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Introduction to Health Care
Homes Webinar Series
Session 4:
Quality Improvement & Culture Change
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Presenter
Janet Jorgenson-Rathke, PT, MA
Quality Coordinator
Plan for Today
0 Overview foundational elements for change
0 Culture transformation ... What?
0 Applying change methodology to your HCH certification
action plan
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Objectives
Upon completion of the webinar, the participant will
be able to:
0 Understand the essential components for creating
and sustaining a HCH quality culture.
0 Be able to apply the model for improvement in
order to accelerate and sustain improvements in
quality initiatives for Health Care Home (HCH)
transformation.
0 Gain an understanding of how to put your HCH
Certification action plan into action.
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Standards and Criteria
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What's Needed to Get Results
Goal
R
E
S
U
L
T
S
Leadership/
Culture
Infrastructure
CQI
Level of Commitment
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System Considerations
An interdependent group
of:
• items, people, or
processes
• Interdependence =
relationships &
interactions among
them
Working together for a
common purpose
• Common purpose aligns
the parts
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Change tools
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Below the Surface
Culture
Deeply held beliefs,
attitudes, values, and
perceptions held
among a group of
people.
"The way we do things around here"
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Beliefs and Assumptions
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A Few Key Points
0 A change in mission and strategy means that
the organization's culture needs to be
modified.
0 Culture can either prevent or facilitate a
change.
0 It is the last thing to change!
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Finally,
You don't change culture by
changing culture
Culture = beliefs, attitudes, and value
0 Asking people to change these creates strong
emotions
0 These strong emotions leads to resistance
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So What Do You Do?
Change what you can see…
Change Behaviors
0 Behaviors are visible and tangible
0 Help people understand the new behaviors needed
0 Leads to a change in the those deeply held beliefs,
attitudes, and values
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Keys to Success
• Share the Aim for becoming a
HCH
• Identify and explain
behaviors (actions) to move
from today's beliefs
• Provide a supportive
structure to sustain the new
beliefs, attitudes, and values
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HCH Transformation Steps for
Leadership
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HCH Certification Standards
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A Roadmap
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Access and Communication
Care Coordination Example
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How We Change…
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PDSA Journal
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PDSA Journal (part 2)
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Final Tips
0 HCH transformation is a non-linear journey
0 Divide the work into manageable chunks to avoid
being overwhelmed.
0 Utilize all of the tools in your change toolbox every
step of the way
0 Remember to apply systems thinking
0 For successful culture change, focus on changing
behaviors and continually reinforce those behaviors
0 Make an overall action plan then engage staff in
developing and completing PDSAs
0 Never let up!
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Time for questions
A Few Resources
0 Burke, W. Warner. 2008. Organization Change: Theory
and Practice, 2nd. 2008.
0 Institute for Clinical systems Improvement. 2013. Value
Stream Mapping. PDF Presentation and Podcast
0 https://www.icsi.org/education__services/other_educa
tion_offerings/past_event_materials/
0 Kotter, J, Rathgeber, H. 2005. Our Iceberg is Melting.
0 Nolan, T, et al. The Improvement Guide, 2nd Ed.
0 Safety Net Medical Home Initihttp://
0 www.safetynetmedicalhome.org/change-conceptsative
Change Concepts.
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Thanks you