Presented at LW1 for Wave 10 APCC Sydney March 2014. The Collaborative Methodology and Change Principles

1. Change Principles
Tony Lembke
Wave 10
Sydney, March 15th 2014

3. alstonville

4. Mick Roberts

6. Professor Barbara Starfield

7. Chronic illness is not improved by:
• More specialists
• Better diagnostic tools
• New treatments
Chronic illness is improved by:
• Better provision of primary care

9. alstonvillegopherfest

10. nimbin mardigrass

15. Four fold
decrease in CHD
Deaths
30% reduction in
one year
60% reduction in
time to see a GP

17. Dale Ford

19. Collaborative Framework

22. 3 p/t doctors, 2 p/t receptionists, 2 p/t nurses, 1 physio, pharmacy

25. Merlin Mann
43folders.com

26. Two Aims
Three Goals
Five Ways of Thinking
Five Change Principles
Hundreds of Change Ideas

27. Your Mission
1 10% reduct cardiac events
2 20% have
CV RiskAssessment
3 20% improve risks to target
4 90% screening of high risk
for CKD

28. your Mission
1 Improve Patient Outcomes
3 More sustainable practice
2 More satisfying for patients,
staff and clinicians.

29. Fall ForwardsFTFTKaizen

30. Think in Systems

31. Tom Nolan and Don Berwick

34. PROTECTED TIME

35. Measure

36. Steal Shamelessly
Share Generously

37. Focus North

38. CP1
CP3
CP2
CP4
CP5
Change Principles

39. CP1 - Build the Practice Team

40. Attitude
Pain is Inevitable. Suffering is optional.
CP1

41. Mood-O-Meter
0
2.25
4.50
6.75
9.00
Mood (/10)
Monday Tuesday Wednesday Thursday Friday
CP1

42. Tom Marshall
General Practice is the best job in the world -
You get paid for talking to your friends!
CP1

43. Brains TrustBoofheads
CP1

44. Lismore Rugby Under 14s
CP1

45. Have you got
the ball ?
No
Get the Ball
Score a Try
Yes

46. Have
you got
the ball ?
No
Get the Ball
Score a Try
Yes
Have
they got
the ball ?
No
Tackle Them
Yes

49. CP1

50. James Sutton
Goal:
Complete transformation of an
ordinary clinic to a cutting edge
facility in one year using
Team Building,
Open Access and
Planned Care

52. Guiding Coalition

53. Vision

54. Repeat
Vision

55. Obstacles

56. Short Term Wins

57. Claiming Victory to Soon

58. Anchor Changes

62. CP2 - Herd Health

65. CP2

66. CP2

68. CP2

69. CP2

71. © Improvement Foundation (Australia) Ltd

72. CP3 - Be systematic

74. Value Streams

75. Cycling Care
CP3

76. CP3

77. CP3

78. Team
Right , right job, right time
Care is Team-based

79. CHRONIC DISEASE
MANAGERS

80. Claim Shamelessly
CP3

81. Month 0 GPMP,TCA 721,723
Month 3 Review 732
Month 6 Review 732
Month 9 Annual Check 732
Month 12 GPMP,TCA 721,723
Cycles of Care
CP3

82. Show me the money
300 CVD Patients
GPMP @ $141 x 300 $42,300
$126,800
TCA @ $112 x 250 $28,000
$21,000
$17,500
Item 723 @ $70 x 300
Item 723 @ $70 x 250
$18,000Item 10997 @ $12 x 5 X 300
4

83. CP4 - Patient Self Management

84. Your patients
Greatest untapped resource in health care

85. CP4

86. The Real Work
CP4

87. Be a teacher
Education vs Advice
CP4

88. CP4

89. TEMPLATES

92. CP5 - Integrated Systems

93. alstonvilleclinic
2005

94. alstonvilleclinic
2014

95. Connected to the
Medical Neighbourhood

96. Model of Care

98. Home

100. Home Medical Home Community Hospital

101. Home Medical Home Community Hospital
Teams

102. Home Medical Home Community Hospital
MEDICARE LOCAL LHD
The Medical
Neighbourhood
Everyone
has two Jobs
Everyone has
three Jobs

103. CP1
CP3
CP2
CP4
CP5
Change Principles

105. Collaborative Care
Care is Holistic
Care is Proactive
Care is Team Based
Care is Integrated
Care is Systematic
Care is Accessible
Care is Patient Centred
Every Single Patient, Every Single Time

107. Zen
and the art of general practice
tony@lembke.me
apcc.org.au
practiceimprovement.com.au
whatIlearnttoday.com.au
my.improve.org.au
medicalhome.org.au
personcentredcare.org.au
lists.apcc.org.au