Leading Systems Network Globalisationof Healthcare ... · PDF fileLeading Systems Network Globalisationof Healthcare, Metrics and Benchmarking McKinsey Health Systems Institute Dr

Leading Systems Network

Globalisation of Healthcare, Metrics and Benchmarking

McKinsey Health Systems InstituteDr Alexander Ng

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HA convention 20118th June 2011

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1McKinsey Health Systems Institute

McKinsey work to improve health system performance globally

EXAMPLESAlberta: Provincial health policy Supply-demand

management Quality control Primary care structure Top team building

Ontario: A&E optimization Patient access

and flow

US: National

reform modelMexico: Avian influenza

response

UK: Framework to evaluate

M&A opportunities Governance structuring Workforce planning Capacity planning

France: National hospital

efficiency programme

Norway: IT transformation Merger management

Sweden: Payor and provider model Compensation system

Italy: Assessment of regional

performance MoH � Transparency of

hospital performance

South Africa: Health system

strategy

Namibia: System diagnostic Maternal health

Tanzania: Set country level health objectives; developed

implementation plan for key initiatives

Egypt: National insurance Hospital/clinic coverage

and operations Quality regulator

Saudi Arabia: Greenfield Health

Systems development Build FDA from

scratch

Qatar: Decentralisation of

healthcare provision

Abu Dhabi: Privatise public

hospitals

Dubai: Build a wellness resort, develop AMC from scratch and health delivery network

India: Design & implementation of

emergency response system Service provider for rural populations

Australia: Regional health reform

China: Perspectives on health

reform

2McKinsey Health Systems Institute 2

In tackling various health challenges, different regions around the world has been asking the same questions ...

Which health systems have significantly improved quality and cost? What insights did they learn?

What is the best way to improve our system?

How can we learnfrom others?

How do we build the capabilities we need to succeed?

Where am I among the best in the world?

What value do we get for what we spend?

Who is best in the world on various performance metrics?


▪ Isolating core metrics that are critical to measure

▪ Understanding dynamics of system-level change

How can you assess and achieve lasting change?

▪ Identifying unique improvement opportunities

▪ Executing on effective implementation

How can you drive and implement innovation?

▪ Benchmarking performance through a global database

▪ Learning from what�s been successful around the world

What does world-class performance look like?

Three themes have emerged

Complex, yet common challenges �

� and the keys to finding the answers


Annual Conference: Meet with your peers and industry thought-leaders to address the fundamental challenges you face

McKinsey�s Leading Systems Network (LSN) is set up to meet this need

Knowledge Bank: Learn from the success of others through an online toolkit of case studies, best practices, and how-to-guides

Live Webinar Series: Monthly series to connect you with peers and other experts, with a focus on high impact topics

HealthTracker: Benchmark performance and obtain unique perspectives on opportunities through a global database

Customized Member Report: Deep dive into specific data, with an action plan for improvement and a network-wide comparison

Expert-on-Demand: Access to internal McKinsey experts with direct experience implementing health system change

Analytics

Forums

Evidence

1

2

3


LothianLothian NorthhamptonshireNorthhamptonshire

South WestSouth WestTrentoTrento

RovigoRovigo

TuscanyTuscany Hong KongHong Kong

SingaporeSingapore

QueenslandQueenslandVictoriaVictoria

LothianLothian NorthhamptonshireNorthhamptonshire

South WestSouth WestTrentoTrento

RovigoRovigo

TuscanyTuscany Hong KongHong Kong

SingaporeSingapore

QueenslandQueenslandVictoriaVictoria

A growing network of innovative systems on three continents

Current members

Current conversations

Current members

Current conversations


Definition: Pathways take a health system end-to-end view of performance with a major focus on clinical outcomes. We focus onthe major evidence that drive prioritised outcomes.

Pathways help to measure, understand, and improve the underlying causes of clinical outcomes. Pathways:

▪ Measure primary and secondary endpoints as well as actionable outcomes relative to regional, national, and international benchmarks

▪ Are complementary to guidelines but are NOT clinical guidelines for decision making at the patient level

▪ Create a methodology that can extend across borders and differences in clinical practice

SOURCE: McKinsey analysis

1 McKinsey Pathway ApproachAnalytics

7McKinsey Health Systems InstituteSOURCE: McKinsey analysis

Define what to include in the pathway

Map best practiceinterventions

Prioritise the most important interventions

▪ Define the scope of disease area

▪ Identify discrete phases of the disease pathway and map the relevant best practice interventions

▪ Review literatureand interview experts to prioritise interventions based on clinical benefit and cost effectiveness

1 Creation of pathwayAnalytics


Not met

Met

Approach DescriptionPatients�benefits Payors� benefits

Clinicians�perspective

Patients�perspective

Payors�perspective

Clinical guidelines

▪ Operational guidelines covering single and specific events, written by clinicians and based on clinical studies

▪ Improved pa-tient out-comes, thanks to the adoption of standardised protocols

▪ Indirect benefits, depends on reimbursement mechanisms

Productivity driven

▪ Efficiency-oriented approach, aimed at maximising each system�s component productivity without an overall view

▪ Indirect benefits ▪ Cost savings, thanks to a specific focus on direct and indirect costs containment

Clinical pathways

▪ Evidence-based and patient-centred perspective, consid-ering patients rather than disease events

▪ Increased satis-faction, thanks to the single point of contact at each step▪ Increased

quality of care and of life, thanks to evidence-based interventions

▪ Cost savings thanks to increased efficiency along the whole chain and better capacity planning▪ More appropriate use

of resources � e.g., avoided unnecessary hospital stays▪ Reduction of

providers� variabilityin outcome

1 The pathway approach ensures that all major stakeholders�perspectives are being considered

Analytics


Primary prevention Acute stroke management

Rehabilitation and secondary prevention

Healthy adultDevelopment of symp-toms suggestive of stroke

Patient physiologically stable

Pathway definition

Start

Development of symp-toms suggestive of stroke

Patient physiologically stable

End of lifeEnd

Outcome of specific part of pathway

▪ Annual incidence of first time stroke

O1 ▪ In-hospital mortality due to stroke

O3

▪ % of patients who die within 28 days after all strokes

O4

▪ % of stroke patients readmitted to inpatient care within 30 days after discharge

O10

▪ Annual incidence of secondary stroke cases

O9

1 Note: O = Outcome

Example Stroke pathway

1Analytics

We mapped key stages of the stroke pathway


1Analytics

And identified internationally recognised interventions

General management

Hemorrhagic stroke

Ischemic stroke

Acute management of stroke

Specialised careDiagnosis confirmation

Acute treatment

Admission

▪ General population� Hypertension reduction in

population� HbA1c reduction to less than 7 in

diabetics� Cholesterol reduction of 1 mmol

LDL� Regular exercise� Obesity management � Smoking prevalence reduction� Excessive alcohol consumption

reduction� Na intake reduction� High veg/ fruit and fish intake� Atrial fibrillation management with

INR of 2�3 � Carotid artery screening programs� Asymptomatic carotid artery

intervention if suitable▪Population specific � Careful anticoagulation monitoring� Surgical repair for asymptomatic

intracranial aneurysm � Blood transfusion for sickle crisis

patients � Stop females >35 years who

smoke taking OCP� Reduce HRT prescriptions

▪Diagnosis � Seen and investigated at specialist

service within 1 days of TIA▪Treatment � Prescribe an alternative

antiplatelet therapy immediately following TIA

� Give BP controlling medication irrespective of baseline BP

� Reduce smoking in TIA patients� Cholesterol reduction following TIA� Carotid Doppler investigation

following TIA� Appropriate neuro-imaging

� Regular neurological observation

� Screening of patients swallowing

� Management of potential complications ▫ Nutrition▫ Hydration▫ Hyperthermia ▫ Hypoxia ▫ Glycemic control

� Early mobilisation � Deep vein thrombosis

prevention� Doppler US to exclude

DVT on admission� Blood pressure

management

▪ Specialist assessment to confirm stroke diagnosis

▪ Baseline blood tests

▪ CT scan within 3 hours of onset of neurological symptoms

� Thrombolysis if patient clinically suitable

� Start aspirin 24 hours following thrombolysis (300 mg) or immediately if not suitable for thrombolysis

� Treat >185 SBP

� Reduce INR if patient on warfarin

� Consider surgical intervention if ▫ Hydrocephalus or

brainstem compression

▫ Lobular haemo-rrhage is >10cm3

� Give antihypertensive treatment for hyper-tensive emergency

Risk factor minimisation

TIA treatments

▪ Immediate transfer by emergency services

▪ Admitted directly to specialised acute stroke facility

Diagnosis

� Rehabilitation� Multi-disciplinary

assessment: Psychological, cognitive, communication, motor, sensory impairment assessment▫ Physiotherap-

y in 24 hrs▫ Speech and

language therapist within 7 days

� Functional rehabilitation interventions ▫ Occupational

therapist with neuro rehab. within 4 days

� CPAP for sleep disorder breathing

� Early supportive discharge

Rehabilitation

▪ Reduce smoking rate amongst stroke patients

▪ Reduce excessive alcohol consumption

▪ Low salt diet ▪ Regular exercise▪ Register patients

who have had a stroke

▪ Reduce HbA1c ▪ Lower cholesterol to

<3.5 mmol/l after 1 week of event

▪ Lower BP to 130/80 ▪ 12 lead ECG when

arrhythmia or no cause found

General

▪ Antiplatelet therapy with aspirin/dipyridamole MR/ clopidigril combinations

▪ Anticoagulation for AF patients after 14 days (without concomitant anti-platelets) to INR of 2�3

▪ Perform Doppler ultrasound of carotid if history of carotid territory stroke

▪ Symptomatic carotid intervention only considered for select cases performed in specialist centre

Ischemic specific

Public education programs

We identified 63 best practice interventions on stroke pathway

Primary prevention of stroke Rehab & Secondary prevention

Stroke rehabilitationGeneral secondary prevention

Specific secondary prevention

Example Stroke pathway


Primary prevention of stroke

Acute management of stroke

Rehab & secondaryprevention

Primary end point

Secondary end points

Actionable outcomes

Average alcohol consumption per capita

PH1

% of adult daily smokersPH2

% of adults with BMI > 30PH3

% of AF or atrial flutter patients at prescribed warfarin

P10

% of high risk TIA patients seen within 24 hours of referral

P18

% of patients with a history of TIA/ stroke with BP< 140/90 mmHg

P20

% of patients with a history of TIA/ stroke with total cholesterol < 5 mmol/l

P22

% of stroke patients prescribed physiotherapy within 74 hours of symptom onset

P52

% of patients with the diagnosis of any stroke for whom rehabilitation services are planned after discharge

P44

% of patients with the diagnosis of ischemic stroke and TIA who were prescribed antiplatelet therapy at discharge

P39

% of hospitalised ischemic stroke patients given aspirin within 48 hours of symptom onset

P51

% of stroke patients who smokeP50

Annual incidence of secondary stroke cases

O1 O9In-hospital mortality due to strokeO3

28 day mortality of strokeO4

Readmission rate for strokeO10

% of stroke patients treated at a special stroke unit

P24

% of patients with ischemic stroke who have thrombolysis within 3 hours of symptom onset

P38

% of patients with ischemic stroke who receive thrombolysis

P38a

% of suspected stroke patients receiving CT or MRI scans within 3 hours

P30

Total mortality due to stroke per 100,000 population

G1

Annual incidence of first time stroke cases

O5 All-stroke 3 month mortality rate post event

O8 % of hospitalized patients returning to the same level of care after discharge for stroke

Average length of stayO2

% of patients returning home after discharge for stroke

P08a

% of ischaemic patients with a diagnosis of nonvalvular atrial fibrillation or atrial flutter and history of stroke who were prescribed warfarin

P10a

1Analytics

Output is a shortlist of the most important metrics along strokepathway


Rehab & secondary prevention

Primary preventionEarly manage-ment of CHD

Acute Management of AMI

Secondary end points

Actionable outcomes

Primary end point

G1 Total mortality due to CHD per 100,000 population

O5 AMI readmission rate within 30 days

O4 In-hospital mortality of AMI

O1 O2 O3 30 day mortality of AMIIncidence of AMI per 100,000 population

PH3 P50% of adults with BMI > 30

P28 % of AMI patients given aspirin within 24 hrs of arrival

P15 % of CHD patients currently treated with beta-blockers

PH2 % of adult daily smokers

P33a % of AMI patients who receive PCI for revascularisation

P16 % of CHD patients treated with aspirin

P33 % of AMI patients with PCI who receive PCI within 90 minutes

P13 % of CHD patients with total cholesterol < 5mmol/L

Average alcohol consumption per capita

PH1

P41 % of AMI patients who receive LMWH during hospitalization

P20 Exercise tolerance testing for patients with new angina

% of AMI patients who receive beta-blockers within 24 hours of AMI onset

P40

P11 % of CHD patients with BP ≤ 140/90 mmHg

% of CHD patientsimmunized w/ flu vaccine

P17 P56a

CHD prevalence rate per 100,000 population

P28a % of AMI patients given aspirin within 60 min of symptom onset

P59 % of AMI patients receiving smoking cessation counsel during hospital stay

P54 % of AMI patients prescribed beta-blockertherapy at discharge

P51 % of AMI patients prescribed a statin at discharge

% of AMI patients assessed for cardiac rehabilitation

P50

% AMI patients currently treated with ACE-I or ARB

P56a

P52 % of AMI patients prescribed aspirin at discharge

1Analytics

Also 24 core metrics for the Coronary Heart Disease pathway


� Diabetes incidenceO1a

� Diabetes prevalenceO2

� Proportion of diabetic patients who have reached the defined glycemictarget

O3a

� Prevalence of retinopathyO4

� Annual incidence of foot ulcersO5

� Prevalence of elevated micro albumin

O6

� Prevalence of elevated cholesterolO7a

� Prevalence of neuropathyO8

� Prevalence of obesityO10

� Incidence of major limb amputationsO13

� Prevalence of renal failureO14

� Prevalence of CHDO15a

� Avoidable diabetes admissionsO16

� % of asymptomatic adults receiving regular BMI check

P25a

� % of diabetics receiving annual retinopathy screening

P24a

� % of diabetics receiving annual foot examinations

P24b

� % of diabetics receiving annual micro albumin excretion screening

P24c

� % of diabetics receiving annual cholesterol screening

P24d

� % of diabetics receiving regular HbA1c testing

P9

� Incidence of StrokeO15b

� Incidence of MIO15c

Prevention of complications

Management of complications

Primary prevention of diabetes

Outcome metrics

Process metrics

� Diabetes incidence without complications

O1a

� Prevalence of elevated blood pressureO7b

� % of diabetics receiving annual blood pressure tests

P25d

1Analytics

� and 24 core metrics Diabetes pathway


Every year, each member on average�

� spend 2,400 per capita on healthcare

� control 265 hospital beds

� employ 183 physicians

� treat 21,749 A & E attendances

� admit 18,295 inpatients

PPP adjusted US dollars

Per 100,000 population




SOURCE: HealthTracker members data collection

1Analytics


Elective Non-elective

Daycases

Inpatient admissions by type



23%

27%

50%

18,916

37%

42%

21%

19,652

48%

37%

16%

22,394

11%

40%

14,442

49%

14,153 13,48335%

21%

21%

52%

27%

51%

37%

13%

25,565

43%

Standardised for age and gender mix difference across member

PRELIMINARY RESULTS

R5 R1R4R3 R2 R6 R8

Acute care admission1Analytics

16McKinsey Health Systems InstituteSOURCE: HealthTracker members data collection

Average length of stay for elective coronary artery bypass graft procedures1

Days

Average length of stay for elective hip replacement procedures1

Days

Average length of stay for elective hysterectomy procedures1

Days

Average length of stay for elective knee replacement procedures1

Days

Improvement potential

1 Standardised for age and gender mix difference across member

13.8

6.69.8

6.58.61.4

8.40.67.8

1.27.2

7.2

07.50.3

0

5.5

11.4

1.70.87.26.11.30.2

7.05.9

5.9

7.6

1.16.8

4.8

8.4

0.44.0

0.23.8

6.5

4.44.00.9

3.60.4

2.9

3.6

0

10.51.6

10.01.3

9.20.9

9.2

0

13.312.2

13.1

10.8 4.24.03.1

PRELIMINARY RESULTS

R4 R7 R3 R6 R5 R2 R1

R4 R3 R2 R7 R5 R6 R1

R4 R5 R3 R2 R6 R1 R7

R2 R4 R6 R5 R3 R7 R1

Average length of stay by procedure1Analytics


0

10

20

30

40

50

60

70

80

90

100

Cataract Inguinalhernia repair

Varicosevein stripping

Pregnancytermination

Myringotomy Sub mucousresection

Arthroscopy Extraction ofwisdom teeth

Proportion of surgeries performed as daycases

Percent

Upper middle quartile range (50%-75%)

Lower middle quartile range (25%-50%)



PRELIMINARY RESULTS

R6

R1

R1

R5

R5

R1

R1

R1

R1

R5

R5R5

R2

R2

R4

R6R6

Day case surgeries1Analytics


Avoidable hospitalisationsPer 100,000 population 2,514.8

2,053.41,811.1

1,639.31,271.3

+

347.1

141.7139.2

59.110.5

1,363.3

864.6

554.1514.7483.2

1,360.2

1,099.3936.0

777.5646.4

Vaccine preventable Per 100,000 population

Chronic conditionsPer 100,000 population

Acute conditionsPer 100,000 population


Top condition

Influenza & pneumonia

Angina

COPD

COPD

Diabetic complications

Diabetic complications

Urinary tract infections

Dental conditions



Urinary tract infectionsStandardised for age and gender mix difference across member

All

R4 R2 R6 R3 R5

R6 R5 R3 R4 R2

R4 R2 R3 R6 R5

R4 R2 R6 R5 R3

R4

R2

R6

R3

R5

R4

R2

R6

R3

R5

Acute care admissions due to ambulatory care sensitive conditions1Analytics


2.4

3.4

3.7

7.7

9.0

11.4

13.3

>5x

In-hospital mortality of AMI

% of AMI admission

In-hospital mortality of Stroke

% of stroke admission

10.5

10.7

12.9

13.1

15.5

17.7

21.1

2x



PRELIMINARY RESULTS

R3

R2

R7

R6

R4

R5

R1

R3

R7

R1

R4

R2

R5

R6

Clinical outcomes1Analytics


Primary screening & Diagnosis

Management of CHD Outcomes

Share of adult daily smokersPercentage

Share of adult with BMI over 30Percentage

AMI patients discharged with beta-blockersPercentage

AMI patients treated with ACEIor ARB

Percentage

AMI inpatient mortality ratePercentage

Readmissions within 30 daysPercentage

21.0

22.9

21.7

13.6

6.9

22.3

23.2

24.5

95.0

40.0

95.0

98.6

86.0

88.5

89.2

92.7

3.7

7.7

9.0

11.4

10.7

12.3

17.6

25.5



PRELIMINARY RESULTS

R6

R4

R5

R2

R6

R4

R5

R2

R6

R4

R5

R2

R6

R4

R5

R2

R6

R4

R5

R2

R6

R4

R5

R2

Coronary heart disease pathway1Analytics

21McKinsey Health Systems InstituteSOURCE: HealthTracker members data collection

Stroke patients given aspirin within 48 hours of symptom onsetPercentage

Patients treated at stroke unitPercentage

Readmissions within 30 days (Stroke-O10)Percentage

Inpatient mortality ratePercentage

48.2

40.0

80.0

64.0

10.7

12.9

15.5

17.7

85.4

79.0

72.3

84.1

5.1

19.2

7.8

2.7

Management of Stroke Outcomes


PRELIMINARY RESULTS

R4

R2

R1

R5

R4

R2

R1

R5

R4

R2

R1

R5

R4

R2

R1

R5

Stroke1Analytics


Prof. James Barbour � Chief Executive NHS Lothian (Scotland)

Sir Ian Carruthers � Chief Executive NHS South West (England)

Dr. Jack Cochran � Executive Director Kaiser Permanente (US)

Dr. Lim Eng Kok � Deputy Director Ministry of Health (Singapore)

Dr. Adriano Marcolongo � Director General Rovigo (Italy)

Dr. Tony O�Connell � Chief Executive Centre for Healthcare Improvement (Australia)

Dr. Hartley Stern � Chief Executive Jewish General Hospital (Canada)

Stephen McKernan � former CEO, Ministry of Health (New Zealand)

Delegates from 15 countries included:

Executive Panel on Innovation

Comparative Analytics: Patient Level Data

Measuring Value for Money in Healthcare

Optimising Clinical Pathways

Driving Value for Healthcare Reform

High impact topics included:

More than 80 health system executives and leading academics in Valencia in 2010

2Forums


Back in Valencia� � members decided that they wanted to

� focus your efforts on one topic for a year of study

�collaborate with other regions to learn new ideas

� move from finding opportunities to proving results

� build capability in your region for clinicians to lead change

� drive innovation through your HSI membership

The Pathway Improvement Network was born as a joint effort from the LSN members to improve the performance across one specific area of care

SOURCE: HSI Conference � November 2010

Four members committed for 2011:

1. Hong Kong

2. NHS Lothian3. Queensland

4. Singapore

Cardiac Improvement Network � the beginning2Forums � Cardiac Improvement Network


An analysis of how your CHD pathway looks likeacross different settings and disciplines compared to best practices

A view on the biggest cost and quality improvement opportunities translated into a prioritised set of initiatives to implement

Insights from peer regions on how to tackle the priority issues along the CHD pathway

New leadership skills for leads and working teams on how to manage change in pathways developed through capability building programme

SOURCE: CIN members

Goals for the improvement network2Forums � Cardiac Improvement Network


Acute managementof AMI

Early managementof CHD

SOURCE: McKinsey

Spend per intervention in CHD pathway, $m per year

Primary prevention

Rehab and secondary prevention

PP

to

tal

EM

tota

l

AM

to

tal

46

55-6

1545352511-4

32, 3

5, 3

8, 4

53736343331

23-3

0222120 501817161514131211 199875-6 48 49

To

tal s

pen

d4710

Reh

ab t

ota

l

Intervention

� Interventions grouped into cost buckets � Interventions 1-4 represent cost of GP appointments related to CHD

Intervention cost waterfall2Forums � Cardiac Improvement Network

26McKinsey Health Systems InstituteSOURCE: McKinsey

7 dimen-sions to achieve excellent pathway manage-ment

Relevant sub-dimensionsRationale

Strategic vision▪ Shared vision and strategy▪ Long-term goals▪ Aim for continuous improvement and innovation

▪ Test if the organization has a clear vision on where to go for a specific care pathway

▪ Existence of standardized protocols ▪ Coherence of patient pathways ▪ Good use of human resources

Process execution

▪ Test if there are standardized processes and if these are well executed

▪ Clearly defined organizational departments and roles▪ Shared set of values▪ Forma/informal coordination tools

Organization/culture

▪ Test if the organization is correctly structured and has the basic elements to perform

▪ Clearly defined clinical leadership roles▪ Adequate clinical leadership skill set▪ Adequate clinical leadership mindset

Clinical leadership

▪ Test whether there is formal clinical leadership that overviews the pathway

▪ Existence/quality of performance reviews and dialogues

▪ Appropriate consequence management▪ Sufficiently broad set of metrics and clear targets▪ Single points of accountability

Performance management

▪ Test whether performance across the pathway is tracked using meaningful metrics and with appropriate regularity

▪ Information systems▪ Infrastructure and equipment▪ Financial support

Resources▪ Test whether the organization has

sufficient resources to provide expected outcomes

Talent management

▪ Test emphasis put on talent management

▪ Value proposition to attract talent▪ Organization�s performance on talent retention

Management practices assessment2Forums � Cardiac Improvement Network

27McKinsey Health Systems InstituteSOURCE: McKinsey

Patient outliers Practice outliers

8

12

0

10

2

14

6

4

Patients100% = 777

Admissions per patient

Identify frequently admitted patients to target

1015

1010

50

4035

30

>6050-60

40-50

30-40

20-30

10-20

5-10<5

GP practices with various numbers of admissions per 1000 CHD patients

Identify opportunities to improve primary care at practice level

Patient and practice outliers2Forums � Cardiac Improvement Network


November 2010 in Valencia, Spain at the Annual LSN Conference

Sir Ian Carruthers (CEO of NHS South West), Jack Cochran (Executive Director at Kaiser Permanente) met with Valencia Deputy Minister Alofonso Bataller to learn more about the Valencia model of allowing private concessions, with capitated payments, within the existing healthcare system.

�At the Valencia hospital's ED I saw the future: An integrated approach across care settings with a risk transfer to the private sector for the public good. Incentives are beginning to align for both the individual and the institution". -Sir Ian Carruthers

April 2011 in London

Alfonso Bataller and Sir Ian Carruthers gave a joint presentation at the London School of Economics on "The Valencia Model and what the NHS can learn from Spain". Sir Ian determined to introduce the concept of private concessions to the NHS to "fuel innovation�."At its best, integration of care provides the right incentives to rally around the patient, not their own respective part of the system.� -Alfonso Bataller

May 2011 in Valencia, Spain

An entire delegation from the Singapore National Health Authority, led by Professor Kwong Ming Fock, went to Valencia to better understand the Valencia system.Discussions included Valencia´s innovative delivery formats and Singapore´s experience in how partial subsidisation/co-payment for health services affects demand, showing how systems have much to learn from each other.

�Health systems need to move towards a more integrated care. Valencia�s model is an intelligent way to create incentives for clinicians and managers in different care settings to align� - Kwong Mong Fock

Network connections carry far beyond the annual conference2Forums


New York City:Combined public health and legislative strategies reduced the smoking rate by over 20%

U.K. and global: Coordinated programmes reduced BMI and increased healthy behavioursamong children ages 7 � 13

London: Restructured stroke services improved stroke outcomes and treatment

New Zealand: High impact smoking cessation reforms in primary care

Michigan: Simple protocols reduced catheter-related bloodstream infections by nearly 70% in >100 ICUs

l

Singapore: Chronic disease management programmesimprove outcomes

Washington: Significant reduction in hypertension with pharmacist care management, home monitoring, and web training

Knowledge bank provides case studies on how new knowledge is successfully being turned into practice

3Evidence


▪ Guidance materials help with virtually any Initiative such as McKinsey�s Five Framework approach to organisational change

▪ Toolkits provide step by step guidance for specific initiatives:

� Improving patient pathways in hospitals

� Assessing primary care performance

� Improving GP access

Insights and tools provide practical guidance from McKinsey�s experience

3Evidence


CHDrehabilitation

▪ Kaiser Permanente�s Collaborative Cardiac Care Service (CCCS) improves secondary prevention in coronary heart disease� Speakers: Dr. John Merenich, program leader, with Jon

Rasmussen, Pharm D. and lead pharmacist

End of life care

▪ Royal Marsden�s Hospital2Home programme allows more patients to die in their chosen setting� Speakers: Dr. Julia Riley, program leader, with researcher

Claire Smith

Diabetes and integrated care

▪ Tower Hamlets PCT�s integrated care programmes have improved outcomes and productivity in diabetes and beyond� Speakers: John Wardell, program director, with Caroline

Bailey and Ryan Meikle

Webinar detailsTheme

Improving Patient pathways

▪ Creating flow in patient-centered pathways� Speakers: John Drew and Rom Revington from Mckinsey

and Ciara Moore, from Cambridge University Hospitals NHS foundation trust

Regular webinars to help member identify improvement opportunities and how that might apply to their region

3Evidence


Questions

Documents

Leading Systems Network Globalisationof Healthcare ... · PDF fileLeading Systems Network Globalisationof Healthcare, Metrics and Benchmarking McKinsey Health Systems Institute Dr