1. Reducing Waste in Care Delivery Michael I. Harrison, Ph.D Sr. Social Scientist, Center for Delivery, Organization, & Markets (CDOM) AHRQ Annual Conference Sept. 28, 2010

2. For Discussion (1): What has been your experience? Do the process redesign strategies and their change techniques fit care settings with which you are familiar? Do the process redesign strategies and their change techniques fit care settings with which you are familiar? Which strategies and techniques are more appropriate to these settings? Which strategies and techniques are more appropriate to these settings? What types of care settings are more likely to benefit from applications of these strategies? What types of care settings are more likely to benefit from applications of these strategies? What are likely facilitators and barriers to implementing these strategies? What are likely facilitators and barriers to implementing these strategies? What types of modifications to these strategies might be needed? What types of modifications to these strategies might be needed?

3. For Discussion (2). How can findings and recommendations from exploratory studies like these be made useful for decision makers in provider organizations? How can findings and recommendations from exploratory studies like these be made useful for decision makers in provider organizations? – Ideas for individual researchers – Ideas for AHRQ Resources Resources Will It Work Here? A Decisionmaker’s Guide to Adopting Innovations. PI – Amy Roussel, RTI TOO – Cindy Brach, AHRQ http://www.innovations.ahrq.gov/resources/resources.aspx Hard copies can be ordered from AHRQ Publications Clearinghouse: 800-358-9295

4. Key Issues for Decision Makers I. Do the redesign strategy and its change techniques fit the target organization? II. Should we do it here? III. Can we do it here? IV. How will we do it here?

5. I. Do the redesign strategy and its change techniques fit the target organization? What is the strategy? What is the strategy? What techniques will be applied? What techniques will be applied? – Where and how will they be applied (i.e., what specific interventions are proposed)? Do the strategy, techniques, and planned interventions further our goals? Do the strategy, techniques, and planned interventions further our goals? Are they compatible with our organization? Are they compatible with our organization? ** Source: Adapted from Brach C, Lenfestey et al. Will It Work Here? A Decisionmaker's Guide to Adopting Innovations. Agency for Healthcare Research and Quality (AHRQ) Publication No. 08-0051. Rockville, MD: AHRQ; September 2008, http://www.innovations.ahrq.gov/resources/guideTOC.aspx; http://www.innovations.ahrq.gov/resources/guideTOC.aspx Will Process Redesign Work Here?**

6. Will Process Redesign Work Here? (2) II. Should we do it here? What are the potential benefits? What are the potential benefits? What are the potential costs? What are the potential costs? Can we build a business case? Can we build a business case? What are the risks? What are the risks? III. Can we do it here? Are we ready for these changes? Are we ready for these changes? What organizational changes will we have to make to implement the redesign? What organizational changes will we have to make to implement the redesign? Do we have the ingredients for success? Do we have the ingredients for success?

7. Will Process Redesign Work Here? (3) IV. How will we do it here? How will we implement the strategy? How will we implement the strategy? How will we monitor and measure intended and unintended effects of implementation? How will we monitor and measure intended and unintended effects of implementation? Are we ready to modify our implementation strategy in response to emerging developments and early effects? Are we ready to modify our implementation strategy in response to emerging developments and early effects? Can we try a limited intervention first? Can we try a limited intervention first?

8. Questions, Feedback, Ideas... Michael.Harrison@ahrq.hhs.gov Michael.Harrison@ahrq.hhs.gov Michael.Harrison@ahrq.hhs.gov http://www.ahrq.gov/qual/systemdesign.htm http://www.ahrq.gov/qual/systemdesign.htm http://www.ahrq.gov/qual/systemdesign.htm