1. Western Collaboratives Med Rec/SSI call September 12, 2006 “Three weeks to go!” Dr. Robin Ensom, co-chair Med Rec Collaborative Shirley Gobelle, SSI Faculty Safer Healthcare Now! Western Node

2. Seven Leadership Leverage Points For organization-level Improvement in Health Care Authors: Reinertsen, Pugh, and Bisognano Source: Institute for Healthcare Improvement, Extranet

3. 1: Establish and Oversee System- Level Aims for Improvement at the Highest Board and Leadership Level Solid system level performance Solid system level performance Establish aims for improvement Establish aims for improvement Establish oversight at the highest level of governance and leadership Establish oversight at the highest level of governance and leadership Personal commitment Personal commitment SHN! Example: How can you ensure your work is shared at a board committee meeting? (aims and achievements) SHN! Example: How can you ensure your work is shared at a board committee meeting? (aims and achievements)

4. 2: Align Measures, Strategy and Projects in a Leadership Learning System QI often not seen as strategic QI often not seen as strategic Results in project by project basis without making a clear direction to the overall aims and performance metrics of the organization Results in project by project basis without making a clear direction to the overall aims and performance metrics of the organization SHN! Example: Build you QI initiative aims into the balanced score card at the department level – encourage your senior leader to have it in his/her balanced score card … etc. SHN! Example: Build you QI initiative aims into the balanced score card at the department level – encourage your senior leader to have it in his/her balanced score card … etc.

5. 3: Channel Leadership Attention to System Level Improvement The currency of leadership is attention. To achieve system-level aims, leaders must actually pay attention to them. The currency of leadership is attention. To achieve system-level aims, leaders must actually pay attention to them. Formal and informal Formal and informal Personal agendas, meeting agenda, project team reviews, executive performance feedback, hiring, membership of design teams Personal agendas, meeting agenda, project team reviews, executive performance feedback, hiring, membership of design teams SHN! Example: Have your team story be profiled in a local newspaper with the help of your region communication department SHN! Example: Have your team story be profiled in a local newspaper with the help of your region communication department

6. 4: Get the Right Team on the Bus Most common reason for failure of large systems to change is the failure of the senior leadership team to function as an effective team Most common reason for failure of large systems to change is the failure of the senior leadership team to function as an effective team Get patients and family members onto the teams Get patients and family members onto the teams We simply must make it a routine matter to bring patients’ ideas, perspectives and insights into the room We simply must make it a routine matter to bring patients’ ideas, perspectives and insights into the room SHN! Example: Pick your high functioning leaders as your promoter and navigator through your health region SHN! Example: Pick your high functioning leaders as your promoter and navigator through your health region

7. 5: Make the Chief Financial Officer a Quality Champion The connection between QI and business performance is weakly made in most health care organizations. The connection between QI and business performance is weakly made in most health care organizations. In other industries, CFO’s spend more time on reducing waste and improving core processes. In other industries, CFO’s spend more time on reducing waste and improving core processes. SHN! Example: Present a cost benefit analysis of your initiative to your CFO. ie., bed days saved by preventing a surgical site infection/increased length of stays avoided by reconciling meds SHN! Example: Present a cost benefit analysis of your initiative to your CFO. ie., bed days saved by preventing a surgical site infection/increased length of stays avoided by reconciling meds

8. 6: Engage Physicians Physicians are in a powerful position to stop it from moving forward, and therefor their engagement is critical Physicians are in a powerful position to stop it from moving forward, and therefor their engagement is critical Leaders are not likely to achieve system level improvement without enthusiasm, knowledge, cultural clout, and personal leadership of physicians Leaders are not likely to achieve system level improvement without enthusiasm, knowledge, cultural clout, and personal leadership of physicians SHN! Example: Find your champion doc who will present at departmental head meetings, grand rounds and his colleagues SHN! Example: Find your champion doc who will present at departmental head meetings, grand rounds and his colleagues

9. 7: Build Improvement Capability Senior leaders must have the ability to know, use and teach: The model for improvement The model for improvement A coherent improvement strategy such as the Toyota Production System A coherent improvement strategy such as the Toyota Production System Concepts and practices of high-reliability organizations Concepts and practices of high-reliability organizations Sophisticated practices in flow management Sophisticated practices in flow management Concepts and practices in scale and spread Concepts and practices in scale and spread SHN! Example: How knowledgeable are your Senior Leaders? Invite them to LS 3 or other opportunities SHN! Example: How knowledgeable are your Senior Leaders? Invite them to LS 3 or other opportunities

10. Discussion What have you done locally to work with your Senior Leader? What have you done locally to work with your Senior Leader? How has your Senior Leader promoted your project and its sustainability? How has your Senior Leader promoted your project and its sustainability? …