Plenary 5e Sustaining Geri-Flood Stakeholder Engagement

Flood, MD Associate Professor Assistant Chief Medical Officer for Care Transitions and Geriatric Quality Officer, UAB Hospital Director, Geriatric Medicine Section Division of Gerontolo

Engaging Providers from All

Disciplines

AKA: creating “little g” geriatricians

October 15, 2015

Kellie L Flood, MD Associate Professor Assistant Chief Medical Officer for Care Transitions and

Geriatric Quality Officer, UAB Hospital Director, Geriatric Medicine Section Division of Gerontology, Geriatrics, and Palliative Care

If they could only see the solutions are right

there…

Engagement Approach is Group Dependent

Engagement Approach is Group Dependent

Engagement Approach is Group Dependent

Kotter’s Eight Steps for Leading

Change

1 Create a sense of urgency

2 Create the guiding coalition

3 Develop a vision and strategy

4 Communicate the change vision

5 Empower broad-based action

6 Generate short-term wins

7 Consolidate gains and produce more change

8 Anchor new approaches in the culture

Defrost a hardened

status quo

Introduce new practices

Ground the changes in the culture so they

stick!

Establishing a Sense of Urgency

Isn’t That Special

Create Urgency at Every Opportunity

 Every meeting/session starts with

a real case

 “If this were your loved one….”

 Bring in families to tell the

Telling the “Why”:

Walking in Another’s Shoes

You Want Them Leaving With A Sense of

Urgency

Empowering Broad-Based Action

13

“I Helped Put a Man on the Moon”

“I Save Lives”

Aspirin reduces risk of death or MI by 25-50% Would we withhold

aspirin from a patient who has cardiovascular disease?

Dependent in all ADLs

Independent in all ADLs

Improves absolute mortality risk by

55%

Why in the world would we not get patients

out of bed?

Empowerment at Every Level

Generating Short Term Wins

20

Celebrating Wins at the Annual Geriatric Scholar

Quality Symposium

> 165 in attendance, from Leaders to Community

Supporters

Celebrating Wins At Annual Event Reaches

All Types of Stakeholders At Once

Anchoring New Approaches in the Culture

“Acefying” UAB Hospital via Virtual ACE:

A Joint Commission Recognized Best Practice Model

Unit-Based Care Delivery Redesign that trains all providers in:

Care Transitions

All coordinated with ACE Tracker

Mobility in the Prior 24 Hours

2 Orthopedic Surgery Units FY 15

Patients with a Baseline Katz Index of 12

P<.01

P=.04

Delirium Prevalence (Convenience Sample)

All Patients, All Visits, 2 Orthopedic Surgery Units

Pre: 44 patients, 60 NUDESCs by RA

P=.02

Data as of 8-12-15

Reduction in Restraints for Patients of All Ages

QUESTIONS?

UAB Hospital 1,152 beds of complexity with folks ranging from

Fred’s to Dr No No’s