Your SlideShare is downloading. ×
VaLUENTiS delivering world class healthcare 210610 final
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×

Introducing the official SlideShare app

Stunning, full-screen experience for iPhone and Android

Text the download link to your phone

Standard text messaging rates apply

VaLUENTiS delivering world class healthcare 210610 final

54
views

Published on

N J Higgins presentation on Delivering World Class Healthcare (large file - allow for download)

N J Higgins presentation on Delivering World Class Healthcare (large file - allow for download)

Published in: Health & Medicine, Business

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
54
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
2
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Delivering World Class Healthcare: Th F Ch ll f h NHSThe Future Challenge for the NHS Nicholas J Higgins, CEO VaLUENTiS & Dean ISHCM NHS-Healthcare Management Practice DrHCMI MSc Fin (LBS) MBA (OBS) MCMI 22nd June 2010 DrHCMI MSc Fin (LBS) MBA (OBS) MCMI VaLUENTiS NHS Prime Network ‘Managing in Challenging Times’ CBI Centrepoint London
  • 2. Statement from the Secretary ofy State extract “I began today by talking about my ambition:I began today by talking about my ambition: for health outcomes and healthcare services in this country to be as good as any in the world.” Andrew Lansley, Patient-centred care, DoH 8 June 2010
  • 3. CONTENTCO NHS h t th ?NHS where art thou? We’re talking quality! The CQC Rating: ‘Mind the gap’Mind the gap What is world class, indeed? Trust Performance I:Trust Performance I: Taking a different step Trust Performance II:Trust Performance II: ‘With an outcome here and outcome there...’ ‘Coming full circle’
  • 4. NHS: Where are we now? A retrospective • Access • Patient safety • Promoting health and LTC• Promoting health and LTC • Clinically effectivey • Patient experience • Equity Effi i• Efficiency • AccountabilityAccountability Source: A High-performing NHS? A review of progress 1997-2010
  • 5. However, productivity according to the ONS has dropped from 1995 2008 by 3 3%dropped from 1995 – 2008 by 3.3%...
  • 6. Treating diseases: Where the money goes... Source: What Do We Want From The NHS, The Daily Telegraph, March 9 2010
  • 7. One macro-perspective on national healthcare performance (spend vs life expectancy)performance (spend vs life expectancy) Source: Adapted from Premium Price, Poor Performance, J Levin-Scherz, Harvard Business Review April 2010 p.70
  • 8. NHS where art thou? We’re talking quality! The CQC Rating: ‘Mi d th ’‘Mind the gap’ What is world class, indeed? T t P f ITrust Performance I: Taking a different step T P f IITrust Performance II: ‘With an outcome here and outcome there...’ We’re talking Q lit !‘Coming full circle’ Quality!
  • 9. Donabedian’s ‘seven pillars’ ofp quality Source: Adapted from An Introduction to Quality Assurance in Healthcare, A Donabedian OUP 2003
  • 10. Source: Adapted from An Introduction to Quality Assurance in Healthcare, A Donabedian OUP 2003
  • 11. The three approaches to assessing lit (D b di ’ SPO d l)quality care (Donabedian’s SPO model) Cause & effect
  • 12. The three approaches to assessing lit (D b di ’ SPO d l)quality care (Donabedian’s SPO model) Cause & effect
  • 13. ‘Quality accounts’ including Floodlight ti ll breporting covers all bases • Trust Leadership & management • Staff engagement M i /CQC• Monitor/CQC ‘Financial’ rating Quality accounts inc NHSc S Floodlight • Staff engagement • VBM Efficiency • VBM Effectiveness • Patient clinical • CQC ‘Quality’ rating • Patient experience * Both include patient safety parameters
  • 14. Mapping the various NHS quality related t th SPO d lassessments across the SPO model • Trust Leadership & management • Staff engagement M i /CQC• Monitor/CQC ‘Financial’ rating Cause & effect • VBM Effectiveness • Patient clinical • Staff engagement • VBM Efficiency • Patient experience * Both include patient safety parameters • CQC ‘Quality’ rating Quality accounts
  • 15. NHS where art thou? We’re talking quality! The CQC Rating: ‘Mi d th ’‘Mind the gap’ What is world class, indeed? T t P f ITrust Performance I: Taking a different step T P f IITrust Performance II: ‘With an outcome here and outcome there...’ The CQC Rating: ‘Mi d th ’‘Mind the gap’‘Coming full circle’
  • 16. Example CQC ‘quality’ indicators/targets: f i l l t d bl l ?a case of single loop not double loop? National commitment indicators Achieve Underachieve Fail
  • 17. CQC Trust Performance Ratings: ‘Quality’ & Financial rating matrix‘Quality’ & Financial rating matrix World class ‘QUALITY’ Excellent GoodGood Fair Weak FINANCIAL Weak Fair Good Excellent World class FINANCIAL
  • 18. Quality axis World class ‘QUALITY’ Excellent GoodGood Fair Weak FINANCIAL Weak Fair Good Excellent World class Finance Poor f f FINANCIAL Finance axis Not fit for purpose
  • 19. CQC Trust Performance Ratings distribution 2008 9 [across 392 Trusts]2008-9...[across 392 Trusts] Q World class Excellent 37 9% 17 4% 3 1% 1 Good 89 53413Good 89 23% 53 14% 41 10% 3 1% Fair 11 3% 61 16% 50 13% 6 2% Weak 2 1% 9 2% 8 2% 1 Weak Fair Good Excellent World class F
  • 20. CQC Trust Performance Ratings distribution 2008 9 [across 392 Trusts]2008-9...[across 392 Trusts] Q World class Excellent 37 9% 17 4% 3 1% 1 Good 89 53413Good 89 23% 53 14% 41 10% 3 1% Fair 11 3% 61 16% 50 13% 6 2% Weak 2 1% 9 2% 8 2% 1 Weak Fair Good Excellent World class F
  • 21. Performance Ratings versus Employee Engagement distributionEngagement distribution Q World class Excellent GoodGood What happens if we plot engagement scores against Perf Rating? Fair Is there any correlation? Weak Weak Fair Good Excellent World class F
  • 22. Performance Ratings versus Employee Engagement score distributionEngagement score distribution (rebased & simplified average per box) Q World class Excellent 776658 65 Good 71727358Good 71727358 Fair 6465 5255 Weak 54523925 Weak Fair Good Excellent World class F
  • 23. NHSNHS NEXT STOP: WORLDWORLD CLASSCLASS
  • 24. NHS where art thou? We’re talking quality! The CQC Rating: ‘Mi d th ’‘Mind the gap’ What is world class, indeed? T t P f ITrust Performance I: Taking a different step T P f IITrust Performance II: ‘With an outcome here and outcome there...’ What is world l i d d?class, indeed?‘Coming full circle’
  • 25. • world-class (wûrldkls) adj. • Ranking among the foremost in the• Ranking among the foremost in the world; of an international standard of excellence; of the highest order.
  • 26. World class ?World class....?
  • 27. Healthcare: Around the world (in 80 ways)...( y ) • AUSTRALIA • BRAZIL • CANADA • CHINA • FRANCE • GERMANY • HOLLAND• HOLLAND • HONG KONG • INDIA • ITALY... • JAPAN • KOREA • NEW ZEALAND• NEW ZEALAND • NORWAY • SINGAPORE • SWEDEN • SWITZERLAND • UK • USA ... and a host of others
  • 28. 12 ‘attributes’ of world class healthcare 1. Practice of Evidenced based medicine (& social care) 2. Possess integrated network of ‘fit-for-purpose’ healthcare facilities 3. Standardised access to healthcare 4. Appropriate investment and innovation on technology and drugs usepp p gy g 5. Embedded patient-centred operating culture 6. Practice of Evidenced based management 7 Utilisation of requisite skilled staff7. Utilisation of requisite skilled staff 8. Embedded data collation infrastructure: 1. Clinical 2. Patient outcomes 3. Patient experience 4. Management/staff 5. Financial costing 6. Operational 9. Practice of Financial management 10. Developed Executive intelligence measurement and reporting 11. Execute intelligence-based decision-making (governance) 12 Demonstrate value-based effectiveness12. Demonstrate value-based effectiveness Source: Delivering world class healthcare – one small step for the NHS? VaLUENTiS whitepaper, forthcoming
  • 29. The attainment of World class: A preliminary view of the NHSof the NHS ‘World class’ attributes Weak Adequate Good Excellent World class C B A AA AAA class
  • 30. NHS where art thou? We’re talking quality! The CQC Rating: ‘Mi d th ’‘Mind the gap’ What is world class, indeed? T t P f I Trust Trust Performance I: Taking a different step T P f II Trust Performance I: Trust Performance II: ‘With an outcome here and outcome there...’ Taking a diff t ‘ t ’different ‘step’‘Coming full circle’
  • 31. "We can only be sure to improve what weWe can only be sure to improve what we can actually measure" Lord Darzi, High Quality Care for All, June 2008 “If you cannot measure it you cannotIf you cannot measure it, you cannot improve it.” Original source attributed to Lord Kelvin 1824 1907Original source attributed to Lord Kelvin 1824-1907, pioneer of physics and thermodynamics, first UK scientist appointed to the House of Lordsappointed to the House of Lords
  • 32. Data collation:Data collation: Staff and patientp surveys...
  • 33. Current NHS staff and patient ‘compliance’ survey process Reported for Reported survey process Reported for macro DoH research for macro DoH research Annual staff survey T t Annual staff survey T t Normally conducted in 10-week window with 4-month turnaround across Trust population (sample) across Trust population (sample) ...... Spot target patient survey ...... Intermittent collection of patient feedback Spot target patient survey Reported for macro DoH feedback *
  • 34. Flipping the current NHS staff and patient survey process into ‘baseline’ executive intelligence Sample for Sample process into baseline executive intelligence Sample for macro DoH research for macro DoH research Annual staff survey f ll T t Quarterly ‘pulse’ Quarterly ‘pulse’ Quarterly ‘pulse’ Annual staff survey f ll T t Normally conducted in 2-week windows with 2-week turnarounds across full Trust population (census) pulse sample surveys pulse sample surveys pulse sample surveys across full Trust population ...... Spot target patient survey ...... Intermittent collection of patient feedback Spot target patient survey Reported for macro DoH feedback *
  • 35. From ‘Baseline to Advanced’... Sample for Sample Sample for macro DoH research for macro DoH research Annual staff survey f ll T t Quarterly ‘pulse’ Quarterly ‘pulse’ Quarterly ‘pulse’ Annual staff survey f ll T t Normally conducted in 2-week windows with 2-week turnarounds across full Trust population (census) pulse sample surveys pulse sample surveys pulse sample surveys across full Trust population ...... Quarterly QuarterlyQuarterly QuarterlyQuarterly QuarterlyQuarterly patient ‘pulse’ reporting Quarterly patient ‘pulse’ reporting Quarterly patient ‘pulse’ reporting ...... Continuous collection of patient feedback reported in quarterly ‘pulses’ Quarterly patient ‘pulse’ reporting Quarterly patient ‘pulse’ reporting p p q y p Sample for Sample forp macro DoH feedback * p macro DoH feedback *Can be selected at any nominated point
  • 36. From Advanced to World Class... Sample for macro DoH research Sample for macro DoH research Normally conducted in 2-week windows against selected samples s Annual staff survey across full Trust population (census) Quarterly ‘pulse’ sample surveys Quarterly ‘pulse’ sample surveys Quarterly ‘pulse’ sample surveys Annual staff survey across full Trust population ...... s ephaseanalysis atephaseanalysis ephaseanalysis ephaseanalysis atephaseanalysis Multivariate Multivaria Multivariate Quarterly QuarterlyQuarterly QuarterlyQuarterly Quarterly Multivariate Multivaria Quarterly patient ‘pulse’ reporting Quarterly patient ‘pulse’ reporting Quarterly patient ‘pulse’ reporting ...... Continuous collection of patient feedback reported in quarterly ‘pulses’ Quarterly patient ‘pulse’ reporting Quarterly patient ‘pulse’ reporting p p q y p Sample for Sample forp macro DoH feedback * p macro DoH feedback Source: Conducting staff and patient surveys in the NHS: A world class solution, VaLUENTiS white paper, forthcoming *Can be selected at any nominated point
  • 37. NHS staff and patient surveys : The PULSAR® designSample for macro DoH research Sample for macro DoH research The PULSAR® design Normally conducted in 2-week windows against selected samples s Annual staff survey across full Trust population (census) Quarterly ‘pulse’ sample surveys Quarterly ‘pulse’ sample surveys Quarterly ‘pulse’ sample surveys Annual staff survey across full Trust population ...... s ephaseanalysis atephaseanalysis ephaseanalysis ephaseanalysis atephaseanalysis Synchronous phase reporting to assist in improving care/embedding engagement in Trusts linking to clinical, quality, management and financial outcomes - see VaLUENTiS NHS Floodlight System™ for example Multivariate Multivaria Multivariate Quarterly QuarterlyQuarterly QuarterlyQuarterly Quarterly Multivariate Multivaria Floodlight System for example Quarterly patient ‘pulse’ reporting Quarterly patient ‘pulse’ reporting Quarterly patient ‘pulse’ reporting ...... Continuous collection of patient feedback reported in quarterly ‘pulses’ Quarterly patient ‘pulse’ reporting Quarterly patient ‘pulse’ reporting p p q y p Sample for Sample forp macro DoH feedback * p macro DoH feedback Source: Conducting staff and patient surveys in the NHS: A world class solution, VaLUENTiS white paper, forthcoming *Can be selected at any nominated point
  • 38. Data collation (staff): Key differentiating factors between ‘Basic’ and ‘World class’between ‘Basic’ and ‘World class’ ‘Basic’ ‘World class’ • As compliance exercise • Seen as ‘imposed task’ • As ongoing evaluation exercise • Seen as ‘integral infrastructure’p • Intermittent ‘past-time’ data • Staff (and patient) data remain g • Continuous ‘real time’ data • Staff (and patient) data used in( ) siloed in disparate format • One-off action plan ( ) multivariable analysis/models • Continual improvement project • Rigid ‘academic’ manual process Infreq ent reporting • Lean adaptive blended (cost- effective) process Freq ent reporting• Infrequent reporting • Less opportunity to embed evidence based management • Frequent reporting • Constantly reinforces evidence based managementevidence based management based management
  • 39. The patient experience...
  • 40. TrustReception FoodAvailability CarePain management
  • 41. TrustReception FoodAvailability CarePain management
  • 42. Data collation (patient): Key differentiating factors between ‘Basic’ and ‘World class’between ‘Basic’ and ‘World class’ ‘Basic’ • As compliance exercise ‘World class’ • As ongoing evaluation exerciseAs compliance exercise • Seen as ‘imposed task’ • Intermittent ‘past-time’ data As ongoing evaluation exercise • Seen as ‘integral infrastructure’ • Continuous ‘real time’ datap • Patient data remains siloed in limited format • Patient data used in multivariable analysis/models • One-off action plan, if any • Limited number of question data • Continual improvement project • Multi-perspective question data • Infrequent reporting • Less opportunity to embed patient relationship management • Frequent reporting • Patient-centricity core with patient relationship management driverpatient relationship management • Patient ‘clinical’ and patient ‘experience’ viewed separately relationship management driver • Patient ‘clinical’ and ‘experience’ viewed as two sides of the sameexperience viewed separately viewed as two sides of the same coin
  • 43. StaffStaff management...
  • 44. Evaluating Trust management practice: (Management Pathfinder™ ‘radar’) DIVERSITY TRAINING & DEVELOPMENT (Management Pathfinder™ ‘radar’) EMPLOYEE CENTRICITY TALENT MANAGEMENT DEVELOPMENT 813 EMPLOYER BRANDREWARD 674 599 416 HR GOVERNANCERETENTION 742 615 431 657 599 ‘Out-performing’ ( ld l ) HR 742 431 487 642 684 (world class) ‘Out-performing’ (peer) ‘Comparable’ (peer) OPERATIONAL EXCELLENCE RESOURCING 642 628 594603 (peer) ‘Under-performing’ (peer) LEADERSHIPPERFORMANCE ORIENTATION 796 ORGANISATION CLIMATEORGANISATION COMMUNICATIONS ORGANISATION DESIGN
  • 45. Trust management practice – composite findings from NHS network cohortfrom NHSPRIME network cohort
  • 46. You may already know that.... • 1860 – set up first nursing school at y y p g St Thomas’ Hospital London (now part of King’s College)part of King’s College) • First female member of the Royal Statistical Society and credited with developing the ‘polar area diagram’developing the polar area diagram (firstly for sources of patient t lit ) l fmortality) –see overleaf But did you know that...?
  • 47. Nightingale’s original ‘polar area diagram’g g g p g
  • 48. Thus our management radar diagrams are a modern reincarnation of Nightingale’s PADmodern reincarnation of Nightingale’s PAD
  • 49. Staff Management: Key differentiating factors between ‘Basic’ and ‘World class’between ‘Basic’ and ‘World class’ ‘Basic’ • No evaluation of organisation ‘World class’ • Management evaluation regularly management undertaken • Consistency of leadership/ t t l undertaken and reported • Reinforces consistency of leadership/ t tmanagement competence low • Staff survey data used in isolation management competence • Used in conjunction with staff survey data and other operational dataisolation • Only proxy metrics like absenteeism used as evaluation data and other operational data • Management evaluation has many multi-perspective measures • Little evaluation of any management development p p • Continual evaluation of management development (including longitudinal) • Management initiatives usually undertaken in adhoc sequence E id b d t • Management initiatives in planned & (co-)sequenced in priority manner E id b d t• Evidence based management practised in ‘blotches’ • Evidence based management practised as key driver
  • 50. NHS where art thou? We’re talking quality! T t The CQC Rating: ‘Mi d th ’ Trust Performance II: ‘Mind the gap’ What is world class, indeed? T t P f I Performance II: ‘With an Trust Performance I: Taking a different step T P f II With an outcome here Trust Performance II: ‘With an outcome here and outcome there...’ and an outcome th ’there...’‘Coming full circle’
  • 51. Trust Performance broken down into four outcome componentsoutcome components rough:uredthrlymeasmpositelCom
  • 52. Performance & Productivity:y A simple graphic OUTCOMES INPUTS THROUGHPUTS OUTPUTSOUTPUTS
  • 53. Performance & Productivity:y Simple healthcare model OUTCOMES INPUTS THROUGHPUTS Physical Effect of treatment Quality of life improvement, THROUGHPUTSNo of doctors, nurses, management, drugs, technology, beds re-admissions, patient experience, etc OUTPUTS etc Financial Healthcare spend (direct and indirect costing) System Volume of patients treatedp (by class), discharges/ consultations etc
  • 54. World Class Healthcare: Value based management in the NHSValue based management in the NHS ‘Macro’ model version 1.21 Leadership & governance Leadership & governance Shareholder value Trust performanceEmployer brand Trust ‘brand’ VBEΣx Human Capital Practices Human Capital Practices ExternalPatient Value Customer Satisfaction Patient Outcome Revenue Growth Quality of provision I di id l/ Portfolio mixSafety X-sellingClinical treatment Patient centric Work valuesWork values Line-of-sightLine-of-sight Development EmployeeStaff g e1 p1-6 poΣx QΣx LΣx b1 Value Proposition Value Proposition PRM Customer Loyalty Patient experience ProfitabilityUse of Resources Individual/ team Productivity Individual/ team Productivity ServicePatient centricDevelopmentDevelopment RewardReward Work environmentWork environment Employee Engagement Staff Engagement Portfolio mixAccess X-sellingEfficiency ServiceEquity s pe rΣy hcmΣy Ef1-5 Employee Retention Staff retention & utilisation ‘Local’ Management ‘Local’ Management Cost management ComplianceCompliance s1 peΣx hcmΣy RΣx ManagementManagement Cost controlCost management FΣy m1 Key: e1 = example VBM pathway © VaLUENTiS VBM Analytics methodology
  • 55. The NHS Floodlight (Internal) system (ORIGINAL)(ORIGINAL) Clinical Patient Financial Management CO#1CO#6 CO#1CO#6 PO#1PO#6 PO#1PO#6 FO#1FO#6 FO#1FO#6 MO#1MO#6 MO#1MO#6 Outcomes Outcomes Outcomes g Outcomes CO#5 CO#2 CO#5 CO#2 PO#5 PO#2 PO#5 PO#2 FO#5 FO#2 FO#5 FO#2 MO#5 MO#2 MO#5 MO#2 DIVERSITY EMPLOYEETALENT TRAINING & DEVELOPMENT 813 DIVERSITY EMPLOYEETALENT TRAINING & DEVELOPMENT 813 CO#3CO#4 CO#3CO#4 PO#3PO#4 PO#3PO#4 FO#3FO#4 FO#3FO#4 MO#3MO#4 MO#3MO#4 MM WP#12 WP#1 MM WP#12 WP#1EE Work Environm EE ne of Sight EE Work Environm EE ne of Sight CENTRICITY EMPLOYER BRAND HR GOVERNANCERETENTION REWARD MANAGEMENT 813 742 674 615 431 657 599 416 CENTRICITY EMPLOYER BRAND HR GOVERNANCERETENTION REWARD MANAGEMENT 813 742 674 615 431 657 599 416 AA MM CCKK BBLL WP#3 WP#10 W P#11 W P#2 AA MM CCKK BBLL WP#3 WP#10 W P#11 W P#2 nmentLine HR ustom EE Operat Cultu 739613 656743 nmentLine HR ustom EE Operat Cultu 739613 656743 442 591 697729 HR Measurement HR Strategy HR temrisk HR Operatio Excellen 442 591 697729 HR Measurement HR Strategy HR temrisk HR Operatio Excellen HR OPERATIONAL EXCELLENCE LEADERSHIP ORGANISATIONORGANISATION PERFORMANCE ORIENTATION RESOURCING 796 487 642 628 594603 684 HR OPERATIONAL EXCELLENCE LEADERSHIP ORGANISATIONORGANISATION PERFORMANCE ORIENTATION RESOURCING 796 487 642 628 594603 684 EE HH FF DD JJ GG WP#9 WP#4 W P#5 W P#8 EE HH FF DD JJ GG WP#9 WP#4 W P#5 W P#8 EE velopmentEEReward Cu ing re 598620 EE velopmentEEReward Cu ing re 598620 619663 HR overnance HR Function ROI Syst onal nce 619663 HR overnance HR Function ROI Syst onal nce ORGANISATION CLIMATEORGANISATION COMMUNICATIONS ORGANISATION DESIGN ORGANISATION CLIMATEORGANISATION COMMUNICATIONS ORGANISATION DESIGN WP#6WP#7 WP#6WP#7eveloard eveloard HR Function Productivity Leadership & Management Eff ti Staff Engagement Workforce Productivity Effectiveness
  • 56. The NHS Floodlight (internal) system (REVISED)(REVISED) Clinical Patient Patient Financial CO#1CO#6 CO#1CO#6 PO#1PO#6 PO#1PO#6 FO#1FO#6 FO#1FO#6 MO#1MO#6 MO#1MO#6 Effectiveness Experience Safety Management CO#5 CO#2 CO#5 CO#2 PO#5 PO#2 PO#5 PO#2 FO#5 FO#2 FO#5 FO#2 MO#5 MO#2 MO#5 MO#2 DIVERSITY EMPLOYEETALENT TRAINING & DEVELOPMENT 813 DIVERSITY EMPLOYEETALENT TRAINING & DEVELOPMENT 813 CO#3CO#4 CO#3CO#4 PO#3PO#4 PO#3PO#4 FO#3FO#4 FO#3FO#4 MO#3MO#4 MO#3MO#4 MM WP#12 WP#1 MM WP#12 WP#1EE Work Environm EE ne of Sight EE Work Environm EE ne of Sight CENTRICITY EMPLOYER BRAND HR GOVERNANCERETENTION REWARD MANAGEMENT 813 742 674 615 431 657 599 416 CENTRICITY EMPLOYER BRAND HR GOVERNANCERETENTION REWARD MANAGEMENT 813 742 674 615 431 657 599 416 AA MM CCKK BBLL WP#3 WP#10 W P#11 W P#2 AA MM CCKK BBLL WP#3 WP#10 W P#11 W P#2 nmentLine HR ustom EE Operat Cultu 739613 656743 nmentLine HR ustom EE Operat Cultu 739613 656743 MO#1MO#6 MO#5 MO#2 MO#1MO#6 MO#5 MO#2 HR OPERATIONAL EXCELLENCE LEADERSHIP ORGANISATIONORGANISATION PERFORMANCE ORIENTATION RESOURCING 796 487 642 628 594603 684 HR OPERATIONAL EXCELLENCE LEADERSHIP ORGANISATIONORGANISATION PERFORMANCE ORIENTATION RESOURCING 796 487 642 628 594603 684 EE HH FF DD JJ GG WP#9 WP#4 W P#5 W P#8 EE HH FF DD JJ GG WP#9 WP#4 W P#5 W P#8 EE velopmentEEReward Cu ing re 598620 EE velopmentEEReward Cu ing re 598620 MO#3MO#4 M 2 MO#3MO#4 M 2 ORGANISATION CLIMATEORGANISATION COMMUNICATIONS ORGANISATION DESIGN ORGANISATION CLIMATEORGANISATION COMMUNICATIONS ORGANISATION DESIGN WP#6WP#7 WP#6WP#7eveloard eveloard Hospital Management Obj ti Leadership & Management Eff ti Staff Engagement Hospital Productivity Objectives Effectiveness
  • 57. The NHS Floodlight system (EXTERNAL): Current [C]Current [C] Cli i l P ti t P ti t Fi i lClinical Effectiveness Patient Experience Patient Safety Financial Management Hospital Management Objectives Leadership & Management Effectiveness Staff Engagement Hospital Productivity GWorld class Excellent Good Adequate Weak Insufficient data
  • 58. The NHS Floodlight system (EXTERNAL): Current plus previous 2 years [C+]Current plus previous 2 years [C+] Cli i l P ti t P ti t Fi i lClinical Effectiveness Patient Experience Patient Safety Financial Management Hospital Management Objectives Leadership & Management Effectiveness Staff Engagement Hospital Productivity GWorld class Excellent Good Adequate Weak Insufficient data Last 3 years performance
  • 59. Quality Accounts: We see 3 versions developing – Standard, Intermediate (Super8) and Advanced( p ) (SuperEight3D) Advanced Intermediate Standard
  • 60. ExIMR... [Executive Intelligence Measurement & Reporting]Reporting] Anal tics Ri k Predictive VisualisationE l ti F ti‘Real time’P fAnalytics Risk modelling VisualisationEvaluation Forecasting‘Real-time’Performance
  • 61. Too often different sourced data is not connectedconnected... Or, conversely, different time-series data is erroneously connected...
  • 62. Real-Time Informed Management and staffManagement and staff AFF CAL NCIAL ENT TIONAL STA MEDI FINAN PATIE OPERATO
  • 63. ExIMR: Key differentiating factors between ‘Basic’ and ‘World class’and ‘World class’ ‘Basic’ ‘World class’Basic • Data collation and measurement driven by ‘external demand’ World class • Data collation and measurement driven by ‘internal strategy’driven by external demand • Viewed as ‘imposed task’ • Intermittent ‘past-time’ data driven by internal strategy • Viewed as ‘integral infrastructure’ • Continuous ‘real time’ dataIntermittent past time data • Selected data used mainly to support ‘chosen view’/defence Continuous real time data • Constant aid to decision-making and governance • Management meetings driven by information swap g • Management meetings driven by knowledge debate/exchange • Tendency to think IT will solve problem – sub-optimal efficiency Operating c lt re still ‘target • Measurement ethos with cost- efficiency uppermost Operating c lt re ‘objecti e’• Operating culture still ‘target driven’ • Quality Accounts seen as • Operating culture ‘objective’ driven • Quality Accounts seen asQuality Accounts seen as compliance exercise Quality Accounts seen as ongoing evaluation exercise
  • 64. NHS where art thou? We’re talking quality! The CQC Rating: ‘Mi d th ’‘Mind the gap’ What is world class, indeed? T t P f ITrust Performance I: Taking a different step T P f II ‘C i f ll Trust Performance II: ‘With an outcome here and outcome there...’ ‘Coming full circle’circle‘Coming full circle’
  • 65. The 12 ‘attributes’ f ld lof world class healthcare 11 healthcare At trust level...8 7 5 ... each one is2 attainable 1
  • 66. The attainment of World class: A small step of steps within 5 years ?steps within 5 years...? ‘World class’ attributes Weak Adequate Good Excellent World class C B A AA AAA class ? ?
  • 67. What’s the answer to ‘Managingg g in Challenging Times’.....? “BEING SMARTER”