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Accelerating Learning and Spread

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© Kaiser Permanente 2016, Internal Use Only 1 Better Together Lisa Schilling, RN Vice President, Quality and Care Delivery effectiveness British Columbia Patient Safety and Quality Council Quality Forum Vancouver, B.C. March 3, 2017
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Page 1: Accelerating Learning and Spread

© Kaiser Permanente 2016, Internal Use Only 1

Better Together

Lisa Schilling, RN

Vice President, Quality and Care Delivery effectiveness

British Columbia Patient Safety and Quality Council

Quality Forum

Vancouver, B.C.

March 3, 2017

Page 2: Accelerating Learning and Spread

Kaiser Permanente by the numbers

• 8 regions serving 8 states and the

District of Columbia

• 11 million members

• More than 24,000 physicians

183,000 employees (including more

than 48,000 nurses)

• 38 medical centers (with hospitals)

• More than 600 medical offices

(ambulatory care buildings)

• $63 billion operating revenue (2015)

Copyright © 2015 Kaiser Permanente

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Page 4: Accelerating Learning and Spread

What if….

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7 12/5/2016

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8 12/5/2016

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“Innovating requires identifying the problems that matter and

moving through them systematically to deliver elegant

solutions.” -Ten Types of Innovation

Page 10: Accelerating Learning and Spread

© Kaiser Permanente 2016, Internal Use Only 10

Leading organizations understand

what needs to be done to facilitate change,

why they exist—the imperative of experiences, and

how change can occur at a pace consistent with the environment.

Design

for spread

Focus the

organization

Design for

experiences

Use a shared

framework

Cultivate

dynamic

leadership

Measure

the value

Copyright © 2015 Kaiser Permanente

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Design driven

by user needs

and experiences

Systems driven

by quality and

efficiencies +

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From diffuse successes

to strategic wow results

and experiences

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© Kaiser Permanente 2016, Internal Use Only 13

4 Phases to Accelerating Learning and Spread

Focus

Setting the strategic direction and priorities.

Understand

Defining what problems that need to be solved.

Design

Creating and rapidly prototyping a portfolio of solutions.

Integrate

Planning, demonstrating and implementing solutions at scale.

Page 14: Accelerating Learning and Spread

How does it work?

Copyright © 2015 Kaiser Permanente

• XLS

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“Plans are only good intentions unless they

immediately denigrate into hard work” - Peter Drucker

10 Copyright © 2015 Kaiser Permanente

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From Strategy to Execution: Building Change into Operations

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Person focused goals

Implement depression care management programs

across Kaiser Permanente A member who feels “off” emotionally can

get trusted, personalized help, when, where and how she wants it

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Surveys, focus groups …

Storytelling, video ethnography, shadowing, touchpoint/journey mapping …

Advisory councils, members on committees, grand rounds, subject matter experts …

Deep partnership to design and improve, define success metrics, and produce health

CoDesign & CoProduce

Advise &

Consult Deeper Dive

Gather Feedback

Our Evolution in Engaging Patients & Families

Partnering with Patients and Community

Source: Estee Neuwirth, KP 2015

Page 19: Accelerating Learning and Spread

Metrics that matter to patients

Healthcare measures:

Diagnosis rate

Medication refill rate

Length of stay

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Copyright © 2015 Kaiser Permanente

Patient measures:

Is my quality of life improving?

Do providers treat me with respect?

Do providers discuss what matters to me?

Page 20: Accelerating Learning and Spread

Three Big Questions

• 2008 –reduce high HEDIS rate of back surgeries in favor of conservative back care management

• Developed Complete Back Care Algorithm implemented 2009-2011

Thousands

Copyright © 2015 Kaiser Permanente

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Discovery:

“How are we doing?”

Learning:

“What does the evidence tell us?”

Performing:

“Is there more than

can be done?”

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Going deeper looking at equity

If we want to “be the best at getting better” then learning is continuous

Most at risk

and lowest BP

control rate

Top 10% in US

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Copyright © 2015 Kaiser Permanente

Page 22: Accelerating Learning and Spread

Accountability with a new lens

US Hospital

Mortality Rate

How can we

learn from the

best

performer?

© Kaiser Permanente 2015 reproduce by permission only

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“I have long believed that an organization can not maximize its potential unless it mentors its people”

- Michael Dowling

Copyright © 2015 Kaiser Permanente 18

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How are you motivating people?

Copyright © 2015 Kaiser Permanente

• Burning Ambition

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Successful Leadership

• Where are you looking to anticipate the next change?

• How diverse is your network?

• Are you courageous enough to abandon the past?

Copyright © 2015 Kaiser Permanente

Page 26: Accelerating Learning and Spread

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