Project Management Healthcare

7/27/2019 Project Management Healthcare

1/29

Project Managementand Healthcare

Daniel B. McLaughlin

Center for Health and Medical Affairsv7


2/29

Outline Issues in American health care today

The Need for Project Management

PM Systems

PMI

Lean Six Sigma Agile

IHI

A systems view of health care andOpportunities for PM

Discussion


3/29

The Best Health Care Systemin the World


4/29

The Best Medical Research

Drug and Device Development

Innovative Care Delivery

Minute Clinic

Electronic Health Record Health 2.0

Health Services Research

Passionate and skilled caregivers

Engaged Consumers and Patients


5/29

Paradox GeographicPractice disparity

Quality: over use,under use, misuseand safety

Acute care modelfor Chronic disability

Professionsshortage

Primary care

Nursing

Emerging public healthproblems

Access problems:

uninsured,underinsured,bankruptcy

Insurance: pre existingconditions, deductibles& co-pays, lifetime limits

Welfare payment foraged and disabled

Most costly system inthe World 17% ofGDP


6/29

Total National Health Expenditures (NHE), 20092020Current Projection and Alternative Scenarios

NHE in trillions

Cumulative redu ction in NHE thro ugh 2020: $3 tr i ll ion

Note: GDP = Gross Domestic Product. Data: Estimates by The Lewin Group for The Commonwealth Fund.Source: Commonwealth Fund Commission on a High Performance Health System, The Path to a High Performance

U.S. Health System: A 2020 Vision and the Policies to Pave the Way(New York: The Commonwealth Fund, Feb. 2009).


7/29

Why is change so Hard? Medicine

Most intense science of all

10,000 new articles a year

17 years from research to practice (AHRQ) Business

Predominately privately owned and operated

Still cottage industry in many places

Many interests dont want change

Market failures abound

Compassion Hippocratic oath

Technological Imperative

Its Personal Everyone is part of the system

Strong feelings about my health, my familys health, my doctor


8/29

Project Management - The Need Cedars Sinai example

Now a defined science Origins in DOD procurement

Evidence based management

Widely used product development,IT and construction

Project Management Institute PMI

Competitive advantage Honeywell example


9/29

Project Management Elements

Initiation

& Charter

Scope

Requirements Project Plan

Scope management

and Work Breakdown

Schedule management

Cost Management

Quality Control

Communications

Risk management

Procurement

Stakeholders

Close out


10/29

Improve Efficiency/Reduce Waste

Measure Analyze Improve ControlDefine

Process Map

Checksheet

Pareto

Run Chart

C&EDiagram

Scatter Plot

StatisticalTools

Basic Six Sigma Tools

Courtesy of Marshfield Clinic


11/29

Lean Tools for Improving Flow

Value stream mapping

Geographic mapping (spaghettidiagrams)

5 Whys (better to use C and E

diagram) 5 S

Standard work

Visual Management

Takt time


12/29

Kaizen Events

(Rapid Process Improvement Workshops RPIW)

Short time periods (1/2 day to 5 days)

Use simple tools Spaghetti diagrams

Process diagrams value streams

People who perform the process or observers Focus on immediate recommendations forchange

Necessary resources available immediately PDCA on changes

Many Kaizen events per year


13/29

The A3Summary of PI project on A3 size paper (2 x 8 by 11 pages)

Issue

Background

Current condition

Problem analysis

Target Condition

Countermeasures

Implementation Plan

Financial analysis

Test

Follow up


14/29

Agile

Charter Project

Determine

expected time

frame, cost and

performance

Collaborate

with customers

to define andrefine

requirements

Build prototype

service or

process

Does it meet

expected

performance?

Implement - go

to scale.

No

Yes


15/29

Institute for Healthcare Improvement

Set Aims

Establish

Measures

SelectChanges

TestChanges

Do

Act

Plan

Study

More is not number and soon is not a date Dr. Don Berwick, CEO IHI


16/29

Health Care A SystemsView

Professional - Patient


17/29

Health System Core


Illness Burden

Consumer Behavior

Knowledge

Tools Dx & Rx


18/29

Health System Tools


Tools Dx & Rx

Facilities

Medical

Technology

Health

Care

Workers

Information

Technology

PMNewer products

- less cost- more efficacy

PM$18 Billion for HealthInformation Technology(Stimulus bill)

PM- Improved payment forprimary care services- More funding for trainingprimary care providers

PM - structureAccountable CareOrganizations


19/29

Health System Consumer


Illness Burden

Consumer BehaviorTools Dx & Rx

Past

Experience Personal,

networks

Information

Market/Clinical

Financial

resources

& goals

Knowledge

Environment:

- Air, food,

water

-Economic

- Cultural

Genetics of

the Individual


20/29

Consumer Behavior and Illness

PM - Disease Management

ChronicDisease Management

Medical home Health IT to track

chronic patients

PM - Consumer behavior

Health promotion and disease prevention

Financial incentives to employers for wellness

programs (Safeway model)


21/29

Health System Education & Research


Illness Burden

Consumer Behavior

Knowledge

Tools Dx & Rx

Primary

Education

Continuing

Education

Research


22/29

Education and Research

PM Research

Funding for ComparativeEffectiveness Research (Stimulus)

Evidence Based medicine projects

Clinical Decision support Data Mining


23/29

Health System Financing


Illness Burden

Consumer Behavior

Knowledge

Tools Dx & Rx

FinancingSources

&

Structure

Individuals

Employers

Government

Financial

resources

& goals


24/29

Employers Remain Primary Sponsor of CoverageDistribution of 307 Million People by Primary Source of Coverage

Employer

Direct

164m

53%

Uninsured

49m16%

Medicare

39m

13%

Medicaid

42m

14%

Medicare

41m

13%

Individual

Direct

14m5%

Employer

Direct

55m18%

Total Employer 164m (53%)

Total Individual 14m (5%)

Source: The Lewin Group, The Path to a High Performance U.S. Health System: Technical Documentation

(Washington, D.C.: The Lewin Group, 2009).


25/29

PM - Insurance

Health Information Interchanges

Simplified and standardized

billing


26/29

Total Health System Model


Illness Burden

Consumer Behavior

Knowledge

Tools Dx & Rx

Facilities

Medical

Technology

Health

Care

Workers

FinancingSources

&

Structure

Information

Technology

Primary

EducationIndividuals

Employers

Government Continuing

Education

Past

Experience Personal,

networks

Information

Market/Clinical

Genetics of

the Individual

Environment:

- Air, food,

water

-Economic

- Cultural

Financial

resources

& goals

Research


27/29

Americans

always do

what is r igh t ,bu t only

after try ingeverything

else.Winston Churchill


28/29

Discussion


29/29

Thank You

Dan McLaughlin

[email protected]

Project Management Healthcare

Documents

Transcript of Project Management Healthcare