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I’m Gaurdia Banister, the Executive Director of the Institute for Patient Care. I’m delighted to welcome you to our second symposium entitled Innovations in Care Delivery: Advancing a Professional Practice Environment. This symposium builds upon our first symposium which was held last year examining strategies for Creating and Sustaining a Professional Practice Environment. We have an exciting and informative 2 day program for you. We’re thrilled that you’ve joined us and we have participants from the United States, Canada, Spain, Japan and England. I encourage you to network with your colleagues and our staff who are here, ask questions and also share how you are innovating in your own organizations. We see this as an opportunity where we can learn from each other. You’re in a sport town. The Patriots won and also the Red Sox that are in the World Series . Unfortunately the Bruins lost on Saturday but they have a 7 -3 record.If you need any help, please look for staff with IDs that say >>>>>> , they will be happy to help you. In our effort to go green, most of the material such as speaker biographies, powerpoint slides, your individual agendas (if you don’t have it or can’t access it, we’ll be happy to print a copy for you and other information pertaining to the symposium can be found on-line. Just a reminder, after the presentations today, we will be hosting a sale and book signing of the 2013 Sigma Theta Tau International “Best of Book Author Award Fostering Nurse-Led Care: Professional Practice from the Bedside Leader edited by Jeanette Ives Erickson, Dorothy Jones and Marianne Ditomassi. We will also have copies available of Nursing at 200 at MGH .
The closure of the federal government related to the Affordable care act.
When we are considering using the word innovation, is sometimes the word is being used as a new term or an approach but we all know that Innovation has been around for a long time. I thought I would start with what I know at the MGH.
William T. G. Morton instructed a patient to inhale the fumes from a ether soaked sponge. After the patient was sufficiently sedated, a surgeon removed a tumor from his neck. When he work up, the patient reported that it felt like he had a scratch on his neck. How different it was from holding down patients who were kicking and screaming and asking them to bit a bullet or a belt to suppress their screams.
Linda received forma training as a nurse and the superintendent, she embedded what she had learned in the training school for other nurses.
Critical part of our interprofessional/interdisciplinary team
I have to reference the government shut down with a focus point on the affordable care act. In addition, with the debacle of the healthcare.gov website where people are trying to sign up for health insurance. There is a lazer focus on health care right now.
Failures of care delivery. This category includes poor execution or lack of widespread adoption of best practices, such as effective preventive care practices or patient safety best practices. Delivery failures can result in patient injuries, worse clinical outcomes, and higher costs. Failures of care coordination. These problems occur when patients experience care that is fragmented and disjointed--for example, when the care of patients transitioning from one care setting to another is poorly managed. These problems can include unnecessary hospital readmissions, avoidable complications, and declines in functional status, especially for the chronically ill.Nearly one-fifth of fee-for-service Medicare beneficiaries discharged from the hospital are readmitted with 30 days; three-quarters of these readmissions--costing an estimated $12 billion annually--are in categories of diagnoses that are potentially avoidable. Failures of care coordination can increase costs by $25 billion to $45 billion annually. Overtreatment. This category includes care that is rooted in outmoded habits, that is driven by providers' preferences rather than those of informed patients, that ignores scientific findings, or that is motivated by something other than provision of optimal care for a patient. Overall, the category of overtreatment added between $158 billion and $226 billion in wasteful spending in 2011, according to Berwick and Hackbarth. Administrative complexity. This category of waste consists of excess spending that occurs because private health insurance companies, the government, or accreditation agencies create inefficient or flawed rules and overly bureaucratic procedures. For example, a lack of standardized forms and procedures can result in needlessly complex and time-consuming billing work for physicians and their staff. Overall, administrative complexity added $107 billion to $389 billion in wasteful spending in 2011. Pricing failures. This type of waste occurs when the price of a service exceeds that found in a properly functioning market, which would be equal to the actual cost of production plus a reasonable profit. For example, Berwick and Hackbarth note that magnetic resonance imaging and computed tomography scans are several times more expensive in the United States than they are in other countries, attributing this to an absence of transparency and lack of competitive markets. In total, they estimate that these kinds of pricing failures added $84 billion to $178 billion in wasteful spending in 2011. Fraud and abuse. In addition to fake medical bills and scams, this category includes the cost of additional inspections and regulations to catch wrongdoing. Berwick and Hackbarth estimate that fraud and abuse added $82 billion to $272 billion to US health care spending in 2011.(http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=82)
Gleicher’s Change Formula*created by Richard Beckhard and David Gleicher, refined by Kathie DannemillerThree factors must be present for meaningful organizational change to take place. These factors are:D = Dissatisfaction with how things are now;V = Vision of what is possible;F = First, concrete steps that can be taken towards the vision;If the product of these three factors is greater thanR = Resistancethen change is possible. Because D, V, and F are multiplied, if any one is absent or low, then the product will be low and therefore not capable of overcoming the resistance.To ensure a successful change it is necessary to use influence and strategic thinking in order to create vision and identify those crucial, early steps towards it. In addition, the organization must recognize and accept the dissatisfaction that exists by communicating industry trends, leadership ideas, best practice and competitive analysis to identify the necessity for change.
Innovation: The Frontier of Patient Care
2013 Massachusetts General Hospital
Professional Practice Symposium
Innovations in Care
Advancing a Professional Practice Model
The Institute for Patient Care
Innovation: A New (and
old) Frontier of Patient
The use of ether
as an anesthetic
and surgery is
pain for the first
Linda Richards served as the
superintendent of the Boston
Training School for Nurses, later
renamed the Training School at
Hospital. Richards was the first
student to graduate from a
training school for nurses in
Dr. Richard Cabot, a senior
physician at Mass General,
hired the first social worker
to provide social work
services in the outpatient
clinics. In 1906, Dr. Cabot
met Ida Maude Cannon and
hired her to jointly organize
the nation's first hospitalbased social work program.
• Failures in Care
• Failures in Care
• Lack of Evidence
• Need for Better
Patients and Families
Guided by the needs of our patients and
their families, we aim to deliver the very
best health care in a safe, compassionate
environment; to advance that care through
innovative research and education; and to
improve the health and well-being of the
diverse communities we serve.
To create new norms we
must first understand
existing norms & barriers
Every change requires
effort and the decision to
make that effort is a
1:00 PM - 2:00 PM
2:00 PM - 2:30 PM
2:30 PM - 3:30 PM
3:30 PM - 4:00 PM
4:00 PM - 5:00 PM
5:00 PM - 6:00 PM
6:00 PM - 8:00 PM
8:30 AM - 8:45 AM
8:45 AM - 9:45 AM
9:45 AM - 10:45 AM
10:45 AM - 11:15 AM
11:15AM - 12:10 PM
12:10 PM - 1:00 PM
1:00 PM - 1:55 PM
2:00 PM - 2:55 PM
3:00 PM - 3:30 PM
3:30 PM - 4:30 PM
4:30 PM - 5:00 PM
Monday, October 28, 2013
Innovation: The Frontier of Patient Care
The Strategic Imperative for Innovation
Innovation in Care Delivery: The Patient Journey
Cocktail Reception in the Museum of History and Innovation
Tuesday, October 29, 2013
Creating the New Culture Through Relationship-Based Care
The Attending Registered Nurse
Breakout Session #1
Breakout Session #2
Breakout Session #3
Tales from the Front Lines: The Clinician’s Experience (Panel)