Innovation Success: Identify the Impacts and Manage the Results

March 1, 2016

John Hansmann, MSIE, FHIMSS, DSHS Sr. Director, Health Catalyst

Conflict of Interest John Hansmann, MSIE, FHIMSS, DSHS Has no real or apparent conflicts of interest to report.

Learning Objectives • Recognize the importance of managing change and addressing workflow impacts related to innovative transformations

• Assess the impact of innovation on current and future work processes

• Identify the necessary skills required to manage innovative transformations to ensure successful implementation and ongoing use

http://www.himss.org/ValueSuite

Realize the Value of Health IT • Value steps impacted:

– Savings – Treatment/Clinical – Satisfaction

• Example Results – $74M savings – Reduces unnecessary chest x-

rays by 49% – Patient satisfaction improved

Agenda • Concept of Innovation • Concept of change management • Operational Innovation Success Stories

– Texas Children’s Hospital – Healthcare System in Intermountain West Region

• Case Study Commonalities • Tools to Assess Work Processes • “New” Innovations • Summary • Questions

Today’s Session will ……. • focus on the impact of innovations on current and future operations.

•discuss the importance of planning for innovative changes, and the skills necessary to manage the change process.

Inventive

Change

New

Modernize

Reform

Upgrade

Develop

Alter

Conversion

Innovation

Advance

Reconstruction

Renew

Improvement

Revolutionize Transformation

Roger’s Diffusion of Innovation Model

2.5% Innovators

13.5% Early

Adopters

34% Early

Majority

34% Late

Majority 16%

Laggards

Tipping point at 15-20% adoption

• Innovators are open to new concepts

• Early adopters tend to be opinion leaders

• Early majority legitimize innovation

• Late majority are skeptics • Laggards want to keep

status quo

Source: adapted from E.M. Rogers, Diffusion of Innovations, 5th ed., Free Press

Characteristics/Attributes/Skills for Successful Change Management • Communicate • Trustworthy • Resilient • Persistent • Manages Ambiguity / Sees “Big Picture”

• Organized • Coach

Operationalizing Innovation

“Success doesn't necessarily come from breakthrough innovation but from flawless execution. A great strategy alone won't win a game or a battle; the win comes from basic blocking and tackling.” Naveen Jain, Innovator & Entrepreneur

Operational Innovation Success Stories Texas Children’s Hospital – Houston, TX • Launched system-wide performance improvement project

(“Delivering on the Vision”-DOTV) • Plan/Goals

– Enhance strategic decision-making – Establish data driven transparent culture – Increase the accountability of leaders, providers and managers

for their clinical and operational performance – Perform detailed assessments of labor, non-labor, inpatient

clinical operations, clinical documentation improvement and physician practice operations

Source: “$74M in Healthcare Operational Improvements: How Texas Children’s Hospital is Delivering on Its Vision”, Health Catalyst, 2015.

Operational Innovation Success Stories Texas Children’s Hospital continued • Methodology/Approach

– Implemented an enterprise data warehouse (EDW) and healthcare analytics applications solutions

– Organized improvement teams – Utilized data to understand current practice and to make decisions

• Results – Realized $74 million in operational improvements (over 18 months) – Practice Management

• 15% increase in provider productivity • 36% decrease in physician clinic no-show rate

Source: “$74M in Healthcare Operational Improvements: How Texas Children’s Hospital is Delivering on Its Vision”, Health Catalyst, 2015.

Operational Innovation Success Stories Texas Children’s Hospital continued • Results continued

– Labor Expense • Improved staff flexing • 2 percentage point reduction in S&B as a percent of net

patient revenue – Clinical Operations

• Implemented clinical care teams (ex. Asthma Care, reduced unnecessary chest X-rays by 49%, utilized best practice order sets 80%)

• 14 percent decrease in hospital LOS while census increased

Source: “$74M in Healthcare Operational Improvements: How Texas Children’s Hospital is Delivering on Its Vision”, Health Catalyst, 2015.

Operational Innovation Success Stories Healthcare System in Intermountain West Region • Design and build new outpatient center

– Included patient services for OP Surgery, Lab and Imaging – Physically detached from main hospital impacting logistics for services – All departments participated in architectural design meetings

• Operational Efficiency Team – Process oriented; operational impact focused – Participated in architectural design meetings

• Assisted depts./functions in current state/future state discussions and designs

• Challenged hospital and departmental leadership to create highly functional, efficient well designed workspace that supported their work processes

Operational Innovation Success Stories Healthcare System in Intermountain West Region • Results

– Construction finished on time and under budget – Operationally only added new program FTEs – Moved into the new space and began working with minimal

rework – Operationalized Patient Kiosks and optimized patient traffic flow – Operationalized combined Lab/Reg and Rad/Reg Check-in

Commonalities • Embraced the challenge, adopted the innovation and adapted as

necessary • Fundamentally understood the impact on work, work processes and

workflow • Managed the change process, dealing with all of the physical and

emotional issues • Created a participatory environment, where physicians, nurses,

administrators, and frontline staff were involved throughout • Communicated clearly and consistently • Made data driven decisions • Changed the culture

Tools to Assess Work Processes • Current State/Future State • Simulation • Interview/Observation • Process Analysis • Workflow Analysis • Flow Charting • Value Stream Map • Impact Analysis • Risk Analysis • Lean and Six Sigma Tools • Others

Tools to Assess Work Processes Workflow Tools

• Current State/Future State

• Process Analysis

• Workflow Analysis

• Flow Charting

• Value Stream Map

• Interviews & Observations

Tools to Assess Work Processes Impact/Risk Assessment

• Impact Analysis

• Risk Analysis (Downstream direct and indirectly affected areas, stakeholders, assets & barriers)

Pro

babi

lity

Impact

Significant Effect

Minor Effect

Tools to Assess Work Processes

Tech

nolog

y

Proc

ess

Cultu

re

Othe

r

1-Lo

w

3-M

ed

5-Hi

gh

Impact Rating

Improvement Opportunity Impacted Process/Function Impacted Department $$$ Impact Potential Mitigating Solutions

Improvement Type

Impact/Risk Assessment

Tools to Assess Work Processes Simulation

Tools to Assess Work Processes Lean & Six Sigma Tools

• Lean (5S, Cause & Effect, 5 Why’s, Value Stream Mapping)

• Six Sigma Tools

• Interviews & Observations

• Others

Tools to Assess Work Processes Lean & Six Sigma Tools

“New” Innovations • “Wearables • Mobile Apps • “The Cloud” • ICD-10 • CRISPR Gene Editing • Value-based Care • Population Health • Staffing and population trends

– 10K per day turning 65 until 20301

– 62% of baby boomer RNs (over 54) considering retiring2

What’s the impact on operations?

Source: 1 Pew Research Center 2 AMN Healthcare 2015 Annual Survey

Summary

”The secret of change is to focus all of your energy, not on fighting the old, but on building the new.” Socrates, Greek Philosopher

http://www.himss.org/ValueSuite

Benefits Realized for the Value of Health IT

• $74M in savings

• 14% LOS

Reduction

• 36% reduction

No-Show rate

• Improved patient

satisfaction

• Improved staff

satisfaction

• 49% decrease in

unnecessary X-rays

• 80% utilization of

best practice order

sets

Questions

Contact Information John Hansmann, MSIE, FHIMSS, DSHS

Sr. Director, Health Catalyst john.hansmann@healthcatalyst.com

214-364-7745