Leading Health Care Transformation: A Primer for Physician Leaders [Team-IRA]

"Readers should go broad and go deep with this book. Readers who do both will find this book a valuable framework for approaching the complexities of leading health care organizations today...it will provide a framework for approaching the work, and that framework is one likely to lead to business success and personal satisfaction." ―From the Foreword by Thomas H. Lee, MD, Chief Medical Officer, Press Ganey and Senior Physician, Brigham and Women’s Hospital The U.S. health care system continues to undergo transformation, with a rate of change that has accelerated in recent years. This rapidly evolving field requires a new level of astute clinical leadership. The bottom line is that physician leadership will be the key ingredient for any dramatic change in our health care system and a fundamental driver of outcomes for patients and communities. Leading Heath Care Transformation prepares physician leaders with the evidence, tools, and ideas to make and lead systemic improvement. This second edition provides fresh insights, new evidence, and modern topics with revised and updated chapters. Each chapter is complete with contemporary evidence, pragmatic case studies, lessons learned, and action steps for physician leaders. This second edition of Leading Health Care Transformation is a succinct and practical primer on 16 key topics in health care transformation. Physician leadership is critical to transform care; this book will help guide the way. Cover Half Title Title Page Copyright Page Table of Contents Foreword About the Authors Chapter 1: The Health Care Landscape Introduction First Curve to Second Curve Leading Transformation Key Factors Driving Transformation High Cost of Care Shifting Demographics: Patients and Workforce Transition to Value-Based Reimbursement Variable Quality Outcomes Expansion of Coverage Impact of the COVID-19 Pandemic Advances in Health Information Technology Shift from Defined Benefit to Defined Contribution Health Plans Action Steps and Strategies to Lead as a Physician Leader Conclusion Note References Chapter 2: Effectively Implementing Quality and Safety Improvement The Evidence The Model for Improvement Lean Six Sigma International Standards Organization 9001 Case Study: Enhancing Vaccine Access Lessons Learned Action Steps and Strategies to Lead References Chapter 3: Building a Culture of Safety The Evidence Transparency around Safety Events AHRQ Surveys on Patient Safety Culture (SOPS) Safety Attitudes Questionnaire Case Study: Improving Organizational Culture of Safety Lessons Learned Action Steps and Strategies to Lead References Chapter 4: Principles and Practices of High Reliability Organizations The Evidence Preoccupation with Failure Reluctance to Simplify Sensitivity to Operations Commitment to Resilience Deference to Expertise Case Studies Preoccupation with Failure: Investigating Near Misses and Good Saves Reluctance to Simplify: Thorough Root Cause Analysis and Event Investigation Sensitivity to Operations: Daily Organization Huddle Commitment to Resilience: Simulation Deference to Expertise: Executive Rounding Lessons Learned Action Steps and Strategies to Lead References Chapter 5: Key Quality, Safety, and Efficiency Measures The Evidence Data for Performance Measurement: The Basics Types and Dimensions of Measures Criteria and Standards Data Sources Metrics of the Future Effective Strategies: Using Data to Drive Performance Improvement Selecting Measures Case Study: Reducing Unnecessary Testing Lessons Learned Action Steps and Strategies to Lead References Chapter 6: Using Data for Feedback and Improvement The Evidence Step 1: Data Collection: Objectives, Sources, and Methods Step 2: Displaying the Data Physician Profiling Dashboards Run Charts Step 3: Analyzing the Data Step 4: Implementing Improvement Cycles Case Study: Improving and Enhancing Surgical Recovery Lessons Learned Action Steps and Strategies to Lead References Chapter 7: Physician Champions The Evidence Characteristics of Effective Champions Case Study: Identifying and Developing Champions Lessons Learned Action Steps and Strategies to Lead References Chapter 8: Leading Effective Teams: For Clinical Care and Performance Improvement The Evidence Clinical Care Teams Performance Improvement Teams Strategies for Success Effective Strategy: TeamSTEPPS Effective Strategy: Understanding the Stages of Team Formation Case Study: Reduction of Central Line Associated Blood Stream Infections Lessons Learned Action Steps and Strategies to Lead References Chapter 9: Spreading and Sustaining Improvement The Evidence Preparing for Spread Establishing an Aim for Spread Developing a Spread Plan Effective Strategies for Executing and Monitoring Spread Sustaining Improvement Case Study: On the CUSP: Stop CAUTI Lessons Learned Action Steps and Strategies to Lead References Chapter 10: Engaging Patients and Families in Safety and Quality The Evidence Effective Strategies for Patient and Family Engagement Strategies at the Direct Care Level Strategies to Engage Patients in Organizational Design and Governance Working with Patients/Family Advisors Case Study: Developing a Patient and Family Advisory Council Lessons Learned Beyond the Bedside Engage Patients as Partners Provide Meaningful Opportunities for Patients and Families to Contribute Patient and Family Engagement as a Strategy to Eliminate Harm Barriers to Engagement Action Steps and Strategies to Lead References Chapter 11: Health Equity and Addressing Disparities The Evidence Effective Strategies Cultural Awareness Stratify Data to Identify Areas of Need Community Partnerships Case Study: A Health Equity Report Lessons Learned Action Steps and Strategies to Lead References Chapter 12: Addressing Variation in Utilization The Evidence Understanding Warranted vs. Unwarranted Variation Choosing Wisely® The Safer Dx Checklist Strategies for Success Case Study: Reducing Opioid Overprescribing Lessons Learned Action Steps and Strategies to Lead References Chapter 13: Improving Care Coordination and Reducing Readmissions The Evidence Boston Medical Center Reengineered Discharge Care Transitions Program Transitional Care Model Strategies for Success Identify Patients at High Risk for Readmission Build Self-Management Skills Discharge Planning Follow-Up and Community Resources Case Study: Increasing Access and Improving Care Coordination Case Study: Improving Access and Preventive Care Lessons Learned Action Steps and Strategies to Lead References Chapter 14: Population and Community Health The Evidence Population-Based Payment Models Per Member Per Month Policy Implementation and Implications The Affordable Care Act Accountable Care Organizations Social Determinants of Health Community Engagement Data Utilization Case Study: Improving Models for Managing Chronic Kidney Disease Action Steps and Strategies to Lead References Chapter 15: New Payment Models: Value-based Purchasing The Evidence Pay-for-Performance Accountable Care Organizations and Shared Savings Identifying an Attributed Patient Population Structure of Risk Sharing Bundled Payments Capitation Case Study: Bundled Payments Lessons Learned Information Technology Data and Analytics Care Management Action Steps and Strategies to Lead References Chapter 16: The Physician Leader Role in Emerging Models of Care, Disruption, and Innovation The Evidence Retail Medicine Mobile Health Artificial Intelligence Case Study: Responding to New and Disruptive Models of Care Lessons Learned Action Steps and Strategies to Lead References Chapter 17: Compendium of Action Steps Chapter 1: The Health Care Landscape Chapter 2: Effectively Implementing Quality and Safety Improvement Chapter 3: Building a Culture of Safety Chapter 4: Principles and Practices of High Reliability Organizations Chapter 5: Key Quality, Safety, and Efficiency Measures Chapter 6: Using Data for Feedback and Improvement Chapter 7: Physician Champions Chapter 8: Leading Effective Teams: For Clinical Care and for Performance Improvement Chapter 9: Spreading and Sustaining Improvement Chapter 10: Engaging Patients and Families in Safety and Quality Chapter 11: Health Equity and Addressing Disparities Chapter 12: Addressing Variation in Utilization Chapter 13: Improving Care Coordination and Reducing Readmissions Chapter 14: Population and Community Health Chapter 15: New Payment Models: Value-Based Purchasing Chapter 16: The Physician Leader Role in Emerging Models of Care, Disruption, and Innovation Index