articles on file

Total Published Articles (Annual), 2003-2009

Literary “Trend” Cont’d…

Generally, across the literature, health innovation usually falls into the following broad categories:

•Research

•New products and technologies

•New processes and approaches

•New ways of thinking

•New ways to use people

• Doing more with similar or fewer resources (productivity and efficiency)

WRHA Strategic Plan - Innovation

• Maximize benefits from research, development & innovation including the increased use of evidence informed decision making.

• Improve productivity through process improvement, service reconfiguration and benchmarking

The WRHA Views of Innovation

Innovation refers to a process through which economic or social value is extracted from knowledge through the generation, development, and implementation of ideas to produce new or significantly improved products, processes, and services.

Model of sustaining innovation

Christensen et al. (2009)The Innovator’s Prescription

Christensen et al. (2009)The Innovator’s Prescription

Innovation within the WRHA

Some (selective) examples include:

• Bell Hotel Redevelopment Project (new thinking)

• Use of evidence in contracting (processes)

• Nurse Practitioners and Physician Assistants (people)

• Manitoba Renal Program’s new Nurse-Led Telehealth Service (technology)

• Business Process Solution Project (processes)

• Home-based specialty services (new thinking)

• Unit-level inventory process improvement (processes)

Workplan for Innovation in the WRHA

• Overall need to develop a culture of innovation with supports to go outside of normal boundaries.

• Committee with focus on fostering and incubating innovative ideas within the WHR.

• Inventory of innovation in the WHR.

• Provision of seed funding for innovative ideas.

• Tolerance for failure and not punitive when innovative ideas fail. Learn from mistakes.

• Better understanding of tolerable risks.

Draft - Enterprise Risk Management Risk Universe

Strategic Operational Compliance Financial

Governance &Leadership

StakeholderRelations

Patient CareHuman

ResourcesInformationTechnology

PhysicalAssets

Compliance Financial

Governance• Board Structure & Performance•Culture and Ethics•Control/Risk Environment•Social Responsibility Planning and Resource Allocation•Organizational Structure•Strategic Planning•HR Strategy•IT Strategy•Partnership Development & Management External Environment•Demographics•Lifestyle Trends•Socio-Political•Economic Factors•Hazards (Pandemic, terrorism, natural disasters, etc)•Business ContinuityMajor Initiatives•Vision and Direction•Planning and Execution•Measurement and Monitoring•Business AcceptanceCorporate Reputation

Communication and Relations• Public and Media Relations•Patient Relations•Government Relations•Employee Communication•Vendor Relations•Union Relations•Crisis Communication

Service Delivery•Admission, Transfer and Discharge•Assessment & Diagnostics•Care & Service Accessibility•Care Plan/ Service Plan•Treatment•Coordination of Services•Patient Rights•Medication ManagementSupport Services•Supply Chain•Food and Laundry Services•Facilities Management•Health Information ManagementPatient Safety•Infection Prevention Control•Incident Reporting•Education & Training•Security

Recruitment, Selection & Retention•Credentialing•Medical staff•Support staff•Contractual staff•Employment Equity Development & Performance•Training and Education•Succession Planning• Performance ManagementLabor Relations•Labor Agreements•Contingency PlanningCompensation & Benefits•Salary Administration and Compensation ManagementEmployee Safety• Health and Safety

IT Management• E-HealthAccess & Security

System Reliability & Continuity•Back up and recovery•Disaster Recovery

System Integrity

End User Support & Education

Infrastructure•Asset replacement, deployment and retirement•Inventory Management

Asset Management •Replacement ManagementCapital/ Construction Acquisition & Disposal•Asset Acquisition•Commitment Tracking & Processing• Contract/Project Management• Asset DisposalEquipment Acquisition, Maintenance & Disposal•Equipment Acquisition•Commitment Tracking & Processing• Contract Management•Maintenance•Equipment Obsolescence & DisposalSite/Asset Security• Asset storage & handling• Facilities•Security and Access Inventory Management• Contract Management•Distribution•Inventory Shrinkage and Obsolescence•Valuation•Product Recalls

Standards of Business Conduct•Ethics•Fraud•Conflict of Interest•Industry RelationsLegal & Regulatory• Governing Legislation, Bylaws & Regulations•Contractual Agreements•Professional Regulatory Bodies•Prescribed Standards of Practice•Data Protection• Privacy•Environmental, Health & Safety•Research•Facility Standards•Procurement Practices •Patient Safety•Intellectual Property

Funding•Capital•Operating•Debt•FoundationMarket•Interest Rates•Foreign Exchange•Financial Instruments•InvestmentsLiquidity and Credit•Cash Management•Credit and Collections•InsuranceAccounting and Reporting• Accounting, Reporting & Disclosure•Internal Control Requirements•Trust Accounts/Special Purpose AccountsPension Funding

Budgeting and Forecasting

Taxes (Property, Commodity)

“If you're not failing every now and again, it's a sign you're not doing anything very innovative.”

- Woody Allen

Enablers of Innovation

• Need for improved knowledge translation:

- Improved spread and adoption of new and best practices- Innovation rounds and storytelling- Increased public and provider engagement- Enhanced supports for publications- Awards – but celebrating the successes as well as failures

Development of Innovation Community of Practice

• Health Sciences Centre Foundation

• St. Boniface Hospital Research Centre

• Professional Associations

• University of Manitoba Centre for Health

Innovation (Faculty of Medicine)

• University of Manitoba – Other Faculties

(mechanic, computer, and biosystem

engineering)

• University of Winnipeg

• Red River College

• Business Council of Manitoba

• Innovation Council of Manitoba

• Manitoba Health Innovation Branch

• Manitoba Centre for Health Policy

• Business Community

How Can We Collaborate More Effectively with the Business Community in

Health Innovation?

First some context…

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Childhood Youth Young Families Middle Age Seniors

Understanding the WRHA Structure

Community Health Centres

Family Physicians

Home Care

Mental Health

Neighbourhood Networks

Public Health

Chronic CareCentral Assessment and

PlacementDeer Lodge Centre

Misericordia Personal Care Homes

Respite CarePalliative Care

Rehab/GeriatricsRiverview

Services to Seniors

ConcordiaGrace

Health Sciences St. Boniface Seven Oaks

Victoria

Prevention Promotion Protection

Primary TreatmentAcute Intervention Supportive and

Restorative Services

Primary CareSecondary and

Tertiary CareLong Term Care

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Community Areas in Winnipeg

1) St. James

2) Assiniboine South

3) Fort Garry

5) St.Boniface

6) Transcona

7) River East

9) Inkster

8) Seven Oaks

10) Point Douglas

12) River Heights

West St. Paul

East St. Paul

1

2

3 4

5

6

7

8

910

11

12

11) Downtown

4) St. Vital

Regional Programs River East / Transcona

Downtown / Point Douglas

Health Science Centre

Seven Oaks Hospital

Primary Care X X

Home Care X X

Mental Health X X X X

Internal Medicine X

Family Medicine X

Renal Health X X

Personal Care Home X X

The WRHA Matrix Structure

Note: This is just a excerpt

The WRHA Matrix Structure(What this Means to Contracting)

Regional Clinical Programs• Strategic Planning• Quality and Standards

(including clinical contracting)• Centralized Operations

Regional Clinical Programs• Strategic Planning• Quality and Standards

(including clinical contracting)• Centralized Operations

Hospitals & Community Areas• Day-to-Day Operations• Managing to Quality• Managing to Budget

(volume and price)

Hospitals & Community Areas• Day-to-Day Operations• Managing to Quality• Managing to Budget

(volume and price)

Contracting Groups(PRES Groups)

n=147 Groups

Members = 1,100Employees

Contracting Groups(PRES Groups)

n=147 Groups

Members = 1,100Employees

WRHA and Product InnovationsCurrent Processes – Challenging!

BusinessCommunity

BusinessCommunity

WRHALogisticsServices

WRHALogisticsServices

InnovativeIdea or Product

PRES Group (n=147)

Regional Program (n=30)

Hospital or Area (n=15)

How Can We Collaborate More Effectively with the Business

Community in Health Innovation?

Improved knowledge sharing• Our priorities and your interests?• Push AND pull innovations?

Contracting flexibility for innovation• Less stringent RFP criteria?• More focus on problem versus solution?

Improved access• PRES Groups?• Regional Programs?• Hospitals and Community Area?• Help in system navigation?

Contract clarity on innovation• Proof of concept costs?• Key risks and mitigation?• Knowledge translation responsibility?

Thank-you

Questions?

Breakout Session

1:30 pm to 2:45 pm

Followed by 30 min Break & Networking Opportunity

Breakout Sessions

• Group 1- Mapleleaf room A• Group 2- Mapleleaf room B• Group 3- Evergreen Room (main room)

• Group 4- Spruce Room (through the restaurant)

• Group 5- Elm Room