SYSTEMIC TRansformations
in health care by design

Stories from the
Center for Innovation (CFI)
AHO

josinavink

manuelaag...
WHY DO SO MANY PEOPLE (FROM
ALL OVER THE WORLD) COME TO
THIS TORNADO-BORN TOWN?
* image by Patti Kuche

AHO

josinavink

m...
1860

1870

1880

1890

1900

1910

1920

1930

1940

1950

1960

1970

1980

ED: OPEN SURGERIES
THE MAYO´S CLINIC
SALARIE...
center for innovation
Transforming the experience
and delivery of health care
64
58

32
28
24

6

8

2

2004

AHO

2005

2...
Research Admin

Facilities & Support Services

Planning Services

Mayo Health System Admin
Human Resources

Public Affairs...
AHO

josinavink

manuelaaguirreu
evidence based
rational
linear
reductive
analytical
comparative
consensus
reactive

possibility based
creative
divergent
g...
AHO

josinavink

manuelaaguirreu
THE GOAL

Reduce outpatient practice costs by at least
30% while improving the patient experience and
maintaining/enhancin...
AHO

josinavink

manuelaaguirreu
CREATING AN ADAPTIVE AND INTELLIGENT SYSTEM

KNOW THE PATIENT
group visits

awareness
micro-consult

smart
space
pre
visit...
group visits

awareness
micro-consult

smart
space
pre
visit

remote
recheck

flexible
day
costumized
ed

adaptability

AH...
pulmonary
specialist

AHO

josinavink

manuelaaguirreu
AHO

josinavink

manuelaaguirreu
AHO

josinavink

manuelaaguirreu
Healthcare
Industry

Mayo
System

Outpatient
Practice

Service
Offerings

AHO

josinavink

manuelaaguirreu
AHO

josinavink

manuelaaguirreu
AHO

josinavink

manuelaaguirreu
Curry, A. and Hodgson, A. (2008). “Seeing in multiple horizons: connecting futures to strategy” . Journal of Futures Studi...
AHO

josinavink

manuelaaguirreu
change
fatigue
AHO

josinavink

manuelaaguirreu
prove it

AHO

josinavink

manuelaaguirreu
systemic

short term

long term

narrow
vision
discrete
* Model from Peter Coughlan and Colleen Ponto

AHO

josinavink

ma...
mitigation
vs
optimization

AHO

josinavink

manuelaaguirreu
structure
drives
behavior

AHO

josinavink

manuelaaguirreu
adding or
disrupting
AHO

josinavink

manuelaaguirreu
do you see any of
these challenges in the
context you are working in

AHO

josinavink

manuelaaguirreu
successes
in facilitating
systems change
AHO

josinavink

manuelaaguirreu
making space
for change
AHO

josinavink

manuelaaguirreu
embrace the
unintended
AHO

josinavink

manuelaaguirreu
ENABLING
practice
champions
AHO

josinavink

manuelaaguirreu
building on what
is working
AHO

josinavink

manuelaaguirreu
identifying
strategic
levers
AHO

josinavink

manuelaaguirreu
connecting
the dots
AHO

josinavink

manuelaaguirreu
possibilities
for the future
AHO

josinavink

manuelaaguirreu
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Manuela systemic transformations in health care by design slideshare

  1. 1. SYSTEMIC TRansformations in health care by design Stories from the Center for Innovation (CFI) AHO josinavink manuelaaguirreu
  2. 2. WHY DO SO MANY PEOPLE (FROM ALL OVER THE WORLD) COME TO THIS TORNADO-BORN TOWN? * image by Patti Kuche AHO josinavink manuelaaguirreu
  3. 3. 1860 1870 1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 ED: OPEN SURGERIES THE MAYO´S CLINIC SALARIED STAFF ECONOMY TECHNOLOGY PROACTIVE APPROACH TOWARDS PHILANTROPY FIRST BLOOD BANK IN UNITED STATES & USE OF EEG TEST FIRST OPERATING TABLE FIRST USE OF X-RAYS 2000 FIRST ICU ICU PRECURSOR FIRST CT SCANNER EARLY USE OF VIDEO VISITS FIRST USE OF COMPUTER EARLIEST PATIENT RECORD WORKFLOW 2020 cfi EARLY USE OF TELEPHONE COMMUNICATION 2010 spark THE NEEDS OF THE PATIENTS COME FIRST & INTEGRATED GROUP PRACTICE VISION 1990 UNIFIED MEDICAL RECORD MEDICAL SURGICAL INDEX COMPUTERS GO MAINSTREAM EMR REPLACED PAPER MEDICAL RECORDS ORANGE/BLUE CALENDAR DAYS EXPERIMENTAL RADIAL NURSING UNIT MAYO CLINIC HEALTH SYSTEM PARTNERSHIPS MAYO CLINIC OPENS IN FLORIDA AND ARIZONA AHO josinavink MAYO CLINIC CARE NETWORK manuelaaguirreu
  4. 4. center for innovation Transforming the experience and delivery of health care 64 58 32 28 24 6 8 2 2004 AHO 2005 2007 2008 josinavink 2009 2010 2012 2013 manuelaaguirreu
  5. 5. Research Admin Facilities & Support Services Planning Services Mayo Health System Admin Human Resources Public Affairs Finance Systems and Procedures Neurology Legal Dental Specialities Environmental Services Dermatology Education Admin Emergency Med Development Molecular Farm Family Med 1900 Nursing Medical Genetics ENT Internal Medicine Molecular Med Oncology 1925 Orthopedics Physical Med Anesthesiology Immunology Radiation Oncology Anatomy Surgery Urology TODAY Lab Med & Pathology Comparative Med Health Sciences Research Biochemistry & Molecular Biology AHO Radiology Psychiatry & Psychology Neurosurgery Obstetrics & Gynecology Ophthalmology - Head & Neck Surgery Physical & Biomedical Engineering josinavink manuelaaguirreu
  6. 6. AHO josinavink manuelaaguirreu
  7. 7. evidence based rational linear reductive analytical comparative consensus reactive possibility based creative divergent generative reflexive disruptive provocative proactive * Comparison by Lorna Ross AHO josinavink manuelaaguirreu
  8. 8. AHO josinavink manuelaaguirreu
  9. 9. THE GOAL Reduce outpatient practice costs by at least 30% while improving the patient experience and maintaining/enhancing quality. TIMELINE Implement new models to >40% of the outpatient practice by the end of 2014. EXPERIMENT FAMILIES: Pre-Visit Smart Space AHO Micro-Consults Group Visits Remote Recheck Flexible Day josinavink manuelaaguirreu
  10. 10. AHO josinavink manuelaaguirreu
  11. 11. CREATING AN ADAPTIVE AND INTELLIGENT SYSTEM KNOW THE PATIENT group visits awareness micro-consult smart space pre visit remote recheck flexible day costumized ed adaptability enhanced integrated care OPTIMIZED CARE OFFERINGS AHO josinavink manuelaaguirreu
  12. 12. group visits awareness micro-consult smart space pre visit remote recheck flexible day costumized ed adaptability AHO enhanced integrated care josinavink manuelaaguirreu
  13. 13. pulmonary specialist AHO josinavink manuelaaguirreu
  14. 14. AHO josinavink manuelaaguirreu
  15. 15. AHO josinavink manuelaaguirreu
  16. 16. Healthcare Industry Mayo System Outpatient Practice Service Offerings AHO josinavink manuelaaguirreu
  17. 17. AHO josinavink manuelaaguirreu
  18. 18. AHO josinavink manuelaaguirreu
  19. 19. Curry, A. and Hodgson, A. (2008). “Seeing in multiple horizons: connecting futures to strategy” . Journal of Futures Studies 13(1). Pp. 1 - 20. AHO josinavink manuelaaguirreu
  20. 20. AHO josinavink manuelaaguirreu
  21. 21. change fatigue AHO josinavink manuelaaguirreu
  22. 22. prove it AHO josinavink manuelaaguirreu
  23. 23. systemic short term long term narrow vision discrete * Model from Peter Coughlan and Colleen Ponto AHO josinavink manuelaaguirreu
  24. 24. mitigation vs optimization AHO josinavink manuelaaguirreu
  25. 25. structure drives behavior AHO josinavink manuelaaguirreu
  26. 26. adding or disrupting AHO josinavink manuelaaguirreu
  27. 27. do you see any of these challenges in the context you are working in AHO josinavink manuelaaguirreu
  28. 28. successes in facilitating systems change AHO josinavink manuelaaguirreu
  29. 29. making space for change AHO josinavink manuelaaguirreu
  30. 30. embrace the unintended AHO josinavink manuelaaguirreu
  31. 31. ENABLING practice champions AHO josinavink manuelaaguirreu
  32. 32. building on what is working AHO josinavink manuelaaguirreu
  33. 33. identifying strategic levers AHO josinavink manuelaaguirreu
  34. 34. connecting the dots AHO josinavink manuelaaguirreu
  35. 35. possibilities for the future AHO josinavink manuelaaguirreu

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