Building and Sustaining Momentum: Engaging Executives

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Building and Sustaining Momentum: Engaging Executives Chris Goeschel ScD RN FAAN [email protected] October 12, 2012

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Building and Sustaining Momentum: Engaging Executives. Chris Goeschel ScD RN FAAN [email protected] October 12, 2012. Learning Objectives. Describe current pressures for Senior Teams to “engage” Define the differences between technical and adaptive work - PowerPoint PPT Presentation

Transcript of Building and Sustaining Momentum: Engaging Executives

Page 1: Building  and Sustaining Momentum:    Engaging Executives

Building and Sustaining Momentum: Engaging Executives

Chris Goeschel ScD RN [email protected] 12, 2012

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Learning Objectives

• Describe current pressures for Senior Teams to “engage”

• Define the differences between technical and adaptive work

• Delineate the role of senior leaders in addressing both types of work in QI efforts

• Discuss tactics used successfully to engage senior leaders in this work

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CEO Checklist for Creating High Value Health Care

1. Foundational Elements– Governance Priority– Culture of Continuous Improvement

2. Infrastructure Fundamentals– IT best practices– Evidence Protocols– Resource utilization

Armstrong Institute for Patient Safety and Quality

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CEO Checklist for Creating High Value Health Care

3.Care Delivery Priorities– Integrated care– Shared decision making– Targeted services

4. Reliability and Feedback– Embedded safeguards– Internal transparency

Armstrong Institute for Patient Safety and Quality

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Pronovost: Health Services Research 2006

Leading Change

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Technical Work

• Addresses problems for which the definition is clear, the potential solutions are reasonably clear, and usually require little or minimal learning

• Responsibility for implementing a solution is reasonably clear between leaders and followers.

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Adaptive Work

• Addresses problems that require a change in attitudes, beliefs, and behaviors

• Involves shared responsibility for change: leaders share responsibility with organizational staff and key stakeholders.

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The Work of Adaptive Change

• Determining the direction – what must change

• Determining the methods - how to change

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Most Common Leadership Error

• Treating an adaptive problem as technical

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Create and Sustain Executive Partnership

• Create a compelling case for participation – (4 Es)

• Design structures and processes to support involvement – (meeting time, place, process)

• Discuss potential barriers to effectiveness (awareness, agreement, ambiguity, ability)

• Identify facilitators unique to your executive and leverage them

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Executive Partnership: Impact and Influence

Executive partnership leverages four main functions of leadership to improve patient safety locally and globally:

Information search (staff safety assessment, executive safety rounds)

Problem solving (learning from defects) Managing material resources (business case, pay for

performance, public reporting) Managing personnel resources (patient and

employee satisfaction)Fleischman et al., 1991

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Leading Change:The Amazing Race to Eliminate VAP

• Is everyone clear on the goals, timelines, and mission?

• Is the necessary structure in place – people, roles, authority and responsibility?

• Are decision making, problem solving and conflict management processes clear?

• Are material resources in place – space, equipment, people, budgets?

• Are financial tracking mechanisms in place (CMS P4P implications)

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Action Items for Senior Leaders

1. Make certain an executive is assigned to each participating unit and meets regularly as a member of the project team .

– let the staff know senior leaders are invested and will work as hard as they do to make it a success.

2. Set clear project goals and expectations for the leaders and staff in participating.

– Provide opportunities for project teams to meet with senior leaders and the board to discuss the project

3. Provide the necessary resources – time to work on the Project, funds for travel, training, equipment, supplies, etc.

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Action Items for Senior Leaders

4. Support transparent communication– VAP rates– Process barriers and successes– Tell your own of a patient who suffered a VAP at

your organization

5. Expect resistance and be prepared to address it

6. Celebrate wins and provide encouragement, support, attention, and resources if there are set backs.

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COURAGE

“Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it’s the only thing that ever has.”

Margaret Meade

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References

Slide 5: Pronovost PJ, Berenholtz SM, Goeschel CA, Needham DM, Sexton BJ, Hyzy, Thompson DA, Lubomski LH, Marsteller JA, Makary MA, Hunt E. Creating High Reliability in Health Care Organizations. HSR. 2006;41:1599-1617.

Slide 11:

Fleishman EA, Mumford MD, Zaccaro SJ, Levin KY, KorotkinAL, Hein MB. (1991). Taxonomic efforts in the descriptionof leader behavior: A synthesis and functional interpretation. LeadershipQuarterly, 2, 245–287.

Armstrong Institute for Patient Safety and Quality