SSM Health CareSSM Health Care

Category 6:Category 6:

Process Process ManagementManagement

SSMHC Process ManagementSSMHC Process ManagementFrameworkFramework

Health CareDelivery

Processes

SupportProcesses

BusinessProcesses

• AdmitAdmit• AssessAssess• TreatTreat• DischargeDischarge

• PhysiciansPhysicians• SuppliersSuppliers

• FinanceFinance• Human ResourcesHuman Resources• Facilities Facilities

ManagementManagement• Information SystemsInformation Systems

Quality Journey: Process FocusQuality Journey: Process Focus

CQI PrinciplesCQI Principles

– Quality is achieved through peopleQuality is achieved through people

– All work is part of a processAll work is part of a process

– Decision-making by factsDecision-making by facts

– Quality requires continuous improvementQuality requires continuous improvement

– Patients & other customers are our first priorityPatients & other customers are our first priority

CQI Model – Process Design CQI Model – Process Design ApproachApproach

IdentifyOpportunity

Conceptual Design Analysis Implement

New Process

ResultsStandard-ization

FuturePlans

Plan

Do

Check

Act

Plan

CQI Model/PDCA in PracticeCQI Model/PDCA in Practice

Slow startSlow start

CQI model undergoes cycles of improvementCQI model undergoes cycles of improvement

How we determine when to appoint a teamHow we determine when to appoint a team The essential link The essential link with strategic planningwith strategic planning

Embedded in our cultureEmbedded in our culture

Health Care Delivery ModelHealth Care Delivery Model

Admit/Registration Assess

Care Delivery/Treat Discharge

Support ProcessesSupport Processes

FinanceFinance– Finance/Patient Accounts/CollectionsFinance/Patient Accounts/Collections

Human ResourcesHuman Resources Facilities ManagementFacilities Management

– HousekeepingHousekeeping– Maintenance/Clinical Engineering ServicesMaintenance/Clinical Engineering Services

Information Systems ManagementInformation Systems Management– Information Systems & HIM (Medical Records)Information Systems & HIM (Medical Records)

Business ProcessesBusiness Processes

Supply chain managementSupply chain management

– Economies of ScaleEconomies of Scale

– Vendor relationshipsVendor relationships

– Managing the supply chain Managing the supply chain management processmanagement process

– Performance measuresPerformance measures

Business ProcessesBusiness Processes

Physician partneringPhysician partnering

Health Care Delivery Process

PatientAdmission/Referrals

to Setting of Care

Physician Recruitment

& Appointment to

Staff

- Business Growth- Excptional Clinical Outcomes- Management of Care Delivery/Resource Management

- Exceptional Patient Care Delivery- Responsiveness, Quality Staff- Facility Improvements/Technological Advancement

SSM Physicians

Key Requirements

Physician PartneringPhysician Partnering

SSMHC Clinical CollaborativesSSMHC Clinical Collaboratives– Consistent with our missionConsistent with our mission– Draw on CQI frameworkDraw on CQI framework– Build on participation in national health Build on participation in national health

care collaborativescare collaboratives

Clinical CollaborativesClinical Collaboratives

The Collaborative missionThe Collaborative mission– To provide an environment conducive to the To provide an environment conducive to the

discovery and development of clinical discovery and development of clinical improvements that can be easily and rapidly improvements that can be easily and rapidly diffused so that all entities and SSMHC diffused so that all entities and SSMHC patients can benefit from the improved value patients can benefit from the improved value of careof care

Clinical CollaborativesClinical Collaboratives

Start of Collaborative

DesignCollaborative

Prework Phase

Continuous Improvement

Phase

Active phase

Send out invitation

Team formation and data collection

Learning session #1

Project work and completion

Learning session #2

Data collection every 3 months

Conference calls every 2 months

Clinical CollaborativesClinical Collaboratives

Improving the Secondary Prevention of Ischemic Improving the Secondary Prevention of Ischemic Heart Disease (1/99)Heart Disease (1/99)

Improving Prescribing Practices (5/99)Improving Prescribing Practices (5/99) Using Patient Information to Improve Care (11/99)Using Patient Information to Improve Care (11/99) Enhancing Patient Safety Through Safe Systems Enhancing Patient Safety Through Safe Systems

(3/00)(3/00) Improving the Treatment of Congestive Heart Improving the Treatment of Congestive Heart

Failure (11/00)Failure (11/00) Achieving Exceptional Safety in Health Care Achieving Exceptional Safety in Health Care

(1/02)(1/02)

Secondary PreventionSecondary Prevention

Heart Attack (MI) patients treated with Lipid- Lowering Agents

0%20%40%60%80%

100%

basel

ine

(1/9

9)'4/

99'6/

99'9/

99'6/

00

'12/0

0'3/

01'7/

01

'12/0

1'3/

02'6/

02

Per

cen

tag

e o

f M

I p

atie

nts

SSMHC   Benchmark 00 Benchmark 02

Good

Achieving Exceptional Safety in Achieving Exceptional Safety in Health CareHealth Care

Good

Use of Dangerous Abbreviations (DAs)

0%

5%

10%

15%

20%

25%

BaselineJan 2002

March, 02 June, 02 Sept, 02 Dec, 02

Per

cen

t u

se o

f D

As

SSMHC use of DAs

Benefits of the CollaborativesBenefits of the Collaboratives

Improve the quality and value of Improve the quality and value of patient carepatient care

Create a network of clinical expertsCreate a network of clinical experts Have an established process for Have an established process for

responding to changes in the health responding to changes in the health care environmentcare environment

Foster organizational learningFoster organizational learning

Organizational LearningsOrganizational Learnings

Continuous improvement requires both an Continuous improvement requires both an unyielding commitment and flexibility.unyielding commitment and flexibility.

Measurement is essential.Measurement is essential. Find creative ways to share best practices Find creative ways to share best practices

and learning across the organization.and learning across the organization. Nurture relationships with your partners.Nurture relationships with your partners.