Private podiatric medical practice
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© 2 • Private podiatric medical practice • Wholly owned subsidiary of public corporation • Manage vascular center • Consultant, Nursing, Interventional Radiology • LLC members = Competing nephrology private practices • Established for ownership of outpatient vascular center DPM • Examination • In-office diagnostic vascular tests • (+) PAD = conservative treatment or refer to LLC CORP • Administrative support • Coordinate DPM & LLC communication • Schedule patients for IR at vascular center LLC • Angiogram • Endovascular intervention at vascular center • Refer to vascular • surgery if • necessary CORP • Screen all HD center patients • Coordinate DPM referrals /appointments if (+) screen 1 2 3 4 This project was designed to develop and implement a multi-disciplinary care team to screen, evaluate, and treat PAD in hemodialysis patients. INTRODUCTION CARE TEAM & INTEGRATED DELIVERY MODEL Hemodialysis patients have numerous medical needs and account for significant healthcare costs. Peripheral arterial disease (PAD) significantly increases admissions, amputations, morbidity, and mortality in hemodialysis patients. Amputations increased Mortality increased PAD is frequently under-diagnosed and many times high-risk patients are not evaluated for PAD. OBJECTIVES RESULTS: STRUCTURAL & PROCESS OUTCOMES CONCLUSIONS Changes made to the initial phase based on team experiences/input led to greater success, team satisfaction. Learning organizations are more likely to achieve success. This program failed due to a lack of: Communication Consensus building Leadership qualities within one unit Leadership from each unit was based on role prior to program development. Leaders by title have a name, whereas leaders who influence others get results. When implementing integrated care models the following are critical: Have leaders for each unit Have the influential leaders, not just leaders based on title Account for complexity of business structures and personal dynamics within and between clinical and functional units 1. Dow AW, DiazGranados D, Mazmanian PE, et al. Applying organizational science to health care: A framework for collaborative practice. Academic Medicine 2013; 88(7): 1-6. 2. Edmondson, AC. Strategies for learning from failure. Harvard Business Review 2011 (April): 48-55. 3. Kouzes J and Posner B. The Leadership Challenge: How to make extraordinary things happen in organizations, 5 th ed. San Francisco: Jossey-Bass, 2012. 4. Spath, PL. Leading your healthcare organization to excellence: A guide to using the Baldridge Criteria. Chicago: Health Administration Press, 2004: pp. 207-212. RESULTS: CLINICAL OUTCOMES Western University of Health Sciences, College of Podiatric Medicine Valuing Leadership and Organizational Learning when Implementing a Multi-disciplinary Care Team REFERENCES Jonathan Labovitz, DPM PROGRAM IMPLEMENTATION Consultant for wholly owned subsidiary of public corporation (CORP) developed care model and was on-site for implementation of the multi- disciplinary care plan for managing PAD in hemodialysis patients Clinical team = Nephrology (competing practices in LLC) Interventional radiology (1099 for LLC) Podiatric medicine (private practice) Feedback from CORP/clinical unit leadership prior to finalizing program for pilot Pilot screening phase at two hemodialysis centers Feedback from staff during screenings and feedback from clinical units after • Screened 201 patients CORP • 87.1% with PAD risk factors or clinical findings CORP • 54.5% diagnosed with PAD DPM For more information: [email protected] Leadershi p Attribute Structural / Process Outcome Unit þ Success Promote Vision Educate nurses on program importance CORP þ Success Follow nursing advice to enhance shared vision CORP þ Success Support Clinical Teams Staff screenings CORP þ Success Consultant/CORP leadership on-site for implementation of pilot CORP ý Failure Perceived lack of respect – LLC referred to hospitals not DPM LLC þ Success Small Group Learning Small, rapid changes from screening teams during program CORP þ Success Implement structural changes from all care teams during program CORP ý Failure Consensus with program misrepresented to LLC
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2. Wholly owned subsidiary of public corporation Manage vascular center Consultant, Nursing, Interventional Radiology. Private podiatric medical practice. CORP Screen all HD center patients Coordinate DPM referrals /appointments if (+) screen. DPM Examination - PowerPoint PPT Presentation
Transcript of Private podiatric medical practice
RESEARCH POSTER PRESENTATION DESIGN © 2012
www.PosterPresentations.com
• Private podiatric medical practice
• Wholly owned subsidiary
of public corporation
• Manage vascular center
• Consultant, Nursing, Interventional Radiology
• LLC members = Competing nephrology private practices
• Established for ownership of outpatient vascular center
DPM• Examination• In-office diagnostic
vascular tests• (+) PAD =
conservative treatment or refer to LLC
CORP• Administrative
support• Coordinate DPM &
LLC communication• Schedule patients
for IR at vascular center
LLC• Angiogram• Endovascular
intervention at vascular center
• Refer to vascular
• surgery if • necessary
CORP• Screen all HD
center patients• Coordinate DPM
referrals /appointments if (+) screen
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2
3
4This project was designed to develop and implement a multi-disciplinary care team to screen, evaluate, and treat PAD in hemodialysis patients.
INTRODUCTION CARE TEAM & INTEGRATED DELIVERY MODEL
Hemodialysis patients have numerous medical needs and account for significant healthcare costs.
Peripheral arterial disease (PAD) significantly increases admissions, amputations, morbidity, and mortality in hemodialysis patients.
Amputations increased Mortality increased
PAD is frequently under-diagnosed and many times high-risk patients are not evaluated for PAD. OBJECTIVES
RESULTS: STRUCTURAL & PROCESS OUTCOMES
CONCLUSIONS
Changes made to the initial phase based on team experiences/input led to greater success, team satisfaction. Learning organizations are more likely to achieve success.
This program failed due to a lack of: Communication Consensus building Leadership qualities within one unit
Leadership from each unit was based on role prior to program development. Leaders by title have a name, whereas leaders who influence others get results.
When implementing integrated care models the following are critical:
Have leaders for each unit Have the influential leaders, not just
leaders based on title Account for complexity of business
structures and personal dynamics within and between clinical and functional units
1. Dow AW, DiazGranados D, Mazmanian PE, et al. Applying organizational science to health care: A framework for collaborative practice. Academic Medicine 2013; 88(7): 1-6.
2. Edmondson, AC. Strategies for learning from failure. Harvard Business Review 2011 (April): 48-55.
3. Kouzes J and Posner B. The Leadership Challenge: How to make extraordinary things happen in organizations, 5th ed. San Francisco: Jossey-Bass, 2012.
4. Spath, PL. Leading your healthcare organization to excellence: A guide to using the Baldridge Criteria. Chicago: Health Administration Press, 2004: pp. 207-212.
RESULTS: CLINICAL OUTCOMES
Western University of Health Sciences, College of Podiatric Medicine
Valuing Leadership and Organizational Learning when Implementing a Multi-disciplinary Care Team
REFERENCES
Jonathan Labovitz, DPM
PROGRAM IMPLEMENTATION
Consultant for wholly owned subsidiary of public corporation (CORP) developed care model and was on-site for implementation of the multi-disciplinary care plan for managing PAD in hemodialysis patients
Clinical team = Nephrology (competing practices in LLC) Interventional radiology (1099 for LLC) Podiatric medicine (private practice)
Feedback from CORP/clinical unit leadership prior to finalizing program for pilot
Pilot screening phase at two hemodialysis centers
Feedback from staff during screenings and feedback from clinical units after screening
Outcomes Assessment Clinical = clinical data from screenings Structural/Process = data from
screenings and interviews of care team leaders
• Screened 201 patientsCORP
• 87.1% with PAD risk factors or clinical findingsCORP
• 54.5% diagnosed with PADDPM
For more information: [email protected]
Leadership
Attribute Structural / Process Outcome Unit
þ Success Promote Vision
Educate nurses on program importance CORP
þ Success Follow nursing advice to enhance shared vision CORP
þ Success
Support Clinical Teams
Staff screenings CORP
þ Success Consultant/CORP leadership on-site for implementation of pilot
CORP
ý Failure Perceived lack of respect – LLC referred to hospitals not DPM LLC
þ Success Small Group Learning
Small, rapid changes from screening teams during program CORP
þ Success Implement structural changes from all care teams during program
CORP
ý Failure Build Consensus
Consensus with program misrepresented to leadership team LLC
ý Failure Only 31% of nephrologists referred to DPM LLC
ý Failure Communication Inconsistent/lack of communication to LLC team CORP/DPM
