The Deployment System: Creating the Organizational Infrastructure to Support Sustainable Change

© 2014 Health Catalyst
www.healthcatalyst.com
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www.healthcatalyst.comProprietary and ConfidentialFollow Us on Twitter #TimeforAnalytics
John L. Haughom, MD
July 2014
The Deployment System:
An Organizational Structure to Support Sustainable Change

Implementing an Effective System of
Production in Healthcare
Analytic
system
Content
system
Deployment
system
Scalable
and
sustainable
outcomes

Content
system
3
Deployment system components
Organize
teams for
scalable
improvement
Analytic
system
Combine
Lean and
analytics
Apply
Agile

A Demonstration…
4
Discovery ApplicationsFoundational Applications Advanced Applications`
Population Suites
e.g., Ischemic Heart Disease
Workflow / Operational Suites
e.g., Acute Medical
Patient Injury Prevention Suites
e.g., Infection Prevention
Patient Injury Prevention Modules
e.g., CAUTI, CLABSI, SSI
Workflow/Operational Modules
e.g., ICU, MedSurg, Emergency
Population Modules
e.g., CABG, Stent, AMI
Labor Management Explorer
Rev Cycle Explorer
Patient Satisfaction Explorer
General Ledger Explorer
Readmission Explorer
Population Explorer
Patient Flow Explorer
Practice Management Explorer Suite
Financial Management Explorer
CAFE—Comparative Analytics Framework and Exchange—across Healthcare Systems and National Benchmarks
EDIT—Executive Dashboard Integration Tool (Key Performance Indicator editable collage from all app categories)
Key Process Analysis (KPA)
Cohort Builder
Comorbidity Analyzer
Payment Model Analyzer
Readmission Predictor
Patient Flight Plan Predictor
ACO Explorer Suite
Metric Correlation Analyzer
Regulatory Explorer
Attribution Modeler

Improvement Methodology
• A goal is a desired result the workgroup
envisions, plans and commits to achieve an
organizational desired end-point by a specified
deadline.
• AIM statements are written, measurable, and
time-sensitive objectives that move the team
toward achieving the goal .

6
CV Heart Failure
Goal: Decrease 30 day readmission rates of heart
failure patients
Establish a baseline of all cause 30
day readmission rates for HF
patients, create and validate 30 day
and 90 day readmission rates for all
HF patients.
AIM #1
AIM #2
AIM #3

7
CV Heart Failure
failure patients
Identify high risk heart failure
patients and extend the
identification of these patients to a
Risk Stratification Model to predict
the likelihood of all cause 30-day
readmission rates.
AIM #1
AIM #2
AIM #3

8
CV Heart Failure
failure patients
Schedule a follow-up appointment
for all HF patients within 24 hours of
discharge with a focus on high risk
patients being seen within 48-72
hours after discharge.
AIM #1
AIM #2
AIM #3

9
CV Heart Failure
failure patients
AIM #1
AIM #2
AIM #4
AIM #3
Establish a medication reconciliation
baseline and track compliance in
order to achieve 75% compliance by
X date.

10
CV Heart Failure
failure patients
AIM #2
AIM #3
AIM #5
AIM #4
A follow-up phone call from a nurse
post-discharge to assess whether
the patient has obtained his/her
medication and has no barriers to
making their follow-up appointment.

Two Important Questions…
• Why is a deployment system
necessary?
• What is the most important ingredient to
make a deployment system successful?
11

Why is a deployment system
necessary?
To spread best practice…
…to sustain improvements..
…and to support continuous learning and
continuous improvement.

For different results, something
has to change…
“Insanity is doing the same thing over and over
and expecting different results.”
Albert Einstein
"Every system is perfectly designed to get the
results it gets."
Paul Batalden, MD

Outcome of a Traditional Deployment System
Baseline
performance
Improvement with focused
project
Inability to sustain
gains over time
Characteristics of a
typical team
• Temporarily
assigned
• No technical team
members
• Approach work like
a project (one-time
event)
• No analytic system

Deployment System Team Structure
Team interactions
Guidance team
Direction, prioritization of
resources & remove
barriers
Clinical
implementation
team
Fundamental
knowledge of process
Work group
drafts:
• Workflows
• Measurements
• Knowledge assets Content
SME*
Technical
SME
Analytic
SME
Nurse
lead
Physician
lead
Broad representation of stakeholders across the continuum of care
*SME = Subject matter expert

Two Important Questions…
• Why is a deployment system
necessary?
• What is the most important ingredient
to make a deployment system
successful?
16

Healthcare: The Way It Should Be
Why?
17
Available for FREE download at: http://www.healthcatalyst.com/ebooks/healthcare-transformation-healthcare-a-better-way/
A handbook…
…for transformation.
engagement.

Levels of Engagement
Engaged
18
• Hungry for best practice
• Committed to continuous learning
Disengaged∧
Traditional Craft of Medicine
Accepting the need for change;
more team oriented, data-driven
profession style of practice
• Less hungry
• “Do it my way”
Traditional Craft of Medicine
Need to be convinced a new way
is necessary; want to be shown it
is necessary and that it works

Engaging the “Smart Cogs”
Focus on the opinion leaders
2º
Many studies have looked at how these groups differ:
• Innovators are highly cosmopolitan and open to new things.
• Early adopters tend to be opinion leaders.
• Early majority provide “legitimization” of the innovation.
• Late majority are skeptical.
• Laggards put trust in the status quo.
Innovations do not
spread equally over
different society
segments (social
groups),but through 5
stages with a particular
profile of reaction.
Tipping point at 15-
20% adoption
Rogers’ diffusion of innovation model

Linking the three systems
Clinical Integration hierarchy
GUIDANCE
TEAM
CLINICAL
IMPLEMENTATION
TEAM
WORK
GROUP

Two additional points…
We are never too old or too young
We achieve the most when we get together
and figure out best practice.

Poll Questions
2. Does your organization have the necessary
organizational structure that not only supports the
spread of innovation and improvement, but also
allows improvements to be sustained over time?
79 Respondents
a. 5 – Definitely – 15%
b. 4 – 17%
c. 3 – 31%
d. 2 – 27%
e. 1 – Not at all – 11%
22

Thank You
Upcoming Educational Opportunities
Six Reasons Why Healthcare Data Warehouses Fail
Date: August 13, 1-2pm, EST
Presenter: Steve Barlow, Co-founder and former CEO, Health Catalyst
http://www.healthcatalyst.com/knowledge-center/webinars-presentations
Healthcare Analytics Summit
Join top healthcare professionals for a high-powered analytics summit using analytics to
drive an engaging experience with renowned leaders who are on the cutting edge of
healthcare using data-driven methods to improve care and reduce costs.
Date: September 24th-25th
Location: Salt Lake City, Utah
Save the Date: http://www.healthcatalyst.com/news/healthcare-analytics-summit-2014
For Information Contact:
Dr. John Haughom: john.haughom@healthcatalyst.com

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The Deployment System: Creating the Organizational Infrastructure to Support Sustainable Change

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