Governance in Healthcare: Leadership for Successful Improvement

Successful outcomes improvement in healthcare requires strong leadership to make decisions, allocate resources, and prioritize initiatives. For improvement to succeed and endure, health systems can’t leave any part of leadership to chance. Instead, effective governance requires thoughtful, deliberate development. Otherwise, improvement initiatives stall or fail to launch, as stakeholders debate goals and strategies. To succeed, governance structure must be solid enough to withstand any challenges to improvement initiatives—from resource constraints to skeptics.

Effective governance in healthcare operates with four guiding principles:

1. Engage the right stakeholders.
2. Establish a shared understanding of objectives.
3. Align incentives and rules of engagement.
4. Practice disciplined prioritization.

Leading Adaptive Change to Create Value in Healthcare

In pursuit of the Triple Aim, healthcare leaders work hard to improve care, reduce costs, and improve the patient experience. But accomplishing these goals requires an engaged staff that makes progress, day in and day out. Adaptive Leadership (AL) principles help leaders understand human behavior to mobilize change and overcome work avoidance, which happens when staff operate above or below the productive zone of tension.

By understanding what adaptive work actually is (and that adaptive problems can’t be solved with technical fixes), and why work avoidance happens (because people are overwhelmed; the heat is too high), leaders can keep their teams engaged by using influence and leadership—not authority—to “lower the heat” on their people:

• Validate the difficulty of the situation.
• Simplify/clarify the work.
• Provide additional resources (time, training, etc.)

Dr. Ulstad has worked with healthcare leaders and teams for the last 20 years to help them understand behaviors triggered by rapid, high-volume change, and apply AL principles to guide the changes critical to their organizations’ success.

5 Principles of Adaptive Leadership and Why It’s a Critical Skill for Healthcare Leaders

Adaptive leadership is a leadership language and conceptual framework developed by Ronald Heifetz, MD, as a way to help hardworking leaders bring about change at their organizations. By applying adaptive leadership principles, leaders can enhance their ability to work with others by seeing human behavior differently and making sense of the behaviors triggered by rapid, high-volume change. The following five principles form the framework for adaptive leadership: (1) There are two types of challenges: technical and adaptive. (2) People need a certain amount of tension to do their best work, but the amount of tension needs to be productive. (3) There is a difference between the role of authority and the exercise of leadership. (4) Work avoidance (resistance) means that people are outside the productive range of tension. (5) Reflect in action by spending time on the balcony and the dance floor.

Successfully Rolling Out Healthcare Improvement Initiatives with Key Influencers

Rolling out a healthcare improvement initiative and getting buy-in from clinicians can be tricky. Paul Revere’s midnight ride shows how finding and using key influencers can help prompt action. This knowledge can be used to drive success of hospital data-driven improvement initiatives too. Achieving buy-in of new best practices and process across an organization is not easy, but it is imperative to success. Picking the right people for these teams means picking the innovators and early adopters in the organization, as the Paul Revere example illustrates. Once these people are identified, putting them into three key teams (the Guidance team, the Workgroup, and the Clinical Implementation team) will get the organization the right deployment system to drive successful improvement initiative on a system-wide basis.

The Best Organizational Structure for Healthcare Analytics

After working with many healthcare organizations to help them implement the appropriate EDW for their needs, we’ve learned how important it is to create cross-functional teams from across the organization. Why? These cross-functional teams will simultaneously improve clinical and financial outcomes and demonstrate ROI. By following this approach, you’ll experience the following advantages:

• Removal of organizational barriers between team members
• Prioritization of BI and analytic efforts according to institutional readiness and need
• Engagement and prioritization from appropriate leadership
• Buy in from each level of the organization to improvement goals

The 4 Clinical Teams Needed to Drive Sustainable Improvement

As the healthcare industry shifts from a fee-for-service to pay-for-performance and accountable care organizations are under greater pressure to make improvements to their clinical, financial and operational outcomes. As clinical quality improvement efforts grow systematically improving and sustaining care across the organization becomes more challenging. In order to ensure sustainable, long-term change a cross-functional, team-based approach that accelerates the implementation of change throughout the organization is necessary. This is the adoption system. Without an adoption system, improvement initiatives become a series of one off projects that may have a temporary positive impact, but soon return to the baseline level.

Keys to a Successful Health Catalyst Data Warehouse Platform and Analytics Implementation

We have found that many customers have similar questions about how the implementation process works when rolling out a Health Catalyst Late-Binding ™ data warehouse platform and analytics solutions.  So, we thought it would be useful to produce a document that we hope will answer the majority of these and other common questions. The keys for a successful Health Catalyst implementation are outlined step-by-step format.

Pre-step (most important): Identify key personnel resources needed on the health system side, 1) Implementation Planning, 2) Deploy Hardware, 3) Technical Kickoff Meeting with the Client and Health Catalyst Deployment Teams, 4) Access Source Data, 5) Install Platform, 6) Load Data, 7) Install Foundational Applications, 8) Install Discovery Applications, and 9) Install Advanced Applications

At the beginning of the project, Health Catalyst will begin a collaborative implementation planning process resulting in a timeline tailored to each project. Some projects can be accelerated, with the initial phase completed in 90 days.  Your health system will have questions specific to your organization and your circumstances. We are happy to answer those in person.