Presentation on theme: "Designing Care Samantha Ludolf Designing Care Project Team"— Presentation transcript:
1 Designing Care Samantha Ludolf Designing Care Project Team Department of Human Services
2 What are the 3 major issues facing the delivery of patient care for your organization? How will Designing Care help to address these?What would the “the government of the day” need to know at the end of the 18 months to continue funding initiatives such as DC?What are the perceived benefits of reporting to DHS on Designing Care?
3 QuestionsWhat would you like to gain from this session?
4 Objectives Overview of Designing Care Overview of your Designing Care Next steps
5 Designing Care: a history Quality improvement Deming / Juran 1960sOrganisational learning / systems theorySenge 1991Re-engineering / process redesign Hammer 1993Breakthrough improvement, Institute for Healthcare Improvement 1996
6 Designing Care Is…….18 month program to either indirectly or directly improving patient care throughLearning & NetworkingMeasurementProjects
7 Priorities for your projects: Patient flow - across the system of care linking in with the work of the Patient Management Taskforce & the Emergency Demand Project TeamQuality management - linking in with Adverse Events, Risk Management and Clinical Governance
8 Designing Care: is not a quick fix the latest management fad a way of avoiding challengingimplementation issuesan all-encompassing strategicapproach
9 Designing Care: what it can do Tackle key issuesCreate significant improvement (up to 50%) in key measures of performanceCreate new ways of working across professional, departmental and organisational boundariesLearning & cultural change
10 ‘not all change is improvement but all improvement is change” Process Improvement‘not all change is improvement but all improvement is change”Don Berwick, President, IHI
12 Process has inputs and outputs Definition - a process is a series of connectedsteps or actions to achieve an outcome
13 Fractured neck of femur process Patient processes cross many boundaries% of workdoesn’t add value for patientup to 50% of process steps involve a “handoff”, leading to error, duplication or delayno one is accountable for the patient’s “end to end” experiencejob roles tend to be narrow and fragmentedorganisational/departmental boundariesBCDEAendoscopy processFractured neck of femur processoutpatient process
14 Berwick and colleagues 1998 “In healthcare, the tendency has been to seek improvement by trying to perfect the elements of careto make doctors better at doctoring,to make nurses better at nursing,to give equipment more functions,or to replace one drug with a better one.All of this “subject matter” or “discipline” specific” improvement helps, but modern systems theory suggests that greater leverage often lies in changing the patterns of interaction and in redesigning the overall flow of work.”Berwick and colleagues 1998Physicians as leaders in Improving Healthcare
15 Your Designing Care Project is stays in the ED, who would you involve in the project?
16 Designing Care Funding for: Multi-disciplinary project teamsCross functional project teamsDedicated time to meetCommitment to changeOwnership of the changeSupport for the change
17 Designing Care Project Teams Executive SponsorProject LeaderProject facilitatorMulti-disciplinary team members
18 What are the roles?What do you think is the role of your Executive sponsor, Project Leader & Project Facilitator?
19 Sponsoring Designing Care provide leadership commitment (clinical/managerial)identify directionensure that the project is feasibleensure that the project area is strategically important & worth doingdefine the aims/objectives and performance measuresremove ‘log jams’gain ‘top team’ approval for the project outcomescontinually reiterate the importance of the projectcelebrate success!
20 Facilitating Designing Care Manage (drive) the projectAvoid advice giving“external” facilitator“mind of a beginner”Share of talking should 75% team, 25% facilitator
21 Project Leader Manage the project Lead from the discipline area Champion of the project with peers and team membersSupported by “external” facilitator
22 What skills do you need? - Executive sponsors Project facilitators Project teams
23 Tools & Learning Project management Process mapping Measurement Process redesignChange management - cultural, people & processesFacilitationConsumer involvementEvidence based healthcare
24 Learning Regional learning sessions Internet based learning/tools Internet based libraryDiscussion groupsOn site learning –e.g process mapping & redesign, coaching & mentoring
25 The toolkit we will have some material for you to create your own toolkit
26 What is the best way of learning? “The best learning is by playing”Harold Bridges, Tavistock Institute
27 4 organizations are all looking at process of care for COPD Patients 4 organizations are all looking at process of care for COPD Patients. Do you think it would beneficial to share the learning with 4 organizations?
28 Networking & Sharing Program of monthly meetings – key topics Quarterly project team meetings: Feb 2001International conference: Feb 2002
29 From you:By June 2002, the end of Designing Care, what will you have achieved?How will you measure your achievements?How will you apply process mapping and redesign methodology?
30 Next steps Feedback from the briefing session Final submission - Jan 01Approval - Feb 200160% Funding - Feb 2001Launch event - Feb 2001Baseline measures