Date: Friday, February 24, 2012, 12:00 noon – 1:00 pm Pacific Time

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Participation in this event is free.

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Event co-presented with:

Abstract

About the Speaker

Dr John Øvretveit

Dr. John Øvretveit is Director of Research and Professor of Health care innovation implementation and evaluation at the Medical Management Centre, The Karolinska Institute, Stockholm, and previously Professor of Health Policy and Management at Bergen University Medical School, Norway and at the Nordic School of Public Health, Gothenburg, Sweden.

Translations of some of his 300 peer reviewed scientific papers and books have been made into nine languages. Six books have won publications awards, including twice winner of the European Health Management Association Award and the Baxter health publication of the year prize for “Action Evaluation” (2002) and “Health Service Quality” (1992). He is currently a reviewer for and editorial board member of eight scientific health journals, a board member of the Joint Commission Resources/ International, of the UK NHS national research and commissioning programme for service and delivery and organisation, and advisor since 1995 to The Netherlands Health Service Research Council.

Dean Giustini, Facilitator & Alyssa Green, CHCM Librarian

Many health care organizations are using social media tools to provide health information, improve patient care and manage organizational branding.  Health care managers need to understand how to use these tools strategically, choosing the best tool for their purpose and avoiding concerns such as breaches of privacy.

The Centre for Health Care Management offered an online workshop during Fall 2011 to help managers gain confidence in using social media tools.  Dean Giustini, a UBC health librarian who is nationally known in this field, was the facilitator.  Participants examined examples of best practices currently used by health care organizations, assessed the evidence on the value of a variety of tools and shared their experiences in using them.  They studied social media policies used by prominent organizations.

Participants were very positive about their experience. Most of them felt that they had gained confidence in using social media.  “I have a much greater understanding of where we are with Social Media and its potential…”

With Dr. Steven Shechter

Operations Research can help solve many health care challenges. During a joint CHCM Seminar and C2E2 Rounds, Dr. Steven Shechter, an Assistant Professor at the Sauder School of Business, presented an example of an Operations Research based solution for optimizing the timing of the stages of treatment necessary for chronic kidney disease.

Periodic laboratory tests help clinicians measure the progress of a disease and forecast when a treatment should start.  Forecast accuracy is particularly important when there is a lead time needed to prepare patients for treatment.  For example, chronic kidney disease patients who will need hemodialysis should ideally have a type of vascular access (called an arteriovenous fistula) created months in advance so that it matures by the time dialysis is needed.  It is undesirable to have the fistula ready too early or too late, which may occur due to the uncertainty in fistula maturation and dialysis start times.

There are many crucial timing points in the treatment of chronic kidney disease. By creating a data-driven tool to help clinicians decide when to begin an arteriovenous fistula, Dr. Shechter and his team are aiming to reduce the frequency of complications relating to vascular access for hemodialysis.

About the Speaker

Dr. Steven Shechter
Steven Shechter is an Assistant Professor in the Operations and Logistics Division of the Sauder School of Business at the University of British Columbia. He is also a faculty affiliate of the Centre for Health Care Management at UBC.

Steven’s research interests lie at the intersection of operations research (OR) and health care. He has collaborated with clinicians, biostatisticians, health policy researchers, and other colleagues from OR to consider optimal decision making for organ allocation and HIV therapy planning. Methodologically, Steven is interested in applying dynamic programming and simulation modeling techniques to inform important problems in medical decision making.

When a person sustains a spinal cord injury, what are the factors in their care that influence the long-term outcomes?  This is one of the questions addressed by a multi-site and long-term study being led by a team of operations research experts from the Centre for Operations Excellence at the Sauder School of Business and surgeons at Vancouver General Hospital, the quaternary care centre for spinal cord injuries in BC.

Dr. John Street substituted for Dr. Marcel Dvorak, and began the presentation by describing two patients with similar injuries but very different outcomes.  Data gathered by the research team demonstrated that more than 75% of patients with spinal cord injuries suffer one or more adverse events or complications during their care.  The overall goal of the study was to estimate the effect of interventions throughout the system of care (first responders, acute care, rehabilitation and community care) for spinal cord patients.

Dr. Derek Atkins described the parts of that journey of care, emphasizing that episodes of care need to be followed over the lifetime of the patient, with a focus on improving quality of life.  He presented several scenarios in which specific interventions could be improved that would change many aspects of the patient’s journey of care, and as a consequence, the use of resources in the health care system.  He showed simulation models that captured many different trajectories through the system of care and the data that are being collected on patients at multiple sites across Canada.

Dr. Vanessa Noonan used the models to illustrate how several interventions, both clinical and administrative, might affect the patient’s quality of life as well as use of resources in the health care system.  She showed how this information can be used in a business case for planning for future care needs. In addition, she showed how the models could be used to compare two patient populations who are treated at different centres and evaluate the impact that the different care they receive has on their outcomes.  One of the major benefits of this modeling and data gathering is the view of the whole system as well as comparisons of care across sites.

About the Speakers

Derek Atkins
Derek Atkins, Professor of Operations Research at the Sauder School of Business, UBC was educated at Oxford, Lancaster and Warwick universities in the UK. He came to Canada in 1976. Since then he has taught and researched in operations research at UBC, concentrating on supply chain improvements and latterly in health care. During this time he was also Dean pro tem of the School and Associate Vice –President Academic, UBC. For five years he was the Director of the Centre for Operations Excellence at Sauder and many of his graduates now work in health care in BC.

Marcel Dvorak
Dr. Marcel Dvorak is a Professor and Head of the Academic Division of Spine, Department of Orthopaedics, at the University of British Columbia. He is also Medical Director of the Combined Neurosurgical and Orthopaedic Spine Program (CNOSP) at the Vancouver General Hospital. A strong proponent of clinical and academic focus through sub-specialization, he confines his practice to adult spine surgery. His teaching efforts have been focused on the education of spine surgeons in advanced spinal surgical decision-making and techniques, and his research focus is care of patients with spinal injuries. He is the Scientific Director of the Rick Hansen Institute.

*Note: Dr. Marcel Dvorak was away for the presentation. Dr. John Street substituted for his portion.

Vanessa Noonan
Vanessa Noonan is a physical therapist and she is currently the Director of Research for the Rick Hansen Institute. Her research interests include developing outcome measures and evaluating how to effectively integrate research into clinical practice.  Vanessa is currently a co-investigator on the Access to Care and Timing project, which is a collaborative project between the Rick Hansen Institute and the Centre for Operations Research (at the UBC Sauder School of Business).  She has also been involved with developing the Rick Hansen SCI Registry and assisted in the development of a comprehensive community-follow-up questionnaire for the Registry. In addition, Vanessa has worked with colleagues internationally to develop data sets for SCI.

John Street
John Street is an Orthopaedic Spine Surgery and an Assistant professor at UBC. He is both a MD and a PhD. He is co-Medical Director of the Complex Spine Program at Vancouver General Hospital, Clinical Lead for the Integrated Ambulatory Spine Program and Coordinator of the undergraduate and post graduate education program.

For background reading on this event, please visit the READ Portal hot topics page.

Event cosponsored by CCHL BC Lower Mainland Chapter Organizing Committee: Paul Gallant, Chapter Executive, CCHL BCLM Linda Peritz, Executive Director, Centre for Health Care Management

Date: Wednesday, February 15, 2012, 8:00 am – 9:00 am Pacific Time

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Participation in this event is free.

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Abstract

Most of us appreciate the powerful influence of good management, trusted leadership and effective work processes. In contrast, we grossly underestimate, and know relatively little about, the important impact of coworkers’ day to day treatment of one another at work. In this talk, Dr. Robinson will address coworker dynamics.

Dr. Robinson will discuss what we know so far about how coworkers’ behavior impacts attitudes and behavior at work. She will also share the highlights of several empirical studies she has conducted examining the influence of coworker treatment upon nurses’ attitudes and behaviours. In particular, the talk will touch upon the influence of social support, social exclusion, being the direct target of bullying, and will also address the negative impact of working in a ‘socially toxic’ work environment even when one is not the direct recipient of mistreatment by others.

For background reading please visit the READ Portal hot topics page.

About the Speaker

Sandra Robinson (Ph.D.) is a Distinguished University Scholar, Professor of Organizational Behavior and Human Resources. Prior to joining UBC, she taught at New York University and Northwestern University in Chicago.

Dr. Robinson’s research expertise focuses on the “dark side” of organizational behavior, including research on bullying, aggression, anti-social behavior, territoriality, toxic handlers, trust betrayal and psychological contract breach.  Her numerous publications have appeared in many journals, such as the Harvard Business Review, Administrative Science Quarterly, and Academy of Management Journal.  In addition, her work has appeared in a wide range of press outlets, from The Economist, to the Wall Street Journal, to the Washington Post.  She speaks frequently with the press on topics such as stress in the workplace, workplace aggression, and employment relationship issues.  She has been the recipient of numerous awards for her work, such as the Ascendant Scholar Award from the Western Academy of Management and the Cummings Scholar Award from the Academy of Management, for her significant contributions to the field of management. She recently completed her five year service as Chair for the Organizational Behavior Division of Academy of Management, the 18,000 member international organization for management scholars.

For over a decade, Dr. Robinson has been providing management education to undergraduates, MBA students, PhD students and executives on three different continents. She was appointed by the Premier of British Columbia to serve as a commissioner determining the compensation for elected Members’ of the Legislative Assembly of British Columbia. She has also provided training and consulting to a wide variety of organizations, ranging from non-profits, such as the Casey Foundation (Seattle), to government, to public service organizations such as the United States Postal Service (Washington, D.C.), to private enterprises, such as Futureshop (Vancouver) and Citibank (New York City).

Event cohosted by CCHL BC Lower Mainland Chapter Maintenance of Certification Attendance at this program entitles certified Canadian College of Health Leaders members (CHE / Fellow) to 1 MOC Category I credit toward their maintenance of certification requirement. Organizing Committee: Paul Gallant, Chapter Executive, CCHL BCLM Linda Peritz, Executive Director, Centre for Health Care Management

Date: Tuesday, February 7, 2012

This event is passed.  If you are interested in receiving notification when the archive appears on the CHCM website, please complete the registration form below.

Abstract

BC Children’s and Women’s Health Center provides specialized care to local and provincial population and is a well known academic and research center. The organization has been on Lean journey for almost 4 years. When a new Acute Care Center was approved to replace exiting building, the organization decided to apply lean thinking and principles in building design.

Four 3P (Production, Preparation, Process) workshops were held from September 2010 to February 2011. These sessions focused on:

• The macro 7 flows of medicine and service relationships across C & W including Child Development and Rehab Center;
• The flow of patient arrival (planned and unplanned);
• The flow of inpatients and,
• The flow of procedures & interventions requiring sedation or anaesthesia.

Each session required four weeks of data collection followed by an intensive weeklong workshop.  45 to 55 staff from all disciplines including family representatives attended each weeklong workshop using the previously collected data to determine how flows could be optimized to inform design. These sessions then led to the creation of some break-through ideas on how flows could improve, ultimately leading to better patient care.

After 4 3P events, full size room mock ups were conducted to determine appropriate room sizes for optimal patient care. Space required for various rooms in the Pediatric Intensive Care, Neonatal Intensive Care as well as operating rooms were reduced 10 -30% as the result of the mock ups.

Since October, the organization has advanced to next stage of lean design – Integrated Facility Design. A Core Team consisting of medical directors, administrators, program managers, family representatives and architects has been assigned the responsibility of providing the guidance and leadership required to conduct the IFD process.

The presentation will discuss the journey that the Children’s and Women’s Redevelopment Project has undertaken to incorporate Lean process redesign as a precursor to the design of the physical structure.

For background reading please visit the READ Portal hot topics page.

About the Speaker

Bob Breen

Bob Breen is the Chief Project Officer of the BC Children’s and BC Women’s Redevelopment Project.

Bob has held a variety of healthcare positions over the past 38 years. His involvement in healthcare design began in 1988 when he became responsible for replacing the aging medical infrastructure for the Canadian Forces in Canada and Europe.  He moved to BC in 1991 to take over the planning for the replacement of the MSA General Hospital which now stands as the Abbotsford Regional Hospital and Cancer Centre.  He has also held the position of President and CEO of MSA General Hospital and as the Regional Chief Operating Officer of Health Programs in the Fraser Valley Health Region.

In 2001, Bob left the public sector to become President of MDS Metro Laboratories in BC, the largest outpatient laboratory services provider in Western Canada.  It was during this time that Bob became involved with Lean planning when he brought the process into the business as a means of improving productivity in response to government cutbacks on laboratory fees.  Bob returned to the public sector in 2008 when he accepted his current position as Chief Project Officer for the redevelopment of the BC Children’s and Women’s Hospital.  Bob has his MSc in Health Services Planning, is accredited in Evidence Based Design and has his green belt certification in Lean/Six Sigma.

Event cohosted by CCHL BC Lower Mainland Chapter Maintenance of Certification Attendance at this program entitles certified Canadian College of Health Leaders members (CHE / Fellow) to 1 MOC Category I credit toward their maintenance of certification requirement. Organizing Committee: Paul Gallant, Chapter Executive, CCHL BCLM Linda Peritz, Executive Director, Centre for Health Care Management

Dr. Daniel Skarlicki (left) and Dr. Jugpal Arneja (right)

There is ample evidence that physician leadership contributes to excellent health care.  But who are physician leaders and how are they developed?  Drs. Jugpal Arneja and Daniel Skarlicki set out to explore these questions.  Dr. Arneja is Clinical Assistant Professor, Division of Plastic Surgery at UBC and Associate Chief, Surgery (Interim) British Columbia Children’s Hospital.  He is also a student in the Executive MBA in Health Care program at the Sauder School of Business.  Dr. Skarlicki is the Edgar F. Kaiser Chair of Organizational Behavior and Professor, Organizational Behaviour and Human Resources at the Sauder School of Business, UBC.  They have presented the results of their study to health care leadership teams and several physician groups and on October 5, they spoke at Urology Grand Rounds at Vancouver General Hospital.

Dr. Skarlicki opened the presentation by describing some qualities of leaders, such as team skills, a focus on innovation, clear values, and especially humility.  He distinguished management and leadership by saying that managers focus on getting things done and leaders think about the future.

What is leadership – Dr. Daniel Skarlicki

Dr. Arneja reported on their survey of Canadian surgeon leaders (heads of departments, divisions and programs), which sought to gather data on the demographics of this group as well as how they use their time and their major challenges.   More than 80% of the respondents were male, between the ages of 45-55.   About 60% had no advanced degree, although 30% held M.Sc., Ph.D. and M.Ed. degrees.  Very few had any background in management.  They spent 70% of their time on clinical work and education, with the balance used for leadership, administration and research.  Most were promoted to a leadership position based on their clinical and education skills rather than leadership qualities.  Statistical analysis demonstrated that the characteristics most predictive of achieving a leadership position were male gender and years of practice.

Why were leaders promoted – Dr. Jugpal Arneja

Who gets to be a leader – Dr. Jugpal Arneja

The survey results demonstrate that physician leaders are usually promoted to their roles without specific training or skills to perform well.  Can they develop their leadership skills? The literature suggests that, with appropriate training and practice, most can develop the competencies needed to be successful in their roles.  Drs. Skarlicki and Arneja hypothesize that facilitating and encouraging physician leaders to grow their skills will produce value for the health care system.

Would better leaders produce better health care? – Dr. Jugpal Arneja

Whose mandate is it to develop leaders – Dr. Jugpal Arneja

Sponsored by Pfizer

Online Learning – You set your study times
5 Weeks: February 6, 2012 – March 11, 2012

This workshop is now full and registration is closed. Please complete the form below to join the waitlist for our next workshop!

You make important decisions.

Designed for managers in Canadian health care organizations, this workshop is offered online over a five-week period starting February 6, 2012.

You will work in small groups to learn strategies that will help you structure your priority setting decision-making and tackle resource allocation challenges. To fit your busy schedule, the workshop requires a commitment of only 2 to 3 hours per week, and you’ll be able to integrate what you learn into your current work scenario immediately.

Presented with C2E2

Learning Objectives

Upon completion of the workshop, participants will be able to:

• Discuss economic and ethical principles underlying health care resource allocation decision making, and compare these principles with an ‘evidence-based medicine’ approach

• Outline commonly used approaches to priority setting by health care decision makers both within Canada and elsewhere
• 

  Participants gained confidence in skills learned after completing a previous CHCM workshop (different topic)

  Describe practical steps for resource allocation priority setting, including generating -and applying decision making criteria

• Understand how economic evaluation can be used alongside of other types of evidence to inform real world health care priority setting

• Draw out practical insight on key concepts and methods through an understanding of case studies and real world examples

• Discuss individual and organizational success factors related to improving priority setting and resource allocation practices

• Outline a process for resource allocation in a health care organization

“Emergency departments have been identified…as the site of a high proportion of preventable patient harm”.  Dr. Garth Hunte listed the reasons, such as uncertainty, time constraints and overcrowding, which makes this likely to be true.  Management of safety is a key priority in emergency departments, and that usually manifests as support for error reporting systems.

Dr. Hunte took a different approach to exploring safety, which included observation of emergency staff as they worked, as well as interviews and focus groups of emergency department staff and senior hospital leadership.  His study involved exploration of the culture of safety through practice, drawing on theory from sociology and anthropology, and describing patterns of interactions among staff that impact safety.

One of his conclusions was that safety arises as a result of interactions between people. Dialogic storying, resilience and phronesis are three concepts that Dr. Hunte explained are related to safety-creating interactions. Dialogics is a theoretical concept that considers situations and interactions as primary, focusing on sensemaking by the participants moment-to-moment as they exchange information about the patient. Resilience is borrowed from engineering, referring to the ability of a system to adjust its function under expected and unexpected conditions. Finally, phronesis is a term used by Aristotle, used to refer to practical wisdom derived from experience.

Data collected by Dr. Hunte spoke to frequency and number of communications that took place by individuals working in the emergency department, the quality of those communications and number of interruptions.  He emphasized the very limited communication that happens between staff members caring for a specific patient and thus the limited opportunity for sense-making.

The concept of resilience comes into play when an organization can adapt to changing conditions.  Dr Hunte pointed out that a major challenge in health care is that the move to efficiency is removing the slack in the system that allows adaptation in the moment, which might help to stabilize a situation that was becoming unsafe.

About the Speaker

Dr. Chris Ham, Chief Executive of UK health think tank The King’s Fund, reviewed the transformation of the English National Health Service in the past 10 years.  He characterized the approach of the previous Labour government to health care reform and “targets and terror”: targets were set for provision of services, such as wait times in Emergency and times for provision of specific acute care services, and management of health care organizations were expected to meet the targets. Many of the targets were met, often by significantly increasing the funding available to hire new staff and building new facilities.

The current government has moved away from setting targets and is emphasizing leadership. (This was the topic of a previous seminar: Succession Planning During Large-Scale Organizational Change).  In addition, organizations will compete to provide patient services; anyone who is clinically competent, whether in the public or private sector, is eligible to compete.  Dr. Ham expressed concern that market forces may result in the closing of public organizations, which could limit the choices patients have to obtain the services they need, but that this may be unacceptable to government.

Organized collaboratively with:

About the Speaker
Professor Chris Ham, CBE, PhD, MPhil, FRCP (Hon)

Dr. Chris Ham

Chris Ham took up his post as Chief Executive of The King’s Fund in April 2010. He has been professor of health policy and management at the University of Birmingham, England, since 1992. From 2000 to 2004 he was seconded to the Department of Health where he was director of the strategy unit, working with Ministers on NHS reform. Chris is the author of 20 books and numerous articles about health policy and management. His work focuses on the use of research evidence to inform policy and management decisions in areas such as health care reform, chronic care, primary care, integrated care, performance improvement and leadership.

Chris has advised the WHO and the World Bank and has served as a consultant to governments in a number of countries. He is an honorary fellow of the Royal College of Physicians of London and of the Royal College of General Practitioners, an honorary professor at the London School of Hygiene and Tropical Medicine, a companion of the Institute of Healthcare Management, a senior associate of the Nuffield Trust, and a visiting professor at the University of Surrey.

In 2004 he was awarded a CBE for his services to the National Health Service.

Dr. Ham’s Full Bio