Enabling Health Professionals V2 E Rev
- 1. Enabling Health Professionals to Respond to Their Customers Daniel A. Gregorie, M.D., M.B.A
- 2. Enabling Health Professionals to Respond to Their Customers Who are their customers? What are their customers telling them? How are they responding? What is required to respond effectively? Why are they unable to do so? What is needed to enable and support them?
- 3. Enabling Health Professionals to Respond to Their Customers Who are their Customers? The people who pay for and / or benefit from their services Patients Consumers Purchasers (employers and government) Payers ( insurers and third party administrators)
- 4. Enabling Health Professionals to Respond to Their Customers What are their customers telling them ? The direct $ cost of medical care is untenable The numbers of un/underinsured are growing.
- 5. Enabling Health Professionals to Respond to Their Customers What are their customers telling them ? (cont) More is not necessarily better High Rates of Error and Non Evidence Based Care Significant variation in process and outcome
- 6. Enabling Health Professionals to Respond to Their Customers What are their customers telling them? (cont) Poor Service-- access, personal attention, and convenience
- 7. Enabling Health Professionals to Respond to Their Customers What are their customers telling them? In short, they want better VALUE VALUE=QUALITY/COST
- 8. Enabling Health Professionals to Respond to Their Customers Components of Value Quality Service : access, personal attention, convenience Care: Evidenced based standardized processes and expected outcomes
- 9. Enabling Health Professionals to Respond to Their Customers Components of Value (cont) Cost Direct $ Morbidity/Functional Impairment Lost Productivity
- 10. Enabling Health Professionals to Respond to Their Customers What are their customers telling them? (cont) More than just reassurance of value Transparency Measures of Value Objective Information Involvement in Decision Making
- 11. Enabling Health Professionals to Respond to Their Customers How are they responding? Struggling to understand Running faster on the same wheel Unable to see the path off that wheel
- 12. Enabling Health Professionals to Respond to Their Customers What is required to mount an effective response? WELL LED AND MANAGED ORGANIZATION OR ORGANIZATIONS (SINGLE AND / OR MULTI-SPECIALTY) WHICH SUCCESSFULLY INTEGRATE THE BUSINESS AND CLINICAL REQUIREMENTS OF HIGH VALUE HEALTH SERVICES DELIVERY AND WORK IN AN ALIGNED PARTNERSHIP WITH THE OTHER COMPONENTS OF THE HEALTH CARE DELIVERY SYSTEM* *See Appendix A and B
- 13. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Unconscious incompetence They don’t know what they don’t know and don’t know it
- 14. INCOMPETENCE COMPETENCE CONSCIOUSNESS UNCONSCIOUSNESS CONSCIOUS INCOMPETENCE UNCONSCIOUS INCOMPETENCE CONSCIOUS COMPETENCE UNCONSCIOUS COMPETENCE
- 15. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Unconscious Incompetence (cont) They missed the 20 th Century Quality and Quality of Management Revolution Customer Focus Continuous Improvement Total Participation Societal Networking
- 16. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Unconscious Incompetence (cont) They are unaware of major global trends* and the implications for their world Global Markets Democratization of Technology, Information, and Finance Decentralization of Decision Making *Tom Friedman, The Lexus and the Olive Tree
- 17. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Unconscious Incompetence (cont) Leadership and Management Knowledge, Skills & Commitment You can’t lead and manage a successful organization taking off your white coat and putting on your business suit a couple of hours a week between patients
- 18. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Cultural Barriers INDIVIDUAL AUTONOMY Practicing alone together
- 19. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Cultural Barriers (cont) INDIVIDUAL vs. TEAM / ORGANIZATIONAL ACCOUNTABILITY
- 20. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Cultural Barriers (cont) ATHENIAN DEMOCRACY Elected “political” leaders The interest of the whole is the sum of the individual interests of its constituents
- 21. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Cultural Barriers (cont) DYSFUNCTIONAL LEADERSHIP MODEL Unpaid, Unprepared, and Rotating Political Accommodation vs. Principle Based Facilitation
- 22. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Cultural Barriers (cont) CONSENSUS DECISION MAKING “ Black Ball” Obstructionism
- 23. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Cultural Barriers (cont) PATERNALISM Patients as “wards” vs. customers
- 24. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Cultural Barriers (cont) PROVIDER CENTRISM “ My time and responsibilities are more important than my patients’ “
- 25. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Cultural Barriers (cont) CLINICAL JUDGEMENT Standardization and process control is “cook book” medicine
- 26. Misaligned economic incentives Aligned incentives (e.g. performance based compensation) require the organizational capability to respond Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively?
- 27. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Inadequate Access to Capital Adequate access to capital requires a successful business model and the organizational capability to execute it
- 28. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Inadequate enabling and support resources Private consultants Project and solution focused “ expensive” Variable quality
- 29. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Inadequate enabling and support resources (cont) Association programs Episodic—lack sequential comprehensiveness, cohesiveness and longitudinal continuity Variable quality
- 30. Enabling Health Professionals to Respond to Their Customers Why are they unable to respond effectively? Inadequate enabling and support resources (cont) Institute for Health Improvement (IHI) Focused on the upper tiers of organizational development—the top stories of a building with no foundation
- 31. ORGANIZATION AND LEADERSHIP CULTURE VALUES AND BEHAVIORS SUPERORDINATE MISSION VALUE PROPOSITION COMMITMENT AND ACCOUNTABILITY RESOURCES OPERATIONAL CAPABILITIES AND COMPETENCIES SYSTEMS AND PROCESSES MEASURABLE RESULTS
- 32. Enabling Health Professionals to Respond to Their Customers What is needed to enable and support them? A SHARED REALISTIC INTERPRETATION OF THE INTERNAL & EXTERNAL ENVIRONMENT AND RELATED REQUIREMENTS A SHARED COMMITMENT TO A STRATEGIC DIRECTION BUSINESS GOVERNANCE &ORGANIZATIONAL LEADERSHIP AND MANAGEMENT COMPENTENCY COLLECTIVE PROFESSIONAL CONTROL, RESPONSIBILITY, AND ACCOUNTABILITY INDIVIDUAL ACCOUNTABILITY FOR INDIVIDUAL AND COLLECTIVE PERFORMANCE CULTURAL TRANSFORMATION CAPITAL PARTNER
- 33. Enabling Health Professionals to Respond to Their Customers What is needed to enable and support them? A Sustained and Adaptable Ongoing Facilitation, Education and Support Resource with the Requisite Expertise and Experience To Assure A Clear Viable Vision and the Organizational Capability & Commitment to Achieve It