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E-grāmata: Guide to Achieving STEEEP(TM) Health Care: Baylor Scott & White Health's Quality Improvement Journey

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  • Formāts: 180 pages
  • Izdošanas datums: 02-Aug-2017
  • Izdevniecība: Apple Academic Press Inc.
  • Valoda: eng
  • ISBN-13: 9781482236828
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Guide to Achieving STEEEP(TM) Health Care: Baylor Scott & White Health's Quality Improvement JourneyPalielināt
  • Formāts: 180 pages
  • Izdošanas datums: 02-Aug-2017
  • Izdevniecība: Apple Academic Press Inc.
  • Valoda: eng
  • ISBN-13: 9781482236828
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In terms of health care, STEEEP stands for safe, timely, effective, efficient, equitable and patient-centered. This gold standard of health care though can be challenging for providers to achieve and is an on going process. Every level of the health care structure must be willing to work to achieve high quality service but there must be a specific focus on developing administration and governance, clinical leadership, quality programs and expertise, data analytics and accreditation. The book includes a plan consisting of four phases for health care providers to follow when trying to achieve STEEEP care. Numerous real world examples and extensive appendices that include everything from checklists for success to sample learning boards are provided. Annotation ©2015 Ringgold, Inc., Portland, OR (protoview.com)

Achieving health care that is safe, timely, effective, efficient, equitable, and patient-centered (STEEEP) is not an endpoint, but a journey. This journey requires a commitment to quality improvement (QI) from the highest levels of leadership combined with the interdependent development of several key components of health care delivery: administration and governance, clinical leadership, quality programs and expertise, data analytics, and accreditation. As each organization travels along its journey, these components must evolve at a common pace. With each component of a given phase of the quality journey firmly developed, the organization can expect to advance to the next phase knowing that the requisite factors are aligned.

Winner of a 2015 Shingo Research and Professional Publication Award

Baylor Scott & White Health (BSWH) has formalized its commitment to quality with the adoption of the STEEEP framework supporting the Institute of Medicine's call for health care that is safe, timely, effective, efficient, equitable, and patient centered. This Shingo Prize-winning guide book is a companion to BSWH's recent book Achieving STEEEP Health Care. It presents practical approaches and tools, including sample workflows, forms, charters, and checklists, that health care delivery organizations can use to organize, lead, execute, and measure the impact of their own improvement efforts.

BSWH has traveled the QI journey during its 100 years as the largest not-for-profit health care system in Texas and one of the largest in the U.S. With a history of visionary care, its aim is to help others achieve the highest levels of quality and safety for their patients. To learn more about the BSWH quality journey and to find additional case studies and tools, please visit www.steeepglobalinstitute.com.

Recenzijas

"For quality leaders who are wondering what to do and how to do it this book provides the detail that you have been seeking, right down to the level of the types of people to hire, what their qualifications should be, where they should fit in the governance chart, and the nature of their deliverables." Thomas H. Lee, MD, Chief Medical Officer, Press Ganey Associates, Inc.

"Organizations that can reliably and effectively implement best practices will be leaders in the health care field in the 21st century. This book is a gold mine of practical and valuable resources and tools for health care organizations to use today and for years to come in their improvement journeys." Maulik Joshi, Dr.P.H., President, Health Research & Educational Trust; and Senior Vice President of Research, American Hospital Association

"Baylor Scott & White Health has again provided a road map, this time exceptionally documented and annotated. This effort will assist health care institutions in consistently improving the care provided to their patients. In today's ultra-competitive world focused on the right care at the right time in the right setting, Baylor Scott & White Healths second effort is a must read. It provides both the rational and in-depth tools to transform an organization into a world-class provider of safe and efficient health care services. Combined with strong patient and family participation, it offers the road map to substantially improved patient satisfaction, staff retention and community endorsement. Kudos to Dr. Ballard and his teama clear, clean and crisp presentation." Arja P. Adair, Jr., MBA, President & Founder of TOKOBE, LLC; Retired President and CEO of CFMC

"Baylor Scott & White Health's journey to improve health care guided by the Institute of Medicine's STEEEP aims serves as a role model for all of us in health care. But then comes the hard part -implementation. The practical, well-organized suggestions contained in this guide, harvested from the organizations real-life experience, are an invaluable resource for others considering a similar journey. The guide is helpful for anyone, novice or expert, who is helping to lead large-scale clinical change in today's challenging health care environment." Gary Yates, MD, President, Healthcare Performance Improvement, LLC; President, Sentara Healthcare Quality Care Network; Former Senior Vice President and Chief Medical Officer, Sentara Healthcare

"Achieving best clinical outcomes at lower costs, while creating an ideal patient and provider experience, requires a set of intentional structures and processes. Dr. Ballard and his team have developed the 'how-to manual.'" Ziad Haydar, MD, MBA, Senior Vice President and Chief Medical Officer, Ascension Health

"This guide to achieving STEEEP health care lays out a very practical approach to patient safety and quality improvement based on the extensive experience of Dr. Ballard and his team. The practical examples included in this guide are a goldmine of useful approaches for any healthcare system wondering where to start or how to take the next step in their journey. This companion to the earlier book should be welcomed by many waking up to the importance of driving change in the delivery of care at the present time." J. Michael Henderson, MD, Chief Quality Officer, Cleveland Clinic

"... includes a plan consisting of four phases for health care providers to follow when trying to achieve STEEEP care. Numerous real world examples and extensive appendices that include everything from checklists for success to sample learning boards are provided." Ringgold, Inc. Book News, February 2015

Preface xi
Acknowledgments xiii
Introduction xv
About the Author xxiii
Chapter 1 Phase 1 of the STEEEP Quality Journey: The Initiation Phase 1(14)
Introduction to Phase 1: Initiation
1(1)
Other Organizations
2(1)
The Initiation Phase: The Administration and Governance Role in the STEEEP Quality Journey
2(3)
Develop an Awareness of the Importance of QI to Your Organization
2(1)
Participate in Education Programs Focusing on QI's Application to Health Care
3(1)
Commit the Organization to Pursuing a Path toward Excellence in Quality and Patient Safety That Will Culminate in Phase 4: Continuous QI
3(1)
Create a Board Resolution That Challenges the Organization to Achieve the Highest Levels of Quality and Patient Safety
4(1)
Set Macro-Level Goals for the Organization for Quality and Patient Safety
4(1)
Form a QI Governance Council
5(1)
Develop an Organizational QI Entity
5(1)
The Initiation Phase: The Physician and Nurse Leadership Role in the STEEEP Quality Journey
5(3)
Develop an Awareness of the Importance of QI to Your Organization
5(1)
Participate in Education Programs Focusing on QI
5(1)
Hire/Develop High-Level Clinician Leaders
6(1)
Assess and Define Your Role in Organizational QI
6(1)
Take a Leadership Role in Gaining Commitment from Your Board and Administrative Leaders for the QI Program
7(1)
Participate in QI Council and Programs with Your Nonclinician Colleagues
7(1)
Put in Place a Structure to Provide Leadership to Other Clinicians
8(1)
Initiate QI Projects within Your Network of Colleagues
8(1)
The Initiation Phase: The Role of Quality Improvement Programs and Expertise in the STEEEP Health Care Journey
8(3)
Hire/Develop a Chief Quality Officer
8(1)
Hire/Develop a Director of QI
9(1)
Hire/Develop a QI Coordinator
9(1)
Approve the Macro-Level Goals Set Prioritized and Agreed to by the Board and Administration
9(1)
Provide Education Programs to Train Administrative and Clinician Leaders in QI
10(1)
Establish Ability to Perform Data Collection, Abstraction, and Reporting
10(1)
Ensure the Organization Meets Basic Performance Benchmarks for Quality and Patient Safety
10(1)
The Initiation Phase: The Role of Data and Analytics in the STEEEP Health Care Journey
11(2)
Develop Department and Systems to Measure, Analyze, and Report Organizational Performance as Well as the Effects of Specific QI Initiatives
11(1)
Develop Capabilities Critical to Organizing, Using, and Reporting Existing Organizational Quality Data
12(1)
Define and Identify Performance Metrics
12(1)
Identify Requirements for Data Collection
12(1)
The Initiation Phase: The Role of Reputation and Accreditation in the STEEEP Health Care Journey
13(2)
Establish Your Organization with Accrediting Agencies as One That Prioritizes the Delivery of STEEEP Care
13(2)
Chapter 2 Phase 2 of the STEEEP Quality Journey: The Foundation Building Phase 15(14)
Introduction to Phase 2: Foundation Building
15(1)
The Foundation Building Phase: The Administration and Governance Role in the STEEEP Quality Journey
16(3)
Continue to Learn about QI by Participating in Education Programs and Seeking Advanced Leadership Training
16(1)
Set Moderately Aggressive Quality, Patient Safety, and Patient Experience Goals
17(1)
Continue to Develop a Culture of QI by Linking Financial Incentives to Quality, Patient Safety, and Patient Experience
17(1)
Establish a Formal Governance Structure for Quality and Patient Safety
18(1)
Include Patients and Families in QI Efforts
19(1)
Drive toward Measurement and Reporting That Will Highlight Successes and Opportunities
19(1)
The Foundation Building Phase: The Physician and Nurse Leadership Role in the STEEEP Quality Journey
19(2)
Take a More Public QI Leadership Role
19(1)
Engage in Formal Clinician Leadership Training That Includes Education in Finance
20(1)
Collaborate with Administrative and Quality Leaders to Set Annual Quality, Patient Safety, and Patient Experience Goals for the Organization
20(1)
Establish Teams of Individuals from the Entire Organization Focused on QI and Encourage Active Participation
20(1)
Evolve QI Focus from Point Solutions to Solutions That Are More Systemic and That Have an Impact on a Larger Portion of the Continuum of Care
21(1)
The Foundation Building Phase: The Role of Quality Improvement Programs and Expertise in the STEEEP Quality Journey
21(4)
Collaborate with Administrative and Clinician Leaders to Set Annual Quality, Patient Safety, and Patient Experience Goals for the Organization
21(1)
Hire/Develop QI and Patient Safety Staff, Preferably with Advanced Degrees or Years of Experience
22(1)
Ensure That QI Education Personnel Have Experience in Achieving QI as Well as in Educating Others
23(1)
Open the Door to Patient and Family Involvement in the QI Program
23(1)
Deploy a Patient Safety Culture Survey
23(1)
Deploy an Adverse Event Measurement Tool
24(1)
Improve Equitable Care throughout the Community
24(1)
The Foundation Building Phase: The Role of Data and Analytics in the STEEEP Quality Journey
25(1)
Develop Infrastructure for Data Collection and Analysis
25(1)
Support Administrative, Clinician, and Quality Leaders in Interpreting Outcomes of QI Initiatives
25(1)
Provide Measurement Support for the Patient Safety Culture Survey
26(1)
Support Organizational Assessment of Adverse Events, Inpatient Mortality, and Patient Satisfaction
26(1)
The Foundation Building Phase: The Role of Reputation and Accreditation in the STEEEP Quality Journey
26(3)
Build Local Reputation through Community Affiliations, Relationships with Key Stakeholders, and Employee Engagement
26(1)
Identify and Apply for Some Advanced Accreditation
27(2)
Chapter 3 Phase 3 of the STEEEP Quality Journey: The Operationalizing Phase 29(12)
Introduction to Phase 3: Operationalizing
29(1)
The Operationalizing Phase: The Administration and Governance Role in the STEEEP Quality Journey
29(4)
Provide Funding and Support to Achieve Phase 3 Quality, Patient Safety, and Patient Experience Goals and Launch the Organization to Phase 4
29(1)
Inculcate and Embed a Culture of Quality, Patient Safety, and Patient Centeredness throughout the Organization
30(1)
Evaluate and Refine QI Metrics and Commit to a Quantitative Approach to Goal Setting
31(1)
Insist on Transparency of Quality, Patient Safety, and Patient Experience Data to Enable Internal Comparisons and Drive Organization-Wide QI
31(1)
Engage Patients in Discussions and Decisions about the QI Program
32(1)
The Operationalizing Phase: The Physician and Nurse Leadership Role in the STEEEP Quality Journey
33(2)
Drive a Model of Shared Governance throughout the Organization
33(1)
Leverage the Effectiveness of Your QI Efforts by Expanding Your Focus Organization-Wide
34(1)
Expand Your Circle of Influence across the Organization through Participation in Committees and Other Multidisciplinary Groups
34(1)
Create and Strengthen Relationships with Finance Leaders and Leaders of Core Business Support Functions
34(1)
Serve as the Voice of the Patient in Discussions and Decisions about QI
35(1)
The Operationalizing Phase: The Role of Quality Improvement Programs and Expertise in the STEEEP Quality Journey
35(2)
Make Education in QI Mandatory for All Senior-Level Administrative and Clinician Leaders and Provide QI Training for Additional Leaders
35(1)
Provide Senior-Level Administrative and Clinician Leaders with Continuing QI Education
35(1)
Dedicate Infrastructure and Resources to an Organization-Wide Patient Safety Department
36(1)
Dedicate Infrastructure and Resources to an Organization-Wide Patient Experience Department
36(1)
The Operationalizing Phase: The Role of Data and Analytics in the STEEEP Quality Journey
37(2)
Enhance Ability to Extract and Analyze Data to Drive QI Initiatives
37(1)
Establish Data Governance Policies and Procedures
38(1)
Employ Reporting Methods That Make Data Interactive, Dynamic, and Drillable
38(1)
Develop Facility and Service-Line Performance Reports
38(1)
Use Comparative Data to Improve Patient Care
39(1)
The Operationalizing Phase: The Role of Reputation and Accreditation in the STEEEP Quality Journey
39(2)
Build Regional Reputation through Quality Awards and Recognition
39(1)
Further Develop Focus on Health Equity
39(1)
Achieve Additional Advanced Accreditation and Certification
40(1)
Chapter 4 Phase 4 of the STEEEP Quality Journey: The Continuous Quality Improvement Phase 41(9)
Introduction to Phase 4: Continuous Quality Improvement
41(1)
The Continuous Quality Improvement Phase: The Administration and Governance Role in the STEEEP Quality Journey
42(2)
Sustain an Organizational Culture That Embraces and Advances Quality, Patient Safety, and Patient Experience at All Levels
42(1)
Spread QI Successes by Acknowledging Achievements and the People Responsible for Them
42(1)
Promote Accountability for QI by Hardwiring Variable Pay and a Quantitative Approach to Organizational Goal Setting
43(1)
Continuously Drive a Care Partnership with Patients and Families
43(1)
Measure and Publicize the Link between Quality and Cost
44(1)
The Continuous Quality Improvement Phase: The Physician and Nurse Leadership Role in the STEEEP Quality Journey
44(1)
Continuously Drive Organizational Goal Setting with Your Clinical Expertise, QI Experience, and Role as Patient Advocate
44(1)
Drive Innovation within Your Discipline, Both Inside and Outside the Organization
44(1)
Continuously Define, Refine, and Implement Evidence-Based Best Practices throughout the Organization
44(1)
Establish and Lead Service-Line Quality Improvement Councils to Foster a Stronger Connection among the Elements of STEEEP Care
45(1)
The Continuous Quality Improvement Phase: The Role of Quality Improvement Programs and Expertise in the STEEEP Quality Journey
45(2)
Continuously Refine Organizational Goals and the QI Program to Enable the Organization to Reach and Exceed Performance Established by National Benchmarks
45(1)
Continuously Develop Infrastructure for Coordinating and Managing the QI Program
46(1)
Provide Formal QI Training for Staff at Multiple Levels
46(1)
Spread Successful QI Initiatives by Fostering and Rewarding Improvement
46(1)
Utilize Decision Support Tools to Drive Innovation and STEEEP Care
47(1)
The Continuous Quality Improvement Phase: The Role of Data and Analytics in the STEEEP Quality Journey
47(1)
Support the Establishment and Maintenance of Data-Driven Clinical and Operational Best Practices
47(1)
Use Data to Promote a Proactive Organizational Approach to Health Care QI That Is Policy Driven
47(1)
Develop Resources and Technology to Utilize Large Data Sets and Integrate Data from Multiple Sources
48(1)
Develop Advanced Analytic Capabilities That Include Financial-Modeling Abilities
48(1)
The Continuous Quality Improvement Phase: The Role of Reputation and Accreditation in the STEEEP Quality Journey
48(1)
Apply for National Quality Awards and Recognition
48(1)
Tell the Story of Your Organization's STEEEP Quality Journey
49(1)
Summary
49(1)
Appendixes: Tools, Methods, and Case Studies to Operationalize the STEEEP Quality Journey 50(97)
Appendix 1: The Initial Presentations to Board and Administrative Leaders to Gain a Commitment to Quality
51(2)
Appendix 2: Quality Improvement Training-STEEEP Academy
53(4)
Appendix 3: Example Presentation Slides: Building a Business Case for Quality
57(2)
Appendix 4: Board of Trustees Resolution
59(2)
Appendix 5: Sample Job Description for Chief Population Health Officer
61(4)
Appendix 6: Sample Job Description for an Accountable Care Organization Chief Medical Officer
65(2)
Appendix 7: Sample Job Description for a Medical Group Chief Medical Officer
67(2)
Appendix 8: Sample Job Description for Chief Quality Officer
69(4)
Appendix 9: Sample Job Description: Director of Quality Improvement
73(2)
Appendix 10: Sample Job Description: Quality Improvement Coordinator
75(2)
Appendix 11: Centers for Medicare and Medicaid Services Value-Based Purchasing
77(2)
Appendix 12: Advanced Quality Improvement Training for Board Members
79(2)
Appendix 13: Presentations to Leaders to Sustain a Commitment to Quality
81(2)
Appendix 14: Aligning Incentives with Organizational Goals
83(2)
Appendix 15: BSWH STEEEP Governance Council Charter
85(2)
Appendix 16: Physician Leadership Education Needs Assessment
87(2)
Appendix 17: Physician Leadership Training
89(2)
Appendix 18: Nurse Leadership Training
91(2)
Appendix 19: STEEEP Academy Leadership Series: Clinical Leadership in Quality Improvement and Patient Safety
93(2)
Appendix 20: Attitudes and Practices of Patient Safety Survey
95(2)
Appendix 21: Sample Job Descriptions for Community Health Workers
97(8)
Appendix 22: STEEEP Care Report: All-Topic All-or-None Care Bundle Compliance
105(4)
Appendix 23: Diabetes Health and Wellness Institute Model of Diabetes/Chronic Disease Care
109(2)
Appendix 24: Sample Learning Boards to Drive Transparency and Employee Engagement
111(2)
Appendix 25: A Quantitative Approach to Goal Setting
113(2)
Appendix 26: Example Reports: Inpatient Mortality and 30-Day Readmission Rates
115(4)
Appendix 27: Areas of Focus for Key Department of Patient Safety Personnel
119(2)
Appendix 28: Areas of Focus for Key Department of Patient Experience Personnel
121(2)
Appendix 29: Eight Fundamental Service Behaviors
123(2)
Appendix 30: Blood Utilization Dashboard
125(2)
Appendix 31: Baylor Scott & White Quality Alliance Data Architecture and Example Screen Shots from the Baylor Scott & White Quality Alliance Dashboard
127(2)
Appendix 32: Sample Performance Award Program Measurements
129(2)
Appendix 33: Sample Safe Surgery Saves Lives Checklist
131(2)
Appendix 34: Cardiovascular Surgery Quality Council Charter
133(2)
Appendix 35: Case Studies: Driving STEEEP Care through Quality Improvement
135(10)
Appendix 36: Trauma Readmission Analysis
145(2)
Bibliography 147(2)
Index 149
David J. Ballard, MD, MSPH, PhD, FACP, is senior vice president and chief quality officer for the Baylor Health Care System (BHCS), Dallas, Texas; executive director of the BHCS Institute for Health Care Research and Improvement; and president and founder of the BHCS STEEEP (safe, timely, effective, efficient, equitable, and patient centered) Global Institute. Under his leadership, BHCS has received many awards for health care quality improvement, including the 2010 Medical Group Preeminence Award of the American Medical Group Association, the 2008 National Quality Healthcare Award of the National Quality Forum, and the 2007 Leapfrog Patient-Centered Care Award.

Prior to joining BHCS in 1999, Dr. Ballard held progressive academic appointments as assistant and then associate professor at the Mayo Medical School, associate professor with tenure at the University of Virginia School of Medicine, professor of medicine in the Emory University School of Medicine, and professor of epidemiology in The Rollins School of Public Health at Emory University. He also served as founding head of the Mayo Section of Health Services Evaluation, founding president of the Kerr L. White Institute for Health Services Research (19911999), president (20012003) of the International Society for Quality in Health Care, and chair of the Agency for Healthcare Research and Quality (AHRQ) Health Care Quality and Effectiveness Research study section (20062010). He currently chairs the AHRQs Centers for Education and Research on Therapeutics Steering Committee (20132014).

Dr. Ballard serves on several editorial boards of peer-reviewed medical journals, including Health Services Research, the Journal of Comparative Effectiveness Research, and the Mayo Clinic Proceedings (for which he serves as Health Policy section editor). He has published over 200 articles and is the 1995 recipient of the AcademyHealth New Investigator Award, which is given annually to the outstanding health services research scholar in the United States less than 40 years of age. His research also received the 2012 John M. Eisenberg Article-of-the-Year award from Health Services Research. He is a member of the UNC School of Public Health Foundation Board and a past member of the Board of Trustees of the Texas Hospital Association.

A board-certified internist, Dr. Ballard trained at the Mayo Graduate School of Medicine following completion of his MD, MSPH, and PhD in epidemiology, and BA in chemistry and economics from the University of North Carolina, where he was a Morehead Scholar, North Carolina Fellow, and junior year Phi Beta Kappa inductee. In 2008, Dr. Ballard received the Distinguished Service Award from the UNC School of Medicine.
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