Achieving Change in Complex Systems

Jeff Sperring, MD

What are you trying to achieve?

• Alternative Change

• Progressive Change

• Transformative Change

James Whitcomb Riley Hospital for Children

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Hospital for Crippled ChildrenHospital for Crippled ChildrenHospital for Crippled ChildrenHospital for Crippled Children

1924192419241924

Riley Hospital for Children

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Family Centered CareFamily Centered CareFamily Centered CareFamily Centered Care

2015201520152015

What Will the Next 90 Years Bring?

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Personal Experiences with Change

• Hospitalist – what’s a Hospitalist?

• Reducing Length of Stay

• Expanding a brand outside the comfort zone

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Pediatric Hospitalists:Pediatric Hospitalists:Pediatric Hospitalists:Pediatric Hospitalists:Is This the Future of Inpatient Pediatrics?Is This the Future of Inpatient Pediatrics?Is This the Future of Inpatient Pediatrics?Is This the Future of Inpatient Pediatrics?

Jeff Sperring, MD, FAAP

Assistant Professor of Clinical Pediatrics

Director, Pediatric Hospitalist Program

Department of Pediatrics

Indiana University School of Medicine

The Length of Stay Project

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Riley Physicians

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Clinical Practice Change

• Clinical Pathways

• VIP – Improvement Networks

• Top 10 Articles at SHM

Pediatric Grand Rounds

September 8, 2004

Key Controversies in Pediatric Hospital Medicine

� Treatment of Bronchiolitis

� Urinary Tract Infections

� Follow-up cultures

� Timing/Need for Imaging Studies

� Rule-Out Sepsis/Fever in Infants

� Emerging Pathogens

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Transformation within in an Industry

Curve 1Curve 1Curve 1Curve 1 Curve 2Curve 2Curve 2Curve 2

*Morrison, Ian “The Future of the Healthcare Marketplace” www.ianmorrison.com

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Transformation within in an Industry

Curve 1

Print Photography

Curve 2

Digital Photography

*Morrison, Ian “The Future of the Healthcare Marketplace” www.ianmorrison.com

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Transformation within in an Industry

Curve 1

Hardware-based Solutions

Curve 2

Software-based Solutions

*Morrison, Ian “The Future of the Healthcare Marketplace” www.ianmorrison.com

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Adapting to a new Health Care Market

Curve 1

Hospital Volume Based

Curve 2

Population Health

*Morrison, Ian “The Future of the Healthcare Marketplace” www.ianmorrison.com

“Riding the Wave”

Kotter’s 8 Steps to Successful Change

Group/System Change isn’t linear

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Job Security

Job Security

Job Security

Job Security

Job Security Job Security

CHANGECHANGECHANGECHANGE

Group/System Change isn’t linear

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Job Security

I Created This

Loss of Control

Don’t Believe the Data

Financial Security Don’t Like Risk

CHANGECHANGECHANGECHANGE

QRS of Transformation

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Current State

I’ve Broken It!

We’re Unstoppable

Future State

The Rogers Adoption Model

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“Crossing the Chasm” by Scott Ambler

http://www.drdobbs.com/architecture-and-design/crossing-the-chasm/187200223

Impact on Spread and Sustainability

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https://markabouzeid.wordpress.com/2011/11/28/technology-adoption-lifecycle-revisited/

Crossing the Chasm

• Building a coalition

• Don’t make the change about you

• THE FIRST FOLLOWER

– Derek Sivers

– First Follower: Leadership Lessons from Dancing Guy

– https://www.youtube.com/watch?v=fW8amMCVAJQ

Real Change is Bigger than You

• You are just a piece of the change

• You may never see or benefit from the change

• It must sustain beyond your work and your effort

• But sustainable change still starts with a first step

– HOW WOLVES CHANGE RIVERS

– https://www.youtube.com/watch?v=ysa5OBhXz-Q

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