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  • 1. Quality Leadership in Health Care: Creating a Culture for SuccessDecember 2009
    John G. Reiling
  • 2. Background - IOM Report
    • The risk of dying as a result of medical error far surpasses the risk of dying in an airline accident.
    • 3. Death on domestic flights:
    1 in 8,000,000 flights.
  • 4. Background - IOM Report(continued)
    • Death in hospitals from medical errors:
    1 in 343 admits to 1 in 764 admits.
    • Adverse Events in Hospitals:
    1 in 27 admits to 1 in 34 admits.
  • 5. Safety in Healthcare
    • The environment (facilities, equipment, technology)
    affects performance.
    • The processes affect performance.
    • 6. The culture affects performance.
  • The National Learning Lab
    The participants:
  • 15. Creating a Culture of Safety
    • Shared Values/Beliefs about Safety within the Organization
    • 16. Always Anticipating Precarious Events
    • 17. Informed Employees and Medical Staff
    • 18. Culture of Reporting
    • 19. Learning Culture
    • 20. “Just” Culture
    • 21. Blame-Free Environment Recognizing Human Fallibility
    • 22. Physician Team Work
    • 23. Culture of Continuous Improvement
    • 24. Empowering Families to Participate in Care of Patients
    • 25. Informed & Activated Patient
  • 26. National Advisory Committee(Invitees)
    Jim Adams, Exec. Director & Fellow, IBM Center of Healthcare Management
    Frank T. Brogan, President, Florida Atlantic University
    Carolyn Clancy, MD, MPH, Director of Agency for Healthcare Research & Quality
    William F. Coyne, PhD., Former Senior VP for R&D for 3M, Healthcare for 3M, and 3M Canada
    Tim Flaherty, M.D., Past Chairman, NPSF & Past Chair of American Medical Association
    Lillee Smith Gelinas, RN, BSN, MSN, FAAN, Vice President & Chief Nursing Officer of VHA, Inc.
    Pascal Goldschmidt, MD, Senior Vice President & Dean, University of Miami Miller School of Medicine
    Donald Holmquest, M.D., Ph.D., J.D., President & CEO of California Regional Health Information Org
    Beverly Johnson, President & CEO, Institute for Family Centered Healthcare
    Lucian L. Leape, MD, Adjunct Professor, Harvard Univ. School of Public Health
    Kathy Malloch, PhD., MBA, RN, FAAN, Pres of Malloch & Assoc & Director of the MHI Program at ASU
    David Marx, J.D., President of Outcome Engineering, LLC
    David Nash, M.D., M.B.A., FACP, Chairman, Jefferson Medical College, Thomas Jefferson University
    Richard Norling, Chief Executive Officer and Director of Premier, Inc.
    Dennis O’Leary, President Emeritus of Joint Commission
    Paul O’Neill, Former Secretary of the U.S. Treasury
    Mary A. Pittman, Ph.D., American Hospital Association & Current President of the Public Health Institute & Past President of the Health Research and Educational Trust
    William Rupp, MD, Past President of Luther Midelfort & Immanuel St. Joseph’s-Mayo Health Systems & Institute for Healthcare Improvement
    Donna E. Shalala, Ph.D, President, University of Miami
    Gail Warden, President Emeritus, Henry Ford Health Systems
    Bennet Waters, D.H.A., Chief of Staff for the US Dept. of Homeland Security, Office of Chief Medi Officer
  • 27. Results of NAC Leadership
  • 28. Leadership
    Management, CEO
    Medical Staff 
  • 29. Deming’s 14 Points
    1). Create Constancy of Purpose for the Improvement of Product and Service
    2). Adopt the New Philosophy
    3). Cease Dependence on Mass Inspection
    4). End the Practice of Awarding Business on Price Tag Alone
    5). Improve Constantly and Forever the System of Production and Service
  • 30. Deming’s 14 Points
    6). Institute Training and Retraining
    7). Institute of Leadership
    8). Drive Out Fear
    9). Break Down Barriers Between Staff Areas
    10). Eliminate Slogans, Exhortations, and Targets for the Workforce
  • 31. Deming’s 14 Points
    11). Eliminate Numerical Quotas
    12). Remove Barriers to Pride of Workmanship
    13). Institute a Vigorous Program of Education and Retraining
    14). Take Action to Accomplish the Transformation