Den gamla och den nya tiden

Transkript

1 Triple Aim som rettesnor for udvikling og kvalitetsarbejde, Göran Henriks utvecklingsdirektör Region Jönköpings län Den gamla och den nya tiden Kan du komma ihåg den tiden då folk blev sura för att någon läste deras dagböcker nu blir de sura om man inte läser deras bloggar och twitter

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3 The Imagination Age: How we develop value? Imagination Age Adapted from:

4 En sammanhållen långsiktig strategi för framtidens hälsooch sjukvård och omsorg. Social hållbarhet och jämlik hälsa

5 Verkligheten har många kartor - En gemensam karta kan förändra verkligheten Genom att förstå att alla har olika kartor, och att vår egen karta behöver uppdateras kan vi lättare navigera i verkligheten. Det är ofta lättare att respektera andras agerande, genom att förstå deras kartor. (ange enhet via Infoga sidfot)

6 Challenges Vertical or Network Model? Single Integrator Business model O w n e r s h i p Co-dependent Independent Dependent Multiple Co-Integrators: A modernized Municipality Model Co- Independent Horizontal Integration Network Model Vision, Vertical Principles, Integration Collaborative, Trustable meeting places Source: Stephen Covey and Bill Tolbert, Adapted by Dave Ford

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8 Region Jönköping County 1)More engaged, activated citizens and better health outcomes 2)Better knowledge of one s illness and capacity for selfmanagement 3)Health systems adopting processes and achieving outcomes that matter to patients/citizens 4)Find ways of managing healthcare costs

9 Region Jönköping County 13 municipalities, population: hospitals, 44 primary care centers (public and private), rehabilitation, and home and community care Qulturum: resource center for improvement, innovation, and redesign

10 One of ten healthiest areas in the world Easy to have a healthy lifestyle here Healthcare at the top of the league Clean air Green areas Healthy food Excellent public transport According to this report:

11 Ranking list, County Hospitals: 1. Ryhov 4. Värnamo Höglandet, strongest runner up

12 I have access to the care I need

13 here are reasonable waiting times at the care centers

14 My trust for the health and care centers in my region

15 Overall trust for health and care services in your region

16 Your impression as a whole largest amount of positive answers in the whole of Sweden: Rydaholm

17 Net cost development accumulated adjusted Region Jönköping lower than average average Regionlednigskontoret

18 Fyra ledarskapsfrågor! Do you know how good you are? Do you know where you stand relative to the best? Do you know where the variation exists? Do you know the rate of improvement over time? Ref:Bisognano, Welch

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22 Referens: John Whittington, IHI

23 Referens: John Whittington, IHI

24 Ref: Nolan, Whittington, Triple Aim

25 Ref: Nolan, Whittington, Triple Aim

26 Amount of deaths in different ages

27 Amount of deaths in different ages

28 In percent, increased amount of citizens and the demographic demand in Sweden

29 Sweden 34,1 -** - 7,5 31,1 67/69 10/16 Municipality Average days on sick leave (paid sick days) July 2009 Percentage of 19 years old without dental caries 2008 Percentage of 4 year olds with overweight and obesity Born Percentage of pregnant women smoking 2006 Children per 1000 births with low birth weight Percentage of inhabitants with good selfperceived health (W/M) Percentage of inhabitants with high alcohol consumpti on (W/M) Jönköping 31,5 30%-53% 14,6% 5,8% 32,7 65/73 7/14 Habo 28,4 35% 12,9% 9,2% 21,6 73/74 6/15 Mullsjö 37,7 30% 16,4% 9,6% 28,1 73/67 7/14 Tranås 39,0 42% 12,6% 9,1% 20,3 69/73 7/22 Aneby 34,5 48% 16,3% 10,9% 58,8 68/70 7/13 Eksjö 35,0 48%-59% 13,8% 9,3% 22,8 67/70 5/14 Nässjö 35,4 28%-30% 13,9% 9,8 % 21,7 68/75 6/15 Sävsjö 35,2 41%-54% 12,5% 8,4% 20,4 70/67 8/8 Vetlanda 33,4 35%-42% 15,8% 8,8% 39,2 72/73 9/14 Gislaved 31,3 33%-35% 16,9% 13,6% 33,8 71/73 7/14 Gnosjö 29,2 29% 15,8% 8,9% 32,9 74/72 10/12 Vaggeryd 29,0 28% 14,3% 6,7% 35,6 72/70 9/14 Värnamo 26, % 15,3% 8,8% 23,4 76/75 5/11 County 32,0 38% 14,7% 8,1 30,1 70/73 7/14

30 Olika syn på hur verkligheten är beskaffad

31 Choluteca river bridge Honduras

32 TES and learning

33 Social hållbarhet och jämlik hälsa

34 (4:16)

35 Wholeness: The new agenda Wellness Prevention Diagnostics Treatment

36 Olika typer av värdelogiker 1. Värdecentra som erbjuder svar genom enkla tjänster (solution shops, Friskis) 2. Individcentrerade vårdförlopp (value chains) 3. Samverkande nätverk (facilitating networks) Referens: Lifvergren, Batalden, Fjelstad

37 Talk with me, not to me Meet me with respect Give me knowledge Treat me like a fellow human being Don t let me be reduced Look into my eyes and imagine you are me Let me be a part of my own care Let my family be part of my health care Listen to me Anette Abrahamsson,

38 What matter s to you? Maureen All services are in one or the other way co-produced, codesigned - We need new models of health and care! Utvecklingskraft

39 Esther

40 Esther From traditional healthcare to Process thinking Traditional "functional" Pharmacy Primary care areas (6) Högland hospital Communities (6) Patient focused activities and part of processes are organized after Prioritated patient values" Undersökning Diagnos & beslut Rehabilitering primärvården om åtgärd PV/ Primärvården Sjukhuset pat ill Esther patient treated Medicin Akuten Rehab Lab Pat söker Undersökningar Behandling primärvården Sjukhuset Sjukhuset Rehabilitering Kommunen

41 Esther-results Hospital admissions fell from approximately 9,300 in 1998 to prognostic 7,300 in Hospital days for heart failure patients decreased from approximately 3,500 in 1998 to 2,500 in Waiting times for referral appointments with neurologists decreased from 85 days in 2000 to 14 days in Waiting times for referral appointments with gastroenterologists fell from 48 days in 2000 to 14 days in 2003.

42 Patient Partnership Partnership means seeing and meeting the whole person. The person s story is the starting point for building a relationship, common planning and mutual respect for each other s knowledge.

43 Patrik

44 Patient Supporters, Region Jönköping County

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46 Hälsa och vård arbetar uppströms Föräldrautbildning MVC BB etc. Barn med olika vårdbehov Akut/subakut vårdbehov Planerade icke-akuta vårdbehov Kronisk sjd, cancersjd Multisjuk, åldrad Palliativ

47 Mätningar utifrån värdetrippeln (Triple aim) Befolkningens hälsa Patienterfarenheter Kostnad per individ 48