reengineering health care by dr. greenspun
TRANSCRIPT
Reengineering Health Care
Harry Greenspun, MD March 30, 2011
Global Marketing
We need radical and dramatic change through
Why Reengineer Healthcare?
3/30/2011 2 Confidential
Cost
Inefficiency
Quality
Technology
People
Process
Global Marketing
People Zeev Neuwirth’s Experience
Confidential 3 3/30/2011
New technology embedded in the old paradigm still fails
Problems Solutions
1) Communication issues between personnel and patients
2) Malpractice worries vs Patients not following doctors orders
3) No cooperation or collaboration = ineffective health system
• Used group therapy skills to change ER culture
– One-on-one meetings
– Employees confronted each other with issues
• Studied time management
• 1/3 time spent with patients
• 2/3 time spent on data entry/retrieval
• Build underlying structure to move forward
Global Marketing 4 Confidential
People
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• Change what people do before trying to change what they think, doing leads to thinking
• All reengineering efforts take 2-3 years to achieve full implementation
• Need enthusiastic support of top people, admin and clinical
• “We turn thought leaders into action leaders” – create positive change everywhere
• Leaders get the courage to abandon outmoded ways and tap into talent/aspirations
Global Marketing
• Identify how behaviors contribute to issues
• Assign appropriate people to reengineering teams
• Ensure people’s skills align with their job
• Address changes in social interactions between staff
• Document issues of quality, safety and inefficiency
• Engage people who will help encourage change
5 Confidential
Checklist for People
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Global Marketing
Process Debra Geihsler
Confidential 6 3/30/2011
“If we focused on preventing illness, instead of treatment, we’d need less primary caregivers”
Processes about prevention and wellness, and less on chronic disease and hospitals
Able to show proof of success with some areas before moving onto stubborn ones
Move doctors out of hospitals and into workplaces of potential patients More outpatient work will lead to less hospitalization
Start small, in teams/departments/practices first, before going system-wide
Global Marketing
Be iterative – test ideas at each stage and reevaluate for the final product
Educate patients to enhance whole experience and more likely to follow treatment plans
“In-between coaches” – med advisors who contact chronic patients to keep them healthy
Process
Confidential 7 3/30/2011
Global Marketing
• Be prepared for long journey
• Address fragmentation of health care
• Plan for patient education
• Demonstrate results and maintain momentum
• Address systemic issues
• Select reengineering leader
• Support of executive team
8 Confidential
Checklist for Process
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Global Marketing Confidential 9 3/30/2011
Technology Scharmaine Lawson-Baker Experience
Technology is only an enabler
Hurricane Katrina wiped out office and records
Maintained skeleton records for
patients on palm pilot
Global Marketing
Develop a culture of safety
Advances in diagnostic and treatment capabilities have outgrown the health care delivery infrastructure
Technology Tom Knight, MD
Confidential 10 3/30/2011
Used computerized physician order entry (CPOE) to be rid of unclear handwritten orders
Put in place an error-response system, to improve and provide space for feedback
Be wary of “alert fatigue” when they ignore the warning light after too many false alerts
“Technology can’t work alone … needs to be wrapped within a
culture”
Global Marketing
• Project management structure and methodology
• Attention to detail
• Engage right people in work redesign effort
• Training programs
• Systems and process skills
• Establish a set of principles
• Keep final objectives in sight
• Identify leader
• Establish governance process
11 Confidential
Checklist for Implementing New Technologies
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Global Marketing
Opportunities for Reengineering
Confidential 12 3/30/2011
Those who know how to Reengineer will thrive!
Find a small starting point, not the whole organization
Focus on areas of risk – breakdowns in communication and repetitive human tasks
Talk to front-line employees, use error reports
Focus on high-cost areas – usually signal inefficiencies ripe for reengineering
Costs will continue to rise unless delivery becomes more efficient
Global Marketing
Future of Healthcare Reform
13 Confidential 3/30/2011
Global Marketing
Contact Information
Email: [email protected]
www.twitter.com/harrygreenspun
www.facebook.com/harry.greenspun
www.facebook.com/reengineeringhealthcare
www.dell.com/speakers-bureau
Thank you
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