Disclosure Presenter / Faculty Dr. Gordon Hoag Relationships with - - PowerPoint PPT Presentation

Disclosure

2

Presenter / Faculty

• Dr. Gordon Hoag

Relationships with commercial interests: Grants / Research Support Merck Frosst, Amgen,Sanofi, Pfizer, Regeneron, Boehringer Ingelheim and GlaxoSmithKline Speakers Bureau/ Honoraria Merck Frosst, Amgen and Sanofi-Aventis Consulting Fees Merck Frosst, Amgen and Sanofi-Aventis Other None

Managing Potential Bias

2

Not Applicable

7 Health Authorities

Doctors of BC Ministry of Health Physician Master Agreement (PMA)

General Practices Services Committee (GPSC) Shared Care Committee (SCC) Specialist Services Committee (SSC) Joint Standing Committee on Rural Issues (JSC)

• Joint Collaborative Committees

PQI

• 3. Supporting Physicians
• SSC Strategy & Work-plan

Physician Leadership & QI Training Service Delivery (Fees) SSC Resources (Staff Support)

• 2. Enabling System Improvement
• 1. Engaging Physicians

Facility Engagement Staff Quality Improvement Teams SSC Leaders

Facility Engagement (FE) Physician Quality Improvement (PQI) SSC Provincial Projects & Spread Quality & Innovation Projects Health System Redesign Fund

• Getting the Physician Involved
• Physicians have great ideas and are passionate about

improving patient care

• The Opportunity: Physician Quality Improvement (PQI)
• Endorsement: Specialist Services Committee
• The Culture: The IHI Triple Aim
• The Organization: Health Authority
• The Outcome: The physician gets training, financial

resources, protected time, and team support

Steering Committee Technical Staff Training QI Project

Slightly different approaches/models (NHA, IHA, VIHA, FHA, VCH, PHSA). $1.3 - $1.6M per HA per year

• PQI

Hierarchical 1) Accountability 2) Auditing/Monitoring 3) Empowering 4) Mentoring/Facilitating

Teams Need: Clear purpose; individuals empowered; respect all opinions/ participants;

• wnership, responsibility, high morale

Collaborative 1) Mentoring/Facilitating 2) Empowering 3) Auditing/Monitoring 4) Accountability

• Key Ingredients

• The Shift

• Opportunities for PQI Improvements
• Focus on:
• Data
• Role Clarity
• The SSC PQI Program
• SSC PQI Provincial Meetings

• Gap
• We know physicians are passionate about improving care, they have many ideas, and

very interested:

• Past SSC Quality/Innovation Funding (EOIs)
• SSC funding towards Shared Care (Partners in Care & Transitions in Care)
• Recent surveys and member engagement
• BC health authority VP’s of Medicine have told SSC the same things in slightly different

words…

• “nurses, clinicians and other staff participate in quality activities, but we struggle

with physician participation… we welcome your (SSC) support…”

• MoH awareness and need to go beyond health Redesign Funds… Leadership
• While the JCC’s had some good programs or initiatives underway, including the Practice

Support Program, at SSC there was a feeling that more was required to close this “Gap”

Challenges

ƒFlexibility ƒAccessibility ƒOwnership ƒAlignment Deliverables Roles Clarity RACI Championship Mindset

Co-Creation of Value

…the customer is always a co-creator

• f value.

Disclosures

• No disclosures
• No conflict of interest

Why Co-creation?

• ‘Transactional’ becomes ‘interdependent’
• “….of, by and for stakeholders.”
• Shift from ‘work processes’ to ‘engagement’

Value co-creation behaviour scale

Participation Behaviour

Information seeking Information sharing Responsible behaviour Personal interaction

Citizenship behaviour

Feedback Advocacy Helping Tolerance

Benefits of Co-Creation

• Relationships
• Interactions
• Engagement
• Alignment
• Assets
• Appropriateness
• Self-management
• Satisfaction

Quality in Co-creation

• Customer defines value
• Interactivity
• Relationships
• Respect
• Listening
• Resources
• Engagement

Enabling Co-creation

• Be intentional about the value
• Establish the user as Co-creator
• Bridge language issues carefully
• Create a range of ways to voice opinion

Challenges: Listening

Challenges: Time

• Trust
• Safety
• Provocation
• Silence
• Recruitment
• Teamwork

Challenges: Hierarchy

SSC Physician Quality Improvement at Northern Health

Candice Manahan, Executive Lead, Physician Quality Improvement

No conflicts to disclose

Overview

κ Where we started and what we heard κ Proposal development κ Guiding Principles κ Steering Committee κ Our approach

Pre Consultation 2016

κ Lots of driving! κ 4 major themes:

– Shared Understanding of QI Concepts – Data Feedback & Reflection – Making Connections – Celebration & Raising Awareness

Local/Unit Level Themes

• Provide support for the existing
• CME and/or reimbursement for time
• Local voice to regional
• Access to local/individual data to look for

areas for improvement

• Local access to supports for follow-up on

quality issues or ideas in the facility

• Physician Lead or collective (sub

committee) specific to quality improvement

Process: Timeline & Activities

• 1. HA to share vision,

interest and need for resources June 2015

• 2. HA & SSC to sign-off
• n “Letter of Intent”

July 2015

• 3. Jointly develop plan

Mar- June 2016 (4 meetings)

• 4. Starting at NHMAC,

consulting the broader stakeholders June-Aug 2016

• 5. Take to Medical

Directors and Executive for approval, then submit to SSC Sept 2016

Principles & Approach

κ Create a joint governance structure to

support collaboration and integrate with the various existing structures at NH.

κ Raise awareness around the current resources

available and enhance those successful structures to strengthen a culture of quality improvement.

κ Empower providers to drive quality from the

edge of health care.

NH/SSC QI Steering Committee: Spirit of Collaboration

κ Bring the varying perspectives together to

create a team “we” to the region:

– Patients – Physicians – Northern Health (Primary Care, Quality &

Innovation, Physician Services, Programs, and Operations),

– Specialists Services Committee, new Medical

Staff Associations and Division

κ Provide overall accountability, ensuring

alignment and use of existing resources

Our Approach

κ We are a bit different in the North…..

“Just in Time” education

Our Stats: Workshops & Supports

Type Requests QI Projects 9 Support Requests 35 Data Requests 8 Education # of Physicians Attending Total # Participants Principles of QI 24 40 IHI training in Terrace 7 n/a Yellow Belt 17 50 NH Intermediate QI 3 n/a Skill Building Workshops 1 15 Clinician Academy 5

New! Physician Mentor

• Dr. Jamil Akhtar

New! North East Coach Andrea Goodine