Aligning Leaders to Make Great Choices Wednesday, March 3, 2016

Transcription

1 Aligning Leaders to Make Great Choices Wednesday, March 3, 2016 David Frank Consultant Lisa Olenski Executive Director

2 Conflict of Interest BJC HealthCare Lisa K. Olenski, BS, MBA, MCP Kepner-Tregoe David Frank, BA, LSSMBB, PMP Has no real or apparent conflicts of interest to report

3 Agenda Kepner-Tregoe (KT) Overview BJC Overview How Our Brains Get in the Way BJC HealthCare adoption of Kepner-Tregoe methodology The Story loss of power and redundancy (a raccoon, a transformer and a fire) The Impact Realizing the Value of Health IT STEPS The Key Stakeholders What would you do? Rational Thinking Visible Thinking Process Applying Rational Thinking to The Story Insights Summary of How Benefits Were Realized for the Value of Health IT Questions and Answers

4 Learning Objectives Demonstrate the rational decision making tool process Analyze alternative solutions against weighted objectives Decide on a balanced decision using data and risk assessment Demonstrate how facilitated decision making tool use leads to reduction in unconscious bias and emotional response

5 Benefits Realized for the Value of Health IT T The value STEPS impacted were: Satisfaction Patient Satisfaction Staff Satisfaction Treatment/Clinical Efficiencies Safety Electronic Secure Data Enhanced Communication Data Sharing

6 Preserve Satisfaction, Treatment/Clinical Effectiveness and Electronic Secure Data S Maximize Patient Satisfaction Maximize Staff Satisfaction T Maximize Patient Safety Maximize IS Specialty Resource Efficiency Minimize Time on Generator E Minimize Downtime for End User Minimize Disruption/Maintain Data Integrity

7 How Our Brains Get in the Way Daniel Kahneman s Nobel Prize winning research identified 5 common errors in Human Thinking that drive behavior and lead to poor decisions. Source:

8 Thought errors that lead to poor decisions Halo Effect - If I like some of the parts, I will like the whole What You See Is All There Is (WYSIATI) Effect - What you see is all there is Framing Effect - The same information can be viewed favorably or unfavorably depending on how it is stated Anchoring Effect - We can be strongly influenced by numbers and facts not really relevant to the issue Availability Bias Effect - We don t access all of our memories, we recall the impactful, unusual occurrences

9 BJC HealthCare BJC Hospitals 1. Alton Memorial Hospital 2. Barnes-Jewish Hospital 3. Barnes-Jewish St. Peters Hospital 4. Barnes-Jewish West County Hospital 5. Boone Hospital Center 6. Christian Hospital and Northwest HealthCare 7. Missouri Baptist Medical Center 8. Missouri Baptist Sullivan Hospital 9. Parkland Health Center 10. Progress West Hospital 11. St. Louis Children's Hospital 12. The Rehabilitation Institute of St. Louis BJC Health Services BJC Accountable Care Organization BJC Behavioral Health BJC Corporate Health Services BJC Home Care Services BJC Medical Group BJC Shared Services

10 BJC HealthCare Hospitals 12 Employees 26,514 Physicians 3,869 Staffed Beds 3,380 Hospital Admissions 138,909 Home Health Visits 201,240 Emergency Department Visits 463,033 Net Revenue Charity and Unreimbursed Care Community Health Programs (providing more than 592,000 individual services) $4.1 billion $301 million* $19.6 million* 2014 data; * = based on 2013 data Statistics are from year-end 2014, except where noted. Totals are aggregate figures for the hospitals and health care services that are members of BJC HealthCare.

11 BJC HealthCare adoption of rational decision making methodology BJC leadership identified the need for a rational decision making and problem solving process Initiated as a leader driven approach Application and adoption of a rational decision making process within the BJC culture Formally added rational decision making as a core competency within transformation tool set

12 BJC HealthCare Transformation Core Competencies

13 The Story Ameren experienced a power outage 4:35am 12/2/08 BJC s UPS was damaged and the data center suffered a partial down Ameren power was restored and BJC received power directly from Ameren while UPS was being repaired X UPS repairs were completed and BJC attempted a standard Hot Switch to restore redundant power systems 11:25am 12/2/08 System control panel failed during Hot Switch and caused a HARD DOWN to data center, network, storage across BJC 8-11 hour impact to BJC and patients How have these events affected our ability to make the next decision??? 11:00am 12/3/08 BJC decided to bring system back up using generator power until UPS repaired/replaced and a decision could be made on the best way to restore redundant power systems

14 Encountering the Perfect Storm Initial power surge event Power directly from Ameren Decision to use HOT switchback to UPS Second failure - UPS Impact result Decision to run on generator power X BJC impacted by an external event Standard procedure Standard procedure built by IT subject matter experts Continued trust in Ameren Standard procedure - performed monthly Decision made by IT vendor subject matter experts Trust in UPS vendor repairs Catastrophic impact organization wide Patients at risk Different UPS failure Lost trust in Ameren Lost trust in UPS vendor 8-11 hours downtime Lost trust in BJC IT from IT customers Higher and broader level of visibility including external media Need for additional decision makers (not all subject matter experts) Tendency to make decision based on avoiding previous events versus best alternative Within BJC control (not relying on Ameren or UPS vendor) Decision made by IT management Environment of high risk, no redundant power source, extended use of generator, single source of failure

15 The Impact Series of sequential failures Higher and broader level of involvement Highly visible Expectations and anxiety was rising Greater sense of urgency was mounting Current environment extremely risky (single point of failure)

16 The Key Leadership Stakeholders John Barenkamp, Vice President, Information Services Ginny Clark, Director, Information Services Chero Goswami, VP, Information Services, Core Clinical Solutions Mike Kelly, Vice President, Information Services, Community Hospitals Gary LaBlance, Vice President, Quality and Safety Steve Mapes, Manager, Health Information Management Pam Overman, Director, Information Services Dave Streibig, Director, Information Services Jerry Vuchack, Vice President, Information Services, Academic Hospitals Chris Ward, Director, Technology and Infomatics Lisa Olenski, Certified Kepner-Tregoe Program Leader/Facilitator

17 The Key Stakeholders Responses

18 What would you do to restore UPS (Uninterrupted Redundant Power Source)? (remove dependency on generator power) Hot Switch Warm Switch Cold Switch All applications continue running Flip the switch to UPS Turn off generator Mission critical applications are shut down in controlled order Flip the switch to UPS Turn off generator Bring mission critical systems up in controlled order All applications are shut down Flip the switch to UPS Turn off generator Bring all applications back up AUDIENCE POLLING: Which option would you choose?

19 Thinking Process

20 Visible Thinking Making thinking processes visible will help to: Capture progress and outputs Avoid jumping to conclusions Improve communications Establish a consistent approach Promote use of common language and terminology Provide foundation for effective questioning

21 Decision Statement Choose best method to restore UPS/redundant power systems with minimal impact on patient safety Key Decision #1 - Choose the best data center UPS Redundancy switchback method with minimal customer impact Key Decision #2 - Choose the best timing to conduct switchback

22 MUST and WANT Objectives MUST Objective Maximize patient safety WANT Objectives Weight Minimize downtime for users in hours 10 Minimize time on generator in hours 7 Minimize disruption & maintain data integrity in number of users and applications Maximize resource efficiency in number of subject matter experts needed 5 5 Maximize communication to the customers 3

23 The Alternatives and the Risks Hot Switch Warm Switch Cold Switch All applications continue running Flip the switch to UPS Turn off generator Mission critical applications are shut down in controlled order Flip the switch to UPS Turn off generator Bring mission critical systems up in controlled order All applications are shut down Flip the switch to UPS Turn off generator Bring all applications back up 294 Points 108 Points 144 Points Assessed Risk: IF we lose power to the data center, THEN we could suffer a HARD DOWN and must execute the recovery plan as established in the COLD switch alternative.

24 The Best Balanced Choice Execute a HOT switch to restore protected power AND Plan for COLD switch for up to a 12 hour recovery period in case of failure IT and UPS vendor have >90% confidence level in this decision based on testing data Our Next Step - Communicate honestly with employees and customers

25 Rational Decision Making Process

26 The Results! Summary of How Benefits Were Realized for the Value of Health IT S Maintained Patient Satisfaction Maintained Staff Satisfaction T Protected Patient Safety Effective use of IS Specialty Resources Removed Dependency on Generator E Restored All Power for End User Maintained Data Integrity Loss of one pesky raccoon

27 Insights Benefits of using rational thinking process: Use of a Rational Decision Making Process allowed for a reduction of unconscious bias and emotional responses Engaged a diverse team with right skills to make critical decisions Achieved alignment through transparent and visible thinking All were confident in the decision due to a disciplined, factual thoughtful process Leaders were equipped to communicate clearly and answer questions after the best balanced decision was determined Effective execution of the decision The initial proposed solution was not the final decision

28 "Plan to be better tomorrow than today, but don't plan to be finished." Carol Ann Tomlinson, US Educator

29 Questions Lisa K. Olenski Executive Director David Frank Consultant LinkedIn: Lisa Olenski LinkedIn: David Frank