Transcript Online Communities Improve Performance, Quality, and

Online Communities
Improve Performance,
Quality, and Efficiency
Holly Pendleton
Manager Knowledge
Management
Catholic Health Initiatives
Denver CO
Janet Guptill
Consultant
Health Evolutions, Inc.
St Louis MO
Twelfth National Forum on Customer Based Marketing Strategies
April 23, 2007 Orlando
Seminar Description
Virtual communities can be used to
accelerate the ability of healthcare
organizations to deliver safe, effective,
and efficient care.
Hear how a hospital alliance and a large
healthcare system are sharing evidencebased practices and data-driven results.
Identify the difference they are making.
Creating “Community” Online
 What is a “community”?
 Why are they moving
“online”?
 Why should this matter
to you?
 What is hard about it?
 What makes it easier?
Creating Community: people
connecting through shared needs
Who else faces similar
challenges to mine?
Who has
expertise in
this area?
Is anyone else working
on this same problem?
What ideas have been
tried and tested?
How can I share what I
have learned?
Is there a recommended
way to do this?
What are online communities?
 Online communities are social networks
 They are supported by web technologies
 They exist to solve problems
What are online communities in
healthcare?
 Consumer communities –
 Disease support groups, weight loss/stop smoking,
connect patients and families
 Professional communities –
 Professional societies, physician networking,
hospital business alliances, software users
 Employee communities –
 Best practice adoption, process improvement
teams, peer networking
Online communities are it!
 MySpace
Generation
 Collaboration
Expectations
 Customer
Interactions
 Engagement
Why use online communities?
Virtual Communities are used across hospitals to:
 Create relationships across time and space for peer
learning and experience sharing
 Identify successful practices, lessons learned, and
critical success factors for achieving better results
 Encourage and reward adoption of innovative
practices and data-driven business processes
Why use online communities?
Virtual Communities are used within hospitals to:
 Collaborate across roles, departments, or functions
to solve operational problems
 Simplify access to experts and expertise,
encourage new ideas
 Save time and money by re-using work done in
another department or area
What are key building blocks
for effective communities?
 Value Add – both the individual and the organization
have to see it as useful
 Culture – a new way of working – inherently more open
and collaborative
 Infrastructure – making it look simple is hard work to
begin with
 Communicating Impact – stories drive change
IHI Profiles in Improvement
Who's improving health care? People are.
Listen to the story of Jennifer Dunscomb of
Columbus Regional Hospital.
Source: www.IHI.org
Who is doing this now?
 CHCA
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3 pronged approach to virtual communities: Peer
Networking Forums, Performance Improvement
Collaboratives, Race for Results Awards Program
 CHI
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Embedded knowledge transfer and learning:
Knowledge Communities, Practice in Action, Calls
to Learn, Relay Reports, LEARN
CHCA Case Study
 Background of CHCA
 Overview of Forums, Collaboratives,
Race for Results
 Strategic Impact to date
 Lessons Learned
Improving the Performance of Children’s Hospitals
Knowledge Transfer to Improve
Performance: A Case Study
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42 non-competing hospitals US, Canada
$14 billion combined revenue (1)
Average per member revenue of $330 million
If Fortune 500 would be ranked 142
IDN influence:
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500,000 inpatients; 10 million outpatients (2)
102,000 employees (2)
>20,000 pediatric physicians (5,162 medical specialists;1,985 surgical
specialists(2)
 Top 5 among U.S. health systems/IDNs
Sources: (1) Estimated from Goldman Sachs report to CHCA, July 2004; (2) Estimated from personnel report in AHA
Guide 2003/ 2004
CHCA’s 3-pronged strategy
Peer Networking
TECHNOLOGY
PEOPLE &
PROCESS
Performance
Improvement
Spread
 Online communities
 Collaboratives
 RACE for Results
 Peer group meetings
 C, C, c
 Juried annual award
 Teleconferences
 PDSA approach
 Awards process with
 List serves
 Results reported to peers
 Forum directors
and executives
 Dedicated PI staff
 Special reports
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 Benchmarking
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STRATEGIC
IMPACT
external judges
Peer reviewed
publication
Ambassador program
External published
results
Real time tools and
resources
 Individual employee
 Organization-wide
 Focus on spread
improvement in
productivity
 Satisfaction + individual
hospital improvement in
results
improvement, e.g., cost
reduction, error reduction,
safety improvement
 Accelerate improvement
 Safe, efficient and
effective
 Knowledge available
when you need it
 Best practices
 Peer assistance
1 - Peer Networking Forums
 Internet site for Forum members only
Exclusivity, confidentiality, knowledge of colleagues
 Dedicated staff facilitator – Supports 3-5 Forums depending
on content knowledge and required expertise
 Share documents, post weblinks, initiate discussions, find
resources
 Technology combined with meetings keeps the group
connected
 Teleconferences, webcasts, bi-annual meetings
 Ad hoc conversations, focused research, group
problem-solving
 Rapid response to posted questions
 Benchmarking and identifying variation

Peer Networking Forums are Highly Active
2006 Hospital Participation in Forums
Ambulatory
22
Materials Management
33
Cardiac
28
OR Directors
31
CFO
40
PACT
34
CHAPs
17
Patient Financial Services
21
CIO
36
Payor Contracting
33
CNO
40
Pediatric Practice Exec.
22
COO
40
Pharmacy Buyers
40
Corporate Compliance
28
Pharmacy Directors
39
Customer Service
20
PHIS
37
Dietary
33
Physician Relations
22
Executive Dialogue
40
Quality and Safety
Leaders
42
Facilities Management
33
Radiology Directors
33
Health Information Mgmt
33
Respiratory Directors
32
Home Care
17
Risk Managers
25
Human Resources
32
SMAC
30
JCAHO
35
Social Work Community
15
Lab Directors
32
SPBD
28
Overall
2006
satisfaction
5.24 of 6.0
(87%)
Peer Networking Forums webpage example
2 - Performance Improvement Collaboratives
 Dedicated Performance Improvement staff and resources
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Trained in IHI improvement methodology
Hospitals agree to share results, post data and publish results
Use industry and hospital expert panels to validate clinical
direction
Combine research and rapid cycle - essential for academic
engagement
 Technology tools and partners integral to success
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Knowledge repository available real time
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improvements, tool kits, lessons learned, comparative data,
audios of webcasts and lessons learned
Strategic partners essential to spreading results and gaining
credibility
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AHRQ Partnership for Quality Grant helped fund participation and
training for all 42 hospitals
Data-sharing agreements developed to expand comparative data
sets (Vermont Oxford Neonatal Network and others)
Performance Improvement Collaboratives
Example: Reduced Adverse Drug Events
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 11 teams (61%) had at least a 50% reduction in ADE
rate
0%
-40%
Goal
-60%
Avg.
-80%
CHCA Hospitals with reduction in ADE rate
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-100%
BETTER
-20%
er
ag
Morgan-Stanley
 New York/
Komansky Center
 Orange
 Palo Alto
 Pittsburgh
 St. Petersburg
Average among teams with a reduction:
64% reduction
Average for all teams: 49% reduction
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Av
 Atlanta
 Birmingham
 Buffalo
 Cincinnati
 Columbus
 Corpus Christi
 Dayton
 Fort Worth
 Kansas City
 Miami
 Nashville
 New Orleans
 New York/
 16 teams (89%) had a reduction in ADE rate
% change
Hospital Teams:
Collaboratives have own web-sharing spaces
Adverse Drug Event Collaborative webpage
Blood Stream Infection Collaborative webpage
Surgical Infection Prevention Collaborative
3 - Awards Program Encourages Spread
 Formal RACE for Results awards program
 Formal application process with strict submission requirements
 External judges panel representing industry experts in quality and
patient safety
 Results announced at award ceremony during annual Quality
& Safety Meeting
 Winners required to serve as Ambassadors during subsequent year to
teach techniques and encourage adoption of proven practices
 Formal marketing campaign to publicize event
 Emails, posters, web notices to promote the competition and publicize
winners
 Email-based Relay Report to report progress as proven practices are
replicated across the alliance
 Resources and contacts posted on the intranet to facilitate connections
and encourage adoption
 Benchmarking reports regularly published to document improvements
 Improve Today Webcasts connect colleagues
RACE for Results
Awards Program
2004
Little Rock:
Reducing CatheterRelated
Bloodstream
Infections through
Repeated Rapid
Cycle Improvements
Cincinnati:
Reducing Cost
through Improving
Quality
11 Entries
2005
Palo Alto:
Decreasing ADEs
By Implementing
Safety Best
Practices
Washington DC:
Using PHIS to
Target Reducing
Infections in VP
Shunt Surgeries
12 Entries
2006
2007
Omaha: "Asthma
Attack“
Dayton: Reducing
CatheterAssociated
Bloodstream
Infections in
Children
17 Entries
30 Entries
RACE Results in Performance Improvement
Conclusions for CHCA
Strategy Drives Approach
 Informal peer networking builds a culture of sharing and collaboration
 Formal collaboratives are needed to create immediate results
 Systematic rewards and support are needed to spread initial results
Knowledge Transfer involves Technology, People/Process, and Strategy
 Technology enables information sharing and people directories
 People processes ensure productive interaction and knowledge exchange
 Strategy determines impact measures and ensures organizational momentum
CHCA Case Study Results:
 42 children’s hospitals participate in 30 peer networking forums, regularly sharing
improvement tools and resources, exchanging best practices and learning from
industry experts
 18 children’s hospitals averted 13,478 adverse drug events (ADEs), representing $2.7
million
in net savings, and reduced PICU blood stream infections (BSIs) by 57%
 More than 60 intensive care units are working to sustain and spread improvements in
ADEs and BSIs based on the initial collaboratives’ work
CHI Case Study
 Background of CHI
 KT&L Strategy and Scope
 Relay Report results to date
 Lessons Learned
CHI Fast Facts
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 Multi-institutional System of
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Catholic Healthcare Providers
Dedicated to the healing ministry of the Catholic Church
National Offices: Denver, Northern KY, and Minneapolis
Market Based Organizations (MBOs)
 19 states
 68 rural and urban communities
 71 hospitals (63 acute care, 5 behavioral, 2 rehabilitation, 1 long
term acute care)
 43 long-term care, assisted living facilities and residential units
 5 Community Health Services Organizations
Licensed acute care beds range from 15 to 1,546
$7.1 Billion in Annual Revenues
66,000 Employees (and growing)
Vision for CHI
Catholic Health Initiatives’ Vision is to live out its
Mission by transforming health care delivery and
by creating new ministries for the promotion of
healthy communities.
CHI Strategic Plan: 2007 - 2011
Leveraging the Knowledge Within
“Our goal is for CHI to become known as an
innovative organization. That will be our legacy
for the future health care system – that CHI
learns to leverage the wisdom of the whole,
efficiently, effectively, and humanely.”
- Kevin E. Lofton, FACHE, CEO, Catholic Health Initiatives
Knowledge Leadership
Knowledge Leaders are Leaders who are
effective at…
 Embracing and driving change
 Sharing experiences and applying learning
 Modeling the expected behaviors grounded in
the culture of the organization
… in order to tap into the intellectual capital
of the organization and harness it to innovate
and grow
Knowledge Transfer & Learning at CHI
Knowledge
Communities
Communication
& Collaboration
Strategic
Priority
Consulting
Formal
Education
Practice in
Action
CHI’s KT&L Strategy
Communication
& Collaboration
TECHNOLOGY
 Practice in Action - Proven
 Calls to Learn
 Relay Report
Practices database
 Pathfinders collection of expert
resources
 Annual Events &
 Calls to Learn
 Integrated into Annual Planning
 Centralized calendar of
 National office sponsors
 KC metrics reports
Budget Review process
 Formal process to confirm a
proven practice
 KT&L staff support system-wide
initiatives e.g., CHI Connect,
service line development
Calls to Learn across the
organization and beyond
 LMS intended to address
CHI-wide practices
 Integration of
organizational
effectiveness research
with delivery of new
education
 Enable innovation
 Organization-wide
 Compliance adherence
 Focus on strategic
improvement, e.g., cost
reduction, error reduction,
safety improvement
 Accelerate improvement
 Safe, efficient and effective
 Strategic Priority Consulting
 Enable delivery of
conferencing
 List serves
STRATEGIC
IMPACT
Integrated
Learning
 Knowledge Communities
 Live Meeting web-
PEOPLE &
PROCESS
Knowledge Transfer
 KC Chartering process
priorities
 Defined and
implemented new
standards of practice
Conferences
 System-wide LMS LEARN
education in support of
strategic priorities across
the system
Knowledge Communities:
Collaborate and Innovate
An environment that enables innovation, supports the
development and spread of new ideas and builds the
organizational social network to save time and reduce
costs.
Value of Pharmacist
as part of bedside
patient care team proved
and $53 Million saved
Why CHI uses online communities
 Connect peers and experts across CHI
 Common space across space and time
 Supports the work of the Knowledge Community:
 Enable and leverage knowledge sharing
 Learn before doing
 Problem solving: find, innovate, and accelerate
solutions
 Reduce costs, save time, and increase social fabric
 A strategic resource
Making it Easier to Connect with
Knowledge Communities
Relay Report: Communicate,
Connect, Celebrate
Improve connectivity, celebrate successes and increase
awareness and utilization of KT&L resources.
Accelerate the
implementation of
clinical imaging
technology, resulting
in accelerated
NPSR of $1.5 - $3.0 M
Practice in Action:
Transfer Critical Knowledge
Increase adoption of reliable, evidence based
practices, identify organizational expertise, and
recognize facilities that have achieved success.
Avoided medication
errors through
improved reconciliation
of home and hospital
medications.
Strategic Priority Consulting:
Support Organizational Priorities
Accelerate achievement of strategic priorities
by creating a plan to leverage available
knowledge transfer and learning resources.
Accelerate the
implementation of
ERP technology
(Lawson) and the
realization of
projected savings
Formal Education: Sustain Change
Coordinate and share system resources to insure that
education and training help employees learn the skills,
behaviors and competencies they need to move strategic
priorities forward.
Avoid dangerous /
deadly events in OB
through a targeted
Advanced Fetal
Monitoring curriculum
Knowledge Transfer is both
Organic AND Strategic
Accelerate Learning & Enable Innovation through…
Knowledge
Communities
Communication
& Collaboration
Strategic
Priority
Consulting
…leading to new models of
care delivery and creative
solutions…
…resulting in improved
outcomes:
• Quality & Patient Safety
Formal
Education
Practice
in Action
• Employee Satisfaction
& Engagement
• Increased Operating
Margins
Communities Are Here!
A 2001 best practice study (Using Communities of
Practice to Drive Organizational Performance and
Innovation) found:
“…strong evidence that communities are the next step in
the evolution of the modern, knowledge-based
organization. Communities … are a legitimate way to
spend time, engage an amazing percent of employees,
are held accountable for producing and stewarding
business-critical knowledge (and often results), and are
assuming a formal voice in the organization, based on
the power of their knowledge, not their position.”
Conclusions for CHI
Knowledge Leadership is at the core of CHI’s business strategy
 New Leadership competencies are based on collaboration & change
 Knowledge communities build a culture of sharing and innovation
 KT&L team has become core resource for national strategic initiatives
Knowledge Transfer has become the way CHI works
 Web tools support connectivity and facilitate communicating about key knowledge
resources and success stories
 New roles have evolved as collaboration has become embedded in the way CHI
works
 Strategic initiatives rely on knowledge tools to speed adoption
CHI Case Study Results:
 A total of 48 knowledge communities involve over 1600 associates across the
system
 Knowledge communities have yielded both “hard” and “soft” dollar savings, impact
patient outcomes through improved practices, increase reuse of proven practices
 After 5+ years, CHI leadership expect KT&L resources to be utilized as part of
strategic priority projects and leaders will be held accountable to Knowledge
Leadership competencies
Online Communities – Key
Takeaways
 Charter the community and know why it exists –
 connect it to the core strategy
 continually deliver value
 build a structure for care and feeding
 Build the web tools and support structure
 facilitate effective collaboration
 combine people, content, and context
 make it easy to use
Online Communities – Key
Takeaways
 Continually bring people into the conversation
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use both push and pull marketing tactics
link the website with other daily work tools (email,
work scheduling, news)
remind people of the resources available
celebrate the success stories
 Redesign how work gets done
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reward collaboration
share lessons learned
simplify knowledge re-use
Online Community Building Blocks
Social
Networking
Link to
Strategy
Ongoing
Marketing
TECHNOLOGY
Create MySpace for
your employees,
physicians, and
customers
Identify the
communities needed to
fulfill the organization’s
strategic objectives and
charter them
Use push and pull
tactics to continually
engage people in the
conversation of
collaboration
PEOPLE &
PROCESS
Create online people
directories, create peer
group moderator roles,
highlight personal
success stories
Make it someone’s job
to ensure that
collaboration is
integrated into the
organization; create a
process for connecting
related efforts
Incorporate proven
practice sharing into
annual awards
ceremonies, dept
budget reviews,
employee performance
reviews
STRATEGIC
IMPACT
Enhanced employee
satisfaction and
productivity, strong
customer satisfaction
scores
Define and track the
impact measures, e.g.,
patient safety, financial
performance, wait
times, turnover, market
share, etc.
Faster decisions,
quicker adoption of
proven practices, rapid
innovation absorption
Let’s Connect!
Janet Guptill
Consultant, Health Evolutions
314.378.6612
[email protected]
Holly Pendleton
Manager, Knowledge Management, CHI
303.383.2736
[email protected]
Kate Collins
Director, Knowledge Management, CHCA
913.262.1436
[email protected]
Carol Dobies
President, Dobies Healthcare Group
816.753.3336
[email protected]