Seven Leadership Leverage Points for Organization-Level Improvement in Health Care

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Seven Leadership Leverage Points for Organization-Level Improvement in Health Care. Presented by: Robert L. Colones, MBA President and Chief Executive Officer Florence, South Carolina. A Quality Leadership Challenge. - PowerPoint PPT Presentation

Transcript of Seven Leadership Leverage Points for Organization-Level Improvement in Health Care

  • Seven Leadership Leverage Points for Organization-Level Improvement in Health CarePresented by:Robert L. Colones, MBAPresident and Chief Executive OfficerFlorence, South Carolina

  • Seven Leadership Leverage Points for Organization-Level Improvement in Health Care

    A Quality Leadership ChallengeWe have become good at making improvement happen for one condition, on one unit, for a while.We have not learned how to get measured results, quickly, and sustainably, across many conditions for the whole organization.

  • Seven Leadership Leverage Points for Organization-Level Improvement in Health Care

    Give me a lever long enough, and I shall move the world.ARCHIMEDESThe leverage points are offered as a sort of hypothesis If leaders are to bring about system-level performance improvement, they must channel attention to and take action on these points.

  • Seven Leadership Leverage Points for Organization-Level Improvement in Health Care

    1 Establish and Oversee System-Level Aims for Improvement at the Highest Board and Leadership Level

  • 1 - System-Level Aims for Improvement

    Chart2

    0.02948169280.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02622289460.02440799590.02840322010.02041277160.03239844440.0164175473

    0.03174603170.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02587800370.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02691721690.02440799590.02840322010.02041277160.03239844440.0164175473

    0.03421532850.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02515090540.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02800579430.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02651325660.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02761904760.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02775119620.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02596153850.02440799590.02840322010.02041277160.03239844440.0164175473

    0.01988071570.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02811244980.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02272727270.02440799590.02840322010.02041277160.03239844440.0164175473

    0.01760228350.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02180232560.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02166666670.02440799590.02840322010.02041277160.03239844440.0164175473

    0.0211946050.02440799590.02840322010.02041277160.03239844440.0164175473

    0.01906090190.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02079482440.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02414113280.02440799590.02840322010.02041277160.03239844440.0164175473

    0.01925545570.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02193187120.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02250.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02306967980.02440799590.02840322010.02041277160.03239844440.0164175473

    0.01804511280.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02492668620.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02367472980.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02954545450.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02125279640.02440799590.02840322010.02041277160.03239844440.0164175473

    0.02170.0243233710.02834717280.02029956920.03239844440.0164175473

    0.02110.02422569310.02822567620.020225710.03239844440.0164175473

    0.02760.02432493740.02830613080.0203437440.03239844440.0164175473

    0.01970.02432493740.02830613080.0203437440.03239844440.0164175473

    MRMC

    Average

    Avg+1Std

    Avg-1Std

    Avg+2Std

    Avg-2Std

    Mortality Rate - MRMC

    mcleod health measures pg2

    3.Percent of Patients Receiving "Perfect" CareDisease Specific Projects for HQI Demonstration, Joint Commission, CMS

    McLeod Regional Medical Center - Florence

    AMIPercent of Patients that had ALL Quality Indicators Met: Aspirin at arrival & discharge, Beta Blocker at arrival & discharge, Smoking counseling, LVSD assessment, & ACE/ARB at discharge for appropriate patients

    CHFPercent of Patients that had ALL Quality Indicators Met: LVF Assessment, ACEI/ARB for LVSD, Smoking counseling, 6 components of Discharge Instructions

    PNEUMONIAPercent of Patients that had ALL Quality Indicators Met: Antibiotic received within 4 hours of arrival , appropriate antibiotic, O2 assessment, Blood Cultures before Antibiotic. Pneumovax given, smoking counseling

    CABGPercent of Patients that had ALL Quality Indicators Met: Antibiotic received within 1 hour of incision, appropriate antibiotic, Antibiotics discontinued within 24 hours of surgery, Aspirin at discharge

    HIP & KNEE

    Percent of Patients that had ALL Quality Indicators Met: Antibiotic received within 1 hour of incision, appropriate antibiotic, Antibiotics discontinued within 24 hours of surgery, appropriate VTE prophylaxis ordered, appropriate VTE prophylaxis ordered

    McLeod Medical Center - Dillon

    CHF

    Jul-04Aug-04Sep-04Oct-04Nov-04Dec-04Jan-05Feb-05Mar-05Apr-05May-05Jun-05Jul-05Aug-05Sep-05Oct-05Nov-05Dec-05Jan-06Feb-06Mar-06

    Dillon NNo report171722242091191171514211821

    Apr-06May-06Jun-06Jul-06Aug-06Sep-06Oct-06Nov-06Dec-06Jan-07Feb-07Mar-07Apr-07May-07Jun-07Jul-07Aug-07Sep-07Oct-07Nov-07Dec-07

    Dillon N2319171814101816111716132114

    PNEUMONIA

    Jul-04Aug-04Sep-04Oct-04Nov-04Dec-04Jan-05Feb-05Mar-05Apr-05May-05Jun-05Jul-05Aug-05Sep-05Oct-05Nov-05Dec-05Jan-06Feb-06Mar-06

    Dillon NNo report1823271784145691811201829

    Apr-06May-06Jun-06Jul-06Aug-06Sep-06Oct-06Nov-06Dec-06Jan-07Feb-07Mar-07Apr-07May-07Jun-07Jul-07Aug-07Sep-07Oct-07Nov-07Dec-07

    Dillon N20131189151915232617252825

    McLeod Medical Center - Darlington

    CHF

    Jul-04Aug-04Sep-04Oct-04Nov-04Dec-04Jan-05Feb-05Mar-05Apr-05May-05Jun-05Jul-05Aug-05Sep-05Oct-05Nov-05Dec-05Jan-06Feb-06Mar-06

    Darlington N0533334109575444333955

    Apr-06May-06Jun-06Jul-06Aug-06Sep-06Oct-06Nov-06Dec-06Jan-07Feb-07Mar-07Apr-07May-07Jun-07Jul-07Aug-07Sep-07Oct-07Nov-07Dec-07

    Darlington N58521665855518

    PNEUMONIA

    Jul-04Aug-04Sep-04Oct-04Nov-04Dec-04Jan-05Feb-05Mar-05Apr-05May-05Jun-05Jul-05Aug-05Sep-05Oct-05Nov-05Dec-05Jan-06Feb-06Mar-06

    Darlington N302327157463733142310109

    Apr-06May-06Jun-06Jul-06Aug-06Sep-06Oct-06Nov-06Dec-06Jan-07Feb-07Mar-07Apr-07May-07Jun-07Jul-07Aug-07Sep-07Oct-07Nov-07Dec-07

    Darlington N331011822591201

    mcleod health measures pg2

    0.0286

    0.0257

    0.0285

    0.0257

    0.026

    0.0331

    0.0234

    0.0258

    0.0252

    0.0267

    0.0268

    0.0262

    0.0191

    0.0278

    0.0218

    0.0176

    0.0218

    0.0217

    0.0212

    0.0191

    0.0208

    0.0241

    0.0193

    0.0219

    0.0206

    0.0231

    0.021

    0.0225

    0.0216

    0.0303

    Actual Mortality Rate

    Mortality Rate - MRMC

    no not use

    10.39.39.7

    1.29.39.7

    1.19.39.7

    1.49.39.7

    19.39.7

    1.39.39.7

    0.29.39.7

    0.989.39.7

    2.139.39.7

    1.35555555569.39.7

    McLeod Health

    OSHA SC Benchmark

    OSHA National Benchmark

    Average days per case incident

    Work Days Lost - McLeod Health

    mcleod health measures pg1

    0.95555555560.966

    0.94892915980.966

    0.9550.966

    0.97166666670.966

    0.95945945950.966

    0.94188034190.966

    0.9860.966

    0.9870.966

    0.970.966

    McLeod Health

    2005 PRC Norm

    Overall Quality of Care - McLeod Health% Patients Satisfied

    MortRateSummary

    0.95726495730.9523

    0.9604612850.952

    0.97166666670.952

    0.97166666670.952

    0.98141891890.952

    0.96729776250.952

    0.9750.952

    0.9790.952

    0.960.952

    PRC Norm - annual benchmark

    McLeod Health

    2005 PRC Norm

    Likelihood To Recommend - McLeod Health% Patients Satisfied

    data sheet

    0.8888888889

    0.9574468085

    0.8666666667

    0.9523809524

    0.9107142857

    0.8846153846

    0.8428571429

    0.8909090909

    0.9807692308

    1

    0.95

    0.9365079365

    0.875

    0.9583333333

    0.9464285714

    0.9491525424

    0.8524590164

    0.9142857143

    0.9253731343

    0.9315068493

    0.9491525424

    0.9206349206

    0.875

    0.9206349206

    0.9523809524

    0.9

    0.9850746269

    1

    0.875

    0.9259259259

    0.9130434783

    0.9107142857

    0.9245283019

    0.9375

    AMI

    % of Patients

    All Indicators Met - AMIMRMC

    perfect care data

    0.5692307692

    0.4337349398

    0.5833333333

    0.425

    0.476744186

    0.6578947368

    0.6282051282

    0.5135135135

    0.7246376812

    0.7076923077

    0.7868852459

    0.6721311475

    0.7213114754

    0.7096774194

    0.75

    0.6794871795

    0.776119403

    0.8055555556

    0.7894736842

    0.8

    0.8301886792

    0.7714285714

    0.8392857143

    0.9215686275

    0.7285714286

    0.7931034483

    0.8421052632

    0.8771929825

    0.7222222222

    0.6964285714

    0.8701298701

    0.7575757576

    0.7058823529

    0.701754386

    CHF

    % of Patients

    All Indicators Met - CHFMRMC

    0.5

    0.8285714286

    0.796875

    0.6808510638

    0.8039215686

    0.7638888889

    0.5949367089

    0.7572815534

    0.7763157895

    0.6470588235

    0.8666666667

    0.8947368421

    0.8269230769

    0.875

    0.74358