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Wednesday 10 June 2015
Carrie Marr
Executive Director Organisational Effectiveness
WSLHD
Mobilising People and Leading Sustainable
Change
Integrating Finance & Quality
• Financial • Waste
• Demographic • Harm
• Safety & Quality • Variation
Context
The “Triple Aim”
Health of the Population
Experienceof Care
Per CapitaCost
3
Voices of America’s Best: Strategies that Sustain Quality
3 Keys to Success:
• Engaged leadership
– Ambitious goals, inspire change and benchmark against the best
• Established culture
– Patient centred, teamwork is valued and staff empower each other
• Continuous improvement
– Transparency and consistency in reporting, identifying vulnerabilities and testing improvement strategies to close the gaps
(Health Grades 2014)
6 Essential Capabilities to Creating High-Performing Organisations (KP)
• Leadership and the ability of leaders to identify the “vital few breakthrough opportunities”
• A systems approach
• Measurement capability at all levels
• The culture of a learning organisation (with an infrastructure to harvest best practices for sharing and learning to create potential for spreading practices with the greatest impact)
• Team engagement from the bottom up
• A strong internal capability to improve
Bosignano, M & Kennedy, C (2012) Pursing the Triple Aim
Characteristics Created By Leading QI Organisations To Deliver Improved Outcomes
Build Infrastructure
& Capacity
Quality improvement education programme
Evidence based learningLeadership development
Priorities maintained during crises Stability of general management and
program management Supporting and enabling staff in their “day
job” of improvementAdaptive internally and externally
Technology & Innovation• Real time
measurement and information systems
Alignment:• Will and commitment• Vision• Strategy• Culture• Measurement• Learning organisation
Ref: Staines 2009
Hard wiringExcellence
Continuous Learning
Continuous improvement
Creating Public Value Through Quality
Inno
vativ
e
Coa
chin
g
Acc
ount
abili
ty
Eng
aged
/C
omm
itted
Saf
e an
d re
liabl
e
Car
ing
&
Com
pass
iona
te
Res
ilien
t
Col
labo
rativ
e
“A Just Culture”
“focusing on information and data to provide assurance on improvement and quality to deliver better, safer care”.
Board
ET
EMT
Directorate / CHP
Ward / Team Level
Patient / Practitioner Level
ASSURANCE
Validated Data for 6 domains: Access, Efficiency, Infection & Prevention, Quality & Patient
Experience, Patient Safety and Data Quality
PERFORMANCE
Validated and un-validated data across 6 domains:Clinical Excellence, Finance & Activity, Valuing Staff, Capacity &
Activity Planning, Patient Experience and Patient Safety
Imp
rove
men
tP
erfo
rman
ceA
ssu
ran
ce
Dat
a an
d M
easu
rem
ent
for
imp
rove
men
t
IMPROVEMENT
Un-validated data provided in real time through Unified Patient Tracking, Clinical Portal and operational dashboard with metrics covering Patient Flow, Inpatient Activity, Out Patients, Waiting
Times, Patient Safety, Infection Control, Clinical Outcomes
Creating the conditions for change…
Create the conditions for change
Is there an agreed aim known by everyone involved?
Do we have the knowledge to prioritise our
biggest QI impact and stop/start
where appropriate?
Is everyone clear about the means
of securing improvement
towards our aim – our tools and
techniques?
Are we able to measure and
report progress on our aim in
realtime?
Do we know how to deploy our resources and
expertise to accelerate
change when required?
Do we have a plan to test and
spread new learning?
Experts0.5%
SeniorLeaders
& Boards(All)
ChangeAgents
(Middle Managers,
project leads10-15%)
Everyone
Staff
Teams
Continuum of PI Knowledge and Skills
Deep Knowledge
Many People Few People
What Skills Do We Need?
Source: Kaiser Permanente, 2008
SharedKnowledge
A key operating assumption of building capacity is that different groups of people will have different levels of need for QI knowledge and skill – what will you need people to have?
Our approach will be to make sure that each group receives the knowledge and skill sets they need when they need them and in the appropriate amounts.
Changing the old
Making the future attractive
Framework: Leadership for Improvement
WillIdeas
Execution
Establish the Foundation
Setting Direction: Mission, Vision, and Strategy
PULL
PUSH
We need to deliver on our statutory responsibilities as well as our ‘contract’ with Ministry
But we also need to create capacity and capability within the District to realise the potential for reducing unwarranted variation, waste an harm.
The simple truth is that it is these resources that will realise our ability to transform our services.
The Leadership Challenge
