A presentation delivered by Eric Schneider MD, FACP at the Association of American Medical Colleges' 2018 Integrating Quality Conference. Dr. Schneider presented as part of the "Building Capacity for Quality Improvement & Clinical Innovation at AMCs" panel.
Panel Description:
Clinical innovation and continuous quality improvement are critical to success in today’s health care system with its shift to value-based care delivery and financing models. While there is a need to implement, evaluate, and scale successful QI efforts and clinical innovations, there is wide variation in how health systems are supporting this work. This session will include presentations by leaders from three AMCs describing their institutions’ various approaches to supporting QI and innovation activities, including staffing, funding, evaluation, and scaling. The session will begin with an overview of a proposed framework for understanding the differences and intersections between QI, implementation, systems redesign, and innovation. The speakers will then share their perspectives on some of the core organizational competencies needed to support QI and innovation activities, including opportunities for career pathways. Finally, there will be an opportunity for participants to share their own successes and challenges to supporting QI and innovation at their institutions, and to provide feedback on opportunities for continuing this work.
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Innovation Centers and Health Care
1. Eric C. Schneider MD, FACP
Senior Vice President for Policy and Research
@ericschneidermd
Innovation Centers and
Health Care
High Quality, Affordable Care?
2. 2
• Academic health centers have a long tradition of
biomedical innovation
• Many factors pushing delivery systems to achieve higher
quality care at lower cost (increasing value)
• Are academic medical centers prepared to innovate in
the delivery of health care?
The Rise of the Innovation Center
3. 3
How do other industries innovate to
achieve value?
Core
Optimizing current
practices within
existing delivery
models
Transformational
New and disruptive
delivery models
Adjacent
Innovation within
existing delivery
models
Existing
systems&
stakeholders
Newsystems&
stakeholders
Existing process &
service improvement
New processes &
services
4. 4
Strong link to senior
leadership
Integrated with
front-line
Separate from
front-line
Weak link to senior
leadership
Skunkworks
Functional
Organizational structures for innovation
5. 5
Innovation Centers in 2015
Question Range of Responses Median
Year started 1995 to 2014 2010
Annual budget
(when disclosed)
$150,000 to $18,000,000 $1,950,000
Number of staff
(full-time equivalents)
1 to 215 6
Number of innovations
being tested
2 to 100 12.5
Note: Number of innovation center respondents varied from 21 to 32, depending on the question.
Hostetter et al, 2015 (www.commonwealthfund.org/publications/chartbooks/2015/apr/survey-
of-health-care-delivery-innovation-centers)
6. 6
2003-2007
Organizational Structures for Innovation
Strong link to senior
leadership
Integrated with
front-line
Separate from
front-line
Weak link to senior
leadership
7. 7
What Do Innovation Centers Focus on?
29%
35%
55%
61%
61%
65%
65%
68%
71%
74%
77%
77%
84%
87%
87%
90%
0% 50% 100%
Other responses
Price transparency
Community-based services
Devices
Patient safety
Wellness
Home-based care
Utilization
Intraprofessional communication
Clincal decision support
Population health
Workflow efficiencies
Patient engagement
Access
Disease-specific outcomes
Care coordination
Notes: N=31. Other responses include spending reductions, the uninsured, helping
seniors age in place, teaching/education, data mining, and data analysis.
Percent of innovation center survey respondents
8. Thank you
AAMC
June 7, 2018
Eric C. Schneider, MD, MSc, FACP
Senior Vice President for Policy and Research
The Commonwealth Fund
@ericschneidermd
9. 9
Method Lean/Six Sigma Agile Design Thinking
Desired
endpoint
Improved existing
processes
Improved
solution
Job-to-be-done and
prototype solution
Problem
identification
Process-maps,
run-charts, data
Designer-
customer
interaction
Eliciting end-user
needs and wants
(latent)
Origin Manufacturing Software Human-centered
design
The Improvement-Innovation Spectrum
InnovationImprovement
5
Editor's Notes
Goal is cross-pollination without cross-contamination
Standardize processes once you have them
In this case, you had a broken process and the lead, who had QI training was stuck
This method is not as effective when you need to start from scratch
Failure of the imagination