valuentis delivering world class healthcare 210610 final
DESCRIPTION
N J Higgins presentation on Delivering World Class Healthcare (large file - allow for download)TRANSCRIPT
Delivering World Class Healthcare:Th F Ch ll f h NHSThe Future Challenge for the NHS
Nicholas J Higgins, CEO VaLUENTiS & Dean ISHCMNHS-Healthcare Management PracticeDrHCMI MSc Fin (LBS) MBA (OBS) MCMI
22nd June 2010
DrHCMI MSc Fin (LBS) MBA (OBS) MCMIVaLUENTiS NHS Prime Network ‘Managing in Challenging Times’CBI Centrepoint London
Statement from the Secretary of yState extract
“I began today by talking about my ambition:I began today by talking about my ambition:for health outcomes and healthcare services inthis country to be as good as any in the world.”
Andrew Lansley, Patient-centred care, DoH 8 June 2010
CONTENTCO
NHS h t th ?NHS where art thou?
We’re talking quality!
The CQC Rating: ‘Mind the gap’Mind the gap
What is world class, indeed?
Trust Performance I:Trust Performance I:Taking a different step
Trust Performance II:Trust Performance II:‘With an outcome here and outcome there...’
‘Coming full circle’
NHS: Where are we now?A retrospective• Access• Patient safety• Promoting health and LTC• Promoting health and LTC• Clinically effectivey• Patient experience• Equity
Effi i• Efficiency• AccountabilityAccountabilitySource: A High-performing NHS? A review of progress 1997-2010
However, productivity according to the ONS has dropped from 1995 2008 by 3 3%dropped from 1995 – 2008 by 3.3%...
Treating diseases: Where the money goes...
Source: What Do We Want From The NHS, The Daily Telegraph, March 9 2010
One macro-perspective on national healthcare performance (spend vs life expectancy)performance (spend vs life expectancy)
Source: Adapted from Premium Price, Poor Performance, J Levin-Scherz, Harvard Business Review April 2010 p.70
NHS where art thou?
We’re talking quality!
The CQC Rating: ‘Mi d th ’‘Mind the gap’
What is world class, indeed?
T t P f ITrust Performance I:Taking a different step
T P f IITrust Performance II:‘With an outcome here and outcome there...’
We’re talking Q lit !‘Coming full circle’ Quality!
Donabedian’s‘seven pillars’ of pquality
Source: Adapted from An Introduction to Quality Assurance in Healthcare, A Donabedian OUP 2003
Source: Adapted from An Introduction to Quality Assurance in Healthcare, A Donabedian OUP 2003
The three approaches to assessing lit (D b di ’ SPO d l)quality care (Donabedian’s SPO model)
Cause &
effect
The three approaches to assessing lit (D b di ’ SPO d l)quality care (Donabedian’s SPO model)
Cause &
effect
‘Quality accounts’ including Floodlight ti ll breporting covers all bases
• Trust Leadership & management
• Staff engagementM i /CQC• Monitor/CQC ‘Financial’ rating
Quality accounts inc NHS c S
Floodlight
• Staff engagement• VBM Efficiency
• VBM Effectiveness• Patient clinical
• CQC ‘Quality’ rating • Patient experience* Both include patient safety parameters
Mapping the various NHS quality related t th SPO d lassessments across the SPO model
• Trust Leadership & management
• Staff engagementM i /CQC• Monitor/CQC ‘Financial’ rating
Cause &
effect
• VBM Effectiveness• Patient clinical
• Staff engagement• VBM Efficiency
• Patient experience* Both include patient safety parameters
• CQC ‘Quality’ rating
Quality accounts
NHS where art thou?
We’re talking quality!
The CQC Rating: ‘Mi d th ’‘Mind the gap’
What is world class, indeed?
T t P f ITrust Performance I:Taking a different step
T P f IITrust Performance II:‘With an outcome here and outcome there...’
The CQC Rating: ‘Mi d th ’‘Mind the gap’‘Coming full circle’
Example CQC ‘quality’ indicators/targets:f i l l t d bl l ?a case of single loop not double loop?
National commitment indicators Achieve Underachieve Fail
CQC Trust Performance Ratings:‘Quality’ & Financial rating matrix‘Quality’ & Financial rating matrix
World class‘QUALITY’
Excellent
GoodGood
Fair
WeakFINANCIAL
Weak Fair Good Excellent World class
FINANCIAL
Qualityaxis
World class ‘QUALITY’
Excellent
GoodGood
Fair
WeakFINANCIAL
Weak Fair Good Excellent World classFinance
Poorf f
FINANCIAL
Financeaxis
Not fit for purpose
CQC Trust Performance Ratings distribution2008 9 [across 392 Trusts]2008-9...[across 392 Trusts]
Q
World class
Excellent 379%
174%
31%
1
Good 89 53413Good 8923%
5314%
4110%
31%
Fair 113%
6116%
5013%
62%
Weak 21%
92%
82%
1
Weak Fair Good Excellent World class F
CQC Trust Performance Ratings distribution2008 9 [across 392 Trusts]2008-9...[across 392 Trusts]
Q
World class
Excellent 379%
174%
31%
1
Good 89 53413Good 8923%
5314%
4110%
31%
Fair 113%
6116%
5013%
62%
Weak 21%
92%
82%
1
Weak Fair Good Excellent World class F
Performance Ratings versus Employee Engagement distributionEngagement distribution
Q
World class
Excellent
GoodGoodWhat happens if we plot
engagement scores against Perf Rating?
Fair Is there any correlation?
Weak
Weak Fair Good Excellent World class F
Performance Ratings versus Employee Engagement score distributionEngagement score distribution (rebased & simplified average per box)
Q
World class
Excellent 776658 65
Good 71727358Good 71727358
Fair 6465 5255
Weak 54523925
Weak Fair Good Excellent World class F
NHSNHSNEXT STOP:
WORLDWORLD CLASSCLASS
NHS where art thou?
We’re talking quality!
The CQC Rating: ‘Mi d th ’‘Mind the gap’
What is world class, indeed?
T t P f ITrust Performance I:Taking a different step
T P f IITrust Performance II:‘With an outcome here and outcome there...’
What is world l i d d?class, indeed?‘Coming full circle’
• world-class (wûrldkls) adj.
• Ranking among the foremost in the• Ranking among the foremost in the world; of an international standard of excellence; of the highest order.
World class ?World class....?
Healthcare: Around the world (in 80 ways)...( y )• AUSTRALIA• BRAZIL• CANADA• CHINA• FRANCE• GERMANY• HOLLAND• HOLLAND• HONG KONG• INDIA• ITALY... • JAPAN
• KOREA• NEW ZEALAND• NEW ZEALAND• NORWAY• SINGAPORE• SWEDEN• SWITZERLAND• UK• USA... and a host of others
12 ‘attributes’ of world class healthcare
1. Practice of Evidenced based medicine (& social care)2. Possess integrated network of ‘fit-for-purpose’ healthcare facilities3. Standardised access to healthcare4. Appropriate investment and innovation on technology and drugs usepp p gy g5. Embedded patient-centred operating culture6. Practice of Evidenced based management7 Utilisation of requisite skilled staff7. Utilisation of requisite skilled staff 8. Embedded data collation infrastructure:
1. Clinical2. Patient outcomes3. Patient experience4. Management/staff5. Financial costing6. Operational
9. Practice of Financial management10. Developed Executive intelligence measurement and reporting11. Execute intelligence-based decision-making (governance)12 Demonstrate value-based effectiveness12. Demonstrate value-based effectiveness
Source: Delivering world class healthcare – one small step for the NHS? VaLUENTiS whitepaper, forthcoming
The attainment of World class: A preliminary view of the NHSof the NHS
‘World class’ attributes Weak Adequate Good Excellent World class
C B A AA AAA
class
NHS where art thou?
We’re talking quality!
The CQC Rating: ‘Mi d th ’‘Mind the gap’
What is world class, indeed?
T t P f I
TrustTrust Performance I:Taking a different step
T P f II Trust Performance I:
Trust Performance II:‘With an outcome here and outcome there...’
Taking a diff t ‘ t ’different ‘step’‘Coming full circle’
"We can only be sure to improve what weWe can only be sure to improve what we can actually measure"
Lord Darzi, High Quality Care for All, June 2008
“If you cannot measure it you cannotIf you cannot measure it, you cannot improve it.”
Original source attributed to Lord Kelvin 1824 1907Original source attributed to Lord Kelvin 1824-1907, pioneer of physics and thermodynamics, first UK scientist appointed to the House of Lordsappointed to the House of Lords
Data collation:Data collation:Staff and patient psurveys...
Current NHS staff and patient ‘compliance’ survey process
Reported for Reported
survey processReported for macro DoH
research
for macro DoH
research
Annual staff survey T t
Annual staff survey T t
Normally conducted in 10-week window with 4-month turnaround
across Trust population (sample)
across Trust population (sample)
......
Spot target patient survey
......
Intermittent collection of patient feedback
Spot target patient survey
Reported for macro DoHfeedback *
Flipping the current NHS staff and patient survey process into ‘baseline’ executive intelligence
Sample for Sample
process into baseline executive intelligence Sample for macro DoH
research
for macro DoH
research
Annual staff survey f ll T t
Quarterly ‘pulse’
Quarterly ‘pulse’
Quarterly ‘pulse’
Annual staff survey f ll T t
Normally conducted in 2-week windows with 2-week turnarounds
across full Trust population (census)
pulse sample surveys
pulse sample surveys
pulse sample surveys
across full Trust population
......
Spot target patient survey
......
Intermittent collection of patient feedback
Spot target patient survey
Reported for macro DoHfeedback *
From ‘Baseline to Advanced’...
Sample for Sample Sample for macro DoH
research
for macro DoH
research
Annual staff survey f ll T t
Quarterly ‘pulse’
Quarterly ‘pulse’
Quarterly ‘pulse’
Annual staff survey f ll T t
Normally conducted in 2-week windows with 2-week turnarounds
across full Trust population (census)
pulse sample surveys
pulse sample surveys
pulse sample surveys
across full Trust population
......
Quarterly QuarterlyQuarterly QuarterlyQuarterly QuarterlyQuarterly patient ‘pulse’
reporting
Quarterly patient ‘pulse’
reporting
Quarterly patient ‘pulse’
reporting......
Continuous collection of patient feedback reported in quarterly ‘pulses’
Quarterly patient ‘pulse’
reporting
Quarterly patient ‘pulse’
reporting
p p q y p
Sample for Sample for pmacro DoHfeedback *
pmacro DoHfeedback
*Can be selected at any nominated point
From Advanced to World Class...Sample for macro DoH
research
Sample for macro
DoHresearch
Normally conducted in 2-week windows against selected samples
s
Annual staff survey across full Trust
population (census)
Quarterly ‘pulse’ sample surveys
Quarterly ‘pulse’ sample surveys
Quarterly ‘pulse’ sample surveys
Annual staff survey across full Trust
population......
s
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Quarterly QuarterlyQuarterly QuarterlyQuarterly Quarterly
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tivar
iate
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ia
Quarterly patient ‘pulse’
reporting
Quarterly patient ‘pulse’
reporting
Quarterly patient ‘pulse’
reporting......
Continuous collection of patient feedback reported in quarterly ‘pulses’
Quarterly patient ‘pulse’
reporting
Quarterly patient ‘pulse’
reporting
p p q y p
Sample for Sample for pmacro DoHfeedback *
pmacro DoHfeedback
Source: Conducting staff and patient surveys in the NHS: A world class solution, VaLUENTiS white paper, forthcoming
*Can be selected at any nominated point
NHS staff and patient surveys : The PULSAR® design
Sample for macro DoH
research
Sample for macro
DoHresearch
The PULSAR® design
Normally conducted in 2-week windows against selected samples
s
Annual staff survey across full Trust
population (census)
Quarterly ‘pulse’ sample surveys
Quarterly ‘pulse’ sample surveys
Quarterly ‘pulse’ sample surveys
Annual staff survey across full Trust
population......
s
e ph
ase
anal
ysis
ate
phas
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Synchronous phase reporting to assist in improving care/embedding engagement in Trusts linking to clinical, quality, management and financial outcomes - see VaLUENTiS NHS
Floodlight System™ for example
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iate
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iate
Quarterly QuarterlyQuarterly QuarterlyQuarterly Quarterly
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tivar
iate
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tivar
iaFloodlight System for example
Quarterly patient ‘pulse’
reporting
Quarterly patient ‘pulse’
reporting
Quarterly patient ‘pulse’
reporting......
Continuous collection of patient feedback reported in quarterly ‘pulses’
Quarterly patient ‘pulse’
reporting
Quarterly patient ‘pulse’
reporting
p p q y p
Sample for Sample for pmacro DoHfeedback *
pmacro DoHfeedback
Source: Conducting staff and patient surveys in the NHS: A world class solution, VaLUENTiS white paper, forthcoming
*Can be selected at any nominated point
Data collation (staff): Key differentiating factors between ‘Basic’ and ‘World class’between ‘Basic’ and ‘World class’
‘Basic’ ‘World class’• As compliance exercise• Seen as ‘imposed task’
• As ongoing evaluation exercise• Seen as ‘integral infrastructure’p
• Intermittent ‘past-time’ data• Staff (and patient) data remain
g• Continuous ‘real time’ data• Staff (and patient) data used in ( )
siloed in disparate format• One-off action plan
( )multivariable analysis/models
• Continual improvement project• Rigid ‘academic’ manual
processInfreq ent reporting
• Lean adaptive blended (cost-effective) processFreq ent reporting• Infrequent reporting
• Less opportunity to embed evidence based management
• Frequent reporting• Constantly reinforces evidence
based managementevidence based management based management
The patient experience...
TrustReception
FoodAvailability
CarePainmanagement
TrustReception
FoodAvailability
CarePainmanagement
Data collation (patient): Key differentiating factors between ‘Basic’ and ‘World class’between ‘Basic’ and ‘World class’
‘Basic’• As compliance exercise
‘World class’• As ongoing evaluation exerciseAs compliance exercise
• Seen as ‘imposed task’• Intermittent ‘past-time’ data
As ongoing evaluation exercise• Seen as ‘integral infrastructure’• Continuous ‘real time’ datap
• Patient data remains siloed in limited format
• Patient data used in multivariable analysis/models
• One-off action plan, if any• Limited number of question data
• Continual improvement project• Multi-perspective question data
• Infrequent reporting• Less opportunity to embed
patient relationship management
• Frequent reporting• Patient-centricity core with patient
relationship management driverpatient relationship management • Patient ‘clinical’ and patient
‘experience’ viewed separately
relationship management driver• Patient ‘clinical’ and ‘experience’
viewed as two sides of the sameexperience viewed separately viewed as two sides of the same coin
StaffStaff management...
Evaluating Trust management practice: (Management Pathfinder™ ‘radar’)
DIVERSITYTRAINING &DEVELOPMENT
(Management Pathfinder™ ‘radar’)
EMPLOYEECENTRICITY
TALENTMANAGEMENT
DEVELOPMENT
813
EMPLOYERBRAND REWARD
674599 416
HRGOVERNANCE RETENTION
742
615
431
657599
‘Out-performing’ ( ld l )
HR
742 431
487
642
684
(world class)‘Out-performing’ (peer)‘Comparable’ (peer) OPERATIONAL
EXCELLENCE RESOURCING 642
628594603(peer)
‘Under-performing’ (peer)
LEADERSHIPPERFORMANCEORIENTATION
796ORGANISATION
CLIMATE ORGANISATIONCOMMUNICATIONS
ORGANISATIONDESIGN
Trust management practice – composite findings from NHS network cohortfrom NHSPRIME network cohort
You may already know that....
• 1860 – set up first nursing school at
y y
p gSt Thomas’ Hospital London (now part of King’s College)part of King’s College)
• First female member of the Royal Statistical Society and credited with developing the ‘polar area diagram’developing the polar area diagram (firstly for sources of patient
t lit ) l fmortality) –see overleaf
But did you know that...?
Nightingale’s original ‘polar area diagram’g g g p g
Thus our management radar diagrams are a modern reincarnation of Nightingale’s PADmodern reincarnation of Nightingale’s PAD
Staff Management: Key differentiating factors between ‘Basic’ and ‘World class’between ‘Basic’ and ‘World class’
‘Basic’• No evaluation of organisation
‘World class’• Management evaluation regularly
management undertaken• Consistency of leadership/
t t l
undertaken and reported• Reinforces consistency of leadership/
t tmanagement competence low• Staff survey data used in
isolation
management competence• Used in conjunction with staff survey
data and other operational dataisolation• Only proxy metrics like
absenteeism used as evaluation
data and other operational data• Management evaluation has many
multi-perspective measures• Little evaluation of any
management development
p p• Continual evaluation of management
development (including longitudinal)• Management initiatives usually
undertaken in adhoc sequence E id b d t
• Management initiatives in planned & (co-)sequenced in priority mannerE id b d t• Evidence based management
practised in ‘blotches’• Evidence based management
practised as key driver
NHS where art thou?
We’re talking quality!
T tThe CQC Rating: ‘Mi d th ’ Trust
Performance II:‘Mind the gap’
What is world class, indeed?
T t P f I Performance II:‘With an
Trust Performance I:Taking a different step
T P f II With an outcome here
Trust Performance II:‘With an outcome here and outcome there...’
and an outcome th ’there...’‘Coming full circle’
Trust Performance broken down into four outcome componentsoutcome components
roug
h:
ured
thr
ly m
eas
mpo
site
lC
om
Performance & Productivity:yA simple graphic
OUTCOMES
INPUTS THROUGHPUTS
OUTPUTSOUTPUTS
Performance & Productivity:ySimple healthcare model
OUTCOMES
INPUTS
THROUGHPUTSPhysical
Effect of treatmentQuality of life improvement, THROUGHPUTSNo of doctors,
nurses, management,
drugs, technology, beds
re-admissions, patient
experience, etc
OUTPUTS
etc
FinancialHealthcare
spend (direct and indirect
costing)SystemVolume of
patients treated p(by class), discharges/
consultations etc
World Class Healthcare:Value based management in the NHSValue based management in the NHS
‘Macro’ model version 1.21
Leadership &
governance
Leadership &
governance
Shareholder valueTrust
performanceEmployer brandTrust
‘brand’
VBEΣx
Human Capital
Practices
Human Capital
Practices External PatientValue
Customer Satisfaction
Patient Outcome
Revenue Growth
Quality ofprovision
I di id l/
Portfolio mixSafety
X-sellingClinical treatment
Patient centric
Work valuesWork values
Line-of-sightLine-of-sight
Development EmployeeStaff
g
e1 p1-6poΣx
QΣxLΣx b1
Value
Proposition
ValueProposition
PRMCustomer
LoyaltyPatient
experience ProfitabilityUse of Resources
Individual/ team
Productivity
Individual/ team
Productivity
ServicePatient centricDevelopmentDevelopment
RewardReward
Work environmentWork environment
Employee Engagement
Staff Engagement
Portfolio mixAccess
X-sellingEfficiency
ServiceEquity
s pe
rΣy
hcmΣyEf1-5
Employee Retention
Staff retention& utilisation
‘Local’ Management
‘Local’ Management Cost management
ComplianceCompliance
s1 peΣxhcmΣy
RΣx
ManagementManagementCost controlCost management
FΣym1
Key: e1 = example VBM pathway
© VaLUENTiS VBM Analytics methodology
The NHS Floodlight (Internal) system (ORIGINAL)(ORIGINAL)
Clinical Patient Financial Management
CO#1CO#6 CO#1CO#6 PO#1PO#6 PO#1PO#6 FO#1FO#6 FO#1FO#6 MO#1MO#6 MO#1MO#6
Outcomes Outcomes Outcomesg
Outcomes
CO
#5
CO
#2CO
#5
CO
#2 PO#5
PO#2PO
#5
PO#2 FO
#5
FO#2FO
#5
FO#2 M
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MO
#2MO
#5
MO
#2
DIVERSITY
EMPLOYEETALENT
TRAINING &DEVELOPMENT
813
DIVERSITY
EMPLOYEETALENT
TRAINING &DEVELOPMENT
813CO#3CO#4 CO#3CO#4 PO#3PO#4 PO#3PO#4 FO#3FO#4 FO#3FO#4 MO#3MO#4 MO#3MO#4
MM
WP#12 WP#1
MM
WP#12 WP#1EE Work Environm
EE
ne of Sight EE Work Environm
EE
ne of Sight
CENTRICITY
EMPLOYERBRAND
HRGOVERNANCE RETENTION
REWARD
MANAGEMENT 813
742
674
615
431
657599 416
CENTRICITY
EMPLOYERBRAND
HRGOVERNANCE RETENTION
REWARD
MANAGEMENT 813
742
674
615
431
657599 416
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HR OPERATIONALEXCELLENCE
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PERFORMANCEORIENTATION
RESOURCING
796
487
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LEADERSHIP
ORGANISATIONORGANISATION
PERFORMANCEORIENTATION
RESOURCING
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EEHH FF
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ORGANISATIONCLIMATE ORGANISATION
COMMUNICATIONS
ORGANISATIONDESIGN
ORGANISATIONCLIMATE ORGANISATION
COMMUNICATIONS
ORGANISATIONDESIGN WP#6WP#7 WP#6WP#7eveloard eveloard
HR FunctionProductivity
Leadership & Management Eff ti
StaffEngagement
Workforce Productivity
Effectiveness
The NHS Floodlight (internal) system (REVISED)(REVISED)
Clinical Patient Patient Financial
CO#1CO#6 CO#1CO#6 PO#1PO#6 PO#1PO#6 FO#1FO#6 FO#1FO#6 MO#1MO#6 MO#1MO#6
Effectiveness Experience Safety Management
CO
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PO#2PO
#5
PO#2 FO
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FO#2FO
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FO#2 M
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#5
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DIVERSITY
EMPLOYEETALENT
TRAINING &DEVELOPMENT
813
DIVERSITY
EMPLOYEETALENT
TRAINING &DEVELOPMENT
813CO#3CO#4 CO#3CO#4 PO#3PO#4 PO#3PO#4 FO#3FO#4 FO#3FO#4 MO#3MO#4 MO#3MO#4
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EE
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EE
ne of Sight
CENTRICITY
EMPLOYERBRAND
HRGOVERNANCE RETENTION
REWARD
MANAGEMENT 813
742
674
615
431
657599 416
CENTRICITY
EMPLOYERBRAND
HRGOVERNANCE RETENTION
REWARD
MANAGEMENT 813
742
674
615
431
657599 416
AA
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HR OPERATIONALEXCELLENCE
LEADERSHIP
ORGANISATIONORGANISATION
PERFORMANCEORIENTATION
RESOURCING
796
487
642
628594603
684HR
OPERATIONALEXCELLENCE
LEADERSHIP
ORGANISATIONORGANISATION
PERFORMANCEORIENTATION
RESOURCING
796
487
642
628594603
684
EEHH FF
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WP#5WP#8
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M 2
ORGANISATIONCLIMATE ORGANISATION
COMMUNICATIONS
ORGANISATIONDESIGN
ORGANISATIONCLIMATE ORGANISATION
COMMUNICATIONS
ORGANISATIONDESIGN WP#6WP#7 WP#6WP#7eveloard eveloard
HospitalManagementObj ti
Leadership & Management Eff ti
StaffEngagement
Hospital Productivity
Objectives Effectiveness
The NHS Floodlight system (EXTERNAL): Current [C]Current [C]
Cli i l P ti t P ti t Fi i lClinical Effectiveness
PatientExperience
PatientSafety
FinancialManagement
Hospital ManagementObjectives
Leadership & Management Effectiveness
StaffEngagement
Hospital Productivity
GWorld class
Excellent
Good
Adequate
Weak
Insufficient data
The NHS Floodlight system (EXTERNAL): Current plus previous 2 years [C+]Current plus previous 2 years [C+]
Cli i l P ti t P ti t Fi i lClinical Effectiveness
PatientExperience
PatientSafety
FinancialManagement
Hospital ManagementObjectives
Leadership & Management Effectiveness
StaffEngagement
Hospital Productivity
GWorld class
Excellent
Good
Adequate
Weak
Insufficient dataLast 3 years performance
Quality Accounts: We see 3 versions developing –Standard, Intermediate (Super8) and Advanced ( p )(SuperEight3D)
Advanced
Intermediate
Standard
ExIMR...[Executive IntelligenceMeasurement & Reporting]Reporting]
Anal tics Ri kPredictive
VisualisationE l ti F ti‘Real time’P fAnalytics Risk modelling VisualisationEvaluation Forecasting‘Real-time’Performance
Too often different sourced data is not connectedconnected...
Or, conversely, different time-series data is erroneously connected...
Real-Time Informed Management and staffManagement and staff
AFF C
AL
NC
IAL
EN
T
TIO
NA
L
STA
ME
DI
FIN
AN
PATI
E
OP
ER
ATO
ExIMR: Key differentiating factors between ‘Basic’ and ‘World class’and ‘World class’
‘Basic’ ‘World class’Basic• Data collation and measurement
driven by ‘external demand’
World class• Data collation and measurement
driven by ‘internal strategy’driven by external demand• Viewed as ‘imposed task’• Intermittent ‘past-time’ data
driven by internal strategy• Viewed as ‘integral infrastructure’• Continuous ‘real time’ dataIntermittent past time data
• Selected data used mainly to support ‘chosen view’/defence
Continuous real time data• Constant aid to decision-making
and governance• Management meetings driven
by information swap
g• Management meetings driven by
knowledge debate/exchange• Tendency to think IT will solve
problem – sub-optimal efficiencyOperating c lt re still ‘target
• Measurement ethos with cost-efficiency uppermostOperating c lt re ‘objecti e’• Operating culture still ‘target
driven’• Quality Accounts seen as
• Operating culture ‘objective’ driven
• Quality Accounts seen asQuality Accounts seen as compliance exercise
Quality Accounts seen as ongoing evaluation exercise
NHS where art thou?
We’re talking quality!
The CQC Rating: ‘Mi d th ’‘Mind the gap’
What is world class, indeed?
T t P f ITrust Performance I:Taking a different step
T P f II
‘C i f ll
Trust Performance II:‘With an outcome here and outcome there...’
‘Coming full circle’circle
‘Coming full circle’
The 12 ‘attributes’ f ld lof world class
healthcare11
healthcare
At trust level...8
7
5
... each one is 2
attainable 1
The attainment of World class: A small step of steps within 5 years ?steps within 5 years...?
‘World class’ attributes Weak Adequate Good Excellent World class
C B A AA AAA
class
??
What’s the answer to ‘Managing g gin Challenging Times’.....?
“BEING SMARTER”