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Page Strategic Conversation Management Risk 10 Healthcare 10 10 Page Page 1st Singapore Standard hospital in Vietnam Page 1st Singapore Standard hospital in Vietnam Doctors of VietnamGermany Hospital operated the wrong leg! The operation took place in the evening of July 19, instead of surgical treatment for paralysis in the left leg of the male patient, the doctor in the Department of Orthopedic of Vietnam-Germany Hospital operated the right left Page 1st Singapore Standard hospital in Vietnam Strategic Conversation • Moved from the Age of Knowledge to the Age of Intelligence • The 21st century started as a century of uncertainty • Hospital Risk Management: Why flags matter The impossible made possible Clem Sunter Success Stories Nelson Mandela was the first black President of South Africa During apartheid, he was imprisoned for 27 years From prison, many believe he lead the ANC and drove the successful movement to stop apartheid He was released from prison in 1990 and was President by 1994 Do you think that transition occurred by chance? Most not Most believe the transition of South Africa to majority rule was carefully choreographed Page 1st Singapore Standard hospital in Vietnam Strategic Conversation Strategy, the aim of the healthcare business, should not change that often, while tactics to stay on course will vary according to how the game evolves Seven (7) principles of strategy Page Strategy is direction Tactics are how to get there Strategy formulated without first consulting the context will probably end up being bad strategy Strategy is as much about ruling in potential paths that fit our scope as ruling out others that don't Good strategy can be turned into bad strategy by a future change in the context Scenarios are a way of exploring alternative futures, which might necessitate a change in strategy Bad tactics can destroy good strategy, but no tactic can rescue bad strategy Good strategy has a greater chance of being converted into good results if tactics are accompanied by a set of measurable outcomes to which people can aspire Above all, strategy is about understanding what we and don't control, and what is certain and uncertain about the future - and knowing when to change direction to avert unintended, and possibly tragic, consequences 1st Singapore Standard hospital in Vietnam 10 steps to Future Risk Management Program Two questions healthcare leaders ask before committing to action: what we and we not control? What is certain and uncertain about the future? Many healthcare leaders have constructed an ingenious matrix around these questions, which assists to identify the rules of the game; assess the key uncertainties; paint scenarios; evaluate realistic options; and thereby make effective decisions Essentially the matrix will give us the edge: Page 1st Singapore Standard hospital in Vietnam 1 Hospital Risk No 1: Medication Errors: A 2006 report from the Institute of Medicine estimated that every year, there are 450,000 injuries resulting from medication errors in hospitals, and perhaps many more that are unreported Hospital Risk No 2: MRSA and Other Hospital-Acquired Infections: According to the CDC, there are 1.7 million health-careassociated infections every year; 22% are infections of surgical wounds Even more 32% are urinary tract infections Hospital Risk No 3: Pneumonia Hospital Risk No 4: Deep Vein Thrombosis (DVT) Hospital Risk No 5: Bleeding After Surgery Hospital Risk No 6: Anesthesia Complications Speaking Up Lowers Hospital Risks Page 1st Singapore Standard hospital in Vietnam Questions to ask: Page 10 Is my hospital prepared to respond to these events? Does my hospital need to be prepared anyway? What are our priorities? Have we done our risk assessment? 1st Singapore Standard hospital in Vietnam identify and develop the organizational structure to promote Risk management program within hospital Who are the Players (internally or externally) who can significantly affect the outcome of the Risk Management Game we have chosen? Who are the ones for us, who want to win; who are those against us, who want to lose; who are neutral and liable to swing either way? Page 20 Quick Observation: we arehospital ‘Reactive’ 1st Singapore Standard in Vietnamrather than ‘Proactive’ This Risk Management program needs to create rules of the game to win Fundamentally, there are three rules: Descriptive Rules (those that give us license to operate), Normative Rules (those that cover ethics, corporate governance, the environment, health, safety and corporate social investment), and Aspirational Rules (those that will give our organization the edge to win the Game) and influence whole hospital! Page 21 1st Singapore Standard hospital in Vietnam What are the major uncertainties surrounding your risk management program that keep you up at night? Which are internal (usually controllable)? Which are external (sometimes uncontrollable)? Page 22 1st Singapore Standard hospital in Vietnam Will they, in your opinion, affect the outcome of the Game? Can you or your organization influence these uncertainties or will you just have to deal with them? Follow the American Society for Healthcare Risk Management, ASHRM Page 23 1st Singapore Standard hospital in Vietnam • What are the two principle variables affecting your risk management program from which you can construct a Best-Case Scenario, a Worst-Case Scenario and two Intermediate Case Scenarios? An example might look like this, depending on the State of the program and State of the Acceptance: Page 24 Strong Program/High Acceptance (Best) Strong Program/Low Acceptance (Intermediate); High Acceptance/Weak Program (Intermediate); Low Acceptance/Weak Program (Worst) 1st Singapore Standard hospital in Vietnam SWOT – The “As Is” to the “Should Be” – How determine strengths and weakness inside our organization? How see opportunities and threat from outside our organization? How create Action Plan and monitor progress? Page 25 • What are your internal Strengths and Weaknesses? • Consider this question in terms of your: Customers, Products & Services, Human Resources, Support Services, Administrative Management System and Financial Management System) 1st Singapore Standard hospital in Vietnam Patient Services Strength Weaknesses Opportunities Threats •Philosophy, Nature, & Scope •Standards •Performance Indicators •Quality Management •Strategic Planning Human Resources Management Support Services System •Organizational Structure •Staffing •Wage & Salary •Training & Development •Recruitment •Succession Planning •Facilities •Technology •Technical Support •Maintenance •Supply Chain Management Administrative Management System Financial Management System Page 26 •Demographics •Needs/ Expectations •Issues •Knowledge of Service/ Product 1st Singapore Standard hospital in Vietnam •Policies, Procedures, & Protocols •Regulations •Compliance •Contracts •Legal •Revenue Analysis •Budgeting •Accounting •Management Reports •Accountability What are your Strategic and Tactical Options to take the negative scenarios out of play? What are those that will help you to thrive in the good scenarios? How you get closer to the Rules to Win? Does your organization have the Resources – Time, Material, People and Money (TMPM) – to execute the delineated Options? Are your Options exclusive (either/or) or inclusive (this and that)? Page 27 1st Singapore Standard hospital in Vietnam What preferred Options can be exercised right now? What Decisions these Options dictate? For each Decision, what action steps are required? • • • • • Page 28 Start the monitoring of the data of incidence and complaints Calculate risk associated event for prevent recurrence? Draft all the necessary document for compliance Do PDCA? Lead the staff involvement within the process? 1st Singapore Standard hospital in Vietnam 10 What is your personal criterion by which you will judge whether your risk management program has won or lost the Game in five years? How will the organization track incremental performance against the Desired Result? What will you measure day-to-day, week-to-week and monthto-month to ensure you are on track? Current Condition The Tactical Response Gap Analysis Page 29 Action Plan Execution 1st Singapore Standard hospital in Vietnam Future Condition 10 Gantt Chart (Year-wise) Action to be done 2016 2017 Risk Department Organogram Recruitment of Staff Department budget Policy on incident, complaint and grievance reporting Activate RM Committee Start risk collection data Annual risk management action plan Fire safety plan Infection control safety plan Biomedical and equipment safety plan International patient Safety Goals implementation plan Patient and visitor safety plan Anaesthesia and surgery safety plan Medication management and safety plan Facility Safety Plan FMEA Score for the hospital (department-wise) Staff privileging, ensure clinical safety Laboratory safety plan Imaging and radiology safety plan Follow-up FMEA score Page 30 1st Singapore Standard hospital in Vietnam Risk management Dashboard with Live FMEA score 2018 2019 2020 Context 10 Meaning of Winning Strategic Conversation Game Board Level of Acceptance Decisions Options Scope Strong Weak Strong Strong Weak Weak Weak Strong Level of Risk program component Key Uncertainti es S.W.O.T Scenarios Page 31 1st Singapore Standard hospital in Vietnam Players Rules of the Game Phoenix Global Academy 10546 E Karen Gannon Place Tucson, Arizona 85747, USA Page 32 1st Singapore Standard hospital in Vietnam https://phoenixglobal-international.com/advisory-board/ Email: drmzkarim@gmail.com Email: drmzkarim@gmail.com Page 33 Email: 1st Singapore Standard drmzkarim@gmail.com hospital in Vietnam Cam on | Thank you! Page 34 1st Singapore Standard hospital in Vietnam ... first consulting the context will probably end up being bad strategy Strategy is as much about ruling in potential paths that fit our scope as ruling out others that don't Good strategy can be... bad strategy by a future change in the context Scenarios are a way of exploring alternative futures, which might necessitate a change in strategy Bad tactics can destroy good strategy, but no... bad strategy Good strategy has a greater chance of being converted into good results if tactics are accompanied by a set of measurable outcomes to which people can aspire Above all, strategy is