Executive Quality Academy Institute for Healthcare Improvement IHI High Impact Leadership Framework Barbara Balik EdD, RN [email protected]November 16, 2015 ACMA Leadership Conference Learning Objectives Describe IHI’s High Impact Leadership Framework and its three major components Explain how High Impact Leadership can enable leaders to achieve the Triple Aim – better health, better care, lower costs Define strategies for applying the High Impact Leadership Framework to your department, organization, and community Field of Dreams
26
Embed
IHI High Impact Leadership Framework - Case …acmaweb.org/Leadership/15Leadership_Handouts_Session1_Balik.pdfIHI High Impact Leadership Framework Barbara Balik EdD, RN ... – For
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Executive Quality Academy
Institute for Healthcare Improvement
IHI High Impact Leadership Framework Barbara Balik EdD, RN
• How leaders react to critical incidents and organizational crises
• Deliberate role modeling, teaching and coaching
• Observed criteria by which leaders allocate rewards and status
• Observed criteria by which leaders recruit, select, promote, and terminate organizational members
Secondary• Organizational design and
structure
• Organizational systems and procedures
• Organizational rites and rituals
• Design of physical space and buildings
• Stories, legends and myths about people and events
• Formal statements of organizational philosophy, values and creed
E. Schein, Organizational Culture and Leadership,1994
Or This?This?
Executive Quality Academy
Institute for Healthcare Improvement
Culture - What is it?
Finish the statement:
– This is an organization where . . .
What Culture do You Want?
Current State Desired State
Where are you in the Journey?
Executive Quality Academy
Institute for Healthcare Improvement
Doing To – When:
We say – you do: schedules; visiting hours
We waste your time – come to the clinic & wait
We assume we know what the community needs
Information is not shared or understandable
Health sciences students lack skills to partner with patients
Participation in research studies is not equitable
We determine if you are compliant
There is helplessness – when the patient/family say:– I don’t know what is the plan of care or what happens next
– I don’t know who is in charge of my care
– I don’t feel like you know me
Barbara Balik
Doing For – When:
We keep the patient or community member in mind when designing or improving programs, research studies – then ask
We design the teams to help you – without you
We manage your expectations about waiting, what healthcare can do, or what the community needs
Early use of health literacy
We teach you – lots & lots & lots
We are beginning to get it about cross-continuum but don’t know much about the white spaces
We assume we know everything about health and healthcare
Barbara Balik
Doing For – Service Design
What Matters to You?
Executive Quality Academy
Institute for Healthcare Improvement
Doing For
“We are really good
about caring what you
think about us. We are
not good about caring
what you think.”– Catherine Lee, VP Service Excellence, McLeod
Regional Medical Center
Barbara Balik
Doing With – When:
Patient/family and community member advisors are essential team members to design or improve programs that follow the patient journey; to design research or evaluation outcomes
All key decisions are mutual – including who is on my team
All staff are viewed as caregivers and are skilled in respectful communication and teamwork
Health Literacy is everywhere in patient care
Senior leaders model that patient’s safety and community well-being guide all decisions
Staff, providers, leaders are recruited for values and talent
Barbara Balik
Doing With – Mental Health Design
Executive Quality Academy
Institute for Healthcare Improvement
Where are you in doing to-for-with?
To-For-With Assessment
1. Individually – Complete 1-2 examples in each category
2. Review as a group at your table
3. What do your lists tell you? What gets in the way of doing with?
Doing To – Patients, Families, Community Members
Doing For – Patients, Families, Community Members
Doing With – Patients, Families, Community Members
Barbara Balik
Shape Culture
Engage Across Boundaries
Create Vision & Build Will
Deliver ResultsDevelop
Capability
Driven by
Persons &
Community
IHI High-Impact Leadership Framework
Executive Quality Academy
Institute for Healthcare Improvement
Understand care and health from partners’ view – their
journey and needs
Move knowledge not people*
Focus on what determines health: Work with community
– “I was standing in the river looking for water”
– Education
– Social and Community Context
– Health and Healthcare
– Neighborhood and Built Environment
– Economic Stability
Boundarilessness Thinking
*Don Berwick, Change from the Inside Out; JAMA 2015
Leading Across Boundaries
Establish a shared purpose – don’t assume
Communicate a shared vision
Ask questions and listen to responses
Build consensus
Show respect for the partner’s strengths, business models,
and constraints
Adopt a collaborative approach and demonstrate patience
Volunteer resources when needed
Ensure that the right people are in the room
Maternal and
Neonatal Mortality
Due to Faulty
Referral Processes
Inadequate Clinical Skills &
Management
Transportation & Communication
Barriers
Sociocultural Barriers
Late/no identification of high-risk clients
Failure to stabilize client before referral
Poor documentation of indications for referral & interventions to date
Lack of readiness of receiving facility
Poor hand-off management processes
Unreliable use of referralprotocols
Unavailability of local transportation
Insufficient funds for transport & telephone credits (both family & staff)
Long distances, poor roads/bridges
Inadequate ambulance services
Unreliable telecom services
Preference for home/TBA deliveries and self-medication (hospital as last resort)
Delay in decision to seek skilled care (recognition, permission, financial etc.)
Delay in acceptance of referral
Low risk awareness & management of obstetric/neonatal complications
Negative perceptions about health facilities as places to “go and die”
I pray you enough sun to keep your attitude bright no matter how gray the day may appear
I pray you enough rain to appreciate the sun even more
I pray you enough happiness to keep your spirit alive and everlasting
I pray you enough gain to satisfy your wanting
I pray you enough challenges to think
outrageously big!
Executive Quality Academy
Institute for Healthcare Improvement
Resources
ResourcesNew Rules for Radical Redesign in Health Care
Change the balance of power by co-producing health and well-being in partnership with patients,
families and communities.
Standardize what makes sense to reduce unnecessary variation and increase the time available for
individualized care.
Customize to the individual's needs, values and preferences, guided by the understanding of what
matters to the person, in addition to the typical "What's the matter?”
Promote well-being and focus on outcomes that matter the most to people, appreciating that their
health and happiness may not require health care.
Create joy in work by cultivating and mobilizing the pride and happiness of the health care workforce.
Make it easy, continually reducing waste and all non-value-added requirements and activities for
patients, families and clinicians.
Move knowledge, not people, exploiting all helpful capacities of modern digital care and continually
substituting better alternatives for visits and institutional stays.
Collaborate and cooperate, recognizing that the health care system is embedded in a network that
extends beyond traditional walls.
Assume abundance by using all the assets that can help to optimize the social, economic and physical
environment, especially those brought by patients, families and communities.
Return the money from health care savings to other public and private purposes.
Berwick, D., et al. Change From the Inside Out: Health Care Leaders Taking the Helm, 3/26/2015
http://jama.jamanetwork.com
Balik, B., Gilbert, J. (2010). The Heart of Leadership: Inspiration and Practical Guidance for Transforming Your Health Care Organization. Chicago: AHA Press.
Balik B, Conway J, Zipperer L, Watson J. The Patient and Family Experience. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2011.
Braaten, J, Bellhouse, D. Improving Patient Care by Making Small Sustainable Changes. Nursing Economics, May-June 2007, Vol 25, No. 3, 162-66.
Collins, J. (2009). How the Mighty Fall. NY: Harper Collins
Collins, J. (2001). Good to Great, NY: Harper Business.
Collins, J. (2005). Good to Great & the Social Sectors: A Monograph to Accompany Good to Great. Boulder, CO: www.jimcollins.com
Duhigg, C. (2012). The Power of Habit: Why We Do What We Do in Life and Business. NY: Random House.
Edmondson, A. (2012). Teaming: How Organizations Learn, Innovate, and Compete in the Knowledge Economy. San Francisco: Jossey-Bass.
Gilbert, J. (2007). Strengthening the Ethical Wisdom: Tools for Transforming Your Healthcare Organization. Chicago: Health Forum
Resources
Barbara Balik
Executive Quality Academy
Institute for Healthcare Improvement
Resources
Heath, C. & D. (2010). Switch: How to Change Things When Change is Hard. NY: Random House.
Heifetz, R. (1994). Leadership Without Easy Answers. Cambridge, MA: Belknap Press.
Heifetz, R., Grashow, A., Linsky, M. (2009). The Practice of Adaptive Leadership. Boston: Harvard Business Press.
Kenagy, J. (2009). Designed to Adapt. Second River Publishing.
Kouzes, J., Posner, B. (2002). The Leadership Challenge. San Francisco: Jossey-Bass.
Kouzes, J., Posner, B. (2003). Encouraging the Heart: A Leader’s Guide to Rewarding & Recognizing Others. San Francisco: Jossey-Bass.
Krause, T. (2007). NASA after Columbia & Lessons for Healthcare. National Patient Safety Board of Governors presentation. June 2007.
Keroack, M., Youngbird, B., Cerese, J., Krsek, C., Prellwitz, L., Trevelyan, E. Organizational factors associated with high performance in quality & safety in academic medical centers. Academic Medicine 82: 1178-1186, December 2007
Barbara Balik
ResourcesMoss Kanter, R. (2004). Confidence: How Winning Streaks & Losing Streaks Begin & End. NY: Crown Business.
Patterson, et al., (2008). Influencer. New York: McGraw-Hill.
Pink, D. (2009). Drive: Surprising Truth About What Motivates Us. NY: Riverhead Books.
Rother, M. (2010). Toyota Kata: Managing People for Improvement, Adaptiveness, and Superior Results. NY: McGraw Hill.
Schein, E. (1999). The Corporate Culture Survival Guide: Sense & Nonsense About Cultural Change. San Francisco: Jossey-Bass.
Schein, E. (2004). Organizational Culture & Leadership, 3rd Edition. San Francisco: Jossey-Bass.
Senge, P., Kleiner, A., Roberts, C., Ross, R., Roth, G., Smith, B., (1999). The Dance of Change: The Challenges of Sustaining Momentum in Learning Organizations. New York: Doubleday.
Spear, S. (2010). The High Velocity Edge. New York: McGraw Hill.
Barbara Balik
Resources
Spear, S., Bowen, HK. Decoding the DNA of the Toyota Production System. Harvard Business Review, Sept-Oct 1999; 77; 99-106.
Spear, S. Learning to Lead at Toyota. Harvard Business Review, May 2004; 78-86.
Spear, S. Fixing Health Care from the Inside, Today. Harvard Business Review, Sept 2005; 78-91.
Spear, S., Schmidhofer, M. Ambiguity & Workarounds as Contributors to Medical Error. Annals of Internal Medicine, April, 19, 2005, Vol. 142, No. 8, 627-630.
Tucker, A. & Edmondson, A. Why Hospitals Don’t Learn from Failures: Organizational & Psychological Dynamics that Inhibit System Change. California Management Review, Vol. 45. No 2, Winter 2003, 55-72.
Weick, K., Sutcliffe, K. (2001). Managing the Unexpected: Assuring High Performance in an Age of Complexity. San Francisco: Jossey-Bass.
Barbara Balik
Executive Quality Academy
Institute for Healthcare Improvement
Heart of LeadershipAdditional resources
Four Personal Characteristics
Patient care is my North Star
My actions show commitment to that North Star
Words and Actions Match;
Authenticity; Humility
Words and Actions Match;
Authenticity; Humility
Care about and Trust OthersCare about and Trust Others
Passion for Care is a Personal ValuePassion for Care is a Personal Value
Intelligent; Hungry for
Learning;Reflective
Intelligent; Hungry for
Learning;Reflective
Others can count on what I say
Others at all levels say I build trustI do not consider myself superior to anyone
I am comfortable not knowing
I am hungry to learn from anyone and anythingI regularly step back from everyday pressures
Encourage the Heart reflections:I express high expectations about what people are capable of accomplishingI personally acknowledge people for their accomplishmentsI get to know, at a personal level, the people I work with