SRM 1/5/08 In Pursuit of Excellence Implementing Across AHA and Beyond Opportunities to Lead

SRM 1/5/08 Opportunities for Leadership: Hospitals Safe Make effective use of information and clinical technology designed to improve safety. Implement specific practices shown effective in improving safety. Redesign care processes to eliminate defects. Collect and report errors in care to patient safety organizations. Support patients, their families, doctors and other caregivers when patient harm occurs. Timely Reduce emergency department wait times. Reduce the time between scheduling an appointment and seeing a health care practitioner. Speed procedures, test results, patient diagnosis and treatment. Smooth the movement of patients throughout their care delivery experience. Effective Ensure the use of current best evidence in patient care. Share information with clinicians on how their clinical practice compares to "best practices" or "benchmarks”. Ban unhealthy products on hospital campuses, such as tobacco, use of trans fats, or availability of unhealthy foods. Promote better nutrition and fitness among our own hospital employees and within the broader community. Lead community based initiatives to reduce obesity, diabetes, HIV or other local needs. Efficient Employ techniques to optimize performance. Reduce process variation to improve reliability of care. Manage organizational variability to streamline processes. Adopt health information technology to eliminate duplication of effort and reduce administrative costs. Efficient (cont.) Participate in payment approaches that reward efficiency and quality. Track patients with chronic conditions and provide them with effective chronic care management to avoid hospitalization. Equitable Collect patient data on race, ethnicity and language to look more closely at hospital quality and patient satisfaction. Make translation services available for patients and their families. Strengthen the diversity of hospital governance, management teams and workforce. Provide employees training in cultural competence. Work with community leaders and organizations that serve racial or ethnic minorities or other groups to reduce care disparities. Patient-centered Encourage active patient and family involvement in care delivery and decision-making. Customize care to meet each individual patient’s needs and preferences. Educate patients and families on palliative care and end-of- life care options. Embrace transparency in the reporting of quality and pricing information to help people be better educated patients. Ensure the protection of patient privacy and the confidentiality of medical information. Expand the health care literacy of communities and patients served. Integrate the care delivered by physicians, nurses and others to create a coordinated, seamless continuum of care for patients. Examples of ways to reach the goal:

SRM 1/5/08 In Pursuit of Excellence: What Is It? WHAT: A field-wide focus on performance excellence in hospitals and health systems to accelerate performance improvement and enhance hospitals’ ability to deliver safe, timely, effective, efficient, equitable and patient-focused care WHO: Executive, trustee and physician leadership as well as other clinical and non-clinical leaders and managers in America’s hospitals and health systems WHERE: Local, Regional and National WHEN: Starting NOW. HOW: (1) engage leaders, (2) align our efforts, (3) provide services and resources, and (4) measure performance and progress etc. Collect and spread proven innovations—spanning the Boardroom to the Bedside—across the hospital field

SRM 1/5/08 1.Hospitals become clinically, operationally and financially more capable, effective and efficient. 2.Patients gain equal access to safer, higher quality and more affordable care. 3.Hospitals become better connected to their patients and the communities they serve. Goals Focused on 3 Main Goals

SRM 1/5/08 Engage Leaders -Systemness -Culture -Structure -Strategy -Process environment -Process Excellence -Competencies -Team -Training In Pursuit of Excellence Requires Collaborative Leadership Context Leaders (executive, trustee, physician leaders) Content Leaders (clinical and non- clinical) Information From: Proven Performers/ Proven Practices Case Studies -Better Practices -Etc. Information To: The Field -Create initiatives -Adopt Better Practices -Etc. Collaboration Communication

SRM 1/5/08 In Pursuit of Excellence COMMUNICATION Communication Planning Key messages Branding Channel selection/usage Integration with H4L Channels Web (QC, etc.) Publications Journals and magazines Presentations A2 State Associations National Partners Etc. CONSULTATION/ COLLABORATION Stakeholders CEOs/C-suite State Assoc Physician Leaders QI Leaders Change Management Experts Consumer Voice Business Insurer/Payer Disparity Leaders Other Internal Alignment Incorporation of POE in business unit plans Consistent messaging Consistent Identity MEASUREMENT AND REPORTING Internal Measurement Member satisfaction Focus groups External Measurement HCAHPS Hospital Compare Other In conjunction with Data and Research Strategy Team “In Our Hands” Resource Guide Leadership Education Consistent Identity and Presence National Advisory Group Hospital Performance Measurement Tool CONTENT Engage Leaders: system thinking for process excellence Principles of Performance Excellence Patient focus for everything Create Culture of Reliability Manage organizational variation (smooth census) Remove waste Eliminate defects Reduce process variability Achieve IOM Six Aims Safe Efficient Timely Equitable Effective Patient-Focused Initial Areas of Focus Throughput/flow (efficiency)  E.D. waits  Elective surgery Hospital-acquired infections Medication management (prescribing, dispensing, administering)  ADEs Patient safety (ulcers, falls, etc.) Patient & Provider Communication