The Patient Centered Value System: Transforming Healthcare through Co-Design PDF
Preview The Patient Centered Value System: Transforming Healthcare through Co-Design
The Patient Centered Value System Transforming Healthcare through Co-Design Pull quotes for The Patient Centered Value System: Transforming Healthcare through Co-Design, by Anthony M. DiGioia, M.D. and Eve Shapiro “The spiraling costs of healthcare and diminishing value for organizations, patients, and families requires a new, transformative approach to healthcare deliv- ery. The Patient Centered Value System is the answer to lowering costs, improv- ing clinical outcomes, and increasing the patient and family care experience. The PCVS has resulted in tangible improvements on all levels at the Connecticut Joint Replacement Institute at Saint Francis Hospital.” —Steve F. Schutzer, M.D., Medical Director, Connecticut Joint Replacement Institute, President, Connecticut Joint Replacement Surgeons, LLC “The Patient Centered Value System: Transforming Care through Co-Design offers a highly readable and practical approach for dramatically improving patient out- comes and experiences. As health care consumers, we would definitely want our providers to be following the Patient Centered Value System principles, delivering high-quality, empathetic, and lower-cost patient care.” —Robert S. Kaplan, Marvin Bower Professor of Leadership Development, Emeritus at the Harvard Business School “This book captures perfectly the challenge that faces quality improvers every- where: that lasting change can only be achieved through a change in mindset which places patients and families at the centre of the improvement agenda. The Patient Centered Value System is one of the few approaches which does just this. This system works. What it also does is transform the working lives of the staff applying it, reconnecting them powerfully with their core mission to care. It has been a privilege to use this approach with teams from around the United Kingdom, and a joy to see the changes they make when they see care through patients’ eyes.” —Bev Fitzsimons, Head of Improvement, Point of Care Foundation, U.K. “DiGioia and Shapiro have achieved the goal of every author: to make under- standable that which is complex, and to make implementable complex principles. When the subject is patient (and family)-centered care, those goals are both formi- dable and critical to the nation’s health.” —John R. Ball, M.D., J.D, Executive Vice President, Emeritus, American College of Physicians “This book will teach you how to see. Whether you are a hospital CEO, as I have been, or a care giver at the front lines of care, as I have been, this book will open your eyes to the journey of a patient and family throughout care. The care systems of the future will be designed with and for our patients and their families. This book is the best guide to give you the tools and methods to co-design care with them.” —Maureen Bisognano, President Emerita and Senior Fellow, Institute for Healthcare Improvement The Patient Centered Value System Transforming Healthcare through Co-Design By Anthony M. DiGioia, M.D. and Eve Shapiro CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2018 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Printed on acid-free paper International Standard Book Number-13: 978-1-138-05596-4 (Hardback) International Standard Book Number-13: 978-1-3151-6561-5 (eBook) This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use. The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information stor- age or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copy- right.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. goShadow® is a trademark of AMD3 Consulting, Inc. and goShadow®, LLC. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging‑ in‑ Publication Data Names: DiGioia, Anthony M., author. | Shapiro, Eve., author. Title: The patient centered value system : transforming healthcare through co-design / Anthony M. DiGioia and Eve Shapiro. Description: Boca Raton : Taylor & Francis, 2018. | “A CRC title, part of the Taylor & Francis imprint, a member of the Taylor & Francis Group, the academic division of T&F Informa plc.” | Includes bibliographical references and index. Identifiers: LCCN 2017014903| ISBN 9781138055964 (hardback : alk. paper) | ISBN 9781315165615 (ebook) Subjects: LCSH: Patient centered health care. | Managed care plans (Medical care) | Health services administration. Classification: LCC R729.5.H43 D54 2018 | DDC 362.1/04258--dc23 LC record available at https://lccn.loc.gov/2017014903 Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com For patients, families, and providers everywhere. For Don Berwick, Maureen Bisognano, Gene Lindsey, and Bev Fitzsimons for their enthusiasm, encouragement, and support of patient and family centered care, for demonstrating how to drive transformational change, and for continuing to inspire and lead the way. For the early adopters of the Patient Centered Value System and its components, who have helped this dynamic methodology to evolve and transform the care and experiences of patients, families, and providers. For the giants on whose shoulders the Patient Centered Value System is built: John Kotter, Tim Brown, Paul Bate, Glenn Robert, Herbert Simon, B. Joseph Pine II, Clayton Christensen, Stephen Denning, Robert S. Kaplan, and Michael Porter. And, in gratitude, to my wife, Cathy (A.M.D.), and my husband, Howard (E.S.). We couldn’ t have done this without you. Contents Contents Fo reword.................................................................................xv P reface....................................................................................xix Acknowled g ments...............................................................xxv List of Figures .....................................................................xi About the A uthors............................................................xxvii List of Tables .....................................................................xiii Introd uction........................................................................xxix Foreword .............................................................................xv P taHrEt PIatIENt CENtErED VaLUE Preface ................................................................................xix SYStEM IN aCtION: a StOrY Acknowledgments ...........................................................xxv Prtohloeg Eupei:p hany ..........................................................3 About the Authors .........................................................xxvii 1 How to Introduce the Patient Centered Value Introduction ....................................................................xxix System in Your Organization .................................15 Part I tHE PatIENt CENtErED VaLUE 2 Cho ose Your Champions: Establish the Care SYStEM IN aCtION: a StOrY Experience Guiding Council ..................................31 Prologue: the Epiphany ..........................................................3 References .........................................................................44 1 How to Introduce the Patient Centered Value 3 Sha dow Patients and Families to Co-Design the System in Your Organization .................................15 Care Experience .....................................................45 2 Choose Your Champions: Establish the Care 4 Dev elop Your Care Experience Working Group ....69 Experience Guiding Council ..................................31 5 Cre ate a Shared Vision by Writing the Story of References .........................................................................44 the Ideal Care Experience ......................................93 3 Shadow Patients and Families to Co-Design the 6 Clo se the Gaps between the Current State and Care Experience .....................................................45 the Ideal ...............................................................111 4 Develop Your Care Experience Working Group ....69 7 The Patient Centered Value System: Fact, Not 5 Create a Shared Vision by Writing the Story of Fiction ..................................................................153 the Ideal Care Experience ......................................93 vii viii ◾ Contents 6 Close the Gaps between the Current State and the Ideal ...............................................................111 7 The Patient Centered Value System: Fact, Not Fiction ..................................................................153 Part II D EtErMINE aND DrIVE DOWN tHE trUE COSt OF CarE DELIVErY aND aCHIEVE tHE trIPLE aIM 8 Determine the True Cost of Care Using Shadowing and Time-Driven Activity-Based Costing .................................................................159 Origins of the Patient Centered Value System ................162 What Is Time-Driven Activity-Based Costing in the Context of the Patient Centered Value System? ..............163 Benefits of Time-Driven Activity-Based Costing .............164 Time-Driven Activity-Based Costing Plus Shadowing: A User’ s Manual ...............................................................165 Step 1: Shadow the Care Segment(s) ...........................166 Time Detail for Personnel, Space, and Activities ....167 Photo Option for Consumables and Equipment .....167 Step 2: Develop Time-Driven Activity-Based Costing Process Maps ..................................................167 Step 3: Calculate Costs in Four Buckets of Resources— Personnel, Space, Equipment, and Consumables— to Determine Cost Drivers and Start Process Improvement Efforts .......................................170 Personnel ..................................................................173 Consumables ............................................................174 Space .........................................................................175 Equipment ................................................................176 Calculate the Actual Cost of Each Care Segment and the Full Cycle of Care .......................................177 The Patient Centered Value System: Identify Cost Drivers to Begin Improvements...................................177 Cost Drivers ..............................................................179 Contents ◾ ix Implement the Patient Centered Value System ...........180 The Need for the Patient Centered Value System in Today’ s Healthcare Environment .................................182 References .....................................................................185 Part III tHE PatIENt CENtErED VaLUE SYStEM: tHEOrY aND PraCtICE 9 The Science behind the Patient Centered Value System: Built on the Shoulders of Giants ............189 “ Borrowing Brilliance” .....................................................196 Shadowing Patients and Families ................................196 Shadowing to Determine Actual (True) Costs.............197 Storytelling and Storydoing .........................................198 High-Performance Care Teams ....................................199 Overcoming Expected Hurdles .................................. 200 Conclusion ........................................................................201 References ........................................................................201 10 Patient Centered Value System + Lean or Other Process Improvement Approaches = Rapid Improvement ........................................................203 Similarities between the Patient Centered Value System and Other Process Improvement Approaches ....204 Differences between the Patient Centered Value System and Lean or Similar Process Improvement Approaches .......................................................................205 Shadowing ....................................................................206 Performance Improvement ..........................................207 Integrating the Patient Centered Value System with Lean and Similar Process Improvement Approaches .....209 Conclusion ........................................................................210 References ........................................................................211 11 The Patient Centered Value System in Practice ...213 Patient Partnerships = Engagement = Better Outcomes ....214 The Problem .................................................................214
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