High-Impact People Development in Post-Acute Care

Transcription

1 National Forum - Orlando, FL December 10-13, 2017 A12/B12 High-Impact People Development in Post-Acute Care

2 Disclosures Mike Billings is employed as the President of Infinity Rehab Derek Fenwick is employed as the Director of Professional Development at Infinity Rehab No other financial or non-financial interests to disclosure

3 Session Objectives Describe how the Model for Improvement and PDSA cycles support real-time learning and continuous performance improvement. Explain the essential role that leadership development plays in creating and sustaining an organizational model geared toward continuous improvement and effective change management. Develop a strategy for implementing an evidence-based approach to human resources within his or her own organization.

4 Who We Are & Who We Serve Provider of clinically intensive, comprehensive physical, occupational and speech therapy in the sub-acute and long-term care environments. Based in the Pacific Northwest (near Portland, OR) Over 220 facilities across 14 states and covering the entire postacute care continuum: Skilled Nursing Outpatient Home-based Care LTAC Assisted Living Independent Living Over 1.5 million patient visits annually

5 Our Business Challenge How do we prepare our workforce to deliver high-quality care in a value-based reimbursement environment? Deadline: October 2018

6 Too Much Variability If there were no variation in PAC spending, variation in total Medicare spending would fall by 73 percent. If there was no variation in both acute care and PAC spending, total Medicare spending variation would drop by 89 percent. Institute of Medicine Variation in Health Care Spending: Target Decision Making, Not Geography. Washington, DC: The National Academies Press. doi:

7 Key Legislation Affordable Care Act o Signed into law March 23, 2010 Protecting Access to Medicare Act of 2014 o Signed into law April 1, 2014 o SNF Value Based Purchasing Improving Medicare Post-Acute Care Transformation Act of 2014 o Signed into law October 6, 2014 o Quality Reporting Program

8 Market Drivers

9 Volume-to-Value Marches On In 2016, 25% of health care $ were in Cat 3&4 models for commercial plans, Med Adv, and Medicaid

10 ACOs & Covered Lives

11 Medicare APMs

12 Medicare Advantage

13 Infinity Rehab: Vision Statement Infinity Rehab will lead a post-acute care revolution by relentlessly pursuing unparalleled quality, value, and patient, customer, and employee experience. We will create an irresistible culture that inspires individuals to grow as leaders, clinicians, and innovators.

14 Organizational Strategies Master the Process Systems Information Master the Data Master Change People

15 Organizational Strategies Prepare workforce to deliver new models of care Re-program from FFS to episodic thinking Re-design the delivery of therapy for quality and value-driven outcomes Workforce Preparation Focus on Quality & Outcomes Sustain & Grow New Customer Collaborations Sustain current operations and grow company Create innovative partnerships to help face the evolving health care environment

16 People: Achieve Clinical Leadership Clinicians who are experts in their field, and who, because they are approachable, effective communicators and empowered, are able to act as role models, motivating others by matching their values and beliefs about therapy and care to their practice

17 Culture of Excellence Achieving a culture that supports excellence in therapy requires four elements: 1. Shared beliefs and values 2. Shared leadership with a clear vision 3. Drive for excellence with high expectations 4. Vital partnerships

18 Model for Improvement Image retrieved from IHI.org

19 Work Redesign Identify Teams Engage the right people Participation builds buy-in Front-line therapists hold knowledge of the process including work-arounds Start by identifying key stakeholders Source: Everett Rogers Point of inflection

20 Berwick s Stages of Facing Reality The data are wrong. The data are right, but it is not a problem. The data are right; it is a problem; but it is not my problem. I accept the burden of improvement. Retrieved from Escape Fire, Don Berwick, (2002 Forum Speech), page

21 Prepare for Obstacles of Arrogance I know what s best for my patients.

22 Our Response To achieve a better standard of care requires rigor, creativity, and innovation It is anything but cookbook therapy! Truly patientcentered care Standard work does NOT equal average work Focus on systems of care rather than relying on culture of heroes

23 Our People: Aim Statement To become the employer of choice in post-acute care rehab by developing our workforce at Infinity Rehab to be the strongest group of clinicians, managers, and leaders delivering the best patient outcomes found anywhere in the industry. Deadline: October 2018

24 Outcome Level 3 vs. Level 1 mid-market companies Anticipates change and responds effectively & efficiently 3.2 times more likely Assesses and selects the right candidates 3.2 times more likely Coaches and develops people for better performance 2.4 times more likely Innovates 3 times more likely Manages performance problems 2.4 times more likely Source: Bersin by Deloitte

25 Strategy Shift Improve Acquisition Increase Engagement Demonstrate Leadership Behaviors Maximize Retention Manage Turnover But HOW will we reach our Aim Statement? Develop Clinical Capability Deliver Management Results

26 People Charter: Three Key Drivers Demonstrate Leadership Behaviors Develop Clinical Capability Deliver Management Results

27 Strategy Sources: IHI Demonstrate Leadership Behaviors Develop Clinical Capability Deliver Management Results

28 Strategy Sources: Bersin

29 Develop Clinical Capability

30 Key Example: Clinical Champions

31 Deliver Management Results

32 Demonstrate Leadership Behaviors

33 Our Spread Strategy

34 Our Results

35 Our Results: Work Opportunity At work, I have the opportunity to do what I do best every day

36 Our Results: Trust Among Co-Workers Do you trust your Infinity coworkers? No Mostly No Mostly Yes Yes

37 Our Results: Recommend Infinity Would you recommend Infinity Rehab to a friend? 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Yes! Yes Yes, but

38 Our Results: Scholar Projects Expanding the Role of Rehabilitation Therapists in Successful Case Management and Discharge Planning Improving Multi-Disciplinary Communication to Increase Patient Satisfaction and Compliance Fostering Emotional Intelligence in Infinity s Directors-in-Training In Pursuit of the 24-Hour Therapeutic Environment Influence of Insurance on Functional Outcomes in Post-Acute Rehabilitation Optimizing Patient Outcomes & Department Operations by Improving Therapist Accountability

39 Our Results: Scholar Feedback This Academy experience is literally changing my life. I am learning not only to be a better leader but how to balance my entire life without sacrifice. This experience is better than I could have imagined. I m putting my new learning into practice immediately and feel great about knowing I m moving in the right direction. My understanding of leadership and the change that I can affect is so much deeper because of this course. I knew a lot of these principles in theory but now I understand them at a much deeper level and am learning to use them in practice. Applying for the Leadership Academy is the best decision I've made in years.

40 Our Results: Organizational Maturity 70 Employee Net Promoter Score * (enps) *among 188 Infinity leaders surveyed; enps scale -100 to 100

41 Our Results: Published Key Example

42 Early Process Measure Adherence Success Found Reporting Planning Retreat ARD Reports 1 st Anniversary Established Target

43 Our Results Gait Speed Analysis

44 Five Takeaways Know Your Distinct Needs Look Outside Yourself Engage the Grassroots Consistency is King Leadership is Everything

45 Thank You! Derek Fenwick, PT, MBA, GCS Mike Billings, PT, DHSc, MS, CEEAA