Federal Health Care Center - National-Academies.org/media/Files/Activity Files... · Captain James A. Lovell Federal Health Care Center Acronyms BUMED: Bureau of Medicine and Surgery

Institute of Medicine:Quality

Mark Albrecht

Captain James A. LovellFederal Health Care Center


OutlineWelcome/Introduction

Overview

Quality: From Two to One

FHCC Quality Program Structure

Aligning, Integrating, Maximizing

Building a Systematic Approach

Going Forward: Challenges and Opportunities


Acronyms BUMED: Bureau of Medicine and Surgery CARF: Commission on Accreditation of Rehabilitation

Facilities CLC: Community Living Center CPI: Continuous Process Improvement DoD: Department of Defense ED: Emergency Department FHCC: Federal Health Care Center ICU: Intensive Care Unit LSS: Lean Six Sigma MH: Mental Health NCVAMC: North Chicago Veteran’s Affairs Medical Center


Acronyms (cont’d) NHCGL: Naval Health Clinic Great Lakes

NME: Navy Medicine East

OME: Home Care

NAVOSH: Naval Occupational and Safety Health

OSHA: Occupational and Safety Health Administration

PACT: Patient Aligned Care Team

SR: Systems Redesign

VA-TAMMCS: Vision Analyze Team Aim Map Measure Change Sustain

VHA: Veteran’s Health Administration

VHA CO: VHA Central Office


Quality: From Two to One Pre-Integration

Different Operations

NCVAMC: Inpatient and Outpatient, Surgery, ICU, Med Surg, ED, MH, OME, CLC, etc.

NHCGL: Ambulatory only, focused on supporting Recruit Mission, Operational Readiness of Sailors at Great Lakes and healthcare for their families and retirees

Post-Integration

Quality infrastructures were already in place

Challenges and opportunities to build upon to bring them together


Quality Approaches NCVAMC and VHA

Data rich

Focus on Performance Measures and Outcomes

Improvement Projects from Central Office

NHCGL and BUMED

Mission-Focused data/productivity measures

Outpatient focused/HEDIS Measures

Fewer centralized improvement programs/priorities from above


PO3

Access for Primary Care Patients (new and established): each Network will monitor the percent of unique Primary Care Patients on the Access List waiting more than 14 days from desired date for an appointment 0.05 0.08 0.09 0.09

VA Primary Care 5 5 5 5DoD Primary Care 5 5 5 5

PO4

Access for Specialty Care Patients (new and established): each Network will monitor the percent of unique Specialty Care Patients on the Access List waiting more than 14 days from desired date for an appointment. 0.25 0.3 0.29 0.29

All prior Performance Measures remain in place, to meet both Navy and VA monitoring requirements


PtFHCC

VHA CPI Approach

System-Wide ImprovementsThrough VHA Strategic Priorities

Organizational Cultures

Local CPI/LSS Improvements

Command Strategies

BUMED Strategies

Navy/DoD

Command-Level Improvementsin Alignment with Navy Strategic Priorities

BUMED/Navy CPI Approach


VHA BUMED

Considerations for Quality

Systems Redesign: VA-TAMMCS (n=4 Belts) Lean Six Sigma (n=35 Belts)

Performance Measures


The Way Forward for Quality

VHA Systems Redesign + Navy Lean Six Sigma

Continue to successfully implementCentrally-Driven Impr0vement Projects

…While maximizing locally-driven systems/process improvements


Combining our Strengths VHA Systems Redesign

Structured SR Program required (this is new to VHA)

VISN 12 Plans for program development are tracked

BUMED LSS

Mandated LSS CPI approach Navy-Wide

Invested earlier in training staff across Navy

FHCC Quality Structure

Integration provides perfect opportunity for Aligning, Integrating, and Maximizing these strengths for FHCC


Executive Steering

Patient Safety

Council

Tactical Management/

Alignment with SP Goals

Strategic Vision

Directorates, Committees, Departments, and Staff Issues Identification

Issue VettingLSS/SR Cadre

Leadership Sub-Group:Assistant Directors

SR/LSS Management Group


ESC - Mondays: One Hour.Director, Deputy Director, Six Associate Directors,Assistant Directors, Command Master Chief,Senior Enlisted Leaders, and OPI.Overall strategic coordination of FHCC according to annual list of topics; Calendar of reports from each Oversight Committee. Serves as Strategic Planning Board for FHCC. Monthly review of all Performance Measures.

Leadership Council - Wednesdays: One Hour.Deputy Director, CMC, Six Associate Directors, OPI. Reviews issues and action items from Oversight Committees. Serves as Leadership body overseeing improvement priorities, coordinating project selection (Charters) and improvement projects oversight.

Committee Process: The five standing Oversight Committees will meet monthly, receive feedback from the committees listed below them, and provide appropriate reports to the ESC. Unresolved issues or items needing action will be forwarded to the LC for analysis, prioritization, tracking, and resolution/management


Quality Program Structure: The System We’re Building

Unique approach to meet our needs:

Engage trained staff throughout the organization

Leadership: Assistant Directors driving improvement activities/priorities

Designating LSS resources for each Directorate

Hiring Full-Time LSS Black Belt to mentor and support projects and activities command-wide

Enjoy support from both Navy and VA LSS/SR resources above us


Summary: Lessons Learned Tremendous Opportunities

Integration provides many challenges amenable to structured process redesign

Ample Resources Growing emphasis for structured quality program from both

Navy and VA Support from both Navy and VA for continued expansion of

LSS trained staff Quality infrastructure/tools available from both Navy and VA

Building program structure to meet FHCC’s needs Adapt from existing Navy and VA structures FHCC Quality program approach is new/potential is

unlimited


VISN 12

VHA

NME

BUMED

FHCC

Quality Reporting and Monitoring

Post-Integration, dual quality oversight remains

Integration Impact: Quality


Integration Impact: QualityWhose “Rules” do we follow? Policy questions – navigate differences in BUMED or

VHA guidance/instructions

Redundancies and/or differences in reporting requirements to higher authorities

Great outside interest in FHCC Multiple (continual) visitors, inspections and reviews –

most requiring responses and follow-up

Potential redundancies of inspection bodies Ex. Two Inspectors General; OSHA and NAVOSH; Joint

Commission and CARF, etc.



Questions?

Documents

Federal Health Care Center - National-Academies.org/media/Files/Activity Files... · Captain James A. Lovell Federal Health Care Center Acronyms BUMED: Bureau of Medicine and Surgery