Organization of Health Care:
Make Improving Chronic Care a Part of the Organization's Vision
- Link measures and outcomes to the strategic business plan:
- Identify expense revenue from the organization's Chief Financial Officer.
- Conduct a unit cost analysis by activity center. For diabetes patients, model the unit cost.
- Document change/time in outcome and document treatment time of patients.
- Document revenue from ancillaries.
- Involve the senior leader early on.
- Gain the senior leader's interest with reports and feedback.
- Involve senior leadership with the team's work.
- Have the team leader or physician champion regularly report Improvement work to Board of Directors.
- Show storyboards, success stories, charts, and graphs to senior leaders, Board of Directors, and all staff to introduce Improvement work.
- Display storyboards in places visible to staff and patients.
- Post reports and graphs so staff can review.
- Discuss with senior leader the direct impact that improved outcomes have on the organization. Provide references of other senior leaders who have undertaken the same effort.
- Assist senior leader in determining the "value" of improving chronic illness care (e.g., quality, accreditation, increased productivity/efficiency, business case, and more patients).
- Test different ways to get senior leader's support. For example, present to the senior leader in the language or areas of "worry" that the senior leader thinks in. Query a discussion group for support and advice.
- Involve the senior leader in developing an aim, and ask the senior leader for feedback on the draft aim statement.
- Discuss the team's choice of measures and how they impact the organization and the patients.
- Make a standing monthly appointment with the senior leader/team leader and team to discuss report(s).
- Provide report(s) 2-3 days prior to the meeting for review time and as a reminder of the appointment.
- Understand the data! Know what the issues/barrieres are, and present them in an objective manner that invites the senior leader to contribute.
- Invite the senior leader to team meetings.
- Assign the senior leader work in removing barriers.
- Involving the senior leader in work and decision making helps builds trust that the team will do the right thing.
- Involve the senior leader in marketing the outcomes in the community for partnership development.
- Keep it simple! Provide a straightforward report that everyone can understand; avoid being too technical or too clinical.
- Provide patients' own words or reactions whenever possible, or discuss provider satisfaction.
- Provide printed reports and, if possible, do overheads of graphs.
- Present barriers to progress (e.g., transportation, eye care, resource development) to Board of Directors and seek their help in overcoming the barriers.
- Post signs reading "For further information, contact XXXXX."
- Create an "HbA1c Club" bulletin board where patients who drop their HbA1c by 1% get their picture taken (with their consent, of course) and put it up on the board - a real reward for them and a motivator for other patients and staff.
- Assign a team member to change the posting of results monthly.
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