Aurora s Quality Journey
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- Winfred Thompson
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1 Aurora s Quality Journey Preparing for Value-based Purchasing Patrick Falvey, PhD Senior Vice President/Chief Integration Officer Aurora Health Care
2 Quality From Tactics to Strategy CQI CM HQID Longterm StrategyQUEST CM Growth
3 Overview Care Management Pre 2004 Hospital Quality Incentive Demonstration Aurora s Long-term Strategy Our Hidden QUEST Pay-for-Performance Care Management Growth
4 Aurora Health Care at a Glance
5 Care Management Pre-2004 Increase the number of people who benefit from care management best practice Diabetes Heart Failure Cholesterol Management AMI CABG Pneumonia
6 Care Management Pre-2004 To them, not with them Relentless incrementalism Process - focused
7 HQID CEO volunteered us Single person of accountability Movement to outcomes Rapid improvement
8 Aurora s #1 Priority Our patients deserve and expect the best care. We will give people better results than they can get anywhere else by achieving top performance in all of our quality measures. For Aurora, there is no alternative.
9 HQID
10 HQID
11 HQID CMS Hospital Quality Demonstration Best Patient Care Project Improvement Trend Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Aurora Top 20% Median
12 Aurora s Long-term Strategy
13 Aurora s Strategic Plan 2008 CM Impact of 3.1 Lean Implementation 5:1 Achieve 30% Loyalty Caregiver Engagement 65% 2009 CM Impact of 3.1 Lean Implementation 5:1 Achieve 40% Loyalty Caregiver Engagement 68% 2010 CM Impact of 3.1 Lean Implementation 5:1 Achieve 50% Loyalty Caregiver Engagement 70%
14 Aurora s Long-term Strategy Aurora s Approach to Quality Outcomes Organizational Learning
15 QUEST Strategic Plan 2010 CM Impact of 3.1 Lean Implementation 5:1 Achieve 70% Loyalty Caregiver Engagement 71% Growth 2011 CM Impact of 3.1 Lean Implementation 5:1 Achieve 90% Loyalty Caregiver Engagement Top Q Growth 2012 CM Impact of 3.1 Lean Implementation 5:1 Achieve 100% Loyalty Caregiver Engagement Top Q Growth
16 QUEST Boards on Board Long-term Strategy Measures Hidden QUEST
17
18 QUEST
19 QUEST
20 QUEST & HQID Pay-for-Performance
21 Strategic Implementation Framework Overarching theme Key components A Targets Metrics Detailed Time bound Forecasted Execution / Implementation Focus Areas Quality / #1 Priority Employee engagement Patient Loyalty Growth/Finance Work Plans Milestones Key Actions Projects Course correction B Previews Quarterly Ongoing mechanism
22 Strategic Implementation Translates long-term to mid- and short-term: Strategic plan directly links to 1-yr actions and budget Top down Start with the answer and build on system strategy and guidance: values / strategies / key actions + targets But also bottom up operating and staff leaders own. Develop the strategies and tactics to achieve key actions and targets Focuses on execution of strategies through Strategic Projects (work plans) Matrix teams Dyads are leading cross-region teams (Quality, Patient Loyalty, Employee Engagement, Growth) Key stewards of the process administration, process improvement & employee & organizational development Tracks progress accountability with course corrections
23 Strategic Implementation Leadership Single Person of Accountability Aligned Incentives Brief and Debrief Monitor Progress
24 Quarterly Business Preview Methodology for implementation of strategy Connects strategy to operations Core element: Projects and work plans 20/80 Rule 20% numbers, 80% actions 20% history, 80% future action plans Creates accountability
25 Flawless Implementation
26 Lesson s Learned
27 Addressing Change The Caregiver Readiness Objective: Minimize the depth and breadth of The Valley of Despair Scenario 3: Proactive Caregiver Readiness Targeted Level of Organizational Performance (future state) Implementation of Initiatives Begin Return to Equilibrium Return on Investment Organizational Equilibrium (current state) The Valley of Despair Scenario 2: Reactive Caregiver Readiness Scenario 1: No Caregiver Readiness
28 Lesson s Learned 1. Single accountable person 2. Set objective 3. React to plan 4. Debrief 5. Share lesson s learned 6. Administrative/clinical leadership engagement
29 Care Management Growth Accountable Care Models Pay-for-Performance Interwoven with Strategy
30 Questions?
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