APCC - Change principles Wave 10

107
Change Principles Tony Lembke Wave 10 Sydney, March 15th 2014

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Presented at LW1 for Wave 10 APCC Sydney March 2014. The Collaborative Methodology and Change Principles

Transcript of APCC - Change principles Wave 10

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Change PrinciplesTony LembkeWave 10Sydney, March 15th 2014

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alstonville

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Mick Roberts

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Professor Barbara Starfield

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Chronic illness is not improved by:

• More specialists

• Better diagnostic tools

• New treatments

Chronic illness is improved by:

• Better provision of primary care

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alstonvillegopherfest

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nimbin mardigrass

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Four fold decrease in CHD Deaths

30% reduction in one year

60% reduction in time to see a GP

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Dale Ford

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Collaborative Framework

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TINTENBAR MEDICAL

CENTRE

3 p/t doctors, 2 p/t receptionists, 2 p/t nurses, 1 physio, pharmacy

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Merlin Mann

43folders.com

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Two AimsThree GoalsFive Ways of ThinkingFive Change PrinciplesHundreds of Change Ideas

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Your Mission1 10% reduct cardiac events

2 20% have CV RiskAssessment

3 20% improve risks to target

4 90% screening of high risk for CKD

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your Mission

1 Improve Patient Outcomes

3 More sustainable practice

2 More satisfying for patients, staff and clinicians.

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Fall ForwardsFTFTKaizen

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Think in Systems

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Tom Nolan and Don Berwick

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PROTECTED TIME

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Measure

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Steal ShamelesslyShare Generously

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Focus North

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CP1

CP3

CP2

CP4

CP5

Change Principles

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CP1 - Build the Practice Team

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Attitude

Pain is Inevitable. Suffering is optional.

CP1

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Mood-O-Meter

0

2.25

4.50

6.75

9.00

Mood (/10)

Monday Tuesday Wednesday Thursday Friday

CP1

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Tom Marshall

General Practice is the best job in the world -

You get paid for talking to your friends!

CP1

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Brains TrustBoofheads CP1

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Lismore Rugby Under 14s

CP1

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Have you gotthe ball ?

No

Get the Ball

Score a TryYes

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Have you got

the ball ?

No

Get the Ball

Score a TryYes

Have they gotthe ball ?

No

Tackle ThemYes

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CP1

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James Sutton

Goal:Complete transformation of an ordinary clinic to a cutting edge facility in one year using Team Building, Open Access and Planned Care

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Guiding Coalition

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Vision

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RepeatVision

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Obstacles

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Short Term Wins

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Claiming Victory to Soon

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Anchor Changes

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CP2 - Herd Health

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CP2

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CP2

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CP2

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CP2

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© Improvement Foundation (Australia) Ltd

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CP3 - Be systematic

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Value Streams

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Cycling Care

CP3

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CP3

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CP3

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TeamRight , right job, right time

Care is Team-based

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CHRONIC DISEASE MANAGERS

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Claim Shamelessly

CP3

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Month 0 GPMP, TCA 721,723

Month 3 Review 732

Month 6 Review 732

Month 9 Annual Check 732

Month 12 GPMP, TCA 721,723

Cycles of Care

CP3

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Show me the money300 CVD Patients

GPMP @ $141 x 300 $42,300

$126,800

TCA @ $112 x 250 $28,000

$21,000$17,500

Item 723 @ $70 x 300

Item 723 @ $70 x 250

$18,000Item 10997 @ $12 x 5 X 300

42300

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CP4 - Patient Self Management

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Your patients Greatest untapped resource in health care

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CP4

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The Real Work

CP4

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Be a teacherEducation vs Advice

CP4

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CP4

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TEMPLATES

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CP5 - Integrated Systems

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alstonvilleclinic

2005

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alstonvilleclinic

2014

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Connected to the Medical Neighbourhood

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Model of Care

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Home

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Home Medical Home Community Hospital

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Home Medical Home Community Hospital

Teams

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Home Medical Home Community Hospital

MEDICARE LOCAL LHD

The Medical Neighbourhood

Everyone has two Jobs

Everyone has three Jobs

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CP1

CP3

CP2

CP4

CP5

Change Principles

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Collaborative Care

Care is Holistic

Care is Proactive

Care is Team Based

Care is Integrated

Care is Systematic

Care is Accessible

Care is Patient CentredEvery Single Patient, Every Single Time

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Zenand the art of general practice

[email protected]

practiceimprovement.com.auwhatIlearnttoday.com.au

my.improve.org.aumedicalhome.org.au

personcentredcare.org.au

lists.apcc.org.au