open your heart and mind to process design category 6
TRANSCRIPT
Open Your Heart and Mind to Process DesignCategory 6
Sandy Churchill
Vice President – Quality and Safety
Marty Dietrich
Manager – Quality Improvement
World-class Criteria
6.1
How do you design your key work systems and
determine your key work processes to deliver
value to patients?
En
ab
l e
VO
C
Achieve
Vision
And
Mission
Enterprise Model
Risk/Patient Safety/Quality
Support Services
Human Resources
Information Systems
Revenue Cycle
Supply Chain Management
Learning and Innovation
Key Work Systems
Organizational Systems that Guide
Building Loyal Relationships
Emergency Care
Inpatient Care
Out Patient Care
• Patient Access•Assessment/Diagnostic•Care Delivery/Treatment•Discharge
Key Work Processes
Input Output
Key
Support
Work
Systems
Clinical Support Services
©
GSAM Leadership System
Understand
Stakeholder Requirements
1
Accountability
for Results
PatientCommunity
Suppliers
Partners
Physicians
Volunteers
Associates
Families
Mission
Values
Philosophy
Integrity
Passion
Caring
Organize,
Plan & Align
Perform to
Plan
Develop, Reward
& Recognize
Learn, Improve
& Innovate
Set Direction
Establish Goals
Leaders initiate/implement meaningful
changes to services/processes to
create new value
PDSA
Determine
Need: New
System or
Service
Gate 1
Justify
Proposal
Gate 2
Secure
Approval
Gate 3
Initiate
Project
Gate 4
Work
Process
Design
Gate 5
Implement
Deploy
Gate 6
Work System Design
1Design
Work
Processes
Gate 5
3 4
PLAN
DO
STUDY
ACT
Determine
Process
Requirements
Benchmark
Best Practices
Identify
Regulatory
Requirements
Determine
If Process Will
Be External or
Internal
5
Map
Processes
6
Evaluate
Technology
8Develop
Education /
Roll-out Plan
Implement
Deploy
Gate 6
Improve
Utilizing
PDSA
2
Design, Manage, & Improve Work Processes
7 Select
In-Process
& Outcome
Measures
1%
3.7% 4%
6%
14%
0%
2%
4%
6%
8%
10%
12%
14%
16%
< 60 61-75 76-90 >91 No Balloon
30
-D
ay M
ort
alit
y (%
)
Door to Balloon Time in Minutes
Survival by the Minute
Reference - Gusto IIb - Berger, Circulation 1999, 100:10-14
Good
Designing & Managing Cardiac Alert Process
Timeliness, high
quality/safe care
Partner with EMS
Determine
Process
Requirements
Determine If
Process Will Be
External or
Internal
1
4
Benchmark Best
Practices
2
Identify
Regulatory
Requirements
3
Designing & Managing Cardiac Alert Process
12-lead EKG
7 Select
In-Process &
Outcome
Measures
5
Map Processes
6
Evaluate
Technology
8Develop
Education / Roll-
out Plan
Arrival EKG ED
MD
Cardiac
MD
Cath
Lab
Balloon
Inserted
Minutes
In Cardiac Alert Process: Time Is Muscle
20
14
9
8
5 4
Min
ute
s
Time to EKG
Years
32
21
1113
107
2
Min
ute
s
Time to Cardiologist
Years
21
10
97
5
5
Min
ute
s
Time to ED Physician
15
108
75
0
Min
ute
s
Time to Alert
Years
Cardiac Alert – In Process Measures
Years
76%
81%
90%
95%
97%98% 98%
2004 2005 2006 2007 2008 2009 2010
Pe
rce
nt
% Door To BalloonWithin 90 Minutes
Good
73
67
63
60
5455
52
2004 2005 2006 2007 2008 2009 2010
Min
ute
sCardiac Alert Process
Average Door To Balloon TimeOutcome Measure
Lives
saved!
Good
Centers for Medicare and Medicaid Services –
CMS Website
http://www.hospitalcompare.hhs.gov
This Information Is Available to You…
89%
90% 90%
98%
84%
86%
88%
90%
92%
94%
96%
98%
100%
National State Closest Competitor GSAM
Door to Balloon Time within 90 Minutes(Data source: www.hospitalcompare.hhs.gov)
Good