Leadership Competencies and Team Building MY STORY Surgical Oncology/Dir. Quality Cancer Committee Chair Cancer Liaison Physician State Chair, CoC Quality Integration Committee AAMC Teaching-4-Quality Institute for Healthcare Improvement UVM Cancer Center
LEADERSHIP LEADERSHIP
DISCUSSION CASE: SUCCESSFUL LEADERSHIP A newly appointed cancer program administrator learned that only 60% of patients 5 years ago received appropriate screening mammography. The current health plan data was limited, so the coordinator designed a data collection tool and convinced the physicians in the practice to use it. Armed with the necessary information, reminder letters were sent out to patients. The rate of appropriate mammography use went up to 80%. The administrator shared the success story to the other physicians in the network, and all of them now use this system. As a result, many more women now receive appropriate mammograms. Adapted from Reinertsen JL, Ann Int. Med, 1998 WHAT DO LEADERS DO? Leaders change the status quo Leaders are not victims Leaders define reality with data Leaders develop and test changes Leaders motivate others Kotter, Harvard Business Rev., 2001
CASE STUDY: ELIMINATING DISPARITIES Project Goal: improve mammography screening rates Actions Collaboration Integrated into organizational goals Development of data systems Outreach Cambridge Health Alliance CASE STUDY: ELIMINATING DISPARITIES Key Lessons Engaging leadership Facilitating communication Leveraging data Cambridge Health Alliance
GREAT TEAMS Know their why Set clear expectations Use bite-sized goals Train appropriately Wendy Soon, Stanford Graduate School of Business GREAT TEAMS Facilitate communication Engage socially Foster collaboration Recognize openly Wendy Soon, Stanford Graduate School of Business
DISCUSSION SCENARIO You have identified a quality need in your institution and require support from your leadership and clinicians in order to implement a new improvement initiative. What are the anticipated barriers? What are potential solutions? MOTIVATING PHYSICIANS TO IMPROVE QUALITY Extrinsic Financial Status Mandates Working conditions Intrinsic Cognitive challenges Problem solving Open-ended thinking Professionalism Herzer KR, Pronovost PJ, AJMQ 2013
MOTIVATING PHYSICIANS TO IMPROVE QUALITY Inspire a Collective Purpose and Vision Articulate why success matters for patient care Craft an inspiring patient-centered vision Purpose-driven physicians become improvement champions Herzer KR, Pronovost PJ, AJMQ 2013 EXAMPLE Our aim for this initiative is to eliminate the things that waste everyone s time, so that you and the entire team can have more time with your patients
MOTIVATING PHYSICIANS TO IMPROVE QUALITY Promote Autonomy Availability of choices allows use of expertise and wisdom Stimulates creativity and innovation Creates physician engagement Herzer KR, Pronovost PJ, AJMQ 2013 MOTIVATING PHYSICIANS TO IMPROVE QUALITY Provide Timely Feedback on Performance Transparent and timely feedback Metrics that physicians view as valid and reliable Education and training opportunities Herzer KR, Pronovost PJ, AJMQ 2013
WHAT DOESN T WORK Appeals to the greater good Empty titles Financial incentives Sharing best practices SECRETS OF MOTIVATION Autonomy Mastery Purpose
CASE EXAMPLE Story Board Rounds IHI archives, Seton Northwest Hospital COMMUNICATION BOARD IHI archives, Seton Northwest Hospital
ENGAGING TEAMS Staff using a decision matrix to harvest ideas during brainstorming session IHI archives, Seton Northwest Hospital INSTITUTIONAL SUPPORT Priority align with organizational strategic priorities Politics navigate sources of power Pragmatic anticipate barriers and bring solutions Perseverance keep it on their radar
INSTITUTIONAL SUPPORT ROLE OF ACCREDITATION
CASE EXAMPLE Medication Errors TESTIMONY
INFLUENCE Three types of people Logical (rational) - motivated by data Formal (political) - endorse as policy Emotional (heart) tell moving stories LEADING OTHERS THROUGH CHANGE Follow the bright spots Script critical moves Point to the destination Find the feeling Shrink the change Grow your people Tweak environment Build habits Rally the herd
MANAGING RESISTANCE TO CHANGE Inspire Champion Capacity High Mitigate Facilitate Low Low Commitment High UVM MDC EXPANSION KEY LESSONS Institutional vision Needs assessment Dyad leadership Performance Dashboards Celebrating wins
TESTIMONY THANK YOU