models quality improvements Fine Art of Collaboratio… · Improved transitions from one care...
14
1 Dominating concept in healthcare today: COLLABORATION “Without the involvement of long‐term care services and supports, ACO’s or other new collaborative models of service delivery will not be able to achieve sustained quality improvements and reduced costs.” ‐MarkMcClellan,MD,Ph.D CASTChair Director,EngelbergCenterforHealthCareReform LeonardD.SchaefferChairinHealthPolicyStudies BrookingsInstitution,WashingtonDC Reform Themes – Driving Collaboration ACOs, Bundled Payments, VBP, Medical Homes Hospital Readmission Reduction Programs Improved transitions from one care setting to another Care delivery moved to a lower cost setting Care Coordination Chronic Disease Management Person‐centered Health information and sharing of data More Managed Care Patient‐centered care/experience
Transcript of models quality improvements Fine Art of Collaboratio… · Improved transitions from one care...
1
Dominatingconceptinhealthcaretoday:
COLLABORATION
“Withouttheinvolvementoflong‐termcareservicesandsupports,ACO’sorothernew
collaborativemodelsofservicedeliverywillnotbeabletoachieve
sustainedqualityimprovementsandreduced
costs.”‐MarkMcClellan,MD,Ph.D
CASTChairDirector,EngelbergCenterforHealthCareReformLeonardD.SchaefferChairinHealthPolicyStudies
BrookingsInstitution,WashingtonDC
ReformThemes– DrivingCollaboration
ACOs,BundledPayments,VBP,MedicalHomes
HospitalReadmissionReductionPrograms
Improvedtransitionsfromonecaresettingtoanother
Caredeliverymovedtoalowercostsetting
CareCoordination
ChronicDiseaseManagement
Person‐centered
Healthinformationandsharingofdata
MoreManagedCare
Patient‐centeredcare/experience
2
DrivingCollaboration
Focusbeingputtowardsintegratedcaredeliverymodelsthatdemandavarietyofformsofcollaborationatmultiplelevels
Providersareseekingscale/growthwhichisdrivinguniquecollaborationsacrossthecontinuum
Providerslookingtotrimcostsassociatedwithduplicativeserviceswhichincludescollaborationviacombiningexpertiseorotherfunctions
Providersinsurvivalmodeandmayneedtopartnertomakeit
MOVINGFROMWHYTOHOW
Howdoweinitiatemeaningfulpartnershipsandcreatethetimerequiredtomaintainandimproveuponthem?
Howdowemovebeyondtheassumptionsthatweholdaboutourpotentialpartnersandmovetowardsunderstandingmultipleperspectives?
Howdowedevelopcollaborationsthatareeffectiveandproducebusinessresultsopposedtojustcollaboratingforthesakeofcollaborating?
Howdoweinspireacultureofcollaborationwhenwemaybemorewiredforcompetitionandprotectionourpersonalagendas?
MOVINGFROMWHYTOHOW Post‐AcuteCareNetworks&ContinuumStrategies
Seeking1st/2nd referral– volume
NewServiceDevelopment
Acquisition/StrongerAffiliations
Positioningtointegratew/hospitals,ACOs,BPinitiatives,etc.
Hospitalsforming“preferredprovider”PACnetworks
CommunityBasedTransitionalCareInitiatives
HospitalsandCBOscollaborating
NewServiceDevelopment
CCTP– sec3026ofACA
QIOdrivenCommunityCollaborative(s)toimprovetransitions/reducereadmissions
3
MOVINGFROMWHYTOHOW Medical&SocialIntegration
Hospitalbasedhubforreferralstothecommunity
ManagedCareentitiesreachingouttoCommunityBasedOrg(CBOs)
ManagedCarecontractingw/CBOsforCT/CMservices
Post‐Acute/LTCleveragingconsumerrelationships&expertisetocreatenewvalue
Foundationfocus
Non‐profitsjoiningforcestostrengthenofferings
Housingwithservicesmodels
Sharingofresources(staffing,billing,etc.)
Combiningexpertise
MOVINGFROMWHYTOHOW Consolidation/JointVentures
Hospital– CCRCJVdiscussion
JV/AcquisitionsofHomeandCommunityBasedServices
SmallerPACproviderslookingtoaffiliate/JV
AcquisitionoforganizationtoactasNewCoforInnovation
HospitalsbackintothePACbiz?
ForProfit– NotforProfitCombinations
4
FURTHEROBSERVATIONPaceisaccelerated&collaborationstaketime
Changeisdifficult&resistancemakesitmoreso
Talkisnotcheap&cancreatetheillusionofcollaborating
Internalculturecantrumpexternalcollaborations
Needtounlearntheirrelevant&prioritizetherelevant
Upfrontworkiscritical&oftenjumpingincreatestheclarityneeded
ObjectivesforthisSessionExplorecreatingandsustainingyourcollaborativeendeavors
Starttocreateaframeworkforaction
Sharesomeideasthatmayhelpadvance&accelerateyourcollaborativeinitiatives
Facilitatediscussiontosupportsharedlearning
Asitrelatestocollaboration/partnership,whatdoyouseeas themostsignificantopportunityforyourorganization?
Whatissues/challengesareinthewayofadvancingthisopportunity?Internally?Externally?
Inwhatmannerdoesyourorganizationcollaborate/partner?
What doyoudofeelyouneedtolearnaboutcollaboration?
Questions
5
Break‐OutDiscussion&Introductions
Groupsoftwo
Discussyourresponses
Introduceyourpartner
Whatisontheirmindasitrelatestocollaboration
#1objectivefortoday’ssession
15minbreak
Considerations Internal– StartwithyourWhy ExternalScan‐ whatistheneed Strategytomeettheneed Research&Education– NewLearning DeeperInternalAssessment‐ PartnerReadiness Abilitytoarticulatevalue– whatyoubringtothepartnership Cleargoals/priorities DeterminePartnershipcriteria UnderstandPartner’sperspective Processforpartnerselection MOUasstagingstrategy&tocreatepartnershipstructure
6
EFFECTIVECOLLABORATION
CLARITY
• InternalAssessment
• Clearpurpose/goals
• Collaborationoranotherstrategy
• Self‐Assess
Startwithyourwhy
Whatareyoutryingtoaccomplish&why?
Externalandinternalfactors–whatisdrivingyourwhy?
IsCollaboration/Partnershiptherightstrategy?
Isthereacompetitiveadvantagebycollaborating?
InternalOrganizationalAssessment
Rightpeople,rightpositionCultureofcollaborationFluidityforchangeWillingnessfororgtostretchbeyondcomfortzoneAbilitytoidentifyandconveyyourvalueRightboardmembersPeerrelationships/councilneededParallelstrategiesCommunicationplan Self‐Assess
7
“Youcan’tshakehandswithaclenchedfist.”
‐MahatmaGandhi
Whatareyourmentalmodels?
KnowThySelf
Awarenessofhowyouthinkabilitytosuspend,examineand
changeyourassumptions
Awarenessofhowyouinteract
creatingbalancebetweenadvocacyandinquiryinexploringcomplexissueswithavarietyof
participants
Impacthowwethink/act
Maybeconscious/unconscious
Incomplete
Easiertoseeinanotherandhardtoseeyourown
Highleverage
* source is ReThink Health
mentalmodelsBeliefs,assumptionsandthethinkingwehaveabouteveryaspectofourselves,others,ourorganizations,andhowthe
worldworks
8
Openness‐ canIbeimpactedandinfluenced?
Transparency‐WillIshowup,beseen,andnothidebehindatitle?
Authenticity‐ CanIsaywhatIthinkopposedtowhatis
politicallycorrect?
Intensity‐Whatismywillingnesstostretchbeyondmycomfort
zone?
AskYourself
BeingAccountable– holdthemselvesandrequireitfromothers
Source: Collaboration by Morten Hansen
collaborativeleader?
RedefineSuccessfromNarrow
AgendastoBiggerGoals
Involveothersindecisionmaking&
exhibitanopenmindtoalternatives,divergent
views,dialogue
COLLABORATIVELEADER
Organization’sgoalsvs.ownAbilitytohelppeopleunderstandthe“bigpicture”Goodatfindingcommongroundamongthosewhohavedifferentgoals/agendas
SeekstounderstandavarietyofperspectivesEncouragesopendiscussionsanddebatesissuesearlyonThinks:HowdoIinvolvepeoplevs.justtellingthemwhattodoTakesresponsibilityforamistakeUseofcollaborativelanguageAccountabilitySource:CollaborationbyMortenHansen
9
COLLABORATIVECULTURE
BehaviorandAttitudeCompetitionoutside,notinsideBalanceofunificationandindividualaccountabilityCreateoptfornetworking,ideasharing,connectw/otherdept. Identifybarrierstocollaboration&seeksolutions
Notinventedhere
Hoardinginfo
Searchproblems
Transferproblems
Source:CollaborationbyMortenHansen
WrittenExerciseReflectonyourapproachtocollaboration
Howdoyouinviteandobtaindiverseviewpoints?
Howdoyouhandleopposingopinions/discussions?
Howdoyougiveandreceivefeedback?
Whatarea/issuemightrequireyoutoseethroughanewlens?
Wherecanyoustretchbeyondwhatiscomfortableforyou?Or,whatisonethingyoucandodifferently?
And,howwillyoudothis?
15minbreak
10
Break‐OutDiscussion
3Groupsof4
Discussthequestions
Discussasalargergroup
Howwasitdecidedthatcollaborationistheappropriate strategy?
Whatprocessdidyourorganizationgothrough?
Howwillthiscollaborativebeevaluated –hassuccessbeenclearlydefinedforallinvolved?
Whathaveyoulearned?
Thinkofacurrentcollaboration
10minbreak
11
Consideringyourcurrentorganizationalstateand/orfuturefocus,whattypeofpartnershipsaregoingtoenhanceyouroperationand/oradvanceyourmission?
QuestiontoConsider
Howwillyouidentify,create,andsustainpartnerships/collaboration(s)?
QuestiontoConsider
ExternalScan
Doweunderstandemergingtrends/issuesonthehorizon?
Doweunderstandpotentialopportunities?
Canwecreateacompetitiveadvantagebytakingactiononidentifiedopportunitiesearlierthanothers?
Arewepayingenoughattentiontowhatwedon’tknow–ifnot,howcanwebetterunderstand?
Howwellarewemonitoringpossiblefuturerisks,challenges,andopportunities?
12
ReferralPatternsandutilizationofpost‐acute
MarketDataReview
Physicianpracticestrategies/hospital&physicianalignment
PayerStrategies
Howfastisthemarketmovingtowardsintegratedcare
Acquisitionstocompletethecontinuum
CompetitorIntelligence
Whatarepotentialcollaboratorsinyourmarketdoing
ExternalScan
ConsiderPartnershipCategories&Structures
Affiliate
Acquire
Merge
Consortium
StrategicPartnerships
PartnershipCriteria
StandardDueDiligence(ops,finance,clinical,IT,compliance)
Partnerknowsthemarketwell
Partnerreputation/currentclients
Understandingofhowproviderhasworkedinotherpartnerships
Understandingofthepartner’scriteria
Mutualrecognitionofthevalueintheofferings
Evaluateinitialinteractions,followup,appetiteforpartnership,willingnesstoinvestinupfrontdiscussions, appropriatepeopleinvolvedearlyon
Alignmentofvalues–whattheydonotwhattheysay
Intangibles– chemistry&trust
13
UseofMemorandumofUnderstanding(MOU) Stagingtoformalcontract
Outlinesintegrationstrategy
Flushoutlingeringquestions,details,etc.
Projectroll‐outschedule
Useasawaytoformulizethepartnership
Roles/Responsibilities‐ whowilldowhatandwhen
Infrastructure/Operations
DecisionMaking
Communications
Resourceallocation
Conflictresolution
MoreQuestions:
Whatareaprovokedthemostinterestforyoutoday?
Whatlevelofprioritydoesthishold?
Whatactioncanyoutaketo moveyourPriorities/collaboration(s)forward?
Whatassistance/resourcesareneeded?
Whatdoyouneedtolearn?Howwillyoudoit?
LASTWORDS
14
"Inthelonghistoryofhumankind...thosewho
learnedtocollaborate and
improvisemosteffectivelyhave
prevailed.”‐ CharlesDarwin
ThankYou!LoriPeterson
866.332.3923
