Description
I want the answer without similarity at all, and Conceptual and professional, they’re important, I want to follow the instructions in the picture.
Unformatted Attachment Preview
Health Administration Press
Chapter 12
Creating Alignment: Quality Measures and Leadership
Chapter Outline
• Introduction and Terminology
• Quality Assurance, Quality Control, and Quality Improvement
• Leadership, Measurement and Improvement
• Case Study
• Keys to Success
• Study Questions
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
1
Health Administration Press
Introduction & Terminology
• Creating alignment of effort around strategic quality, safety, and
operational objectives is a critical leadership function.
• Over the past decade, there has been an explosion of quality metrics
across healthcare both for internal improvement use and to meet
external accreditation, regulation, and payer demands.
• Collecting and publishing quality measures has become big business
for some organizations and a major cost for healthcare delivery
organizations.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
2
Health Administration Press
Introduction & Terminology
• The term “balanced scorecard” is from work by Kaplan and Norton first
published in HBR in 1992.
• “Balanced” means leaders monitor and understand measures of customer, process, quality,
and strategic performance in addition to financial measures, driving increased shareholder
value and performance.
• The terms dashboard and scorecard are often used interchangeably in
practice but denote different concepts.
• Dashboards: real time process and outcome measures that guide operational and
management decision making
• Scorecards: outcome measures of past performance that may be useful for
leadership tracking of strategic deployment, external comparison and
benchmarking, and overall organizational performance benchmarking
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
3
Health Administration Press
Quality Assurance (QA), Quality Control (QC), and
Quality Improvement (QI)
QA, QC, and QI
represent
different mental
models about
quality and the
use of data and
measurement in
healthcare
organizations.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
4
Health Administration Press
QA, QC, and QI
• QA
• Primarily retrospective review to identify problems or levels of performance
• Data often sourced from chart or case review
• Root cause analysis
• QC
• Data collected and monitored from variety of sources
• Measures collected often dictated by external requirements
• Management KPIs or targets often use same data
• Management reacts to measures which underperform
• QI
• In most robust form, adopted as a management philosophy and mental model
• Seek to improve overall outcomes by improving processes and reducing variation and
innovation
• Data used is often collected real time as part of improvement projects
• IHI Triple Aim represents high-level improvement objectives for healthcare delivery
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
5
Health Administration Press
Leadership, Measurement, and Improvement
• IHI High-Impact Leadership Model
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
6
Health Administration Press
Leadership, Measurement, and Improvement
• Transparency
is a critical
leadership
behavior.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
7
Health Administration Press
Leadership, Measurement, and Improvement
• Measurement and
data are important to
leadership efforts to
build will and delivery
results.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
8
Health Administration Press
Leadership, Measurement, and Improvement
• Leadership of
healthcare
organizations can
also be described
as a “system” with
measurement as a
key function.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
9
Health Administration Press
Leadership, Measurement, and Improvement
• Different types of
measures and
measurement sets
support different
functions and
responsibilities.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
10
Health Administration Press
Leadership, Measurement, and Improvement
• Dimensions of
Performance in
Healthcare
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
11
Health Administration Press
Leadership, Measurement, and Improvement
• Creating an organizational
scorecard
• Adopt just enough measures
• Organize by important
dimensions
• Focus on results
• Use to benchmark performance
against the best
• Use to monitor overall
performance and strategic
deployment
• Useful, not pretty
SOURCE: MdP Associates, LLC. Used with permission
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
12
Health Administration Press
Keys to Success
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Develop a clear understanding of the intended use.
Engage the governing board in development of performance measures.
Use the scorecard to evaluate organizational and leadership performance.
Be prepared to change the measures.
Make the data useful, not pretty.
Integrate the measures to achieve a balance view.
Develop clear and measurable strategies.
Use organizational performance dimensions to align efforts.
Avoid using indicators based on averages.
Develop composite clinical indicators for process and outcome indicators for results.
Use comparative data and external benchmarks.
Change your leadership system.
Focus on results, not activities.
Cultivate transparency.
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
13
Health Administration Press
Study Questions
1. In your experience with healthcare, what are the important dimensions of
performance? How would you know whether an organization is
performing well?
2. What indicators do you think are important for a hospital to track? For a
physician practice? A home care agency? A long-term care facility? A
managed care organization?
3. What might be good indicators of patient-centeredness as recommended
by IOM?
4. What are some of the pitfalls of overmeasurement? How do you
determine what is important to measure in an organization?
5. Why is creating alignment an important leadership function? What are
some methods of creating alignment, and how can the use of
measurement support their deployment?
Copyright 2019 Foundation of the American
College of Healthcare Executives. Not for sale.
14
Live Session
Module #5
Patient Safety at a Glance: Ch. 21
Improving the Quality of Clinical
Care
HCM520
Quality and Performance Improvement
Introduction
►
Systemic problems lead to less than optimal experience
for patients
►
Moral/ethical compass shaped by ‘Do no harm’ precept
►
Patient harm alarms clinicians
►
Patient harm exposes contradiction of fundamental
expectation of care
►
Overall quality improvement described through 6 aims
►
Professionals act, don’t just express frustration
►
Professionals have two jobs, clinical and improvement
Science of
Improvement
►
Everyone must seek ways to improve systems
►
Combines subject matter knowledge and tools to create
approach
►
Approach emphasizes innovation, rapid-cycle testing
►
Derived from W. Edwards Deming’s system
►
Requires understanding of systems
►
Understanding of variation
►
Theory of knowledge
►
Understanding of psychology
Model for Improvement
►
Developed by Associated for Process Improvement
►
►
►
‘disciples’ of Deming’s
Three core questions:
►
What are we trying to accomplish?
►
How will we know that a change is an improvement?
►
What changes can we make that will result in
improvement?
Other core element: series of PDSA cycles
►
Inform degree of belief that changes in 3rd question has
desired influence on measures in 2nd question toward
achieving project aim in 1st question
►
PDSA cycles meant to be short, rapid
►
Measurement techniques, statistical analysis helps
determine what leads to improvements
►
Emphasizes importance of starting small
Supporting Use of Model for
Improvement
► Tools visualize, understand, assess current system and plan
changes
► Patient stories are powerful method to accelerate
improvement efforts
► Societal leaders communicate urgency
► Those leading improvement should use stories
► Successful projects run by multidisciplinary teams
► Importance of engaging team and giving a voice paramount
► In improvement, everyone has something to teach and
learn
Challenges and Overcoming
► Planning essential but other challenges exist
► Managing lots of ideas/people
► Delivering the change
► Addressing barriers during project
► Have set of tools
► Visualize theories for change
► Project management methods
► Borrow ideas
► Share learning
► Support other colleagues interested in leading change
Visual of Aims of Improvement
Example of Patient Journey through
Improvement Active Hospital
Patient Safety at a Glance:
Ch. 28
Patient Stories in Improvement
Introduction
►
Stories have been around for centuries
►
Increasing value to objective scientific stories only as
recent as decades
►
UK NHS – taken steps to ensure patient experience
listened to
►
Patient stories skillfully collected, utilized…
►
►
Enable better understanding what is working well
►
Identify what needs improvement
Patient stories become mobilizing narratives for
improvement
Process of Collecting Patient Stories
► Key steps in process
► Recruiting patients
► Obtain consent
► Ethically conduct, record story
► Make sense of story
► Mind-mapping
Recruit and Obtain Consent
►
Avoid temptation to only collect easy stories
►
Tempting to exclude patients of more difficult communication
or access
►
Collecting stories from one side does not provide fair picture
►
►
Stories should not be recorded
►
►
May result in bias
Unless storytellers are informed and provide written consent
Consent should be in writing with a signature
►
Allows use of final version as a publicly available learning resource
Ethically Conduct and Record
► Three practical ethical behaviors
► Respect
► People and stories should always be respected
► Support
► Offered emotional support during and after storytelling
► Confidentiality and anonymity
► Do not name other patients or staff
► All information collected to protect identity unless they
wish to be identified
► Establish trust and rapport
► Ask questions, allowing patient to speak freely
► Be careful with closed-type questions
► Use active listening skills
► Maintain eye contact
► Nodding or respond when appropriate
Mind-Mapping
► Key components are disseminated to colleagues
► Impractical to have staff read whole story
► Summarize story used as themes, triggers for future
improvement
► Mind-mapping used to transform totality of story into a
condensed graphical representation
► Play back recording, mind map contents
► Reduce stories into main themes
► Compare with other patient stories
Visual Summary of Collecting Stories
Tips for Mind-Mapping
Example of Patient Story Mind-Map
Questions?
Purchase answer to see full
attachment
