The Evolution of Cooperation Author(s): Robert Axelrod and ...
Clinical Strategic Plan & Community Best Citizen …expanding quality beyond our traditional...
-
Upload
kelley-francis -
Category
Documents
-
view
213 -
download
0
Transcript of Clinical Strategic Plan & Community Best Citizen …expanding quality beyond our traditional...
Clinical Strategic Plan &Community Best Citizen…expanding quality beyond our traditional definitionsPresented by: Randy Axelrod, MD
The objectives for today include…
• Provide an overview of the new Clinical Strategic Plan and our evolving environment
• Explore the focus on becoming the “Community Best Citizen”
• Discuss governance implications and opportunities
Providence Health & Services | GOVERNANCE CONFERENCE
“The significant problems of our time cannot be solved by the same level of thinking that created them.”
Albert Einstein
Providence Health & Services | 2014 GOVERNANCE CONFERENCE
As we assume more “accountability” and risk increases, the “reward band” widens substantially – we must be creative
Full Risk(Total popula-
tion)
Defined Risk Population
Com-prehen-
sive Bundle
DefinedEpisode
(DRG)Expanded Episode (DRG with penalty)
PercentCharges
Risk
Rew
ard
Low Unit Costs
Optimized Care
Variation Management
Clinical & Contractual Alignment
Advanced Informatics
Population orientation
High Unit Costs
High Variation
No Clinical Alignment
Poor Quality
No Continuum of Care
Providence Health & Services | GOVERNANCE CONFERENCE
Shifting “Event Orientation” to “Community Needs” is the underpinning of our clinical transformation If Quality is defined as “the degree to which health services for individuals and
populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” and…
Unit Cost x Utilization = Total Cost of Care and… Latency inversely related to experience then…
= Value of Care
Our main focus should be the delivery of a refined and enriched value proposition to our patients and customers through the improvement of the total cost of care while maintaining or improving access and quality
5
This is NOT possible without clinical leadership, clinical and financial information, careful strategic planning and community engagement. The world of healthcare is changing – we can choose to be the architects or merely the dwellers.
There was a great deal of developmental work by a broad audience
Providence Health & Services | GOVERNANCE CONFERENCE
As our commitments transform so must our responses – broadening beyond Quality Strategic Framework
• Our commitment to “Create Healthier Communities, Together” demands a new approach
• Era of healthcare accountability requires full continuum involvement
• Quality and safety focus and all it entails must become embedded in everything we do
• Broader organizational engagement will be required to support success in clinical arenaProvidence Health & Services | GOVERNANCE CONFERENCE
Our new Clinical Strategic Plan is comprehensive, including both direct care improvement and innovation efforts as well as enabling factors to support our mission
Leader in Chronic Care
Steward of Care Resources
OptimizeAcute Care
CareCoordinationAcross theContinuum
Design & DeployHigh Reliability
Care
Develop Teams, Clinicians &
Leaders
BestCommunity Citizen
PromoteWellness &Prevention
Optimize Healthcare Informatics & Intelligence
Leverage Research, Technology &
Innovation
STRATEGIESInspire and develop
our people
Build enduring relationships with
consumers
Create alignment with clinicians & care teams
Develop and thrive under new care delivery
& economic models
Grow by optimizing expert to expert
capabilities
SYSTEMWIDE
TACTICS
Recognizing inspired employees are the foundation for providing high-quality care and innovative solutions to our communities, Providence will hold steadfast to our Mission and values and will concentrate on the ongoing development of our people, their health and workplace culture.
Providence will actively engage with the communities we serve to understand their needs and develop an exceptional consumer-centered experience that improves the delivery of high quality, innovative services and fosters lasting partnerships in improving the health of our communities.
Providence will build strong partnerships with clinicians and care teams across the continuum of care, including employed and aligned providers, to create a seamless care delivery system focused on improving quality and safety and working collectively to build healthier communities.
Providence will adopt greater accountability for the overall health of the community, joining with our clinicians, care teams and other partners to develop innovative care delivery and economic models that focus on population health, utilization management, and pioneering technology resulting in improved health care value.
Providence will continue to grow by serving as a valued partner in creating healthier communities by not only offering excellent clinical, operational and administrative services but also by acting as a catalyst to build collaboration, identify and share best practices, and develop innovative partnership approaches.
Creating healthier communities, together
The alignment with overall system Strategic Plan is important as our clinical experience spans all the strategies
Providence Health & Services | GOVERNANCE CONFERENCE
Our traditional quality measures have been narrowly focused
Measured in… Influenced by…
Mortality Acute Acute
Providence Health & Services | GOVERNANCE CONFERENCE
Our new Annual Clinical Excellence Index spans multiple settings and incorporates a broad range of indicators
Measured in… Influenced by…
Mortality (AMI, Pneumonia, HF)Acute Medical Group Acute Medical Group
Continuing Care Health Plan Continuing Care Health Plan
Providence Patient Safety IndexAcute Medical Group Acute Medical Group
Continuing Care Health Plan Continuing Care Health Plan
Cancer Screening IndexAcute Medical Group Acute Medical Group
Continuing Care Health Plan Continuing Care Health Plan
Readmission Process ImprovementAcute Medical Group Acute Medical Group
Continuing Care Health Plan Continuing Care Health Plan
CPS Resource StandardizationAcute Medical Group Acute Medical Group
Continuing Care Health Plan Continuing Care Health Plan
Providence Health & Services | GOVERNANCE CONFERENCE
The “behind the scenes”
detail outlines strategic
initiatives beneath
each operating
imperative
Our remaining focus for today’s
session is on the
operating imperative
“Community Best Citizen”
Providence Health & Services | GOVERNANCE CONFERENCE
Community Health Needs Assessments are routinely performed and have been comprehensive and inclusive
Providence Health & Services | GOVERNANCE CONFERENCE
We think about the “Community Best Citizen” work in three different areas
• Determinants of Health
• Community & Social Partnerships
• Community Education & Activation
Providence Health & Services | GOVERNANCE CONFERENCE
Determinants of Health Our focus on the specific characteristics we must address to create healthier communities
Providence Health & Services | GOVERNANCE CONFERENCE
Defined… Assess major issues, needs and drivers of health in the community and prioritize, plan and implement targeted efforts
Examples… Primary care capacity…tuition repayment incentive program in the family medicine residencyPrimary care access…leading a community forum with providers to revise structure for patients arriving in the emergency department without an assigned primary care provider. Alcohol and substance abuse…development of client-centered, team-driven and evidence-based approaches to treatment and prevention.Transportation…Telehealth, hot-spots, social gathering
Health Field Conceptual Model Influence Factors on Health Status
Mark Lelonde, Canadian Health Ministry
Lifestyle Behavior
50%
Human Biology
20%
Envi-ron-
ment20%
Medical Care10%
Providence Health & Services | GOVERNANCE CONFERENCE
Tobacco Use Diet/Activity Alcohol Use Other
19%
14%
5%
12%
Risk factors and the cause of death – personal choices
Heart Disease
Cancers
Diabetes
Infant Deaths
Heart Disease
Cancers
Diabetes
Infant Deaths Heart DiseaseCancers
All InjuriesInfant Deaths
Heart DiseaseCancers
All InjuriesInfant Deaths
Heart DiseaseCancersDiabetes
All InjuriesRespiratory Disease
HIV/AIDSInfant Deaths
Heart DiseaseCancersDiabetes
All InjuriesRespiratory Disease
HIV/AIDSInfant Deaths
Heart Disease
Cancers
Respiratory Disease
Infant Deaths
Heart Disease
Cancers
Respiratory Disease
Infant Deaths
Providence Health & Services | GOVERNANCE CONFERENCE
Blood PressureIn Finland, a comprehensive national strategy that
combined prevention, community-based health promotion and access to treatment was associated with a 60% decline in mortality rates from CV diseases over a 25-year period.
Improved Dietary Habits• Approximately 58% of diabetes mellitius
globally, 21% of ischemic heart disease and 8–42% of certain cancers were attributable to BMI above 21
• Low intake of fruit and vegetables is estimated to cause about 19% of GI cancer, about 31% of ischemic heart disease and 11% of stroke worldwide
• Living in super-sized worldProvidence Health & Services | GOVERNANCE CONFERENCE
Disease burden is derived from clinical and socioeconomic challenges
0 4 8 12 16 20 24 28 32 36 40 44 48 52 56 60 64 68 72 76 80$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
$35,000
All Comm Asthma Diabetes Male Comm Male MedcdRandy C. Axelrod, MD Copyright @ 2003
Providence Health & Services | 2014 GOVERNANCE CONFERENCE
Decreasing disease burden within any population should focus on risk factor reduction
Providence Health & Services | GOVERNANCE CONFERENCE
Community & Social PartnershipsWho we partner with becomes more critical as our focus becomes more expansive
Providence Health & Services | GOVERNANCE CONFERENCE
Defined… Create and leverage both traditional and novel collaborations with community & social partners to address shared goals for improved community health
Examples… Team-Up Montana – broad collaboration of community sponsors organized by St. Patrick Hospital to raise funds for cancer prevention & detection efforts, and to provide financial support to cancer patients in need
Providence Northeast Washington (NEW) Hunger Coalition – twenty-five community groups brought together to end poverty-induced hunger in Stevens County
Pharmacy Bridge – Providence Health Plan, in partnership with others, created this program to provide access to needed medications for uninsured and underinsured in Portland and surrounding areas
Community Education & Activation Achieving healthier communities will demand a greater level of community activation
Providence Health & Services | GOVERNANCE CONFERENCE
Defined… Activate community members to be a catalyst for change in their own health as well as the health of others in their community
Examples… Global to Local – Partnership led by Swedish to build on the expertise of global health institutions to bring strategies that have proven effective in developing countries to underserved communities in Washington state
Get Out and Live (GOAL) – Outreach program led by Providence Little Company of Mary Medical Centers San Pedro and Torrance supporting underserved community members with diabetes – overall decreases in A1c levels and high retention rate
“Get Movin” program in Everett designed to promote physical activity for kids
Our panelists bring additional perspective to “Best Community Citizen”
• June Altaras– SVP Operations Swedish Seattle and CNO Swedish System
• Elaine Couture– Regional Chief Executive, PHC
• Chris Dyke MD– Chair of the Alaska Community Ministry Board
Providence Health & Services | GOVERNANCE CONFERENCE
Governance implications and opportunities abound
• Vast and exciting opportunity to truly involve and activate our communities
• Begins with each of you:– Local engagement– System level engagement
Providence Health & Services | GOVERNANCE CONFERENCE