UMHS Future StateUMHS Future Statefor thefor the

Ideal Patient Care ExperienceIdeal Patient Care Experience

Presented by Presented by

22ndnd year participants of the year participants of the

UMHS Healthcare Leadership Institute UMHS Healthcare Leadership Institute

November 2006November 2006

This work is respectfully dedicated to the memory of our This work is respectfully dedicated to the memory of our classmate, colleague and friend Thomas Carli, M.D.classmate, colleague and friend Thomas Carli, M.D.

Members:Members:John Billi, MDJohn Billi, MD Linda Larin Linda Larin Thomas Carli, MDThomas Carli, MD Jeanne Rizzo Jeanne Rizzo Kathy Gold Kathy Gold Marcy Marcy

Waldinger Waldinger Jeanne Kin Jeanne Kin

Consultants: Consultants: Judy Calhoun Judy Calhoun Dorene MarkelDorene MarkelJim Ellis, MD Jim Ellis, MD David Pinsky, MD David Pinsky, MD Lindsay Graham Lindsay Graham Heather Heather

WursterWursterNadine LewisNadine Lewis

Our “Change the World” members:Our “Change the World” members:

Crossing the Quality Chasm

• The IOM “Chasm” The IOM “Chasm” Report gives us a Report gives us a vision of where to vision of where to gogo

• Lean Thinking Lean Thinking gives us tools and gives us tools and methods to get methods to get therethere

• The IOM “Chasm” The IOM “Chasm” Report gives us a Report gives us a vision of where to vision of where to gogo

• Lean Thinking Lean Thinking gives us tools and gives us tools and methods to get methods to get therethere

Lean Thinking

““Crossing the Quality Chasm” Six Crossing the Quality Chasm” Six AimsAims

Health care must be:

Safe

Effective

Patient-centered

Timely

Efficient

Equitable

Source: Crossing the Quality Chasm: A New Health System for the 21st Century, Institute of Medicine, National Academy of Sciences, 2000.

““Crossing the Quality Chasm”Crossing the Quality Chasm”Ten Rules For CareTen Rules For Care

• Care based on continuous healing relationships• Customization based on patient needs and values• The patient as source of control• Shared knowledge and the free flow of information• Evidence-based decision making• Safety as a system property• The need for transparency• Anticipation of needs• Continuous decrease in waste• Cooperation among clinicians

UMHS Future State: UMHS Future State: The Ideal Patient ExperienceThe Ideal Patient Experience

A.A. UMHS willUMHS will create an advanced medical create an advanced medical home home for each patient that provides for each patient that provides continuity of care, coordinates care across continuity of care, coordinates care across venues (inpatient, emergency care, venues (inpatient, emergency care, outpatient, home care, procedures, non-UM) outpatient, home care, procedures, non-UM) and promotes provider communication.and promotes provider communication.

The Advanced Medical Home: A Patient-Centered, Physician-Guided Model of Health Care. Policy Monograph of the American College of Physicians. January 22, 2006. pp. 1-21

UMHS Future State UMHS Future State

B.B. The The patient will be the ultimate patient will be the ultimate decision makerdecision maker or source of control or source of control related to their care within medically related to their care within medically appropriate options. This includes a free appropriate options. This includes a free flow of information about the disease or flow of information about the disease or illness; an assessment of the patients' illness; an assessment of the patients' options clearly articulated in a manner that options clearly articulated in a manner that they can understand; and the trusted they can understand; and the trusted clinician’s expert advice. The patient will clinician’s expert advice. The patient will make the decisions for their care to the make the decisions for their care to the degree they are most comfortable. degree they are most comfortable.

UMHS Future StateUMHS Future State

C.C. UMHS will UMHS will promote and utilize promote and utilize standardizationstandardization to eliminate unjustified to eliminate unjustified variability in all we do. This includes: variability in all we do. This includes: eliminating inefficiencies, redundancy and eliminating inefficiencies, redundancy and waste; improving safety; providing greater waste; improving safety; providing greater consistency; and improving quality and consistency; and improving quality and appropriateness.appropriateness.

UMHS Future StateUMHS Future State

D.D. Safety will be a system Safety will be a system priority.priority. This This includes designing includes designing systems and processes systems and processes that minimize that minimize the possibility of errors and the possibility of errors and supports supports and promotes safety initiatives and promotes safety initiatives throughout the Health System.throughout the Health System.

UMHS Future State UMHS Future State

E.E. We will create We will create an environment of an environment of customer servicecustomer service for our patients for our patients

and and families. Every interaction with any families. Every interaction with any faculty, faculty, health profession student and/or health profession student and/or staff staff member will be one that exemplifies member will be one that exemplifies our our caring and sensitivity with the caring and sensitivity with the goal to provide goal to provide excellent customer excellent customer service and a culture that service and a culture that reduces reduces stress and promotes healing.stress and promotes healing.

UMHS Future State UMHS Future State

F.F. Care will be coordinated around Care will be coordinated around the the medical needs of the patientmedical needs of the patient in a in a manner manner that enhances their quality of that enhances their quality of life and future life and future health. This also includes health. This also includes minimizing and minimizing and managing handoffs, managing handoffs, understanding the understanding the patients' goals, their patients' goals, their lifestyle and making lifestyle and making their health care their health care work within that work within that framework. framework.

UMHS Future StateUMHS Future State

G.G. We will We will provide facilities, provide facilities, amenities and amenities and aesthetics that aesthetics that promote health and promote health and well-well- being.being. This includes a clean, safe, This includes a clean, safe, and healing and healing environment that is conducive to environment that is conducive to well-well-being. being.

Points of Synergy/ConvergencePoints of Synergy/Convergence

• Ambulatory Care Operating PrinciplesAmbulatory Care Operating Principles• CVC: Transforming Cardiovascular Care CVC: Transforming Cardiovascular Care • MVN CHOICES Program: ED & ThroughputMVN CHOICES Program: ED & Throughput• MVN Mission and Vision: UMHHC at Home: MVN Mission and Vision: UMHHC at Home:

Creating Ideal Patient Transitions to HomeCreating Ideal Patient Transitions to Home• Children and Women’s Guiding Principles:Children and Women’s Guiding Principles:

Family Centered Care Family Centered Care• FGP/Ambulatory Care Integration and the FGP/Ambulatory Care Integration and the

Medical Management CenterMedical Management Center• Service Excellence Initiative (Ellis, Childs)Service Excellence Initiative (Ellis, Childs)• Michigan Quality SystemMichigan Quality System• Ideal Employee ExperienceIdeal Employee Experience• Criteria for selection of capital projectsCriteria for selection of capital projects

EndorsementsEndorsements

• Health System Executive Group Health System Executive Group endorsed sharing across UMHSendorsed sharing across UMHS

• Endorsed by:Endorsed by:– Senior Leadership Council (Chairs and Senior Leadership Council (Chairs and

SMT)SMT)– CDA Group (CDAs, Amb Care Directors)CDA Group (CDAs, Amb Care Directors)– Faculty Group Practice Board Faculty Group Practice Board

Next StepsNext Steps

• EngagementEngagement, , dialogdialog, , inputinput, and , and endorsement endorsement from all UMHS leadership groupsfrom all UMHS leadership groups

• Create an institutional awareness/common Create an institutional awareness/common understanding of ideal patient experienceunderstanding of ideal patient experience– Clinical mission leaders direct initiatives to support Clinical mission leaders direct initiatives to support

the future statethe future state– Proposals are evaluated for their ability to move us Proposals are evaluated for their ability to move us

toward future statetoward future state– Ongoing moral support and necessary resources Ongoing moral support and necessary resources

are provided to support initiatives that are aligned are provided to support initiatives that are aligned to support future stateto support future state

• Ensure strong coordination with ideal Ensure strong coordination with ideal employee/ provider experienceemployee/ provider experience

Discussion and FeedbackDiscussion and Feedback

• Do you endorse proposed future state?Do you endorse proposed future state?

• What improvements do you recommend?What improvements do you recommend?

• Your thoughts about next steps?Your thoughts about next steps?– What can What can wewe do to make this a reality? do to make this a reality?– What can What can youyou do to make this a reality? do to make this a reality?

• Other considerations or advice?Other considerations or advice?

ReferencesReferences

• Crossing the Quality Chasm: A New Health Crossing the Quality Chasm: A New Health System for the 21st Century System for the 21st Century – newton.nap.edu/catalog/10027.htmlnewton.nap.edu/catalog/10027.html

• Michigan Quality SystemMichigan Quality System– www.med.umich.edu/mqswww.med.umich.edu/mqs

• The Advanced Medical Home: A Patient-The Advanced Medical Home: A Patient-Centered, Physician-Guided Model of Centered, Physician-Guided Model of Health Care. Policy Monograph of the Health Care. Policy Monograph of the American College of Physicians. January American College of Physicians. January 22, 2006. pp. 1-21.22, 2006. pp. 1-21.– www.acponline.org/hpp/adv_med.pdfwww.acponline.org/hpp/adv_med.pdf