Developing a Holistic Infection Risk Management Program ...

AHF WEBINAR

DEVELOPING A HOLISTIC INFECTION RISK

MANAGEMENT PROGRAM

USING 7PS

Presented by

Adel Olleik

www.gates-group.com

Stages for healthcare institutions in the battle against COVID-19 (McKinsey & Company)

Gates Copyright 2020- www.gates-group.com

Resolve: How organizations can structure a Nerve Center to combat COVID-19

1

Resilience: How the economic impact may affect healthcare organizations over time

2

Return: How organizations can begin to scale up operations once the worst of the crisis is over

3

Reimagine: How we can fundamentally reinvent health services given what we have learned

4

Reform: How will the relationship between government, businesses, and individuals change?

5

https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/from-wartime-to-peacetime-five-stages-for-healthcare-institutions-in-the-battle-against-covid-19





Overview of responsibilities for the minimum viable nerve centerBased on discussions with health and risk professionals by Integrated operations


WORKFORCE PROTECTION & PRODUCTIVITY

SUPPLY CHAIN STABILIZATION

CUSTOMER TRANSPARENCY AND SUPPORT

CASH AND FINANCIAL

STABILIZATION

STAKEHOLDER STRATEGY AND ENGAGEMENT

A. BUILDING AN INFECTION RISK

MANAGEMENT (IRM) PROGRAM

BASED ON 7PS


7Ps Performance Value System (Derived from BSC)

GATES Holistic Approach

People(SEAM, BSC)

Process(Lean, TQM, 6 Sigma, BSC, SWOT)

Product(ISO, Lean, 6 Sigma)

Promotion(BSC)

Purpose(SEAM, BCS)

Feedback

Place

Provisions

Fee

db

ack

Organizations as Biosystems : GATES Organization Tree


Stage1: Set a Holistic IRM Program Framework using 7Ps


4.People 3.Process 2.Product 7.Promotion 1.Purpose

6.Place

5.Provisions

Who What HowPhysicians Competency GovernanceStaff Commitment LeadershipSuppliers Teamwork Strategy Regulators Fair Workload CommunicationPartners Productivity Source & Retain

-Mission:

People,

Planet &Profit

-Vision,

Goals, Values

-Standards

-Our Competitive Advantages!-what massage & to Whom!-Public Trust-Community outreach

-Public Awareness

-Screening

-Quarantine

-Transportation

-Primary,

secondary&

Tertiary Care-Rehabilitation

-Patient Flow Volume & Mix

--Space, Cross contamination, zoning..

-Ventilation

-Toilets, cleaning, rest, waiting, eating

areas..

-Isolation, procedure rooms…

-Staff Housing

-Supplies, Equipment

& Technology

-Quantity, Quality &

Cost-Effectiveness

Risks &

Opportunities

Management

PESTELAnalysis

-Governance

Structure

-Process Map

-SOP & JD

-Authority Matrix

SW

OT


Source: Lexis Nexis

Integrated Risk & Disaster Scenario Planning

Risks

1. Lockdown: affecting facility accessibility or workforce attendance or supply chain

2. Facility Outbreak

3. Reimbursement & Cashdeficit

4. Workforce shortage orburnout

5. Technology failures

6. Unanticipated Patient Flow Traffic


1. Determining the Program Vision &

Goals (Purpose) Where to reach!

a. Mission: Serving People, Getting Profits, Saving Planet

b. Vision:

• aggressive fighters/ conservative defenders

• competitive / collaborative

• partial & specialized/ comprehensive services

• staff & physicians health & support

• community involvement

c. Values

d. Goals

e. IRM Normative References: Laws & Standards

f. Identify the 7Ps KPIs Dashboard



2. Identifying the needed community services

(Product) What!

3. Process Mapping & Documentation (Process) How!

A.Governance Structure of IRM:

• Bodies & Teams:

1. Steering Committee- Multidisciplinary (C Sweet)

2. ICP Policy Team,

3. Compliance Team,

4. Staff Support Taskforce

5. Logistics Team

6. Communication, & Networking Team

7. Public Health Promotion

• Roles of Bodies & Collaboration with external stakeholders:

MOH, PHC Centers, Hospitals, Other Ministries,

Municipalities, NGOs, Social influencers, WHO & Other

Organizations


3. Process Mapping & Documentation (Process) How!

B.General Process Map:

• List of processes:

1. IPC

2. Risk Management

3. Crisis Management

4. Occupational Health, Safety & support system

5. Facility Management & Supply Chain

6. Communication during Crisis

7. Housing & Transportation

8. Cash flows & Reimbursement

9. Information Management & Digital Business

10. Digital Health…

• Internal & external correlations

C.Policies, Procedures, & Tools (Instructions, Forms, Lists…)

D.Job descriptions & Authority Matrices (Who dose what!)


4. Specify Workforce quantity, competencies, &

commitments (People/ Players) Who!

a. Competencies: Technical procedures, communication,

stress management…Simulation-based training

b. Commitment: Time, Risk, Motivation…

c. Team Dynamics: Autonomous Coherent teams

d. Productivity & Workload Distribution

e. Workforce Availability and Readiness: Housing,

accessibility, protective equipment, financial &

psychological support.

f. Source & Retain


Accreditation of ICP Actors


4. Specify Workforce quantity, competencies, &

commitments (People/ Players)

• Partners: Regulators, Complimentary Providers,

Community NGOs

• Suppliers: Availability & Quality

• Communication during Crisis: Internal / External

• Governance Practice: Fairness, Accountability &

Transparency, Management Commitment ,resources,

Shared Governance

• Leadership: Leadership Styles: Democratic, Autocratic,

Serving, Quantum (Holistic, Risk anticipation &

mitigation)…


Leadership Comprehensive Conceptual

Model (Quantum)

20Gates Copyright 2020- www.gates-group.com

Risks & Opportunities

5. Specify the needed equipment, material, &

technologies (Provisions) What's Needed!

a. Needed Equipment:

Active, reserve sets,

installation, maintenance

b. sustainable Supply chain

Needed Material: PPEs

(Stock Level)

c. Health ICT diversity &

support: internet

channels, Reporting

Channels, Online

meetings, Telehealth,

Digital business…


6. Plan the space, design, and physical environment required

for a highly performing program (Place) Where!

a. Workflow types & Volume: Patients, Families, Doctors,

Staff, Equipment. No cross contamination

b. Zoning: reception, screening areas, triage, ICU,

isolation, quarantine, …

c. Space: social distance

d. Physical Environment: ventilation +/- pressures for

airborne

e. Infrastructure & Power sustainability

f. Staff Housing & transportation


6. Plan the space, design, and physical environment

required for a highly performing program (Place)


7. Promote the services & create public trust in

the program (Promotion) Why are we special!

a. Program Massage to our Doctors & Staff

b. Program Massage to Community

c. To our Patients & Families

d. To MOH

e. To Other Providers & Collaborators

f. To Competitors

g. To Partners

h. To Government Agencies, Municipalities & NGOS

i. To Social Influencers


Stage 2: Implementing an IRM Program by 5Ds

Drive

Diagnose

7Ps

Develop

Design

7Ps

Do7Ps


7Ps Indicators Dashboard Gaps Diagnosis

People

Gaps 30 %

Process

Gaps 20%

Product

Gaps 20%

Promotion

Gaps 20%

Purpose

Total N of Gaps = 150

Place

Gaps 5%


Provisions

Gaps 5%

7Ps Indicators Dashboard Baseline Diagnosis

People

Score: 10/25

Process

Score: 5/15

Product

Score: 10/20

Promotion

Score: 5/15

Purpose

PerformnceValue Score:

45/100

Place

Score:

7/10

Driver Score: Compliance Rate/ WeighCompliance Rate: achieved results/ targeted resultPerformance Value Score = sum of all scores


Provisions

Score: 8/15

-Competency Levels

-Time to Competency

-Turnover Rate

-Absenteeism

-Staff Infection Rate

-Shortage %

-Unattended Shifts

-Staff Productivity

-N of Tests

-Detection Rate

-Morbidity/ Mortality

-Isolated cases

-Recovery Rate

-Recovery Time-Uncovered Revenues

-IRM Program Cost

-Utilization Rates

-Compliance Rate

-Incidence

-Patient Flow Volume

-Patient Flow Mix

-Patient Bookings

-Patient Satisfaction

-Complaints

-Redundant Patients

-Catchment Area %

-% of Cases with high

affordability

-National Vs Expats

-Media Releases

-Social Media Indicators

-Overall Equipment Effectiveness (OEE) =

UPTIME x RATE x QUALITY

-Shortage in PPE, Disinfectants

-Bed Occupancy Rates

-Utilization Rate

-Refused Patients for

space shortage

7Ps Indicators Dashboard Design (Plan) Targets

People

Score: 20/25

Process

Score: 10/15

Product

Score: 15/20

Promotion

Score: 10/15

Purpose

Performance Value Score:

75/100

Place

Score: 7/10

Targeted Driver Score: Target/ Weigh (Max Target)Targeted Performance Value Score = sum of all Targeted

Scores


Provisions

Score: 8/15

7Ps Indicators Dashboard Doing Evaluation

People

Score: 20/25

Process

Score: 10/15

Product

Score: 15/20

Promotion

Score: 5/15

Purpose

Performance Value Score:

65/100

Place

Score: 7/10

Actual Driver Score: Compliance Rate/ WeighCompliance Rate: achieved results/ targeted resultActual Performance Value Score = sum of all

scores


Provisions

Score: 8/15

Transformation through the 5 Levels of Organizational Performance - GATES- Approach

Drive

Do

Design

Develop

Diagnose

Drive

Do

Design

Develop

Diagnose

Drive

Do

Design

Develop

Diagnose

People-centric Management Foundation

Transforming

Learning & Standardizing

Complying & Accredited

Drive

Do

Design

Develop

Diagnose

Drive

Do

Design

Develop

Diagnose

Sustainable & Innovative

HolisticPerformance(7Ps)

Time

V1

V2

V3

V4

V5

Management Commitment

Level 1

Level 2

Level 3

Level 4

Level 5


B. WHERE ARE WE NOW &

WHAT VIRUSES WE HAVE IN

MANAGEMENT!

Are Our HC Organizations Performing!

Let us look inside the Nutshell :Morgan’s 8 metaphors


Our Assumptions about Staff Behavior !


What are our Staff to Us!

Costs Contracts Capital Followers

Resources Fortune Talents Workforce

Potentials Humans


Where are we focusing in Quality

Improvement Methodologies!

5Ds

BCS

6 SigmaLeanISO

BPRLEAN6 SigmaTQMBSC5Ds

SEAM

TQMBCS5Ds

SEAMBSC5Ds


ISOAccred.BSC5Ds


GAPs in Accreditation Process- ISQua

Automation

Sustainability

The Virus is in Our Management Practices:

CCC Virus (Compliance-Centered Control)

Virus Symptoms:

1. Excessive compliance controls & Audits

2. Compliance dominates Performance

3. Low management commitment to Quality

4. Unempowered Executers

5. Imposed change with extrinsic prescription (standards)

6. Test-oriented, & documentation-based compliance

7. Poor ownership of change & acting behavior

8. Unsustainable performance


CCC Virus

-Imposing compliance

-Poor readiness

-Test-oriented!

CCC Virus

• Nothing in it for staff

• Extra work

Losing Ownership

Losing Sustainability


The day after!

C. CHANGE COVID-19 FROM A

THREAT TO AN OPPORTUNITY TO

CHANGE

397/9/2020 GATES Copyright 2020

1.Be a Humane Quantum Leader

A Story of an Arab Hospital from the field…


1. The Hospital decided to fight Pandemic

2. Quantum Leadership dealing with huge Risks & Changes every day

3. 10s infected & some deaths in front line Doctors & Staff, they never left

4. Governance:

• Psychological support

• Financial: Salary, basic living allowance for high risk staff,

scholarship

• Social Support TEAM: visits, food (Philippian), kids caring &toys

4. Impact: Sustainable Return on Investment in Humane Values

a. Staff Loyalty, Voluntary Workers (Wife of a dead

Husband)…Fundraising for families of dead staff

b. Patient loyalty: Our hospital did not leave us when we needed it

c. Regaining control

2.Never Compromise Competency & Commitment

• Attract, Retain & Motivate

• The best recruitment strategy in hospitals is to grow

internally

• Training is the least investment with the highest return


3. Accredit

your

Managers &

Staff before

your

Programs


4. Love is the Main Productivity Driver

Must

Do

Can

Do

Love to Do


Listen More

Care More

5.Cultural Affects Infection


Effect of Culture on Infection Spread


6. Its Population not Patient

anymore…New Behavioral Patterns


7. One Health & Aligning with SDGs


8. Change our Management Approaches

• Go People-centric (Kill CCC Virus)

• Go Holistic Performance Management (7Ps)

• Change HC Managers mindset (5 axis):

Public Health, Management, Leadership,

Business, & Multidisciplinary

• Risk Anticipation, Agility, & Resilience to changes

in Healthcare Policy & Industry

• Innovation & Sustainability

7/9/2020 GATES Copyright 2020 48

9. Central Monitoring System of IRM by 7Ps Dashboard

Detection, analyzing,

directing, & support:

• Organization Level

• Network Level

• National Level

• International Level


10. Learn our Lesson!

• Mohammad:

ني اني لا أخاف على أمتي الفقر، ولكأخشى عليهم من سوء التدبير

• Jesus: John Maxwell, Steven Covey…

• You may find more solutions for Pandemics in ethics & spirituality books not only medical schools…


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