Manuela systemic transformations in health care by design slideshare

SYSTEMIC TRansformationsin health care by design

Stories from theCenter for Innovation (CFI)

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* image by Patti Kuche

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WHY DO SO MANY PEOPLE (FROM ALL OVER THE WORLD) COME TO

THIS TORNADO-BORN TOWN?

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1860

VISION

ECONOMY

TECHNOLOGY

COMMUNICATION

WORKFLOW

PARTNERSHIPS

1870 1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020

THE NEEDS OF THEPATIENTS COME FIRST

& INTEGRATEDGROUP PRACTICE

ED: OPEN SURGERIESTHE MAYO´S CLINIC

SALARIEDSTAFF

FIRST USE OFX-RAYS

FIRST USEOF COMPUTER

EXPERIMENTALRADIAL NURSING

UNIT

COMPUTERS GOMAINSTREAM

ICUPRECURSOR

FIRST CTSCANNER

MAYO CLINICCARE NETWORK

MAYO CLINICOPENS IN FLORIDA

AND ARIZONA

FIRST OPERATINGTABLE

EARLY USEOF TELEPHONE

EARLY USE OFVIDEO VISITS

EARLIESTPATIENT RECORD

UNIFIEDMEDICAL RECORD

MEDICALSURGICAL INDEX

ORANGE/BLUECALENDAR DAYS

MAYO CLINICHEALTH SYSTEM

EMR REPLACEDPAPER MEDICAL

RECORDS

FIRST BLOOD BANKIN UNITED STATES

& USE OF EEG TEST

PROACTIVE APPROACHTOWARDS PHILANTROPY

FIRST ICU

spark

cfi

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center for innovationTransforming the experienceand delivery of health care

2

68

24

28

32

64

58

2004 2005 2007 2008 2009 2010 2012 2013

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Facilities & Support ServicesResearch Admin

Planning Services

Public A�airs

Systems and Procedures

Legal

Environmental Services

Education Admin

Development

Molecular Farm

Nursing

ENT

Molecular Med

Orthopedics

Immunology

Anatomy

Surgery

Urology

Lab Med & Pathology

Comparative Med

Health Sciences Research

Biochemistry & Molecular Biology

Mayo Health System AdminHuman Resources

Finance

Neurology

Dental Specialities

Dermatology

Emergency Med

Family Med

Medical Genetics

Internal Medicine

Physical Med

Anesthesiology

Radiation Oncology

Radiology

Psychiatry & Psychology

Neurosurgery

Obstetrics & Gynecology

Ophthalmology - Head & Neck Surgery

Physical & Biomedical Engineering

Oncology

1900

TODAY

1925

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josinavink manuelaaguirreuAHO

possibility based

creative

divergent

generative

reflexive

disruptive

provocative

proactive

evidence based

rational

linear

reductive

analytical

comparative

consensus

reactive

* Comparison by Lorna Ross

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josinavink manuelaaguirreuAHO

THE GOAL

TIMELINE

EXPERIMENT FAMILIES:

Reduce outpatient practice costs by at least 30% while improving the patient experience and maintaining/enhancing quality.

Implement new models to >40% of the outpatient practice by the end of 2014.

Pre-Visit Micro-Consults Group Visits

Smart Space Remote Recheck Flexible Day

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KNOW THE PATIENT

OPTIMIZED CARE OFFERINGS

awareness

adaptability

remoterecheck

group visits

micro-consultsmartspace

previsit flexible

day

costumizeded

enhancedintegrated

care

CREATING AN ADAPTIVE AND INTELLIGENT SYSTEM

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awareness

adaptability

remoterecheck

group visits

micro-consultsmartspace

previsit flexible

day

costumizeded

enhancedintegrated

care

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pulmonary specialist

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ServiceO�erings

OutpatientPractice

MayoSystem

HealthcareIndustry

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Curry, A. and Hodgson, A. (2008). “Seeing in multiple horizons: connecting futures to strategy” . Journal of Futures Studies 13(1). Pp. 1 - 20.

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josinavink manuelaaguirreuAHO

changefatigue

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prove it

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systemic

discrete

short term long term

* Model from Peter Coughlan and Colleen Ponto

narrowvision

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mitigation vsoptimization

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structuredrivesbehavior

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adding ordisrupting

do you see any of these challenges in the context you are working in

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successesin facilitatingsystems change

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making spacefor change

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embrace theunintended

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ENABLINGpractice

champions

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building on whatis working

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identifyingstrategic

levers

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connectingthe dots

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possibilitiesfor the future