Leadership and Self-Deception Getting out of the Box Partnership for Patients Thursday, May 1, 2014 Dennis Wagner and Dr. Paul McGann Co-Directors, Partnership for Patients U.S. Department of Health & Human Services CMS Center for Medicare & Medicaid Innovation

Thank You For the hard work you are doing to improve our nation’s healthcare system. For your active commitment to improve the care of patients and clients. For your leadership and history of commitment and success on health care improvement, innovation and spread. 2

Questions To Run On How does a limited mindset unknowingly sabotage our effectiveness? What are some of Georgia Hospital Association “Out of the Box” hospitals? What can each of us do “Out of the Box” to further ramp up urgency, action and results in this final year? 3

Keeps us from connecting with others Keeps us from getting results that exceed our immediate reach Keeps us focusing on ourselves and “justifying” our behaviors, even when deep down we know better Natural Mindset of “The Box”

Blaming Others Critiquing Others Trying to Change Others This mindset: Isolates us from people Generates resistance from people How We Deal With Being “In The Box”

Choosing to Focus on Others…as People Choosing to Focus on Aims & Results…not Ourselves Choosing to Honor Our Sense of Humanity, Rather Than Betraying It – In traffic – Sitting in an airplane as it is filling with people – In our work – In life Choosing to Be Open to Resets Alternatives to Being in the Box

The Most Powerful Model: Choosing How We Respond to the World

Embracing Work on All Harms Embracing EEDs Embracing Marilyn’s Request for Network-wide Results by August, 2012 Embracing Patient & Family Engagement Embracing “Harm Across the Board” as the New Normal Embracing LEAPT as an Extraordinarily Rapid Cycle Initiative with Accountability for Results Evolving to a State of Constant “Reset” Choices: “Embracing” v. Resisting

“Be Kind, for Everyone You Meet is Engaged in a Great Battle” Philo of Alexandria

Our Requests: Focus on People Focus on the Aims – Holding the Line Focus on & Embrace Resets As “The Way We Roll” Focus on Improving Where We Need to Improve – Harm Across the Board; Safety Across the Board – All 3 ADE Priority Areas – Pressure Ulcers “You Move Toward What You Focus On” -- Doug Krug

GHA “Out of the Box” Hospitals SepsisC-diff Procedural Harm Failure to Rescue Culture of Worker Safety Atlanta Medical Centerx x Chatuge Regional Hospitalx x Crisp Regional Medical Centerxx DeKalb Medical Centerx *x Doctors Specialty Hospital (Doctors Hospital of Columbus)x x Effingham Health Systemxx Floyd Medical Center*x x Habersham Medical Centerx *x Midtown Medical Center (The Medical Center)x x Newton Medical Centerxx Northside Medical Hospital (Hughston Hospital)x x South Georgia Medical Centerxx Spalding Regional Medical Centerx *x St. Mary's Healthcare Systemx*x Ty Cobb Regional Medical Centerx *x Union General Hospitalx x University Hospital*xx * indicates Lead Hospital for Topic Area.

“Out of the Box” Prescription for Results Name: Georgia Hospital Association Commit to focus on people, 40/20 Aims, and “resets” as a way of doing business Lead on improving where we need to improve Re-engage top leaders and middle management in your hospital Ramp up work in areas that need further attention – like CAUTI and ADEs, and Pressure Ulcers Sustain GHA’s national leadership in the Partnership Date: May 1, 2014 Make Patients and Families an integral part of your safety program Address Disparities in Harm & Readmissions Support others in this work Achieving a 20% Reduction in 30-Day Readmissions and a 40% Reduction in Hospital Acquired Conditions

Questions To Run On How does a limited mindset unknowingly sabotage our effectiveness? What are some of Georgia Hospital Association “Out of the Box” hospitals? What can each of us do “Out of the Box” to further ramp up urgency, action and results in this final year? 13