Partnership for Patient Safety: Influencing and Integrating Health Policy within an Organization...
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![Page 1: Partnership for Patient Safety: Influencing and Integrating Health Policy within an Organization Tuesday, September 16 th, 2008.](https://reader036.fdocuments.us/reader036/viewer/2022062422/56649e895503460f94b8e752/html5/thumbnails/1.jpg)
Partnership for Patient Safety: Influencing and Integrating Health Policy
within an OrganizationTuesday, September 16th, 2008
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Driving Patient Safety Through Transformation
Background
Institute of Medicine Reports:
• To Err Is Human: Building a Safer Health System (1999)
• Crossing the Quality Chasm (2001)
• Keeping Patients Safe: Transforming the Work Environment of Nurses (2004)
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Driving Patient Safety Through Transformation
“Never Events”
The Eight “never events” will cost hospitals at least $91 million less annually in Medicare reimbursement
Modern Healthcare,2008
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Driving Patient Safety Through Transformation
Key Agencies: Safety Initiatives
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Driving Patient Safety Through Transformation
National Quality Forum: Performance Measures
• Timeliness
• Efficiency
• Coordination of care
• Patient safety
• Prevention or reduction of complications
• Transitions of care
• Patient Outcomes
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Driving Patient Safety Through Transformation
Challenges in Healthcare Quality /Safety
• Three principal indicators of quality problems:
–Error Rates
–Overtreatment
–Undertreatment
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Driving Patient Safety Through Transformation
Going from Evidence- Based Practice to Systems –Based Practice
• Compassion
• Pattern Recognition
• Judgment
PeoplePeople
• Simplification
• Standardization
ProcessProcess++
•↓ Memory Dependence
•↑Forcing Function
InformaticsInformatics++
• Reproducible Performance
SystemsSystems==
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Driving Patient Safety Through Transformation
21st Century Trends: Healthcare Delivery System
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Access
CostQuality
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Driving Patient Safety Through Transformation
What is Value?
Quality
Value = Cost
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Driving Patient Safety Through Transformation
Comprehensive Characteristics of Systems of Quality
• Continuous improvement in all activities and in all people
• Customer satisfaction for internal & external customer
• Efficient deployment of resources
• Employee, supplier, and customer development and recognition
• Environmental well-being
• Exemplary, visionary, and aggressive leadership
• Fast response time
• Full participation of employees, suppliers and customers
• Life- long relationships with customers Malcom Baldridge Nat’l Quality Award, 1995; Deming 1986; Juran,1992
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Driving Patient Safety Through Transformation
Comprehensive Characteristics of Systems of Quality (con’t)
• Long-range perspectives• Partnerships upstream, downstream, and across functions• Prevention of error by designing in quality• Process mapping and process improvement• Providing customer value• Quantitative measurement and management-by-fact• Root- cause analysis• Shared Values, vision, and culture• Standard quality tools• Top management sponsorship and involvement• Waste reduction and cost containment
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Driving Patient Safety Through Transformation
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Driving Patient Safety Through Transformation
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Driving Patient Safety Through Transformation
asking is the answer
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Driving Patient Safety Through Transformation
We need a Health Care Delivery System that is
Predictive
Personalized
Pre-emptive
Participatory
(Elias Zerhouni 2008)
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Driving Patient Safety Through Transformation
We have a Health Care Delivery System that is…..
Provider -- Centered
Price -- Driven
Knowledge-- Disconnected
Disease-- Focused
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Driving Patient Safety Through Transformation
How do we get to the system we want?
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Driving Patient Safety Through Transformation
A
I
D
E
T
Acknowledge
Introduce
Duration
Explanation
Thank You
Studer Group® : Taking You and Your Organization to the Next Level
HCAHPS Survey
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Driving Patient Safety Through Transformation
H
E
A
R
T
Hear the Customer
Empathize
Apologize
Respond
Thank You
Studer Group® : Taking You and Your Organization to the Next Level
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Driving Patient Safety Through Transformation
Healthcare for the Greatest Generation
Hospital
Provider
PharmacyPayer
NursingHome
Other
Patient
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Driving Patient Safety Through Transformation
Healthcare for Boomers
Patient
Internet
PharmaAds
Payer/Employer
Disease Management
Health Clubs
Alternative Medicine Providers
Hospital
Pharmacy PayersImagingCenters
NursingHome
Others
Doctor Patient Relationship
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Driving Patient Safety Through Transformation
Healthcare for Gen X & Y Information Flow Data as Currency
Patient
Payer/EmployerPrograms
PharmacyRetailHealth
UrgentCare
SpecialtyPhysicians
HealthClub
InternetSearches
PHR(Google & Microsoft)
Labs/Imaging &Surgical Centers
PrimaryCare
Providers
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Driving Patient Safety Through Transformation
Intelligent Health Systems
(Gingrich & Desmond, Art of Transformation; 2006 © )
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Driving Patient Safety Through Transformation
“Intelligent Health System” Principles
PEOPLE Individual-Centered, Incentive-Driven, Psychology-
Based Empowerment- Focused, Dedicated to the Right to Know Information About Price, Quality,
Providers and Personal Health Status
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Patient &
Family
PROCESSESPrevention, Early
Detection, Self-Management,
Best Practices
TOOLSInformation Technology, Quality Expert Systems
(Gingrich & Desmond, Art of Transformation; 2006 © )
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Driving Patient Safety Through Transformation
Intelligent Health Systems
•Patient/family Centered
•Values-Driven
•100% Coverage (not all government sponsored)
•Transparent price & quality information
•Knowledge – Intensive
(Gingrich & Desmond, Art of Transformation; 2006 ©)
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Driving Patient Safety Through Transformation
Intelligent Health Systems (cont.)
•Prevention & health focused
•Electronically – based
•Binary – mediated market
(individual provider)
•Increased choice
(Gingrich & Desmond, Art of Transformation; 2006 ©)
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*
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Driving Patient Safety Through Transformation
Intelligent Health Systems (cont.)•New system of health justice
•Focused on quality of care and quality of life
•Metrics-led & outcomes-focused
• Collaborative leadership
• Overall cost decreases
• Rapid diffusion of innovation
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Driving Patient Safety Through Transformation
Health Policy Agenda
• First time in 40 years that Access, Quality and Costs are allall at the top of the Health Policy Agenda – simultaneously
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Driving Patient Safety Through Transformation
Policy
“A Government statement that defines a course of action which will attain or preserve some desired or acceptable state of affairs.” The purpose is to alter what would occur otherwise.
Milio (1981)
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Driving Patient Safety Through Transformation
Health Policy
Both Political Parties will need to work together to develop and implement effective policies
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Driving Patient Safety Through Transformation
Do not sub-optimize nursing,
Speak to the needs of the system as a whole
Nursing Issues regarding Policy
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Driving Patient Safety Through Transformation
Nurses have a special place and a special role in imparting policy
changes but need to get the talk
“right”
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Driving Patient Safety Through Transformation
To Be Successful in Influencing Policy:
• Stop talking about nursing care vs. medical care
Start talking about patient care services given by a
variety of providers with frequent overlap of skills • Stop talking about nursing research
Start talking about patient care outcome research
done by nurses• Provide clear evidence and documentation
- nursing's effect on patient outcomes
- profit & loss
- nursing margin and ROI
- what works
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Driving Patient Safety Through Transformation
To Be Successful in Influencing Policy:
• Stop talking about reimbursement for nurses
Start talking about patient care services done by nurses
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Driving Patient Safety Through Transformation
Strategies • Get involved as a volunteer in political
races. Donate to and attend low dollar events and attend high dollar events as a volunteer
• Stay connected with your professional associations at the state and national level
• Know your lobbyist well (Do not send letters)
• Network for Corporate Board Appointments –particularly in health care
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Driving Patient Safety Through Transformation
Political Appointments how to secure
• Personal contact
• Donations
• Activity in party
• Behavior on other appointed committees
• Plum Book
• Head of appointments in White House and Cabinet offices
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Driving Patient Safety Through Transformation
In Closing………..
The time to take this flight is now and this is your final boarding call.