Pursuing Perfect Care at Cincinnati Childrens

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Pursuing Perfect Care at Cincinnati Childrens

• Keith Mandel, M.D.
• Vice President of Medical Affairs
• Physician-Hospital Organization
• Cincinnati Childrens Hospital Medical Center
• Cincinnati Employer Health Care Alliance
• Annual Meeting
• September 18, 2003

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Content

• Background
• PBS Video
• Project Teams
• Best Results
• Whats working?
• What do we need to do better?
• Transparency
• Resources.

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Pursuing Perfection Background

• 20 million national quality improvement
  initiative funded by The Robert Wood Johnson
  Foundation and administered by the Institute for
  Healthcare Improvement.
• Based on Institute of Medicine report Crossing
  the Quality Chasm and the 6 dimensions of
  quality timeliness, efficiency, effectiveness,
  patient-centered care, equity, and safety.

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Pursuing Perfection Background (contd)

• Over 200 healthcare organizations applied, of
  which 12 received Phase 1 funding to launch pilot
  projects and develop comprehensive plans for
  creating systems that consistently deliver
  excellent healthcare.
• 7 of the 12 were awarded Phase 2 funding to
  implement plans over 2 years
• Cambridge Health Alliance (MA), Cincinnati
  Childrens Hospital Medical Center, Hackensack
  University Medical Center (NJ), HealthPartners
  Medical Group and Clinics (MN), McLeod Regional
  Medical Center (SC), St. Joseph Hospital (WA),
  Tallahassee Memorial Healthcare.

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Pursuing Perfection Project Teams

• Chronic care.
• Cystic fibrosis.
• Diabetes.
• Juvenile rheumatoid arthritis.
• Acute care.
• Perioperative.
• Liver transplant medication safety.
• Advanced access.
• Pain management.

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Cystic Fibrosis
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Cystic Fibrosis (contd)
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Diabetes
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Diabetes (contd)
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Acute Care Team
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Liver Transplant Medication Safety
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Whats Working?

• Leadership commitment.
• Cabinet Champion role.
• Placing elephant on the table to address key
  challenges/barriers.
• Involving parents on project teams.

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Whats Working? (contd)

• Tests of change.
• Breaking down large-scale improvement projects
  into manageable pieces.
• Avoiding implementation of radical redesigns.
• Focusing initially on subset of population and
  staging spread.
• Addressing those processes most critical to
  moving the dial.

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Whats Working? (contd)

• Tracking measures that reflect impact of
  improvement interventions and that directly link
  back to patient/family promises.
• Achieving ownership of measure results at
  microsystem level.

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What Do We Need To Do Better?

• Execute tests of change.
• Spread learnings.
• Incorporate quality improvement science (e.g.,
  reliability, flow).

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What Do We Need To Do Better?(contd)

• Align performance evaluations with improvement
  goals/objectives.
• Learn from others.
• Enhance external transparency.

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Pursuing Perfection Transparency

• Transparent organizations will move quicker and
  be more successful in achieving quality
  improvements.
• To transform an organization, changes must be
  visible.
• Transparency of improvement process and results
  achieved facilitates spread, both internally and
  externally.

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Resources

• Institute of Medicine report Crossing the
  Quality Chasm.
• Executive summary available.
• www.nap.edu/catalog/10027.html
• Institute for Healthcare Improvement.
• Pursuing Perfection www.ihi.org/pursuingperfectio
  n
• Impact Network
• www.ihi.org/impact