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WINNIPEG REGIONALHEALTH AUTHORITY
2012 Supply Chain ForumInnovation in Health Care
Dan Skwarchuk, Executive Director,Health Services Integration and InnovationWinnipeg Regional Health Authority
November 21, 2012
Health Innovation as a Literary “Trend”
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
2003 2005 2007 2009
University of Manitoba Library search…
Found over 268,000 published articles on file
Total Published Articles (Annual), 2003-2009
Literary “Trend” Cont’d…
Generally, across the literature, health innovation usually falls into the following broad categories:
•Research
•New products and technologies
•New processes and approaches
•New ways of thinking
•New ways to use people
• Doing more with similar or fewer resources (productivity and efficiency)
WRHA Strategic Plan - Innovation
• Maximize benefits from research, development & innovation including the increased use of evidence informed decision making.
• Improve productivity through process improvement, service reconfiguration and benchmarking
The WRHA Views of Innovation
Innovation refers to a process through which economic or social value is extracted from knowledge through the generation, development, and implementation of ideas to produce new or significantly improved products, processes, and services.
Model of sustaining innovation
Christensen et al. (2009)The Innovator’s Prescription
Christensen et al. (2009)The Innovator’s Prescription
Innovation within the WRHA
Some (selective) examples include:
• Bell Hotel Redevelopment Project (new thinking)
• Use of evidence in contracting (processes)
• Nurse Practitioners and Physician Assistants (people)
• Manitoba Renal Program’s new Nurse-Led Telehealth Service (technology)
• Business Process Solution Project (processes)
• Home-based specialty services (new thinking)
• Unit-level inventory process improvement (processes)
Workplan for Innovation in the WRHA
• Overall need to develop a culture of innovation with supports to go outside of normal boundaries.
• Committee with focus on fostering and incubating innovative ideas within the WHR.
• Inventory of innovation in the WHR.
• Provision of seed funding for innovative ideas.
• Tolerance for failure and not punitive when innovative ideas fail. Learn from mistakes.
• Better understanding of tolerable risks.
Draft - Enterprise Risk Management Risk Universe
Strategic Operational Compliance Financial
Governance &Leadership
StakeholderRelations
Patient CareHuman
ResourcesInformationTechnology
PhysicalAssets
Compliance Financial
Governance• Board Structure & Performance•Culture and Ethics•Control/Risk Environment•Social Responsibility Planning and Resource Allocation•Organizational Structure•Strategic Planning•HR Strategy•IT Strategy•Partnership Development & Management External Environment•Demographics•Lifestyle Trends•Socio-Political•Economic Factors•Hazards (Pandemic, terrorism, natural disasters, etc)•Business ContinuityMajor Initiatives•Vision and Direction•Planning and Execution•Measurement and Monitoring•Business AcceptanceCorporate Reputation
Communication and Relations• Public and Media Relations•Patient Relations•Government Relations•Employee Communication•Vendor Relations•Union Relations•Crisis Communication
Service Delivery•Admission, Transfer and Discharge•Assessment & Diagnostics•Care & Service Accessibility•Care Plan/ Service Plan•Treatment•Coordination of Services•Patient Rights•Medication ManagementSupport Services•Supply Chain•Food and Laundry Services•Facilities Management•Health Information ManagementPatient Safety•Infection Prevention Control•Incident Reporting•Education & Training•Security
Recruitment, Selection & Retention•Credentialing•Medical staff•Support staff•Contractual staff•Employment Equity Development & Performance•Training and Education•Succession Planning• Performance ManagementLabor Relations•Labor Agreements•Contingency PlanningCompensation & Benefits•Salary Administration and Compensation ManagementEmployee Safety• Health and Safety
IT Management• E-HealthAccess & Security
System Reliability & Continuity•Back up and recovery•Disaster Recovery
System Integrity
End User Support & Education
Infrastructure•Asset replacement, deployment and retirement•Inventory Management
Asset Management •Replacement ManagementCapital/ Construction Acquisition & Disposal•Asset Acquisition•Commitment Tracking & Processing• Contract/Project Management• Asset DisposalEquipment Acquisition, Maintenance & Disposal•Equipment Acquisition•Commitment Tracking & Processing• Contract Management•Maintenance•Equipment Obsolescence & DisposalSite/Asset Security• Asset storage & handling• Facilities•Security and Access Inventory Management• Contract Management•Distribution•Inventory Shrinkage and Obsolescence•Valuation•Product Recalls
Standards of Business Conduct•Ethics•Fraud•Conflict of Interest•Industry RelationsLegal & Regulatory• Governing Legislation, Bylaws & Regulations•Contractual Agreements•Professional Regulatory Bodies•Prescribed Standards of Practice•Data Protection• Privacy•Environmental, Health & Safety•Research•Facility Standards•Procurement Practices •Patient Safety•Intellectual Property
Funding•Capital•Operating•Debt•FoundationMarket•Interest Rates•Foreign Exchange•Financial Instruments•InvestmentsLiquidity and Credit•Cash Management•Credit and Collections•InsuranceAccounting and Reporting• Accounting, Reporting & Disclosure•Internal Control Requirements•Trust Accounts/Special Purpose AccountsPension Funding
Budgeting and Forecasting
Taxes (Property, Commodity)
“If you're not failing every now and again, it's a sign you're not doing anything very innovative.”
- Woody Allen
Enablers of Innovation
• Need for improved knowledge translation:
- Improved spread and adoption of new and best practices- Innovation rounds and storytelling- Increased public and provider engagement- Enhanced supports for publications- Awards – but celebrating the successes as well as failures
Development of Innovation Community of Practice
• Health Sciences Centre Foundation
• St. Boniface Hospital Research Centre
• Professional Associations
• University of Manitoba Centre for Health
Innovation (Faculty of Medicine)
• University of Manitoba – Other Faculties
(mechanic, computer, and biosystem
engineering)
• University of Winnipeg
• Red River College
• Business Council of Manitoba
• Innovation Council of Manitoba
• Manitoba Health Innovation Branch
• Manitoba Centre for Health Policy
• Business Community
How Can We Collaborate More Effectively with the Business Community in
Health Innovation?
First some context…
21
Childhood Youth Young Families Middle Age Seniors
Understanding the WRHA Structure
Community Health Centres
Family Physicians
Home Care
Mental Health
Neighbourhood Networks
Public Health
Chronic CareCentral Assessment and
PlacementDeer Lodge Centre
Misericordia Personal Care Homes
Respite CarePalliative Care
Rehab/GeriatricsRiverview
Services to Seniors
ConcordiaGrace
Health Sciences St. Boniface Seven Oaks
Victoria
Prevention Promotion Protection
Primary TreatmentAcute Intervention Supportive and
Restorative Services
Primary CareSecondary and
Tertiary CareLong Term Care
22
Community Areas in Winnipeg
1) St. James
2) Assiniboine South
3) Fort Garry
5) St.Boniface
6) Transcona
7) River East
9) Inkster
8) Seven Oaks
10) Point Douglas
12) River Heights
West St. Paul
East St. Paul
1
2
3 4
5
6
7
8
910
11
12
11) Downtown
4) St. Vital
Regional Programs River East / Transcona
Downtown / Point Douglas
Health Science Centre
Seven Oaks Hospital
Primary Care X X
Home Care X X
Mental Health X X X X
Internal Medicine X
Family Medicine X
Renal Health X X
Personal Care Home X X
The WRHA Matrix Structure
Note: This is just a excerpt
The WRHA Matrix Structure(What this Means to Contracting)
Regional Clinical Programs• Strategic Planning• Quality and Standards
(including clinical contracting)• Centralized Operations
Regional Clinical Programs• Strategic Planning• Quality and Standards
(including clinical contracting)• Centralized Operations
Hospitals & Community Areas• Day-to-Day Operations• Managing to Quality• Managing to Budget
(volume and price)
Hospitals & Community Areas• Day-to-Day Operations• Managing to Quality• Managing to Budget
(volume and price)
Contracting Groups(PRES Groups)
n=147 Groups
Members = 1,100Employees
Contracting Groups(PRES Groups)
n=147 Groups
Members = 1,100Employees
WRHA and Product InnovationsCurrent Processes – Challenging!
BusinessCommunity
BusinessCommunity
WRHALogisticsServices
WRHALogisticsServices
InnovativeIdea or Product
PRES Group (n=147)
Regional Program (n=30)
Hospital or Area (n=15)
How Can We Collaborate More Effectively with the Business
Community in Health Innovation?
Improved knowledge sharing• Our priorities and your interests?• Push AND pull innovations?
Contracting flexibility for innovation• Less stringent RFP criteria?• More focus on problem versus solution?
Improved access• PRES Groups?• Regional Programs?• Hospitals and Community Area?• Help in system navigation?
Contract clarity on innovation• Proof of concept costs?• Key risks and mitigation?• Knowledge translation responsibility?
Thank-you
Questions?
Breakout Session
1:30 pm to 2:45 pm
Followed by 30 min Break & Networking Opportunity
Breakout Sessions
• Group 1- Mapleleaf room A• Group 2- Mapleleaf room B• Group 3- Evergreen Room (main room)
• Group 4- Spruce Room (through the restaurant)
• Group 5- Elm Room