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Leadership Accountability Demonstration Project INTENSIVE Cohort Call #2: Strategic Prioritization and Learning Tracer Tools September 17, 2014

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Agenda How do we gain focus and reconcile competing priorities? The Strategic Prioritization Tool How do we capitalize on the innovative capacity of our workforce? The Informal Learning Tracer Tool Discussion

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LADP Project Roadmap June August 2014 Site visit conversations August 2014 Cohort tool webinar Try out the Aligning Goals Across the Organization tool Try out the Defining Safety Competencies tool Individual site coaching calls begin September 2014 Cohort horizontal learning webinar Cohort tool webinar Try out the Strategic Risk Assessment and Prioritization Tool Try out the Learning Tracer Tool Individual site coaching calls October 2014 Cohort horizontal learning webinar Individual site coaching calls November 2014 Cohort tool webinar Try out the Collaborative Tactical Decision Making Method Interactive business case presentation Individual site coaching calls December 2014 Cohort horizontal learning webinar Individual site coaching calls

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4 Strategic Prioritization Tool Armstrong Institute for Patient Safety and Quality

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5 What is our aim? Leading with Intent How do we set goals and priorities? many measures have financial, reputational, and regulatory risks How do we balance external priorities with internal priorities?

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How many of you use a systematic process to prioritize organization quality and patient safety goals and priorities? If YES, Is the process well known throughout the organization? Might a systematic approach to guide the process be useful? How do we currently assess risk as an organization?

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Creating High Value Healthcare

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Competing Improvement Goals and Priorities Clinical Outcomes Patient/Family Reported Outcomes Staff Reported Outcomes Financial Goals/Measures of Efficiency

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9 Phase I: Clarify External Reporting Risks and Prioritize Action Areas Armstrong Institute for Patient Safety and Quality Tool guided process to evaluate External patient safety related risks and opportunities for improvement across several domains Use results to help prioritize areas for improvements. Feasibility Financial Risk Reputational Risk Regulatory Risk Patient Harm

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Strategic Risk Assessment and Prioritization

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11 Risk assessment table TYPE OF RISK LEVEL OF RISK LowMediumHigh Patient Risk/Harm Measure indicates potential for low patient harm and/or has limited to no evidence Measure indicates potential for moderate patient harm and/or has ample evidence Measure indicates potential for severe patient harm and/or has strong and compelling evidence Financial Risk (includes penalty, rewards, and opportunity cost) Not a pay for performance/reporting initiative with < $ XK at stake* Pay for performance/reporting initiative with XK and < $XXK at stake* Pay for performance/reporting initiative with $XXK at stake* Reputational Risk Not publicly reported or evaluated by any external agency Reported or evaluated by external agencies but not shared publicly Publicly reported or evaluated by one or more regulatory and external agencies (Leapfrog, Consumers Union, Healthgrades etc.) Armstrong Institute for Patient Safety and Quality

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A Case Example from Johns Hopkins Hospital 12 Aim: Exceed 96% compliance with nine key process measures. PCI