Title: Reengineering Collaborative Model Overview
1Reengineering CollaborativeModel Overview
- Patient Visit Redesign Collaborative
- Francis A. Zampiello, MD
- Director
- Quality Center, Bureau of Primary Health Care,
HRSA - United States Public Health Service
- Department of Health and Human Services
2The Institute of Medicine Challenge
- Between the health care we have and the care we
could have lies not just a gap, chasm. To
Fill that chasm requires we work together to
redesign health care processes - Crossing the Quality Chasm,
- A New Health System for the 21st Century
- IOM March, 2001
3Our Collaborative Itinerary
- Destination
- History
- Approach
- Model
- Results
- What It Can Mean to a CAP Grantee
- Why it Works
4The Patient Redesign Collaborative
Destination
- An initiative to dramatically reduce cycle time
for patient visits to the health center by
redesigning the patient medical visit
5The Patient Redesign Collaborative History
- Started by a small group who worked in and with
health centers - An innovative new learning model
- Proven reengineering strategies
in both CHC private sectors - Medical Economics Jan-June, 2000
- Unique Opportunities May, 2000
- Family Practice Management May 2000
- MGMA Update September, 1999
6 Redesign Collaboratives To-Date
- Northeast May - October, 1998
- Midwest May - October, 1999
- Pacific West Sept. - January, 2000
- Southeast Jan. - June, 2000
- West Central May - Oct., 2000
7The Redesign Collaborative Approach
- A six month learning laboratory
- Multiple organizations
- Rigorous team selection process
- External facilitation and coaching
- Rapid test cycles
- Focused on results
8The Redesign Collaborative Model
- Phases of
- Redesign
- Timeline
Understanding
Track patient visits Map patient visits Read
reengineering literature Document
patterns Analyze the data
Pre-work
9The Redesign Collaborative Model
- Phases of
- Redesign
- Timeline
Redesigning
Understanding
Experiment on paper
Track patient visits Map patient visits Read
reengineering literature Document
patterns Analyze the data
Learning Session 1
Pre-work
10The Redesign Collaborative Model
- Phases of
- Redesign
- Timeline
Testing
Rapid Redesign Tests Controlled tests (PDSA
cycles) of the concept model
Redesigning
Experiment on paper
Learning Session 2
Understanding
Track patient visits Map patient visits Read
reengineering literature Document
patterns Analyze the data
Action Period 1
Learning Session 1
Pre-work
11The Redesign Collaborative Model
- Phases of
- Redesign
- Timeline
Implementing
Trial Run Continuous testing of redesign model
Testing
Rapid Redesign Tests Controlled tests (PDSA
cycles) of the concept model
Action Period 2
Redesigning
Experiment on paper
Learning Session 2
Understanding
Track patient visits Map patient visits Read
reengineering literature Document
patterns Analyze the data
Action Period 1
Learning Session 1
Pre-work
12The Redesign Collaborative Model
- Phases of
- Redesign
- Timeline
Diffusing
Moving the model to other clinical areas or other
sites
Implementing
Trial Run Continuous testing of redesign model
Learning Session 3
Testing
Rapid Redesign Tests Controlled tests (PDSA
cycles) of the concept model
Action Period 2
Redesigning
Learning Session 2
Experiment on paper
Understanding
Track patient visits Map patient visits Read
reengineering literature Document
patterns Analyze the data
Action Period 1
Learning Session 1
Pre-work
1312 Redesign Principles
- Dont Move the Patient
- Start All Visits on Time
- Create Broad Work Roles
- Exploit Technology
- Ruthlessly Eliminate Waste
- Match Capacity to Demand
- Increase Clinician Support
- Get All the Tools You Need
- Plan for the Expected
- Do Todays Work Today
- Organize Patient Care Teams
- Communicate Directly
14Results Cycle Time
15Results Cycle Time
16Results Productivity
17Results Productivity
18Results Value-Added Time
19Case Study CAPs Reengineering Potential
- 10,000 Additional Patients Served
- 19 More Uninsured With Primary Care Homes
- Move from 36 to 55 Access in Six Months
- Save 2.28 Million Dollars in 100 Access
Costs !
20Why It Works
- Competitive selection process
- Strong CEO/ED commitment
- Aggressive external coaching and mentoring
- Creative learning sessions
- Clear performance goals
- Focused on results
- Structured, time-driven
framework
21You Have a Ticket to Ride...
- With an overview of the 6 month Redesign
itinerary, you now understand - The Redesign Goal, History, Approach,
- Model and Results
- Broad redesign application
- CAP Grantees
- Welcome Aboard
- The Innovation Express!
22Reengineering CollaborativeModel Overview
- Patient Visit Redesign Collaborative
- Francis A. Zampiello, MD
- Director
- Quality Center, Bureau of Primary Health Care,
HRSA - United States Public Health Service
- Department of Health and Human Services
- For further information contact
fzampiello_at_hrsa.gov