Modified Driver Diagrams: a tool in strategic...

Modified Driver Diagrams: a tool in strategic deployment

June 25, 2013 (revised)

Communications and Strategic Planning

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Modified Driver Diagrams• Proposed as a tool to support conversations about the Providence Plan

• Intention is that programs/services/departments would look at the

information under each Strategic Direction and talk about:

What does this mean for our program/service/dept?

What will we be focused on?

• Driver diagrams will be updated bi-annually.

• ADS is currently confirming the metrics for each of the strategic aims; the

target completion is Fall 2013

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People Strategic Direction: Aim 1 -Engagement

AIM 1A workplace where all people are highly engaged in contributing to PHC’s success

In all work situations, there will be a culture of civility, respect, and positive regard.

All people have a meaningful voice in the organization

- There is meaningful contact between each leader and staff.- Employees learn about organizational direction, strategy and change directly from the leaders.- Leaders model, live and reinforce PHC’s values.

- Effective and efficient process and structures in place to reinforce values, vision, mission and strategic directions.- Consistency in the day- to-day execution of our shared values and commonly desired behaviors

- There are mechanisms for people including patient and families) to provide input into or about the changes that impact them.- There is transparency around decision making

Primary Drivers Secondary DriversObjectivesAim

Implement a rigorous process to organize, prioritize and coordinate workload allocation and to proactively monitor capacity and impact on people

Develop and reinforce clear decision-making models and processes to improve clarity of roles and accountability, appropriate involvement of people at different levels, transparency and understanding of how decisions are made and the outcomes, and ultimately, the speed in which decisions are made.

Implement the infrastructure to provide equitable and efficient access to meaningful and varied learning opportunities for non-leader staff.

Leaders connect with people in a way that matters

People understand and are connected to PHC’s vision, mission, values and strategic directions

People make the best use of their skills, strengths and abilities

- People have the development and support they need to do their work.- People have the tools and resources to do their work.

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Aim 2 - Exceptional leaders

AIM 2Exceptional leaders who create environments where people do their best.

Create a new Leadership Development Strategy that meets the PHC’s strategic requirements (i.e. innovation, care) and defines learner groups, the required knowledge and competencies and identifies support and evaluation mechanisms.

Re-design the leadership structure in x number of key areas, to ensure that leaders have the capacity to effectively manage staff and to improve patient centred care.

Leaders have skills and abilities and demonstrate behaviours to be successful and grow with the organization.

Leaders have the capacityto work with their people.

Leaders are identified, ready and able to assume increased leadership opportunities.

- Leaders participate in structured development programs that align with and support PHC’s strategic direction.- Foundational skills program prepare and support all managers.- New leaders are well-oriented to the organization and fully prepared for their role.- Processes, tools and skill development help leaders guide the development of their people.

- Regular workforce planning is conducted to identify and plan for PHC’s strategic workforce capacity.- Future leaders are identified and their aspirations and capabilities are identified and nurtured.

- Leaders have a manageable span of control, with clear decision-making authority and accountability.- Leaders have, and use the tools and information they need to work efficiently.- Leadership jobs and scope of responsibilities are designed to leverage peoples’ strengths and interests.


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Aim 3 - Teamwork

AIM 3Team work (Intra and Inter departmental) that produces amazing results.

Research strategies of how to improve ease and speed of collaboration and integration between people who are working toward similar goals but who are participating on teams that are dynamic, quickly evolving, and don’t have regular membership.

Move from a traditional contract-type relationship with physicians to a partner relationship where they are seamlessly integrated in day-to-day work and teams.

Structures are in place to encourage increased, and diverse, participation on teams.

Teams have the skills to be high performing.

Teams have a clear purpose that explicitly aligns to PHC’s strategic goals.

- Leaders expect people to initiate and participate in teams (intra and inter) and hold them accountable.- The creative, engaging and purposeful nature of teams attracts diverse membership (including those who are not remunerated)

- Development is offered around the skills, knowledge and behaviours required to excel as a team.- Teams have the ongoing support they need to do their work (e.g. online tools, in-person development)- Leaders expect, role model and recognize exceptional teamwork and results.

- Teams agree to document and revisit team goals regularly.- Shared goals (including patient goals) across departments are clearly understood.


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Current work to move forward the aims:

• Under Aim 1 – “Engagement”: Work to implement PerformanceLink - performance planning and review and work around Respect and civility at work (define the process, resources, and education of staff)

• Under Aim 2 – “Exceptional leaders”: Leadership development strategy and Clinical leadership support project

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Innovation Strategic Direction: Aim 1 – Innovation Culture

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Aim 2 –Knowledge Translation

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Aim 3 – Management system

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• Under Aim 1 “ Innovation Culture” : They are continuing to work on the R&D approach and are working with some clinical partners to identify their next project. Once they do, they will be combining what they have learned with respect to leadership and culture and will be working on those dimensions simultaneously to apply the methodology to the problem

• Under Aim 3 “Management System”: Continued development of the Project Management Office work; a refresh of the Balanced Scorecard

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Quality & Safety Strategic DirectionAim 1 (“Quality”Right care to the right patient) COPD

Pathway

VTE Guidelines

Stroke Pathway

Primary Drivers

Secondary DriversObjectivesAim

Heart Failure Pathway

Glycemic Control

Standardize Care

Processes

Provide standardized care to specified patients 80% of the time

Guidelines and

pathways based on

best practices

Sepsis Guideline

48/6

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Aim 1 (“Quality” Right care to the right patient)

Other standardized

tools

Surgical Safety Checklist

Medication Reconciliation

Standardize Care

Processes

Provide standardized care to specified patients 80% of the time

Primary Drivers


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Aim 1 (“Safety”No needless harm)

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Primary Drivers


Reduce nosocomial

infection rates

UT infections

Clostridium difficile

infections

Surgical site infections

Catheter associated UTIs

Safe and effective Bed Management

Effective participation in NSQIP

Policy compliance

Transmission

Reduce % of patients with at least one adverse event to: 15% by March 31, 2012; and 10% by March 31, 2013

Hand Hygiene Infrastructure

Education

Motivation

Non-catheter associated UTIs

Enhanced Recovery after Surgery (ERAS)

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Reduce % of patients with at least one adverse event to: 15% by March 31, 2012; and 10% by March 31, 2013

Increase % of falls with no harm from 60% to 90% by June 2013

Harm from falls

Falls Prevention Program

Primary Drivers


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• Many of the quality and safety initiatives are well underway.

Current work to support Quality aims include:

• The Clinical Guideline Initiative (CGI) focuses on the implementation of regional PHC/VCH guidelines. Projects include : Medication Reconciliation; VTE; Prevention; Heart Failure; TIA/StrokeSepsis; Surgical Safety Checklist; COPD; Hand Hygiene; Glycemic Control; 48/6 (roll out not started)

• CGI also supports the Provincial Clinical Care Management (CCM) initiative.

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Current work to move forward the aims (con’t):

Current work to support Safety aims include:

• Reducing catheter days to reduce catheter associated UTIs (urinary tract infections)

• ARO (antibiotic resistant organisms) screening and bed management to prevent C Diff (clostridium difficile infections)

• Reducing SSI (surgical site infections)

• Promotion of hand hygiene

• Falls prevention strategies

• Patient safety culture – conducting survey to understand perceptions of our current patient safety culture

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Care Experience Strategic Direction: Aim 1 - Person & Family Centered Care

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Aim 1 -Person & Family Centered Care

Participation

Patients and families are invited to

participate in clinical decision making at

the level they choose

Patients and families are part of the clinical

care team

Patients, residents and families will experience culturally safe, socially just, person and family centered care across Providence Health Care.

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Aim 1 - Person & Family Centered Care

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Aim 1 - Person & Family Centered Care

Information Sharing

Patients and families have open access to their own information throughout PHC

Metrics are public and easily accessible: PFCC metrics and

Quality/Safety metrics

Clinicians share information with

patients and families in a way that is affirming

and useful

Patients, residents and families will experience culturally safe, socially just, person and family centered care across Providence Health Care.


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Current work to move forward the aim:

• Code Help pilot started

> Recommendation for spread (or not) to be based on evaluation

• Professional image policy work continues – includes engraved name tags for clinical staff

• Care advisor project nearing completion – exploring possible partnership with Patient Voices Network

• Planning for IPFCC conference August 2014

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Infrastructure Strategic Direction: Aim 1 –Redevelopment of SPH

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Aim 2Redevelopment of Mount St. Joseph’s Hospital

By September 2011 report and recommendations received to identify drivers for decreased volumes & increased costs for clinical services

PHC & VCH agree on long-term role of MSJ within Regional Strategy

PHC determines preferred long term role for MSJ

Availability of capital funds for priority capital projects

By November 2011 consultant report on service volume projection data received

By February 2012 Consultant Site Master Plan Report received

Business Cases Completed for Priority Capital Projecs

Aim 2 –Redevelopment of MSJ

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Aim 3 – Renewal of Residential and Hospice facilities

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Aim 4Clinical Information System Transformation

By 2014 implementation of an evidence based clinical system based upon the Cerner applications, that emphasizes standard work and provides an electronic record that enables the continuum of care

Governance Model

Developed

Managed Service Vendor

Selected

Engage Clinicians

Governance model established between VCH, PHC & PHSA

Clinical Leadership roles defined

Successful RFP process


Aim 4 – Clinical Information System Transformation

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Current work to move forward the aim:

• Under Aim 1: Finalization of Functional Program for the new Ambulatory Care Building; complete concept plan for submission to Project Board by June 2013

• Under Aim 2: Work to complete business case for MSJ ED redevelopment by Sept 2013

• Under Aim 3: Working with VCH on a regional residential rejuvenation strategy; March 2013 funding announcement for 12 -14 bed hospice (St. Vincent’s Campus of Care)

• Under Aim 4: Project launched in April; 17 week strategy & verification phase underway

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