Tools for Performance Improvement and Organizational Success
Tools for Performance Improvement and Organizational Success IASHA Session 23-B Shanghai, China
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
謝謝
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Commission on Accreditation of Rehabilitation Facilities • An international accreditation and standard setting organization. • 1966 • Private, non-profit, independent • Areas of focus: – – – – –
Aging Behavioral Health Children and Youth Services Employment/Community Services Medical Rehabilitation
• Field driven – consumers, providers, payers, regulators © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
CARF International • Currently accredits over 49,600 programs, at over 19,000 sites, in over 6786 organizations in United States, Canada, Mexico, Europe, South America, Far East, New Zealand, and Africa (20 countries) • Over 8.2 million people served in 2012 • Peer Review Process • Process emphasizes the person served, performance improvement, business aspects of human service delivery, and good management process © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Quotes • “Overwhelming data show that when residents actively participate in their own care, they have better outcomes.” • Peter J. Pronovost MD, John Hopkins
• Person centered care • Person served … an active member of the team • Part of CARF process since 1966 • Person served are moral owners of CARF © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
qual·i·ty [ kwóllətee ] • standard: the general standard or grade of something • characteristic: a characteristic of somebody or something • essential property: an essential identifying nature or character of somebody or something • Synonyms: excellence, class, eminence, value, worth, superiority – Bing Dictionary
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
ac·cred·it [ ə kréddət ] • give official recognition to somebody: to officially recognize a person or organization as having met a standard or criterion • Synonyms: recognize, sanction, endorse, authorize, certify, certificate, approve
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
If you want to travel fast, you travel alone
If you want to go far, travel with others © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Inform the work we do • Provide guidance in choosing options when making decisions • Goal of improving resident outcomes (results)
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Resident first – partnership in achieving safe, easily accessible, timely and quality services across the continuum of care • Safety – Identification and control of risks to achieve effective results for both the resident and staff
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Personal responsibility – Taking personal responsibility for their own health and other health needs • Defined Authority – scope given to personnel at each level of the organization to carry our their responsibilities. Individual’s authority to act, resources available, and boundaries of the role are confirmed by direct line manager © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Clear accountability: system where individuals, functions, or committees agree accountability to a single individual. • Leadership – Motivating people towards a common goal and driving sustainable change to ensure high quality delivery of clinical and social care © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Interdisciplinary working – – work processes that respect and support unique contribution of each team member – focuses on interdependence between individuals and groups delivering services – requires proactive collaboration between all members
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Supporting performance – – Continuous process – Managing performance – Measuring resident and staff experience
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Open culture – – Trust, openness, respect and caring – Achievements recognized – Open discussion of adverse events part of everyday practice and communicated openly – Staff willingly report adverse events and errors – Focus on learning, improvement, research, and appropriate action taken © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Continuous quality improvement – – Learning environment and system that seeks to improve services – Emphasis on maintaining quality not just controlling processes – Involves setting of objectives, targets , measurement and education for ongoing improvement
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Mission-Driven Measurement
Copyright © 2013 CARF International
Our responsibility • Use our defining principles • Recognize the uniqueness of the people we serve • Be prepared to “make it right” • Measure to improve versus measuring to impress • Continuous improvement © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Contact information • Chris MacDonell – www.carf.org – www.uspeq.org – 866-888-1122 ext. 5007 – [email protected]
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
PIT Crew: A Concept in Performance Improvement
Jefferson Kaighn Vice President – Pennsylvania Region IAHSA Annual Conference – Shanghai November 2013
ACTS Retirement-Life Communities 23 Communities 8 States (East Coast USA) Continuing Care Retirement Communities Celebrated 40 Years in 2012 22 CARF-CCAC Accredited Extensive Participation as Surveyors
Background 25+ Years in Senior Services ACTS since 1994 Operations Industry Involved CASP Curriculum Contributor
What’s In a Name? What’s in a Name? QA CQI QMS JIT Whatever Initials
Common Goals Serve Residents Meet Objectives Enhance Performance Grow Business Fulfill Mission
Inspiration
CARF-CCAC
How Did We Get Here? The first ACTS community under the CARF-CCAC standards Wealth of Data Struggled getting “our hands around” the expectation Limited Conformance Needed a System
“Dazed & Confused” Single System focus on Business Function and Service Delivery Coordinated Effort of Clinical & Nonclinical Staff Distribution of Work Oversight of Process Decision Making Group Communicators
Having The Right Priotities CARF-CCAC was the inspiration but not the motivation Focusing on those things that are truly important Meeting our sacred obligations to Residents, Staff, Organization, Stakeholders
From Out of the Ashes PIT Crew Periodic meetings Determine community needs Develop plans Assign study tasks Review results Communicate progress Coordinate PI strategies
PIT Crew – Team Members
Administration Department Managers Clinical Liaison Line Staff (if applicable) Residents (if applicable) Ad hoc Members - Consultants - Line Staff - Residents - Family Members
PIT Crew - Protocols Impact Entire Community Be Ongoing Effort Involve Studies Impacting: - Business Factors & Service Delivery • Effectiveness: outcomes or results • Efficiency: resources consumed • Access: using services • Satisfaction: process & outcome Establish Study Team Schedule Manage/Monitor Annual Update Requirements Maintain Communication Records PIT Crew Determines Studies
PIT Crew – Data Collection Various Forms of Data Resident & Employee Satisfaction Surveys QI/QM Group Meeting Feedback • Safety Committee • Liaison Committees • Let’s Talk & Town Halls Financial & Occupancy Reports Regulatory Surveys & Internal Audits Corporate Reports • Turnover • Insurance & Risk Reports • Purchasing Reports Dash Boards
PIT Crew – Data Management Data Used in Analysis & Measurement - Reliable: consistent collection allowing data to be reproduced - Valid: measure what is intended to be measured - Complete: reflects population under study - Accurate: proper recording procedures to eliminate errors
PIT Crew - Schedule 2009
Food Temp
Jan
X X X X
Feb Mar Apr May
Jun Jul Aug
Falls
X X X
Agenc y
X X X X X
Ren. Cost
X X X X
Fire Drill
X X
Monthly Flow Chart Identify Anticipated Start & Completion of a Study Graphic Representation of Work Assuring Ongoing Approach to Performance Improvement May note: analysis, data collection, measurement dates
So, What’s It All Look Like? PIT Crew Safety/Risk Culture Change
Access
Business
QA/Clinical
Environment
Culinary
Annual Update Resident Life
Study Team Lead Team Member
Team Member Member
Team Member
PIT Crew - Agenda Review Current Study Status - Team Lead Update on Progress - Team Lead Report on Next Steps Share Area Specific Opportunities - Each Member Reports on Area - Each Member Recommends Studies Assign New Studies - Assign Team Lead and Time Frame Formulate Communication Information - Determine Vehicle & Message Review Performance Improvement Schedule
PIT Crew – Study Team Leader - Appointed by PIT Crew - Should be a PIT Crew Member Study Team Members - Recruited by Study Team Leader - May be Non-PIT Crew Members - May Include a Variety of Stakeholders - May Change as Study Evolves
PIT Crew – Study Team Identify Current Data Position as “Starting Point” Establish Target (goal) Establish Intervention Strategy Implement Strategy for Defined Period Measure Results Analyze Results Data Report Findings to PIT Crew
PIT Crew – Communication Variety of Communication Vehicles - Newsletter Articles - Postings - Committee/Group Meetings - Letters/Memorandums - Presentations - Web Pages - Charts & Graphs
PIT Crew – Key Ideals Buy-in From Department Managers Use Available Data Study Only What You Can Improve Don’t Take On More Than You Can Handle Communicate with Stakeholders in a Format that is Useful & Meaningful Celebrate Your Successes!
PIT Crew - Philosophy Performance Improvement is a Community Responsibility PIT Crew Serves as an Umbrella Over Service Delivery and Business Function PIT Crew is a Repository of Means to Improvement PIT Crew Focuses on Improvement Not Establishing Blame
The PIT Crew Tate Publishing
http://www.tatepublishing.com/bookstore /search.php?search=The+PIT+Crew
Jefferson Kaighn [email protected]
The PIT Crew
Questions?
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
謝謝
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Commission on Accreditation of Rehabilitation Facilities • An international accreditation and standard setting organization. • 1966 • Private, non-profit, independent • Areas of focus: – – – – –
Aging Behavioral Health Children and Youth Services Employment/Community Services Medical Rehabilitation
• Field driven – consumers, providers, payers, regulators © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
CARF International • Currently accredits over 49,600 programs, at over 19,000 sites, in over 6786 organizations in United States, Canada, Mexico, Europe, South America, Far East, New Zealand, and Africa (20 countries) • Over 8.2 million people served in 2012 • Peer Review Process • Process emphasizes the person served, performance improvement, business aspects of human service delivery, and good management process © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Quotes • “Overwhelming data show that when residents actively participate in their own care, they have better outcomes.” • Peter J. Pronovost MD, John Hopkins
• Person centered care • Person served … an active member of the team • Part of CARF process since 1966 • Person served are moral owners of CARF © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
qual·i·ty [ kwóllətee ] • standard: the general standard or grade of something • characteristic: a characteristic of somebody or something • essential property: an essential identifying nature or character of somebody or something • Synonyms: excellence, class, eminence, value, worth, superiority – Bing Dictionary
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
ac·cred·it [ ə kréddət ] • give official recognition to somebody: to officially recognize a person or organization as having met a standard or criterion • Synonyms: recognize, sanction, endorse, authorize, certify, certificate, approve
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
If you want to travel fast, you travel alone
If you want to go far, travel with others © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Inform the work we do • Provide guidance in choosing options when making decisions • Goal of improving resident outcomes (results)
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Resident first – partnership in achieving safe, easily accessible, timely and quality services across the continuum of care • Safety – Identification and control of risks to achieve effective results for both the resident and staff
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Personal responsibility – Taking personal responsibility for their own health and other health needs • Defined Authority – scope given to personnel at each level of the organization to carry our their responsibilities. Individual’s authority to act, resources available, and boundaries of the role are confirmed by direct line manager © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Clear accountability: system where individuals, functions, or committees agree accountability to a single individual. • Leadership – Motivating people towards a common goal and driving sustainable change to ensure high quality delivery of clinical and social care © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Interdisciplinary working – – work processes that respect and support unique contribution of each team member – focuses on interdependence between individuals and groups delivering services – requires proactive collaboration between all members
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Supporting performance – – Continuous process – Managing performance – Measuring resident and staff experience
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Open culture – – Trust, openness, respect and caring – Achievements recognized – Open discussion of adverse events part of everyday practice and communicated openly – Staff willingly report adverse events and errors – Focus on learning, improvement, research, and appropriate action taken © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Guiding Principles • Continuous quality improvement – – Learning environment and system that seeks to improve services – Emphasis on maintaining quality not just controlling processes – Involves setting of objectives, targets , measurement and education for ongoing improvement
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Mission-Driven Measurement
Copyright © 2013 CARF International
Our responsibility • Use our defining principles • Recognize the uniqueness of the people we serve • Be prepared to “make it right” • Measure to improve versus measuring to impress • Continuous improvement © © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
Contact information • Chris MacDonell – www.carf.org – www.uspeq.org – 866-888-1122 ext. 5007 – [email protected]
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
© © 2013 2013 CARF CARF International. International. All All rights rights reserved. reserved.
PIT Crew: A Concept in Performance Improvement
Jefferson Kaighn Vice President – Pennsylvania Region IAHSA Annual Conference – Shanghai November 2013
ACTS Retirement-Life Communities 23 Communities 8 States (East Coast USA) Continuing Care Retirement Communities Celebrated 40 Years in 2012 22 CARF-CCAC Accredited Extensive Participation as Surveyors
Background 25+ Years in Senior Services ACTS since 1994 Operations Industry Involved CASP Curriculum Contributor
What’s In a Name? What’s in a Name? QA CQI QMS JIT Whatever Initials
Common Goals Serve Residents Meet Objectives Enhance Performance Grow Business Fulfill Mission
Inspiration
CARF-CCAC
How Did We Get Here? The first ACTS community under the CARF-CCAC standards Wealth of Data Struggled getting “our hands around” the expectation Limited Conformance Needed a System
“Dazed & Confused” Single System focus on Business Function and Service Delivery Coordinated Effort of Clinical & Nonclinical Staff Distribution of Work Oversight of Process Decision Making Group Communicators
Having The Right Priotities CARF-CCAC was the inspiration but not the motivation Focusing on those things that are truly important Meeting our sacred obligations to Residents, Staff, Organization, Stakeholders
From Out of the Ashes PIT Crew Periodic meetings Determine community needs Develop plans Assign study tasks Review results Communicate progress Coordinate PI strategies
PIT Crew – Team Members
Administration Department Managers Clinical Liaison Line Staff (if applicable) Residents (if applicable) Ad hoc Members - Consultants - Line Staff - Residents - Family Members
PIT Crew - Protocols Impact Entire Community Be Ongoing Effort Involve Studies Impacting: - Business Factors & Service Delivery • Effectiveness: outcomes or results • Efficiency: resources consumed • Access: using services • Satisfaction: process & outcome Establish Study Team Schedule Manage/Monitor Annual Update Requirements Maintain Communication Records PIT Crew Determines Studies
PIT Crew – Data Collection Various Forms of Data Resident & Employee Satisfaction Surveys QI/QM Group Meeting Feedback • Safety Committee • Liaison Committees • Let’s Talk & Town Halls Financial & Occupancy Reports Regulatory Surveys & Internal Audits Corporate Reports • Turnover • Insurance & Risk Reports • Purchasing Reports Dash Boards
PIT Crew – Data Management Data Used in Analysis & Measurement - Reliable: consistent collection allowing data to be reproduced - Valid: measure what is intended to be measured - Complete: reflects population under study - Accurate: proper recording procedures to eliminate errors
PIT Crew - Schedule 2009
Food Temp
Jan
X X X X
Feb Mar Apr May
Jun Jul Aug
Falls
X X X
Agenc y
X X X X X
Ren. Cost
X X X X
Fire Drill
X X
Monthly Flow Chart Identify Anticipated Start & Completion of a Study Graphic Representation of Work Assuring Ongoing Approach to Performance Improvement May note: analysis, data collection, measurement dates
So, What’s It All Look Like? PIT Crew Safety/Risk Culture Change
Access
Business
QA/Clinical
Environment
Culinary
Annual Update Resident Life
Study Team Lead Team Member
Team Member Member
Team Member
PIT Crew - Agenda Review Current Study Status - Team Lead Update on Progress - Team Lead Report on Next Steps Share Area Specific Opportunities - Each Member Reports on Area - Each Member Recommends Studies Assign New Studies - Assign Team Lead and Time Frame Formulate Communication Information - Determine Vehicle & Message Review Performance Improvement Schedule
PIT Crew – Study Team Leader - Appointed by PIT Crew - Should be a PIT Crew Member Study Team Members - Recruited by Study Team Leader - May be Non-PIT Crew Members - May Include a Variety of Stakeholders - May Change as Study Evolves
PIT Crew – Study Team Identify Current Data Position as “Starting Point” Establish Target (goal) Establish Intervention Strategy Implement Strategy for Defined Period Measure Results Analyze Results Data Report Findings to PIT Crew
PIT Crew – Communication Variety of Communication Vehicles - Newsletter Articles - Postings - Committee/Group Meetings - Letters/Memorandums - Presentations - Web Pages - Charts & Graphs
PIT Crew – Key Ideals Buy-in From Department Managers Use Available Data Study Only What You Can Improve Don’t Take On More Than You Can Handle Communicate with Stakeholders in a Format that is Useful & Meaningful Celebrate Your Successes!
PIT Crew - Philosophy Performance Improvement is a Community Responsibility PIT Crew Serves as an Umbrella Over Service Delivery and Business Function PIT Crew is a Repository of Means to Improvement PIT Crew Focuses on Improvement Not Establishing Blame
The PIT Crew Tate Publishing
http://www.tatepublishing.com/bookstore /search.php?search=The+PIT+Crew
Jefferson Kaighn [email protected]
The PIT Crew
Questions?
