Connecting the Dots: Transformation Planning & Minnesota s Health Innovation Climate

Transcription

1 Connecting the Dots: Transformation Planning & Minnesota s Health Innovation Climate May 11, 2016 Jeff Capobianco, National Council Pam Pietruszewski, National Council Rick Lee, Central MN Mental Health

2 Asking Questions

3 Presentation Overview The Current State of Healthcare Minnesota Initiatives Crosswalk into a single cross-initiative Transformation Work Plan 3 Steps Sites Can take to Manage Change 1. Starting with the Organization s Strategic Plan 2. Designing & Executing a Cross-Initiative Transformation Work Plan 3. Sustaining Improvements through Continuous Quality Improvement Navigating a Changing Environment Discussion/Questions

4 The Work Is Never Done

5 Change Is Here: Are You In Front, In Step, or Chasing It? Medicare & Medicaid shifting incentives: volume to value Managed Care Organizations expanding in Medicaid State waivers experiment with integration models HRSA urging community health centers to expand behavioral health services SAMHSA investing in integration Primary & Behavioral Healthcare Integration Grants Certified Community Behavioral Healthcare Clinic funding

6 Integration Value Pathway Source: J. Rubin, Health Management Associates; 2016

7 Weaving Common Threads of Multiple Initiatives into a Single Cross-Initiative Transformation Work Plan STRATEGIC PLAN MN Integration Initiatives C O M M O N Financing Staff Training Clinical Care/ Service Delivery Beh. Health Home (BHH) Pt Centered Medical Home Health Care Home (HCH) Transformation Work Group Cert. Comm. BH Clinic T H R E A D S Data/HIT/QI Cons/Family Involvement/Sat. Network Partnerships Work Plan Objectives

8 Your Toolbox Strategic Planning & Work Plan Execution: Leveraging market place changes (e.g. MN Integration Initiatives) to better serve consumers & secure market share Throughput: The time & cost to complete a process (e.g., intake) Variation: Identification & Resolution of Work Flow Variation Quality Benchmarking: Key performance targets that indicate contained cost & quality service provision

9 Minnesota Integration Land of 10,000 Lakes feels like Land of 10,000 Initiatives Where to start? Use your Strategic Plan to Crosswalk the Initiatives into a consolidated Transformation Work Plan

10 Crosswalk of MN Integration Initiatives Behavioral Health Home (BHH) MN version of the federal health home benefit for Medical Assistance enrollees. All health homes are federally required to provide a set of 6 core services Certified Comm. Behavioral Health Clinic (CCBHC) Designed to provide a comprehensive range of MH & SUD services, particularly to vulnerable individuals with the most complex needs during a federal demonstration program with participating states. Health Care Home (HCH) MN version of medical home a person-centered approach to primary care in which PCP s, families & pts work in partnership to improve health outcomes & quality of life. Patient Centered Medical Home (PCMH) A way of organizing primary care that emphasizes care coordination & communication to transform primary care into "what pts want it to be."

11 Common Threads Financing Staffing/ Training Clinical Care/Svc Delivery Data/HIT/QI Consumer/ Fam Involve & Satisfaction Network partnerships Behavioral Health Home (BHH) Certified Comm. Behavioral Health Clinic (CCBHC) Health Care Home (HCH) Patient Centered Medical Home (PCMH) Moving toward case rates through assessing & understanding your costs. Train your staff in the purpose & practice of IH, new job descriptions. New policies & procedures for care screening, tx goals, care coordination, monitoring target conditions, revised workflows, & wellness programming. Assessing what data is required & what data you have. Standardizing & using data to inform outcomes. Need to talk with consumers/family about their health service needs, & satisfaction with services. Assessing provider network to develop partnerships that will allow data sharing & seamless care coordination

12 Weaving Common Threads of Multiple Initiatives into a Single Cross-Initiative Transformation Work Plan STRATEGIC PLAN MN Integration Initiatives C O M M O N Financing Staff Training Clinical Care/ Service Delivery Beh. Health Home (BHH) Pt Centered Medical Home Health Care Home (HCH) Transformation Work Group Cert. Comm. BH Clinic T H R E A D S Data/HIT/QI Cons/Family Involvement/Sat. Network Partnerships Work Plan Objectives

13 3 Steps to Manage Change 1. Actionable Organization Strategic Plan 2. Designing & Executing a Cross- Initiative Transformation Work Plan 3. Sustaining Improvements through Continuous Quality Improvement

14 What?: Step 1: The Strategic Plan Details Organization Strategy/Prioritization Clarifies How Vision & Mission are achieved both thru improvement initiatives & day-to-day operations Who Owns It? Everyone, but Primary Responsibility of Senior Leadership essentially the Sr. Leadership s Staff Work Plan Why Important?: Without an actionable Strategic Plan, owned by Leadership, the rest of the organization can t execute effectively

15 Step 1: The Strategic Plan Elements 1. Communication Plan detailing how the organization will achieve its Vision & Mission over the next 1-3 years 2. At least quarterly metrics/key performance indicators (KPI s) targets to monitor progress 3. Transformation Work Plan Charges including: a) Staff Champions who will lead the change efforts b) Goals (Objectives/Tasks are developed by work plan staff) c) Timelines d) Resource Allocation & Acquisition e) Risk Identification/contingencies f) Conflict Resolution Procedures

16 Poll Question #1 We have been using our Core Messages (first drafted at Nov 2015 meeting) to communicate the work of our Transformation Plan a. Yes b. No c. Don t know

17 Poll Question #2 Our Transformation Plan has defined metrics to tell us we re making progress a. Yes b. No c. Don t know

18 Step 2: Design & Execute a Cross- Initiative Transformation Work Plan What?: Translates the Strategic Plan charge into a detailed Transformation Work Plan that includes: a) Objectives b) Tasks c) Metrics d) Timelines e) Lead/Accountable & Supporting/Allocated Staff Who Owns It?: Champion/Lead staff are responsible for building out the work plan Why?: Critical to implementation accountability

19 All the MN Integration Initiatives Share Common Objectives/Threads for Building A Single Work Plan STRATEGIC PLAN MN Integration Initiatives C O M M O N Financing Staff Training Clinical Care/ Service Delivery Beh. Health Home (BHH) Pt Centered Medical Home Health Care Home (HCH) Transformation Work Group Cert. Comm. BH Clinic T H R E A D S Data/HIT/QI Cons/Family Involvement/Sat. Network Partnerships Work Plan Objectives

20 Step 2. Example of Cross-Initiative Transformation Work Plan Elements Strategic Area: IH Financing Strategic Plan Goal: By May 2017 XYZ CMHC will have case-ratecalculation methodology for all consumers served Transformation Work Plan Objectives: a.) Research Methods; b.) Gather Cost Data; c.) Test Case-Rate Methodology; etc. Tasks: a.) Literature Review; Meet w/ ABC CMHC to discuss how they have achieved this; Clarify with State Case-Rate Requirements; b.) Gather & clean data; c.) Test adopted model; etc. Metric: Report detailing best strategy for XYZ CMHC including task steps to achieve May 2017 Goal approved by Sr. Leadership Team Timelines: Research Method Task to be completed by July 30, 2016; etc. Lead Staff: CFO Supporting Staff: Jim B; Cindy C; & Glenda G. Resources Needed: 2hrs wk of assigned staff

21 Step 3: Sustaining Improvements via Continuous Quality Improvement What?: Rapid Cycle Plan-Do-Study-Act is a problem solving process that exists to bring a transformation/change about (e.g., design & implement a new way of doing something) AND put an out of control standard process that becomes highly variable back into control. Who Owns It?: All Staff! Why?: Transformation Work Plans drive change in day-to-day operations (policy, procedures, staff work flows, etc.) Rapid input on what is working to sustain change is needed.

22 Poll Question #3 We use Rapid Cycle PDSAs to manage this transformation process a. Yes, frequently and effectively b. Yes, but not frequently c. Yes, but not effectively d. No, we do not use PDSAs e. Don t know

23 Step 3: Continuous Quality Improvement Key Elements Measurement The Transformation Work Plan allows for processes to be created, measured, & tested before becoming a Standard Operating Procedure (SOP) Transformation to SOP - The transition from Transformation Plan Work Plan to SOP must be made very explicit so staff know when to Stop/Change/Start a new Work Flow Behavior! Monitoring Once in place a SOP requires continuous monitoring to ensure it is within specification

24 Strategic Plan Plan for Achieving Vision, Values, & Mission Quarterly Targets Budget Communication Plan Provide Transformation/Work Plan Charges Common Pitfalls! Midlevel Managers/ Supervisors Staff Work Plans Detailing their accountabilities for Operations & Work Plan Activities Often Overlooked Transformation/ Work Plan Sr. Management Charge Objectives Task: ü Measure/targets ü Timeline ü Accountable Staff w/ Designated Lead Day-to-Day Operational Plans Policies Standard Operating Procedures Staff Work Flows Cont. Quality Improvement Often Overlooked

25 Common Pitfalls! Not understanding difference between: a) Goal (High level = Achieve BHH Accreditation ) b) Objective (Category Level Steps needed to achieve Goal = Develop New IH Staff Training ) c) Task (Steps needed to achieve Objective= Research curriculums; Develop curriculum modules; Provide training, etc. ) Balancing Level of Sr. Management Involvement in Work Plan Execution Lack of Communication Plan in Strategic Plan

26 Navigating a Changing Environment: One Organization s Experience Rick Lee, CEO Central MN Mental Health

27 The Only Thing That is Constant is Change -Heraclitus, circa 500 B.C.E.

28 ? Questions Comments?

29 Upcoming Activities Site Visits! Pam & Jeff to meet the teams May 17-June 8 Watch for draft agendas for your input Leadership and teams to participate! July 13, Webinar July 15, 2016 Transformation Plan Updates Due