Whole Health Clinician CareDay 1 Afternoon

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Welcome back from lunch!

Time to Start Taking Aim...

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Part II.  Setting the Compass Heading

The Journey to Transformation: Whole Health Clinical Care

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5. “Aim”‐ing High:The Ultimate WHCC Destination

The Journey to Transformation

Whole Health Clinician CareDay 1 Afternoon

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The Power of Words

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Destinare (Latin): Determine, appoint, choose, make firm

Destination: The purpose for which anything is intended

Destiny: That which has been firmly established

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Leadership Sponsors

ScreenScreen

WH Champions or Points of Contact

Representative Clinicians

Additional Key Stakeholders

Please Divide Up

Shooting for the Stars:Considering the Ultimate WHCC Destination

Start by jotting down ideas:

• What is your vision of the ideal version of WH CC in your VISN, facility, program or practice?

• Using the prompts in your workbook, reflect on where you would ultimately like WHCC to go.  Page 74 has

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Back to Earth:  Share Your Thoughts

1. Name 3 things that made your ideal of WHCC so great.

2. From the perspective you took, what was most important for success?

3. What was absent from your ultimate version of WHCC?

4. If you could bring 1 thing from this idealized clinic into your practice/facility/VISN, what would it be?

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Movement:

Please Move Back to Your Original Seat:

Whole Health Clinician CareDay 1 Afternoon

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6.  Aim Statements:Getting to the First Milestone

The Journey to Transformation

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Taking Aim:  Splashdown 

• It is good to begin with the end in mind, and...

• On every journey, we have to focus on milestones along the way.  We don’t just go from Portland to [insert your destination here!] all at once

• Let’s focus first on your next milestone for this stage of your WH CC journey, because after all...

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Aim Statements: The Basics

• Clear and explicit summary that communicates what you hope to achieve

• Informed by milestones included in the Designation Framework

• Defines timeline and scope

• Captures the voice of those we serve

• Provides alignment of multiple stakeholders

• Provides focus for team(s)

• Gives a vision of what success will look like

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• Define who, what, where, why and howSpecific

• How will I know when the Aim is achieved? Measurable

• Reasonable and realisticAttainable

• Meaningful and worthwhileRelevant

• Time frameTime‐Bound

Let’s be SMART about it...

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• Set Realistic Goals.  SMEs can help.

• Avoid the temptation to go too big.  Start SMALL for BIG wins.

• Timing for our purposes will be the next year or so.

• Leadership and sponsorship make or break success.

What other tips do you have? Where have your past successes been with setting/meeting an Aim?

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Making it Real: Example Aim Statement

As an initial step toward full implementation of WH Clinical Care at Facility Awesome, our PACT pilot team (already trained via WH 202) will initiate WH Clinical Care (identify and document the Veteran’s MAP, and create and document a shared clinical goal linked to the MAP) with 10% of their panel (120 veterans) over a six month period between March 2020 and August 2020.

How is this?• Specific?

• Measurable?

• Attainable?

• Relevant?

• Time-bound?

How is this?• Specific?

• Measurable?

• Attainable?

• Relevant?

• Time-bound?

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Group Activity: Your Aim Statement

• Use the guide in your workbook.

• As a group, create or refine your Aim Statement

• Check to ensure it is SMART

• Write your Aim clearly on a flip sheet.  Post it so that other groups will be able to review.

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During This Next Break

• You’ll have 30 minutes 

• Using the cards at your table, offer feedback for each team’s Aim statemento Be constructive

o Note positives too

• Be sure to take some actual time to relax, get a beverage, take a biobreak as well

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7.  Adjusting Your AimWhere Do You Really

Want to Go?

The Journey to Transformation

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Group Activity: Your Aim Statement Revisited

• Review the feedback your team received

• As a group, modify your Aim statement as you see fit

• Create a flip chart sheet with your new statement. Replace the old one

• Enter your Aim into your PowerPoint template

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Aim Statement (Computer):

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8. Now You Know Where You’re Going...

How Will You Get There?

The Journey to Transformation

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Happy Monday!  Business as Usual?

What if we just hand an “Aim” to stakeholders?

Your Monday Morning Work Email

From: Chief of StaffSent: Friday October 25, 2019 10:33 PMTo: Medical StaffSubject: Implementation of SMA

Effective immediately all PACT providers with patients with chronic pain on opioids will refer them to our new SMA clinic.

This practice will be audited monthly to ensure compliance.

Thank you, Chief of Staff

The People Side of Change...

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We change for a reason.

Organizational change requires individual change.

Organizational outcomes are the collective result of individual change.

Change management is an enabling framework for managing the people side of change.

We apply change management to realize the benefits and desired outcomes of change.

Prosci Five Tenets of Change Management

Source: PROSCI

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Six Essential Questions: Example

1. What’s changing?  Implementation of a Whole Health 

Opioid Safety Shared Medical Appointment (SMA)

2. Why? The widespread over‐prescribing of opioids by 

medical providers for treatment of chronic pain has 

contributed to the current opioid crisis. 

3. Why now?  130 Americans die everyday of an opioid 

overdose and Veterans are 2x as risk.  The current 

approach to decreasing reliance on opioids have been 

ineffective.

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4. What’s not changing?  The PACT model is not changing nor is the excellent, high quality clinical care currently offered to Veterans.

5. What are the expected organizational & individual benefits?   Previous implementation at other sites resulted in 45% decrease in opioid usage in the first year and up to 70% in year two. Individual providers will have more options to offer Veterans and Veterans will have a better quality of life.

6. What’s the risk of not changing?   Ongoing reliance on opioids for chronic pain treatment with ongoing risk of overdose. Ongoing provider burnout.

Six Essential Questions: ExampleIm

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Group Activity:Revisit and Refine Your 6 Essential Answers

• Using the Guide in Your Workbook, complete/update your answers to the question

• Have a spokesperson ready to summarize your answers

• Keep asking how this tied into the people side of change

• Put your answers into your PowerPoint presentation

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Aim Statement (Computer):

Group sharing

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Six Essential Questions: Share Some of Your Answers

1. What’s changing?

2. Why?

3. Why now?

4. What’s not changing?

5. What are the expected organizational & individual benefits?

6. What’s the risk of not changing?

Whole Health Clinician CareDay 1 Afternoon

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Thank You!Please CompleteDay 1 Pulse Checks

See you tomorrow!