developing nursing managers and clinicians to lead ... · 1/25/2012 10 leadership – key change...
TRANSCRIPT
1/25/2012
1
Session Two
Foundational Element: Leadership
Kelly McCutcheon Adams, MSW, LICSW, IHI Director
Barbara Balik, RN, EdD, IHI Faculty
January 25, 2012
2:00 – 3:00pm EST
David Kim
David Kim, Institute for Healthcare Improvement
(IHI), is responsible for managing and
coordinating a variety of programs based on Key
Processes on the IHI Improvement Map. Mr. Kim
is a graduate of Boston University. He has been
with the IHI for 2 years. He enjoys sports, food,
and travel.
2
1/25/2012
2
3
WebEx Quick Reference
• Welcome to today’s session!
• Please use Chat to “All
Participants” for questions
• For technology issues only,
please Chat to “Host”
• WebEx Technical Support:
866-569-3239
• Dial-in Info: Communicate /
Join Teleconference (in menu)
Raise your hand
Select Chat recipient
Enter Text
When Chatting…
Please send your message to
All Participants
4
1/25/2012
3
Kelly McCutcheon Adams, MSW, LICSW
Kelly McCutcheon Adams, MSW,
LICSW, Director, Institute for Healthcare
Improvement (IHI), has served in this
capacity for eight years for a variety of IHI
Collaboratives and programs, particularly
those focused on critical care. She is a
medical social worker with experience in
hospice, nursing home, sub-acute
rehabilitation, emergency department, and
ICU settings. She has also served as
faculty for the US Department of Health
and Human Services Organ Donation
Collaborative and for the Gift of Life Institute.
5
Barbara Balik, RN, EdD
Barbara Balik, RN, EdD, Principal, Common
Fire Healthcare Consulting, is also Senior
Faculty at the Institute of Healthcare
Improvement. Her areas of expertise include
leadership and systems for a culture of quality
and safety, including patient- and family-
centered care, patient experience, systems to
improve transitions in care, and transforming
care prior to or with optimization of an electronic
health record implementation. She works with
leaders to develop adaptive systems to excel
and innovate in complex organizations, and to
ensure sustained improvement and innovation
every day. Ms. Balik's publications include the
book, The Heart of Leadership, and the IHI white
paper on “Achieving an Exceptional Patient and
Family Experience of Inpatient Hospital Care,”
among others. Previously, she served in senior
leadership roles at Allina Hospitals and Clinics,
United Hospital, and Minneapolis Children's Medical Center.
6
1/25/2012
4
Overall Objectives
7
At the end of this program, participants would be able to:
• Articulate key foundational elements in support of all
domains of patient experience improvement
• Share specific testable ideas for improving nurse
communication, pain management, and cleanliness
• Plan small tests of change to try during the Expedition
Session Agenda • Homework – We did you learn?
• Patient Experience Change Package
o Our focus today
• Leadership learning from the Patient Experience
Collaborative
• Hear from successful leaders
o Kris White, VP of Innovation and Patient Affairs,
Spectrum Health
o Mitch Mongell, CEO, Colleton
• Time for Q&A
8
1/25/2012
5
Pre-work
1. Read the IHI White Paper: Achieving an Exceptional Patient and
Family Experience of Inpatient Hospital Care
2. Self Assessment
•The Patient and Family Centered Care Organizational Self-
Assessment Tool
•Observation
3. Observation Exercise
•Understand a Patient Journey
4. WIHI: Health Literacy: New Skills for Health Professionals
9
10
Homework Options
• Before Call 2 January 25, 2012
o Identify 3 lessons learned from the teams on the
call; compare your current activities to theirs;
what is similar or different?
o Review your patient experience data; where is
your greatest opportunity? Areas to celebrate?
o Do another patient/family shadowing activity;
what did you learn that helps explain some of
your patient experience data results?
o Assure senior leaders are on the 1/25/12 call
1/25/2012
6
11
Patient Experience Change Package
• Overview
oOriginal work:
Patient Experience White Paper and Driver
Diagram
o Focused content – 48 hospital collaborative
Nurse Communication
Pain Management
Cleanliness
Exceptional patient and family inpatient hospital experience
(safe, effective, patient centered, timely, efficient,
equitable) as measured by
HCAHPS willingness to recommend
Governance and executive leaders demonstrate that EVERYTHING in the
culture is focused on patient and family
centered care, practiced
everywhere in the hospital (individual,
microsystem, organization)
In words and actions leaders communicate that the patient’s safety and well being is the critical decision
guiding all decision making
Patients and families are treated as partners in care at every level: on decision making bodies to team members with individual care
PFCC is publicly verifiable, rewarded, and celebrated with relentless focus
on measurement, learning, and improvement with transparent
patient feedback
Sufficient staff are available with the tools and skills to deliver the care the
patient needs when they need it
The hearts and minds of staff and providers
are fully engaged
Staff and providers are recruited for values and talent, supported for
success, and accountable individually and collectively for results
Compassionate communication and teamwork are essential competencies
Every care interaction is anchored in a
respectful partnership
anticipating and responding to
patient and family needs (physical
comfort, emotional, informational,
cultural, spiritual, and learning)
Patients and families are part of care team and participate at the level the
patient chooses
Care for each patient is based on a customized interdisciplinary shared care plan with patients educated,
enabled and confident to carry out their care plans
Communication uses words and phrases that the patient understands
and meets their emotional needs
Hospital systems deliver reliable
quality care 24/7
The physical environment supports care and healing
Patients are able to access care and say that there were not long and unreasonable waits and delays
Patients say “there were staff available to give the care I needed”
The care team instills confidence by
providing collaborative,
evidenced based care
Care is safe, concerns are addressed and if things go wrong, there is open
communication and apology
Care is coordinated and integrated through use of a shared can plan and everyone on the patient’s care team,
including the patient, has the information they need
Patients get the outcomes of care they expect
The Patient always means
patient and those they
choose to call family
IHI Patient
Experience
Driver
Diagram
1/25/2012
7
Patient Experience Change Package
• Faculty, exemplars, teams experience:
o Foundational cross-cutting work – address all
domains
Leadership commitment and behaviors
Engaging patients in their definition of:
– family, pain management, cleanliness
o Successful use of the Driver Diagram and
White Paper to assess current state and
develop implementation plans
13
Patient Experience Change Package: Overview
Key areas for improving specific domains of
patient experience: Nurse Communication,
Cleanliness, and Pain Management
Staff and Physicians Patient and Family Connection
Leadership Engagement Improvement/
Infrastructure
Foundational Elements for Improving Patient Experience
Today’s Session
1/25/2012
8
Foundational Elements for Improving Patient Experience
Leaders take ownership of defining
purpose of work and modeling
desired behaviors.
Staff, leaders, and physicians engage
patients and families so that efforts to
improve patient experience reflect
actual patient experience.
Improvement teams are solidly
grounded in skills to effect reliable
change and gain meaningful
understanding of data
Leadership Engagement Improvement/
Infrastructure
Today’s Session
Leadership – Key Change Ideas
• Purpose
• Leadership Behaviors
• “All In” Behaviors
• Leadership Rounding
• Label and Link
• Storytelling
• Champions
16
1/25/2012
9
Leadership – Key Change Ideas
Purpose
• Define and communicate philosophy, intention,
and plan for optimal patient experience.
Include purpose of work in every leadership
meeting, leadership rounding, etc. Include
“impact on patients” in discussion of each
topic at every meeting.
17
Leadership – Key Change Ideas
Purpose
• Impact on patients – sample questions o “How does this improve patient care?”
o “What patients have we asked about this?”
o “What value does this add to patient care and patient experience?”
o “What patients/family members do we have on teams?”
18
1/25/2012
10
Leadership – Key Change Ideas
Leadership Behaviors
• Specify desired behaviors for leadership roles
that are consistent with patient experience goals
and utilize for evaluation (like demonstration of
partnership with patients and families,
commitment of time, engaging the hearts and
minds of providers). Provide a leadership
development process for all leaders in care and
support departments to build skills for patient
experience. Consider a "no meeting zone" time
to make this work possible for leaders.
19
Leadership – Key Change Ideas
“All In” Behavior
• Establish partnerships with patients and families
throughout the organization and develop clear
expected behaviors for all staff and physicians
for collaboration with patients and families (e.g.,
rounding to listen to patients and families,
integrate patient and family needs and safety as
primary criteria in decision making). Set these
actions as behavioral standards. Develop
coaching skills to commend and correct
behavioral standards in real-time.
20
1/25/2012
11
Leadership – Key Change Ideas
Leadership Rounding
• Regular leadership rounding with patients
and families, staff and physicians, and
other leaders for the purpose of
information gathering (to understand what
the daily work is really like), coaching,
recognizing, correcting, role-modeling, and
providing real-time service recovery when
needed.
21
Leadership – Key Change Ideas
Label and Link
• Establish and clearly articulate link
between organizational strategy and
tactics to support patient experience.
Board members, staff, physicians are able
to describe their role in patient experience.
22
1/25/2012
12
Leadership – Key Change Ideas
Storytelling
• Use stories to capture patient and family
experience and to foster learning and
change. Begin every board meeting with a
patient story. Develop storytelling skills
among leaders.
23
Leadership – Key Change Ideas
Champions
• Engage and develop high-influence
physician, board, and staff champions who
can carry the patient experience work
forward in their spheres of influence.
24
1/25/2012
13
Hear from Successful Leaders
• Kris White, VP of Innovation and Patient
Affairs, Spectrum Health
• Mitch Mongell, CEO, Colleton
25
Homework for the next call
• Test one of the Leadership Key Change
• Share what you learned from the test
• Complete an additional patient shadowing
activity
26
1/25/2012
14
Next Call
Session 3 - Foundational Element:
Engagement
Date: Wednesday February 8, 2012
2:00 PM - 3:00 PM Eastern US time
27
Listserv
• Send and receive questions and
comments to/from faculty and participants
• To be added to the listserv please email
28