Download
leading change and delivering value based care n.
Skip this Video
Loading SlideShow in 5 Seconds..
Leading Change and Delivering Value- Based Care PowerPoint Presentation
Download Presentation
Leading Change and Delivering Value- Based Care

Leading Change and Delivering Value- Based Care

88 Vues Download Presentation
Télécharger la présentation

Leading Change and Delivering Value- Based Care

- - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

  1. Leading Change and Delivering Value- Based Care • It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is the most adaptable to change. • Charles Darwin

  2. Step 1: Create a Sense of Urgency

  3. Step 2: Pull Together the Guiding Team.

  4. Step 3: Develop the Change Vision and Strategy.

  5. Strategy is Differentiation • Southwest Airlines? • Starbucks? • Apple? • Banner Health System? • Your Physician Practice?

  6. The Value Equation:The outputs

  7. The Value Equation:The Inputs

  8. The Value Equation

  9. #1 TECHNICAL QUALITY

  10. BANNER PEDIATRIC CAREPATHWAYS • DEFINE : CLINICAL PRACTICES • ASTHMA • BRONCHIOLITIS • FEVER • ABSCESS-CELLULITIS • UTI • GASTROENTERITIS • ALTE

  11. BANNER PEDIATRIC CARE PATHWAYS • DESIGN AND IMPLEMENT • ORDER SETS • MEANINGFUL MEASURES

  12. 4 year boy with no significant PMH • presents with a gluteal abscess (5*6cm) • and fever to 101. • Questions: • When should he get an I/D? • Antibiotics? • Admission? • Labs? • Pain Control?

  13. 5 yo with mild persistent Asthma presents with RR 30; exp wheeze; s.c retractions; prolonged expiratory phase, and oxygen sats of 93%. Afebrile; Nl mental status. • Questions: • How to standardize initial treatment/weaning? • Need for oxygen? • Use of Atrovent? • Use of Xopenex? • Use of MDI vs Nebulizer? • Need for Xrays

  14. does a 6 week old non toxic child require an l.P.? • does a 8 week old with fever and bronchiolitis require a urine culture? • how about a 7 month old non toxic immunized child--does he/she need a blood cx? • a 3 week old with fever-- does he/she need a cxray?

  15. Technical Quality--- how do we measure?Its about Misuse, Overuse and Underuse • Asthma: % steroids; % xrays; % use of “asthma protocol”; • Bronchiolitis: % bronchodilaotors, % cxrays; % steroids; • Fever: % 0-28 days-blood/urine/csfcx; 29 days-3 mo: % blood cx; >= 6 month immunized child: % blood culture

  16. #2: Access to Services • Operational Efficiency • ED: LWOT, Readmissions, Length of Stay, Door to Provider • Inpatient: Discharges before 11am

  17. #3 FUNCTIONAL STATUS • How Functional are your Patients after they leave the Care Setting • Coordination of Care • Connection to other providers (home health, PCP’s, subspecialists) • Patient Education

  18. #4 COMMUNITY HEALTH • POPULATION HEALTH MANAGEMENT • Reducing admission rates? • Reducing readmission rates? • Reducing ED utilization rates? • Compliance to plan of care?

  19. THE VALUE EQUATION

  20. STRATEGY-STRUCTURE--SYSTEM ALIGNMENT

  21. Alignment • Physician Fee for Service vs DRG payment for Hospitals • Value Based Purchasing for Hospitals • Bundled Payment • Accountable Care Organizations

  22. Step 4: Communicate for Understanding and Buy-In

  23. Step 7: Create a New Culture.

  24. Step 8: Don’t Let Up. • “We must become the change we want to see” • Mahatma Gandhi