IHI Engineering Australia IHI Plant Construction Turn-key ...
IHI High-Impact Leadershipapp.ihi.org/.../Presentation_D13_E13_High_Impact_Leadership.pdfIHI...
Transcript of IHI High-Impact Leadershipapp.ihi.org/.../Presentation_D13_E13_High_Impact_Leadership.pdfIHI...
IHI High-Impact Leadership2016 IHI National Form
Workshop Sessions D13, E13
December 7, 2016
These presenters have nothing to
disclose
Michael Pugh, MPHStephen Swensen, MD
Why do we need new ideas about leadership?
“Every system is perfectly designed to produce the
results it gets.”
As leaders, you are responsible for the results of those systems
2
Paul Batalden, MD
IHI Triple AIM:
Success is Leadership Dependent
3
Per Capita
Cost
Experience
of Care
Population
Health
A useful definition…
Leadership is a process of social influence, which
maximizes the efforts of others, towards the
achievement of a goal.
Kev in Kruse Forbes.com What is Leadership April 9, 2013
Kevin Kruse
4
Swensen S, Pugh M, McMullan C, Kabcenell A. High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs. Cambridge, MA: Institute for Healthcare Improvement; 2013. Available on www.ihi.org.
High-Impact Leadership:
Improve Care, Improve the Health of Populations, and Reduce Costs
5
Mental Models
How leaders think is critically important
– Beliefs, theories and assumptions provide a “lens” through which leaders view and filter challenges and define the universe of potential solutions and actions
Fill in the Blank:
Patient experience would be significantly
improved if we ______________________.Think of two management actions you might take based on how you answered
the question.
6
New Mental Models
Reshape Improvement Efforts
7
Patient Satisfaction driven by being nice
Improvement projects are in addition to the daily work
Manage to my budget/funding
Common Mental Models
Patient satisfaction driven by engagement of patients and families
Improvement is part of daily work of everyone
Seek to continuously reduce per unit operating costs
New Mental Models
New Mental ModelsReshape Board and Governance Process
8
Good doctors mean good quality
Patient harm is rare and largely unpreventable or malpractice
The medical staff is responsible for quality
Common Board Mental Models
Safe and reliable systems + good doctors drive quality results
Patient harm is preventable and unacceptable
The Board is responsible for all organizational outcomes including clinical
New Board Mental Models
Transitioning from Volume-based to Value-based
Systems Requires New Mental Models
Swensen S, Pugh M, McMullan C, Kabcenell A. High-Impact Leadership: Improve Care, Improve the Health of
Populations, and Reduce Costs. Cambridge, MA: Institute f or Healthcare Improv ement; 2013. Av ailable on www.ihi.org.
Mental Models: QA, QC and QI
Quality Assurance• Inspection-looking for the
“Bad Apples”
• Retrospective Review
• Risk Management—Root Cause Analysis
Quality Control• Monitor Key Process
Indicators (KPI’s) against targets
• Take Action when not meeting targets
• Regulatory approach Quality Improvement• Process and system
improvement
• Reduce Variation
• Align outputs to customer needs
• Continuous & part of daily work
• Science of Improvement
10
The Big Mental Model ShiftChanging the Way We Think About Patients and Families
11
What’s the Matter?
What matters to you?
12
Builds on the construct of Will, Ideas and Execution
Provides a guide to the key areas where leadership needs to focus efforts to drive improvement and innovation
Useful for organizational assessment and gap analysis
Swensen S, Pugh M, McMullan C, Kabcenell A. High-Impact Leadership: Improve Care, Improve the Health of
Populations, and Reduce Costs. Cambridge, MA: Institute f or Healthcare Improv ement; 2013. Av ailable on www.ihi.org.
IHI High-Impact Leadership Framework
High-Impact Leadership BehaviorsWhat Leaders Do to Make a Difference
14
Swensen S, Pugh M, McMullan C, Kabcenell A. High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs. Cambridge, MA: Institute for Healthcare Improvement; 2013. Available on www.ihi.org.
Leadership Dimensions
Shanafelt, Menaker, Buskirk, Gorringe, Swensen. 12 Leadership Dimensions. Mayo Clinic Proceedings. April 2015: 90(4); 432-440
(P<0.001
)
(P<0.001
)
Mayo Clinic Diffusion ModelLeadershipCulture
Sponsoring Body
Value Creation Team
Best Practice
StandardizedMayo CareProcessModel D
iffu
sio
nT
eam
Best PracticeOwner
Order sets
Rules/Alerts
Patienteducation
Staffeducation
Workflowchanges
Operational Work Unit
Implementation
EMR/Deptsystems
BrochuresPAG, GPS
Ask MayoExpert
Outcomemeasures
IT Liason and Infrastructure Support
Dilling , Swensen… Mayo Clinic Model of Diffusion. Jt Comm J Qual Patient Saf. 2013;39:167.
Doyle, (2013). British Medical Journal, 3(1). Hsu, I, et al. (2012) Patient Education
Counseling. 88(3). Cosley, Journal Experimental Social Psychology 46.5 (2010) 816-
823
Pain
Anxiety
BP
LOS
Readmissions
Wound healing
Kindness
Barsade, O’Neill. What’s Love Got to Do with It? A Longitudinal Study of the Culture of Companionate Love. Administrative Science Quarterly. May 29, 2014
Satisfaction
Engagement
Commitment
Productivity
Exhaustion
Burnout
Companionate Love
Empathy
Systems Issues
Huddleston. Learning From Every Death. J Patient Safety March 2014
Who are the Core Leaders?
Everyone “in the middle” responsible for managing and leading divisions,
departments, functions, programs, and/or clinical teams
– Managers
– VP’s
– Supervisors
– Clinical Leads
– Division Leaders
– Clinical Team Leaders
– Program Managers
– Physician Leaders
20
What do they need to
know?
How do we develop
their leadership skills?
MDP and DM 2016
MDP & DM 2016
High-Impact Leadership Behaviors and Management
Focus Shaped by Distance from the Patient
21
• Vision & Strategy
• Shape Culture
• Allocate Resources
• Track Progress
Senior Leadership
• Deploy Resources
• Manage structure
• Align efforts
• Translate Priorities
Area or Service Leadership
• Provide care
• Manage daily work
• Lead care teams
• Solve Problems
• Improve care
• Keep patients safe
Clinical and Team Leaders and
Managers
Furtherfrom the Patient
Closer to the Patient
MDP 2016
MDP & DM 2016
You can manage things, but you have to lead people
Leadership Skills
•Strategic Thinking•Will Building
•Team Building•Communicating
•Prioritizing•Accountability
•Role Modeling•Engaging
Management Skills
•Allocating•Budgeting
• Improving•Staffing
•Measuring•Hiring & Supervising
•Ordering (Clinical)•Planning
Leadership Management
MDP 2016
MDP & DM 2016
High-Impact Core Leadership Competencies
Manage the Work
Build Team
Capability
Improve the Work
Shape Team
Culture
23
Management
Skills
Leadership
Skills
MDP and DM 2016
MDP & DM 2016
Manage the Work
Manage time and resources
Create standard work and process, including your own
Measure: financial, quality, customer,
key process
Surface and solve problems in real time
Engage across departmental/team
boundaries
Improve the Work
Prioritize and align to strategy and aims
Understand current state, cause and target conditions
Learn and use improvement tools
and methods
Reduce variation and waste
Get results and sustain them
Build Team Capability
Develop competency through coaching
Use the whole team
Communicate effectively
Establish respect and accountability
Shape Team Culture
Share vision and build will
Promote transparency
Model the way
Encourage mindfulness
Keep the person at the center
A Blueprint for High-Impact Core Leader
Development
MDP and DM 2016
Management
Skills
Leadership
Skills
MDP & DM 2016
Contact Information
Michael Pugh, MPH
– (719) 671-2668
Steve Swensen, MD
– (507) 284-6186
25