36. On Death, Dying & Data DENIAL ANGER BARGAINING DEPRESSION ACCEPTANCE
37. On Death, Dying & Data DENIAL “ The data are wrong” ANGER “ The data are right, but it’s not a problem” BARGAINING “ The data are right; it is a problem; but it is not my problem.” DEPRESSION “ This feels too hard to do” ACCEPTANCE “ I accept the burden of improvement ”
47. Projects Connected to Big Dots * Mortality Rate * Cost per Admission * Adverse Events * Functional Outcomes * Patient Satisfaction * 3 rd Available Appointment * Voluntary Turnover * Condition-specific, clinical process indicators * Preventive care measures * Office visit cycle time * ER to bed placement time * PACU to bed placement time * ICU to bed placement time * Bed to LTC placement time * ICU mortality * Catheter related BSI * Average ventilator days per patient * Adverse events/ICU day * Surgical Site Infection Rate * Percent of un-reconciled medications * Staff reporting positive safety climate * Percent of turnover in first year * Employee loyalty
56. What Changes Can We Make? Understanding the System for Weight Loss “ Every system is perfectly designed to achieve the results that it gets”
57. How Will We Know We Are Improving? Understanding the System for Weight Loss with Measures Measures let us • Monitor progress in improving the system • Identify effective changes
63. Transforming Care at the Bedside (TCAB) Med-Psych Workgroup Clinical Informatics ED Safety Central Line Infection Team Multidisciplinary Rounds Rapid Response Team Office Practice Team Perinatal Impact Team Total Joint Team VAP Prevention Team Perioperative Care Medication Reconciliation Team
66. System Level Aims Primary System Aims Additional System Level Aims Zero Hospital acquired infections Patient overall satisfaction to be >90% Readmission rate to decrease by 30% Planned System Level Aims to begin by 2010 Eliminate inequality in at least ten improvement /operational areas by 25% Reduce Ambulatory Care Sensitive Admissions (ACS) to CCRMC by 15% Patient engagement on every innovation and improvement team by January 1, 2010 Develop a formal process for engagement of ethics expertise in operations and quality improvement.