This index is for Make it Happen: Effective Execution in Healthcare Leadership
A
Accountable care organizations (ACO), 16–17, 18, 112–113; scenario analysis of, 45, 47–49
Acute care episode (ACE) projects, 79–80, 82–101; bundled payment rate of, 49–50; change in control system of, 89, 91, 93; monitoring system of, 89, 91; organizational cultural analysis component of, 155–157; project crashing in, 89; project teams of, 85; risk management component of, 95, 96; scheduling of, 85–89
Agency for Healthcare Research and Quality, 109
Archimedes model, 111
Association algorithms, 30, 31
Assumptions, underlying, 146–148, 155, 156–157, 178
Autonomy, of employees, 149
B
Balanced Scorecard: Translating Strategy into Action (Kaplan and Norton), 54–55
Balanced scorecards, 19, 53-69, 121, 178. See also Initiative(s); Strategy maps: case examples of, 65–67; customer/patient perspective on, 56, 57–58, 69; elements of, 55–56; failure of, 64; financial perspective on, 55, 56, 57–58, 69; implementation of, 64–65; internal business process perspective on, 56, 57–58, 69; learning and growing perspective on, 56, 57–58, 69; linkage with budgets, 63; linkage with initiatives, 59; modifications of, 62; monitoring of, 63, 69; scorecard project reporting icon of, 126; use in organizational culture management, 155; use in strategic project identification, 73
Bandhold, Hans, 42
Bar charts, 26
Benchmarking, 31, 38; examples of, 32, 34–35; public reporting of, 32–33; quality measures for, 32–33; sources of, 31–32
Boolean logic, 121, 129
Boston Consulting Group Growth-Share matrix, 11
Brainerd, Mary, 153–154
Brainstorming, 94
Budgets: linkage with balanced scorecards, 63; as project component, 73
Bundled payment systems, 16–17, 18; scenario analysis of, 45, 49–50
Business intelligence, 4, 19–39; case studies of, 34–38
Business rules software, 23–24, 121–122, 123, 124
C
Capacity, for employee engagement, 149, 150
Categorical analysis, 24
Cause and effect, 115
Cause-and-effect statements, 59, 60, 62
Centers for Medicare & Medicaid (CMS): demonstration projects of, 18; hospital performance reports of, 33
Change. See also Clinical change; Clinical innovation: adaptive, implementation of, 161–163; embedding of, 109, 115–129; integrated systems response to, 174–175
Change control, in project management, 89, 91, 93
Change procedures, 73
Chaos, 174–175
Chartering process, for projects, 73, 74–75, 76–78, 79–80, 178
Checklists, 117–119, 129
Chief executive officers (CEOs), involvement in strategic planning, 10
Claims databases, 23
Classification, in data mining, 30, 31
Cleveland Clinic, 166
Clinical decision support systems, 122–124; case example of, 125–126, 127; fault-tolerant, 125–126, 127
Clinical guidelines, 123–124
Clinical innovation, 108–111, 114; case example of, 111–112; large-scale, 110, 114; Learning School model of, 12; organized, 109–110; process of, 55, 58
Clinical knowledge, implementation of, 108
Clinical trials, 111
Clinton Health Plan, 10
Cluster analysis, 30–31
Coaching, versus controlling, 165
Colleagues, leader’s interaction with, 164
Column charts, 26
Commonwealth Fund Commission, 1
Communication: during clinical change process, 110; face-to-face, 104, 125, 129
Communication plans, in project management, 73, 93
Communication skills, of leaders, 166
Compacts, 140, 141–143, 178
Compensation: compacts for, 140, 141–143; effective systems of, 138–139; pay-for-performance systems of, 178; professional services agreement (PSA) model of, 139–143; variable, 143
Competency, scenario analysis of, 44
Competitiveness, 138
Complementarity, 44, 137
Conflict, adaptive change-related, 162–163
Conflict management, team approach in, 164
Contemplative analysis, 24
Contracts, differentiated from compacts, 140
Control charts, 119, 120
Cooperation, versus initiative, 137
Cost reimbursement contracts, 96
Crossing the Quality Chasm (Institute of Medicine), 1
Cultural change, relationship to physician leadership, 165
Culture, organizational, 4–5, 145–158; artifact level of, 146, 147, 148, 155–156; case examples of, 153–157; definition of, 145–146; development of, 146; elements of, 145–146, 147; espoused beliefs and values level of, 146, 147, 155–156; iceberg metaphor of, 146, 147; implication for project management, 77; relationship to employee engagement, 149–157; shaping and embedding of, 148; underlying assumptions level of, 146–148, 155, 156–157, 178
Current procedural terminology (CPT) codes, 31–32
Customer perspective, on organizational performance, 55, 56, 57–58, 69
Customer satisfaction, agile project management approach to, 104
Customer structure, 134, 135, 136, 143
D
Daily huddle meetings, 113, 124, 129
Dashboards, 25, 26, 54, 119–121; graphical data displays of, 119, 120, 129; for organizational culture management, 155; for preventive services, 126, 128
Data access, 24–25
Data analysis, 23–24
Data collection: for balanced scorecards, 63; in strategic planning, 19–23
Data displays: of benchmark data, 34, 119, 120, 121; graphical, 25–29, 119, 120, 129
Data marts, 22, 23
Data mining, 20, 23, 29–31; association in, 30–31; case examples of, 35–37; classification in, 30–31; cluster analysis in, 30–31; definition of, 29; text mining, 31, 35–36; Web mining, 31
Data warehousing, 20, 21–23, 177; case examples of, 34, 35, 37; comparison with transactional data systems, 24; data access in, 24–25; erroneous data entry in, 23; extract, transform, and load (ETL) component of, 22, 23, 34, 37, 38; in integrated healthcare systems, 173; of metadata, 23
Dean Health System, benchmarking use by, 34–35
Denver International Airport, 72
Design, organizational. See Structure, organizational
Design School model, of strategic planning, 10, 13, 18, 50, 56, 177
Detailed task scheduling, 108
Diagnosis-related groups (DRGs), 49–50
DMAIC framework, 105–106, 108, 109, 114
Doughnut charts, 27, 28
Drill-down reporting, 24, 25, 35, 119
Drug prescriptions, 35
E
Eddy, David, 111
Effectiveness, scenario analysis of, 44
Electronic health records (EHRs): data warehousing of, 20, 21–23; definition of, 39; HIMSS Analytics EMR Adoption Model of, 20; implementation of, 20; use in clinical research, 111
Electronic health records (EHRs) systems: clinical support function of, 122–124; text storage function of, 36
Electronic medical records (EMRs), definition of, 39
Emergent strategy formulation, 10
Emotional intelligence, 166
Empowerment, 165
Engagement, of employees: factors affecting, 4–5, 149; “line of sight” approach to, 152–153; relationship to organizational culture, 149–157; strategies for improvement of, 151–153; surveys of, 149–151, 154–155, 158, 178
Environmental assessment, 13, 14, 33
Episode of treatment groups (ETGs), 23, 37, 38
Equity, internal and external, 138
Errors, in data entry, 23
Execution, in healthcare: barriers to, 1; integrated system for, 2, 5, 173–179; need for, 1–6
Exegesis, 39
Exegetical analysis, 24, 25
External assessment, in strategic plan development, 19–21
Extract, transform, and load (ETL) component, of data warehousing, 22, 23, 34, 37, 38
F
Feasibility analysis, of project charters, 77–78
Feedback, 115–116, 117; balancing, 116, 117, 119, 124, 129; reinforcing, 116, 117
Filtering rules, 121–122
Financial perspective, on organizational performance, 55, 56, 57–58, 69
Financial reports, as primary management tool, 53–54
Financing, of healthcare, 2, 3
Fishbone diagrams, 117
Fixed-price contracts, 96
Flowcharts, 117, 118
Force field analysis, 94
Foresight, of leaders, 165
Formulaic analysis, 24
Freedom, role in employee engagement, 149, 150
Fuel gauge indicators, of performance, 26
Functional organization structure, 133–134, 135, 143
Futurescan, 42
G
General systems theory, 115–116, 129
Globalization, 42
Goals: of high-performance healthcare systems, 1; “line of sight” approach to, 152–153; “stretch,” 65
Graphical data displays, 25–29, 119, 120, 129
Great Society, 2, 9
Greenleaf, Robert, 163–164
Griffith, John, 175–176
Growth-share matrix, 11, 12
H
Harrah’s Casino, 21
Harvard University, 160
Health Administration Press, 42
Healthcare: access to, 1; changing emphasis in, 2, 3
Healthcare Effectiveness Data and Information set (HEDIS) measures, 111
Healthcare Information and Management Systems Society (HIMSS), electronic medical record implementation model of, 20
Healthcare Operations Management (McLaughlin and Hays), 29, 55, 58, 80–81, 94, 95, 104
Healthcare policy, 1
Healthcare Strategic Planning (Zuckerman), 13
Healthcare systems, high-performance, 1–2, 5
HealthPartners, 13, 15; business intelligence system of, 34; Care, Innovation, and Measurement department of, 111–112; organizational culture change strategy of, 153–154
Heifetz, Ron, 160, 161–163
HIMSS Analytics EMR Adoption Model, 20
Histograms, 117
“Holding environment,” for conflict management, 162–163
Hospital performance metrics, 32
Huddles, 113, 124, 129
I
“If-then” statements, 59, 60, 62
Implementation planning, 13, 14
Incremental strategy formulation, 10
Information systems, 19; of project management offices, 100
Information technology (IT), vendor contracts for, 77
Information technology (IT) departments, 121
Initiative(s): versus cooperation, 137; development of, 59; failure of, 64; implementation of, 62; linkage of, 62–63; measures for, 59, 60; for organizational synergy, 62; prioritization of, 65; strategy maps of, 60–62; targets of, 63, 65, 69
Innovation. See Clinical innovation
Institute for Healthcare Improvement (IHI), 154; “Hospital to Home strategy of, 18; improvement map of, 110, 114; leadership model of, 166–167; “100,000 Lives” campaign of, 110; project improvement model of, 106–107, 108, 109
Institute of Medicine (IOM), Crossing the Quality Chasm, 1
Integrated system, for execution in healthcare: action plan for, 176–178; demand for, 2; implementation of, 173–179; leader of, 178; Malcolm Baldrige Award criteria for, 175–176, 177, 178, 179
Integrative roles, 136
Internal business process perspective, on organizational performance, 56, 57–58, 69
Internal performance analysis, 38; data access in, 24–25; data analysis in, 23–24; data collection for, 19–23; data displays in, 25–29; of data sources, 19–21
J
Johns Hopkins Hospital, 118
Joint Commission, 33
K
Kaizen events, 106
Kaplan, Robert, 54–55, 64
Knowledge transfer, among colleagues, 125
L
Lagging indicators. See Outcome indicators
Leaders, role in organizational culture, 148, 157
Leadership, 159–170; adaptive, 5, 160–163, 167–169, 178; danger of, 160–161; “great man” theory of, 160; Institute for Healthcare Improvement model of, 166–167; of integrated healthcare systems, 178; as performance criterion, 175, 176, 177; physician, 165–166; power-based, 164; relationship to organizational culture, 153; servant, 163–165, 169–170, 178; team approach in, 164
Leadership skills, training in, 165–166
Leading indicators. See Performance drivers
Lean process improvement approach, 58, 104
Lean Six Sigma process improvement approach, 104–106, 137; DMAIC framework of, 104–106, 108, 109, 114
Leapfrog group, 33
Learning perspective, on organizational performance, 56, 57–58, 69
Learning School model, of strategic planning, 11–12, 15, 16, 50, 56, 175, 177
Lindgren, Mats, 42
Line charts, 26
Linsky, Marty, 160
Listening skills, of leaders, 161–162, 164
M
Malcolm Baldrige National Quality Award criteria, 31, 175–176, 177, 178, 179
Managed care, effect on healthcare strategic planning, 10
Management tools, failure of, 53–54
Market basket analysis, 30, 31
Market share, 11, 12
Marshfield Clinic, data warehousing use by, 35, 36
Massachusetts Institute of Technology, 145
Matrix structures, 136
Mayo Clinic, data mining use at, 35–37
McKinsey & Company, 165
Medicaid, 2
Medical Group Management Association, 31
Medical homes, 16–17, 18, 169–170; dashboards of, 126, 128; employee engagement survey of, 157–158; scenario analysis of, 45–47; strategy maps of, 67–68
Medical practice financial metrics, 32
Medicare, 1, 2, 9; Acute Care Episode (ACE) project of, 49–50, 79–80, 82–101
Meetings: daily huddle, 113, 124, 129; of project teams, 99–100
Metadata, warehousing of, 23
Microsoft Project, 71, 80–81, 80–81 83, 83, 86, 91
Mind mapping, 94
Monitoring systems, real-time, 21
Motivation, 149, 150; as basis for performance analysis, 55, 56; for clinical change, 110; effect of organizational structure on, 137–138
N
National Alliance for Health Information Technology, 39
National Committee for Quality Assurance (NCQA), 33
National Quality Forum, 33, 110, 114
Networks, 135
Norton, David, 54–55, 64
O
Objectives, initiatives for achievement of, 59–63
On Line Analytical Processing (OLAP) software, 24–25; graphical data display component of, 25–29; predictive analysis component of, 29
Operating procedures, 116–117, 129
Operational reports, as primary management tool, 53–54
Operational reviews, 64
Operational systems, comparison with data warehousing, 24
Organizational direction, 13, 14
Outcome indicators, 59, 60, 64
P
Pareto charts, 117, 121–122, 124
Patient management, clinical decision support system for, 125–126, 127
Patient Protection and Affordable Care Act, 1, 16
Pay-for-performance systems, 178
Payment reform, 43–44
Performance: as basis for compensation system, 138–139; Malcolm Baldrige award for, 31, 175–176, 177, 178, 179
Performance data, transparency of, 124–125, 129
Performance drivers, 59, 60, 64
Performance measures: customer-related, 55, 56, 68, 69; financial, 55, 56, 68, 69; learning and growth-related, 55, 56; motivation-related, 55, 56
Performance reporting, 20, 23–25, 30
Physician Quality Reporting Initiative (PQRI), 33
Physicians, as leaders, 165–166
Pie charts, 27
Planning School model, of strategic planning, 10–11, 13, 18, 50, 177
Political skills, of leaders, 162
Portfolio strategies, 11, 12
Positioning School model, of strategic planning, 11, 12, 18, 177
Post-service systems, 58
Poudre Valley Health System, 31
Practice operations metrics, 32
Predictive analysis, 29
Preventive services, dashboards of, 126, 128
Problem-solving skills, 166
Process improvement, tools for, 58
Process management, 175, 176, 177
Process maps, 117, 118
Process simulation, 58
Procurement process, 95–97
Product structure, 134, 135, 143
Professional services agreement (PSA) model, of compensation, 139–143; case example of, 140, 142–143
Project, definition of, 72–73
Project management, 71–101; agile, 103–104, 105, 109, 112–113; change control system in, 89, 91, 93; chartering process in, 73–74, 75, 76–78, 79–80, 178; communication plan component of, 93; comparison of systems of, 107–108, 109; critical path determination in, 89, 90; Gantt chart use in, 86, 88, 89; “gold plating” in, 81; historical background of, 72; indications for, 72–73; Institute for Healthcare Improvement model of, 106–107, 108, 109, 114, 126; “milestones” in, 82; monitoring system in, 89, 91; network diagram use in, 86, 87; poorly managed, 72; procurement component of, 95–97; project closure in, 97–98; project crashing in, 89; Project Management Institute approach to, 103, 108, 112–113; project prioritization in, 73–74, 75; project scope of, 73, 74, 75, 76, 78, 80–81; project selection in, 73–74; quality management component of, 95; risk management component of, 94–95; scheduling of tasks in, 85–89; Six Sigma DMAIC model of, 104–106, 108, 109, 114; slack determination in, 87, 89, 90; software for, 71, 80–81, 83, 86, 91; tools for, 78–81; variations on, 103–114; work breakdown component of, 71, 73, 82–84, 85–89, 94, 95
Project Management Body of Knowledge, 72
Project Management Institute, 4, 72, 103
Project management office, 100–101, 178
Project management professionals (PMPs), 72, 178, 179
Project managers, 75–76, 98
Project plans, 73, 74
Project teams, 77, 109; meetings of, 99–100; performance of, 100; structure of, 98
Pronovost, Peter, 118–119
Pyramid structure, of organizations, 136
Q
Quality, in healthcare: definition of, 95; Malcolm Baldrige award for, 31, 175–176, 177, 178, 179; public reporting of, 43–44
Quality control, as project component, 73, 74
Quality management, 95
R
Radar charts, 27–28
Randomized clinical trials (RCTs), 111
Rapid process improvement workshops (RPIWs), 106
RASIC chart, 85, 86, 91
Referrals, 139
Relative value units (RVUs), 139
Request for information (RFI), 97
Request for proposal (RFP), 97
Rewards-based compensation, 138
Risk, definition of, 94
Risk management, 73, 74, 94–95
Risk mitigation, 95, 96
Risk registers, 95
Root cause analysis, 94
Run charts, 117
S
Safety, as healthcare system goal, 1, 2
St. Mary’s Hospital/Duluth Clinic (SMDC): employee engagement survey of, 154–155; scorecard project reporting icon use at, 126; strategy maps and balanced scorecards of, 65–67
SAS, 121–122
SAS Text Miner, 35–36
Scatter charts/plots, 27, 35, 36, 117
Scenario analysis, 4, 12, 41–50, 165, 175, 177; case example of, 45–50; goals of, 42; trend tracking feature of, 42–43
Scenario cross, 43, 44, 48, 49
Schein, Edgar, 145–146
“Scope creep,” 75
Scope statements, of projects, 73, 74, 75, 76, 78, 80–81
Scorecards. See also Balanced scorecards: definition of, 120
Self-awareness, in leaders, 164
Self-reflection, by leaders, 162
“Silos,” 135–136, 143
Six Sigma process improvement approach, 58, 104, 117, 137
Slack, 87, 89, 90
Society for Healthcare Strategy and Market Development, 42
Sparklines, 28–29
Stakeholders, in projects, 76–77, 94
Standard operating procedures (SOPs), 116–117, 129
Statement of work (SOW), 96–97
Statistical process control (SPC), 119
Stoller, James, 166
Strategic alignment, 149, 150
Strategic planning, 4, 9–18; case studies of, 13, 15–17; Design School model of, 10, 13, 18, 50, 56, 177; external assessment in, 19; historical background to, 9–10; internal assessment in, 19–21; Internet resources for, 18; Learning School model of, 11–12, 15, 16, 50, 56; models of, 10–13; need for, 10; as performance criterion, 175, 176, 177; Planning School model of, 10–11, 13, 18, 50, 177; Positioning School model of, 11, 12, 18, 177; as primary management tools, 53–54; process of, 14; as project management resource, 94; scenario planning and, 41–50; SWOT analysis component of, 94
Strategies: execution of, 173–175; for integrated systems implementation, 177
Strategy development, 56–57
Strategy-Focused Organization (Kaplan and Norton), 54–55
Strategy formulation, 13, 14
Strategy maps, 55, 56–57, 60–63, 178; case examples of, 65–67; linked initiatives of, 62–63; review of, 64
Strategy reviews, 64, 178
Strategy testing/adaptation, 64
Structure, organizational, 133–138; hierarchical, 136; of integrated healthcare systems, 178; of large organizations, 136–138; noncomplexity and nonconcavity of, 137; star model of, 133–134
Surface charts, 28
Surveys, of employee engagement, 149–151, 154–155, 158, 178
SWOT (strength, weaknesses, opportunities, and threats) analysis, 10, 16, 18, 94
Synergy, organizational, 62
Systems theory, 173, 174
T
Team approach, 136; in conflict management, 164; in leadership, 164; project teams, 77, 98, 99–100, 109
Technical skills, of physician leaders, 166
Testing, centralized versus point-of-service, 137
Text mining, 31, 35–36
Theater, as organizational culture change strategy, 153–154
Training, in leadership skills, 165–166
Transparency, of data, 124–125, 129
Trends, tracking of, 42–43
Tufte, Edward, 28
Twin Cities Orthopedics, 15
U
Uncertainty, of trends, 43–44
Unexpected events, response to, 174–175
United States Department of Commerce, 175–176, 177
United States Department of Defense, 72
United States Preventive Services Task Force, 110, 114
University of Michigan, 175
University of St. Thomas, Physician Leadership College, 5, 159
V
Vanderbilt Medical Center, clinical decision support system of, 125–126, 127
Vendors: contracts with, 96–98; of employee engagement surveys, 149–150; procurement of, 95–96, 97
Vincent Valley Healthcare, 5, 15–17; accountable care organization (ACO) project of, 112–113, 167–169; data warehousing use by, 37; medical home project of, 45–47, 126, 128, 157, 169–170; Medicare acute care episode (ACE) project of, 82–101, 155–157; preventive services dashboard of, 126, 128; professional services agreement of, 140, 142–143; project management office of, 101, 113; project management process of, 71–101; scenario analysis use at, 45–50; strategy maps of, 67–68
W
Washington, George, 164
Web mining, 31
Work, technical versus adaptive, 160
Workforce, engaged, 149; surveys of, 149–151
This index is for Make it Happen: Effective Execution in Healthcare Leadership