Capital as a transformation tool Design as a change tool

Transcription

1 Capital as a transformation tool Design as a change tool Presenter: Clifford Harvey Senior Architect, Project Management Office Health Capital Investment Branch Ontario Ministry of Health and Long-Term Care

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5 Applied Research Translational Research Basic Research

6 Applied Research Translational Research Basic Research

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9 The Market: New Environments / New Model of Care

10 1. System (Action Plan) International Public/Private Translational e.g. Telomere Research Distributed Health 2. Care (new models of care) Continuum of Care Preventive / Home - Residential Wellness Primary Ambulatory Acute Post Acute / Rehabilitation Senior Pharmacies Mental Health 3. Health Technology Personal health Schools Workplace Cities Transit Wellness Sustainability 4. Inspirational Case Studies Canada/US Europe Asia

11 The Board:

12 Clayton Christensen Bio: Clayton M. Christensen is the Kim B. Clark Professor of Business Administration at the Harvard Business School, with a joint appointment in the Technology & Operations Management and General Management faculty groups Nigel Crisp Bio: Edmund Nigel Ramsay Crisp, Baron Crisp KCB, is a British former senior civil servant in the Department of Health and Senior Manager in the NHS. He was awarded a life peerage upon retirement, and sits as a crossbencher in the House of Lords Chris Downey Bio: Chris Downey AIA, is an architect, planner and consultant who lost his sight in As one of the few architects in the world practicing without sight, Chris speaks regularly about insights of life and architecture through the apparent paradox of a blind architect. Michael Graves Bio: American architect who is identified as one of The New York Five. An architect in public practice in Princeton, New Jersey, since 1964, Graves is also the Robert Schirmer Professor of Architecture, Emeritus at Princeton University. He directs the firm Michael Graves & Associates, which has offices in Princeton and in New York City Ian Brown Bio: Author and feature writer for The Globe and Mail, and his work has won many National Magazine and National Newspaper awards. He was the host of CBC Radio's Talking Books, and is the anchor of TVOntario's two documentary series, Human Edge and The View from Here Tim Brown Bio: Tim Brown is President and CEO of IDEO. Ranked independently among the 20 most innovative companies in the world, IDEO is a design consultancy whose clients include Steelcase, Mayo Clinic, US Department of Health. IDEO has contributed to such standard-setting innovations as the first mouse for Apple, the Palm V, and Shimano s new Coasting bike. Bruce Mau Bio: Founder of Bruce Mau Design and the Massive Change Network. As Chief Creative Officer from 1985 to 2010, Mau's clients included Coca-Cola, McDonald's, MTV, Arizona State University, Miami's American Airlines Arena, New Meadowlands Stadium, Frank Gehry, Herman Miller, and Santa Monica's Big Blue Bus. Bruce Mau is recognized as an author and publisher of award-winning books, including the celebrated Zone Books series and S,M,L,XL in collaboration with Rem Koolhaas.

13 Mark Kingwell Bio: Author of twelve books, including the national bestsellers Better Living, The World We Want and Catch & Release: Trout Fishing and the Meaning of Life. Mark Kingwell is a Professor of Philosophy at the University of Toronto, where he has taught since 1991 after finishing a PhD at Yale University and Master's degree at Edinburgh University. He has also been, since 2001, a contributing editor of Harper s Magazine. Paul Farmer Bio: Medical anthropologist and physician Paul Farmer. Founding director of Partners In Health (PIH), and Kolokotrones University Professor and Chair of the Department of Global Health and Social Medicine at Harvard Medical School; Chief of the Division of Global Health Equity at Brigham and Women's Hospital; and the United Nations Deputy Special Envoy for Haiti, under Special Envoy Bill Clinton; as well as the author of numerous books on public and global health. Bill Davenhall Bio: Worked in the health and human service field since the early seventies, during which time he has directed many different initiatives that involve the progressive use of information systems within healthcare and human service delivery organizations. Davenhall is a frequent speaker and writer and is well known as one of the leading advocates for the use of GIS to help solve the challenges in health and human services. John Maeda Bio: President of Rhode Island School of Design since June 1, Mr. Maeda has a distinguished career in humanizing technology for creative endeavors. He has been a practicing designer since 1990 and has developed advanced projects for an array of major corporations including Cartier, Google, Philips, Reebok, Samsung, among others. Steve Paikin Bio: Canadian journalist, author, and documentary producer at TVOntario. He is currently anchor and senior editor of TVO's flagship current affairs program The Agenda with Steve Paikin, and previously hosted TVO's Studio 2 and Diplomatic Immunity. Aside from his hosting and journalistic endeavors, Paikin has produced a number of feature length documentaries: Return to the Warsaw Ghetto, A Main Street Man, Balkan Madness, Teachers, Tories and Turmoil and Chairman of the Board: The Life and Death of John Robarts. Eric Topol Bio: Eric Topol is a premier cardiologist, genetic researcher, and technologist. As a leader in the movement to modernize medical treatment through the latest technology, Dr. Topol is creating new, more effective ways to treat patients ways that will dramatically bring down the costs of health care. Dr. Topol's new book is titled The Creative Destruction of Medicine: How The Digital Revolution Will Create Better Health Care

14 Atul Gawande Atul Gawande is a surgeon, writer and public health researcher. He practices general and endocrine surgery at Brigham and Women s Hospital in Boston. He is also Professor of Surgery at Harvard medical School and Professor in the Department of Health Policy and Management at the Harvard School of Public Health. He has been a staff writer for the New Yorker magazine since He has written three New York Times bestselling books: Complications, Better and The Checklist Manifesto. Debra J. Levin Debra has a master's degree in management and organizational leadership from the John F. Kennedy School of Management and a bachelor's degree from Arizona State University's College of Architecture. She serves on advisory boards for the Healthier Hospitals Initiative, American Academy of Healthcare Interior Designers, and Arizona State University Healthcare Design Initiative. A Fellow of the Jim Whittaker Discovery Camp for Innovation and Leadership, Debra was named one of Twenty People Making Healthcare Better in 2007 by HealthLeaders magazine. Alan Dilani Professor Alan Dilani is a founder and General Director of the International Academy for Design and Health. He is cofounder of the journal, World Health Design, He is founder and director of international master program on Design and Health with University of Portsmouth in UK. Dr Dilani has been engaged worldwide in several universities in the field of design and health developing "Psychosocially Supportive Design Program", both in medical and design institutions. He holds a PhD in Health Facility Design from the Royal Institute of Technology, Stockholm and a Masters of Architecture in Environmental Design from the Polytechnic of Turin, Italy.

15 Clayton Christensen Bio: Clayton M. Christensen is the Kim B. Clark Professor of Business Administration at the Harvard Business School, with a joint appointment in the Technology & Operations Management and General Management faculty groups Nigel Crisp Bio: Edmund Nigel Ramsay Crisp, Baron Crisp KCB, is a British former senior civil servant in the Department of Health and Senior Manager in the NHS. He was awarded a life peerage upon retirement, and sits as a crossbencher in the House of Lords Chris Downey Bio: Chris Downey AIA, is an architect, planner and consultant who lost his sight in As one of the few architects in the world practicing without sight, Chris speaks regularly about insights of life and architecture through the apparent paradox of a blind architect. Michael Graves Bio: American architect who is identified as one of The New York Five. An architect in public practice in Princeton, New Jersey, since 1964, Graves is also the Robert Schirmer Professor of Architecture, Emeritus at Princeton University. He directs the firm Michael Graves & Associates, which has offices in Princeton and in New York City Ian Brown Bio: Author and feature writer for The Globe and Mail, and his work has won many National Magazine and National Newspaper awards. He was the host of CBC Radio's Talking Books, and is the anchor of TVOntario's two documentary series, Human Edge and The View from Here Tim Brown Bio: Tim Brown is President and CEO of IDEO. Ranked independently among the 20 most innovative companies in the world, IDEO is a design consultancy whose clients include Steelcase, Mayo Clinic, US Department of Health. IDEO has contributed to such standard-setting innovations as the first mouse for Apple, the Palm V, and Shimano s new Coasting bike. Bruce Mau Bio: Founder of Bruce Mau Design and the Massive Change Network. As Chief Creative Officer from 1985 to 2010, Mau's clients included Coca-Cola, McDonald's, MTV, Arizona State University, Miami's American Airlines Arena, New Meadowlands Stadium, Frank Gehry, Herman Miller, and Santa Monica's Big Blue Bus. Bruce Mau is recognized as an author and publisher of award-winning books, including the celebrated Zone Books series and S,M,L,XL in collaboration with Rem Koolhaas.

16 Mark Kingwell Bio: Author of twelve books, including the national bestsellers Better Living, The World We Want and Catch & Release: Trout Fishing and the Meaning of Life. Mark Kingwell is a Professor of Philosophy at the University of Toronto, where he has taught since 1991 after finishing a PhD at Yale University and Master's degree at Edinburgh University. He has also been, since 2001, a contributing editor of Harper s Magazine. Paul Farmer Bio: Medical anthropologist and physician Paul Farmer. Founding director of Partners In Health (PIH), and Kolokotrones University Professor and Chair of the Department of Global Health and Social Medicine at Harvard Medical School; Chief of the Division of Global Health Equity at Brigham and Women's Hospital; and the United Nations Deputy Special Envoy for Haiti, under Special Envoy Bill Clinton; as well as the author of numerous books on public and global health. Bill Davenhall Bio: Worked in the health and human service field since the early seventies, during which time he has directed many different initiatives that involve the progressive use of information systems within healthcare and human service delivery organizations. Davenhall is a frequent speaker and writer and is well known as one of the leading advocates for the use of GIS to help solve the challenges in health and human services. John Maeda Bio: President of Rhode Island School of Design since June 1, Mr. Maeda has a distinguished career in humanizing technology for creative endeavors. He has been a practicing designer since 1990 and has developed advanced projects for an array of major corporations including Cartier, Google, Philips, Reebok, Samsung, among others. Steve Paikin Bio: Canadian journalist, author, and documentary producer at TVOntario. He is currently anchor and senior editor of TVO's flagship current affairs program The Agenda with Steve Paikin, and previously hosted TVO's Studio 2 and Diplomatic Immunity. Aside from his hosting and journalistic endeavors, Paikin has produced a number of feature length documentaries: Return to the Warsaw Ghetto, A Main Street Man, Balkan Madness, Teachers, Tories and Turmoil and Chairman of the Board: The Life and Death of John Robarts. Eric Topol Bio: Eric Topol is a premier cardiologist, genetic researcher, and technologist. As a leader in the movement to modernize medical treatment through the latest technology, Dr. Topol is creating new, more effective ways to treat patients ways that will dramatically bring down the costs of health care. Dr. Topol's new book is titled The Creative Destruction of Medicine: How The Digital Revolution Will Create Better Health Care

17 Atul Gawande Atul Gawande is a surgeon, writer and public health researcher. He practices general and endocrine surgery at Brigham and Women s Hospital in Boston. He is also Professor of Surgery at Harvard medical School and Professor in the Department of Health Policy and Management at the Harvard School of Public Health. He has been a staff writer for the New Yorker magazine since He has written three New York Times bestselling books: Complications, Better and The Checklist Manifesto. Debra J. Levin Debra has a master's degree in management and organizational leadership from the John F. Kennedy School of Management and a bachelor's degree from Arizona State University's College of Architecture. She serves on advisory boards for the Healthier Hospitals Initiative, American Academy of Healthcare Interior Designers, and Arizona State University Healthcare Design Initiative. A Fellow of the Jim Whittaker Discovery Camp for Innovation and Leadership, Debra was named one of Twenty People Making Healthcare Better in 2007 by HealthLeaders magazine. Alan Dilani Professor Alan Dilani is a founder and General Director of the International Academy for Design and Health. He is cofounder of the journal, World Health Design, He is founder and director of international master program on Design and Health with University of Portsmouth in UK. Dr Dilani has been engaged worldwide in several universities in the field of design and health developing "Psychosocially Supportive Design Program", both in medical and design institutions. He holds a PhD in Health Facility Design from the Royal Institute of Technology, Stockholm and a Masters of Architecture in Environmental Design from the Polytechnic of Turin, Italy.

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19 Values: Discovery (Curious)

20 Generally, research is perceived as either basic or applied (and these days linked by the increasingly popular category of translational research). This structure implies a linear process, wherein basic discoveries are made by scientists who just want to know the truth, and other scientists who recognize some possible applications for a basic discovery try to translate it into a practical context. Applied scientists only care about research that is practical and clearly goal-directed outcome, so only after the translational guys have enough evidence to indicate that it might do the applied guys test something new in the real world of caring for human beings. Voyage of Discovery Predictive Health Michael Johns The real voyage of discovery consists not in seeking new landscapes but in having new eyes Marcel Proust

21 Challenges To flourish, translational research requires a knowledge-driven ecosystem, in which constituents generate, contribute, manage and analyze data available from all parts of the landscape. The goal is a continuous feedback loop to accelerate the translation of data into knowledge. Collaboration, data sharing, data integration and standards are very important. Only by seamlessly structuring and integrating these data types will the complex and underlying causes and outcomes of illness be revealed, and effective prevention, early detection and personalized treatments be realized. Translational research requires that information and data flow from hospitals, clinics and study participants in an organized and structured format, to repositories and laboratories. Also, the scale, scope and multi-disciplinary approach that translational research requires means a new level of operations management capabilities within and across studies, repositories and laboratories. Meeting the increased operational requirements of larger studies, with ever increasing specimen counts, larger and more complex systems biology data sets, and government regulations, requires informatics that enables the integration of both operational capabilities and clinical and basic data. Most informatics systems today are inadequate to handle the tasks of complicated operations and contextually in data management and analysis.

22 Investment Models: Venture

23 Value = (Quality) / (Cost) Quality = (Q 1 + Q 2 + Q 3 + Q 4 + Q 5 + Q 6 ) Q 1 = Effectiveness of Care Q 2 = Efficiency of Care Q 3 = Timeliness of Care Q 4 = Equitable Q 5 = Safety Q 6 = Patient Centre Care ii Cost = (Operation + Capital) Direct Operations = Reimbursement (Volume x Cost ii ) (Staff + Supplies + Facility Costs i ) Indirect Capital = Equipment + Buildings Notes i) Independent Health Facilities (IHF) include a facility fee to cover lease / rent ii) There is a direct relationship between decreased quality and increased operating cost, especially when one looks at the continuum of care versus procedures. For example a Hospital Acquired Infection (HAI) increases the operating costs and decreases the quality of care. Includes the patient experience

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25 Investment Models: Public

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39 (Voice of the Customer) (Gemba) Experience

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42 Resource: (Big) Data

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46 Search for Innovation and Quality

47 Quality Improvement Project: Making the System Better, One Project at a Time Moving from Quality Assurance to Quality Improvement in the Ministry of Health and Long Term Care (MOHLTC) Capital Approval Process Clifford Harvey Masters of Science in Healthcare Quality MScHQ 841: Process Improvement in Health Care Queens University

48 Benchmarking Healthcare Design Case Study: The Emergency Department Clifford Harvey Master of Science in Healthcare Quality MScHQ 842 Research and Evaluation Methods to Assess Healthcare Quality, Risk and Safety Queen s University, Kingston

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54 Platform (eco system)

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64 Thoughts?