In the February 2020 newsletter published by the Nursing Institute for Healthcare Design (NIHD), I contributed an article to honor and celebrate Clay Christensen, whom I refer to as a "disruptive innovator extraordinaire." The article can also be accessed online through the NIHD website. See link below.
https://mcusercontent.com/c4e271f6202bf884295cfd20b/files/c9d613b8-6b10-4c78-b7e4-b26c13d8c903/Clay_Christensen_A_Disruptive_Innovator_Extraordinaire.pdf
Wednesday, February 26, 2020
Wednesday, February 12, 2020
Save the Date - NIHD Webinar - May 21, 2020 - The Public Library - Healthcare Design Opportunities
| NIHD Webinar Series - May 2020: The Public Library - Healthcare Design Opportunities |
Wed May 20, 2020 12:00 PM
REGISTER for the NIHD May webinar!
When: May 21, 2020 @ 12pm EST
Topic: The Public Library – Healthcare Design Opportunities
Speaker: Susan Ziel, BSN, MPH, JD, NIHD Fellow, Consultant @ Integrity Health Strategies and Affiliate Faculty / Teaching Specialist @ University of Minnesota
Susan represents and advises healthcare clients, in the capacity of coach and consultant, as they assemble innovative and optimal healing environments -- whether built or virtual -- that not only comply with applicable requirements but which are also deliver on the Triple Aim's promise to provide better health care earlier and for less, across an entire targeted population. Susan served on the NIHD Board of Directors as Secretary for four years (2016-2019). Her 45+ years of experience in health care, as a registered nurse, healthcare administrator, consultant, health law attorney, plus completion of the Healthcare Design and Innovation Certificate at the University of Minnesota, enables Susan to maximize her "real world" perspectives in working with clients and colleagues.
Representative clients: hospitals, medical care organizations (group practices, clinics, FQHC, RHC, etc.), senior communities (assisted living, memory care, SNF), home health and hospice, online health care providers.
Description: Advanced by the requirements from the Accountable Care Act (ACA), Joe Flowers reported years ago that the Triple Aim, adopted by the Institute for Healthcare Improvement (IHI), seeks to delivery health care better and for less by “doing it earlier across the whole population.” As the health care system continues to be disrupted to meet the needs of vulnerable individuals who are often ignored, the public library remains an essential portal in promoting the achievement of health and health literacy for all persons through its community-based and web-based initiatives.
This webinar will overview five different healthcare design opportunities involving the public library. Every opportunity requires the transformation of stakeholders, built and virtual spaces, staff, and/or processes using evidence-based design principles and human-centered design strategies. Each opportunity also has its own challenges, all of which will be addressed by the speaker with “real world” solutions that address applicable laws, regulations and other industry requirements.
You won’t want to miss this webinar and learn more about the public library and how its stakeholders, spaces, staff and processes can be transformed to promote empowerment and independence and to honor humanity at a time when the world’s citizens are increasingly vulnerable to healthcare challenges.
This webinar will overview five different healthcare design opportunities involving the public library. Every opportunity requires the transformation of stakeholders, built and virtual spaces, staff, and/or processes using evidence-based design principles and human-centered design strategies. Each opportunity also has its own challenges, all of which will be addressed by the speaker with “real world” solutions that address applicable laws, regulations and other industry requirements.
You won’t want to miss this webinar and learn more about the public library and how its stakeholders, spaces, staff and processes can be transformed to promote empowerment and independence and to honor humanity at a time when the world’s citizens are increasingly vulnerable to healthcare challenges.
CEUs:
1 EDAC CEU
For more information:
Contact: Angela Boyle, Executive Director
Email: director@nursingihd.com
Email: director@nursingihd.com
Thursday, January 17, 2019
Non-Obvious 2019: How to Think Different, Curate Ideas and Predict the Future
Non-Obvious (2019)[1]
Since 2011, Rohit Bhargava has curated and annually published an online “Non-Obvious Trend Report” that continues to describe our world in new and interesting ways (http://www.rohitbhargava.com/trends). Simply sharing his annual reports was not enough so Bhargava decided to write a series of annual e-books to describe how he collects non-obvious trends, or “unique curated observations about the accelerating present.” I published a media review of Bhargava’s 2015 e-book in the Interdisciplinary Journal of Partnership Studies[2] in 2016 and I think it’s high time to report an update, after reading his 2019 edition which is just now available in paperback.
Each edition is divided into three parts.
The first part, entitled the “Art of Curating Trends,” includes important information about the power of thinking, the art of curating trends, the five essential habits of trend curators and a step-by-step description of Bhargava’s personal approach to curating trends, using his Haystack Method. According to Bhargava, curators add meaning to isolated beautiful things. According to Bhargava, trend curation can be learned and practiced, using the following five essential habits:
(1) Being curious – always ask why, take yourself out of your day-to-day world to explore the unfamiliar.
(2) Being observant – see what others miss, put away your phone and pay attention.
(3) Being fickle – learn to be nimble, capture ideas to be analyzed later, learn to move on.
(4) Being thoughtful – take time to think, reflect, embrace the pause, share ideas in a considered way.
(5) Being elegant – craft beautiful ideas, bring together disparate concepts in a simple and understandable way, much like poetry which takes words away, leaving only simplicity, beauty and meaning.
In describing his Haystack Method, Bhargava notes that trend curators don’t seek needles in the haystack. Instead, they gather a myriad of stories and ideas (the hay) and then use them to identify a trend (the needle) that gives meaning to them all collectively. The Method has five components:
(1) Gather: Save interesting ideas, start a folder, use an app to save important thoughts.
(2) Aggregate: Curate into clusters, take individual ideas and disconnected thoughts and group together, often based on bigger ideas or questions. Span boundaries, stay away from demographics and industry categories.
(3) Elevate: Identify broader or underlying themes below the surface.
(4) Name: Create elegant descriptions using understandable, memorable words, combine words, use alliteration, give it a twist.
The second part of this year’s edition provides a complete copy of Bhargava’s Non-Obvious Trend Report for 2019 which lists and describes the 15 new trends – divided into five categories - that are expected to shape business and behavior this year. The five trend categories, in addition to the 14 new trends, are listed below to peak your interest:
- Culture and Consumer Behavior Trends
- Strategic Spectacle
- Muddled Masculinity
- Side Quirks
- Marketing and Social Media Trends
- Artificial Influence
- RetroTrust
- B2Beyond Marketing
- Media and Education Trends
- Fad Fatigue
- Extreme Uncluttering
- Deliberate Downgrading
- Technology and Design Trends
- Enterprise Empathy
- Innovation Envy
- Robot Renaissance
- Economics and Entrepreneur Trends
- Good Speed
- Overwealthy
- Passive Loyalty
The third part of this book provides many different tips on making trends actionable. Guides for four different types of workshops are included. Bhargava also discusses the method of “intersection thinking” which overlaps seemingly disconnected ideas in order to generate new solutions, directions and strategies. He also suggests five book on trends worth reading and he also offers a useful discussion on the notion of “anti-trends.”
Lastly, the book has several appendices, including the Non-Obvious Trend Reports for years, 2011-2018.
As before, I believe this 2019 edition is once again an important tool for any individual interested in “discovery”, that process which “consists of seeing what everybody else has seen and thinking what nobody has thought.” Whether around the board room table, in the executive suite or in the trenches, individuals will more effectively activate and revitalize their organization’s culture, partnerships and priorities if they are nimble in detecting the many emerging new ideas, inventions, innovations, and discoveries that will continue to shape our world, now and in the future.
[1] Bhargava, R. (2019). Non-Obvious: How to Predict Trends and Win the Future. www.ideapresspublishing.com, Idea Press Publishing, Inc.
[2] Ziel, Susan E. (2016) "Media Review: Non-Obvious: How to Think Different, Curate Ideas and Predict the Future," Interdisciplinary Journal of Partnership Studies: Vol. 3: Iss. 3, Article 8. Available at: http://pubs.lib.umn.edu/ijps/vol3/iss3/8.
Friday, September 28, 2018
New CMS Proposed Rule - Reducing Regulatory Burden For Healthcare Providers
On September 17, 2018, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule to reduce burdensome regulations affecting healthcare providers as part of its "Patients Over Paperwork" initiative which began in 2017. https://www.cms.gov/About-CMS/story-page/patients-over-paperwork.html
Healthcare experts agree that reducing unnecessary burden spent complying with regulations is critical to improving patient care and reducing the risk of clinician burnout. One example is a study published in the Annals of Medicine which reported two hours of paperwork for every one hour of patient care. http://annals.org/aim/fullarticle/2614079/putting-patients-first-reducing-administrative-tasks-health-care-position-paper. In support of the "Patients Over Paperwork" initiative, CMS Administrator Seema Verma advocates that "we are committed to putting patients over paperwork while increasing quality of care, ensuring patient safety and bolstering program integrity." As a result, this new CMS proposed rule seeks to eliminate a lengthy list of monitoring and reporting requirements across the agency's programs, saving healthcare providers approximately $178 million over the next three (3) years, including but not limited to the following:
Healthcare experts agree that reducing unnecessary burden spent complying with regulations is critical to improving patient care and reducing the risk of clinician burnout. One example is a study published in the Annals of Medicine which reported two hours of paperwork for every one hour of patient care. http://annals.org/aim/fullarticle/2614079/putting-patients-first-reducing-administrative-tasks-health-care-position-paper. In support of the "Patients Over Paperwork" initiative, CMS Administrator Seema Verma advocates that "we are committed to putting patients over paperwork while increasing quality of care, ensuring patient safety and bolstering program integrity." As a result, this new CMS proposed rule seeks to eliminate a lengthy list of monitoring and reporting requirements across the agency's programs, saving healthcare providers approximately $178 million over the next three (3) years, including but not limited to the following:
- Emergency programs. Program review at least every two (2) years, training at least annually, greater flexibility in conducting annual testing exercises, elimination of duplicative documentation requirements.
- Hospitals. Multi-hospital systems to have unified and integrated quality, performance improvement and infection control programs, elimination of duplicative autopsy requirements, greater flexibility in establishing medical staff policies for outpatient pre-surgery/procedure patient assessments and authorized use of non-physician practitioners in psychiatric hospitals.
- Critical Access Hospitals (CAH), Rural Health Centers (RHC) and Federally Qualified Health Centers (FQHC). Removes duplicative CAH ownership disclosure requirements, and only requiring biennial (every other year) review of policies and procedures for CAH, RHC and FQHC.
- Ambulatory Surgical Centers (ASC). Elimination of duplicative requirements governing transfers agreements and medical staff's local hospital admitting privileges, removal of current patient history and physical (H&P) requirements with a proposal to require ASCs to adopt a policy that identifies those patient categories who require H&P prior to surgery.
- Transplant Centers. Eliminate duplicative requirements to submit data and other information more than once for "re-approval" by Medicare.
- Hospices. Eliminating duplicative requirements, thus streamlining he hiring and training process for nursing assistants.
- Comprehensive Outpatient Rehabilitation Facilities (CORF). Moving to annual, as opposed to quarterly, utilization review plans.
- Community Mental Health Centers. Relaxing the 30-day assessment requirements only for those CMHC clients who receive partial hospitalization program services.
- Portable X-Ray Services. Allows services to be ordered in writing, by telephone or by other electronic methods and modernizes technologist personnel requirements.
This CMS proposed rule can be viewed in its entirety in the Federal Register, dated September 20, 2018, and comments may be submitted electronically until November 19, 2018. https://www.federalregister.gov/d/2018-19599
If you have questions or require additional information, please contact me through Integrity Health Strategies at sziel@ihsconsultinggroup.com. Thank you very much.
Thursday, August 30, 2018
On Wednesday, September 5, 2018, please join me for a 30-minute webinar at 12 noon (Eastern) to learn more about how to conduct a "real world" assessment of your organization's corporate compliance program and more importantly, how to breathe life into your program structure, process and outcomes. Register online, using the link below. Let's talk.
https://www.kriegdevault.com/events/1263-register
https://www.kriegdevault.com/events/1263-register
Sunday, August 12, 2018
HIPAA Assessments ... Here's Looking at You!
Whether you are the Privacy Officer, the Security Officer, or both, the question remains the same.
When was the last time you scheduled a "walk through" of your work space for the sole purpose of looking into the "eyeballs" of your personnel and finding out what they are really doing (or not doing) to protect the privacy and security of your customers' health information?
No, this is not the annual HIPAA security risk assessment. No, this is not a surprise, mock survey in preparation for some third party visit. Instead, you are simply showing up and letting your personnel know, first hand, that you really are interested in what they are actually doing to safeguard your customers' protected health information or "PHI." Nothing more.
In working with our HIPAA clients, we always recommend an annual HIPAA assessment calendar that sets out a series of compliance "questions" that will be reviewed -- one for each of the 12 months -- as part of an ongoing assessment process. The calendar can always be updated (or supplemented) as new questions or issues arise through the year.
For example, if this is January, then you may be in the HR department with the education coordinator reviewing a sample of personnel files to confirm that documentation exists to confirm completion of all new hire and annual HIPAA training. In March, you may join a supervisor and walk through their department work space at the end of the business day to look for any printed copies of PHI that may have been left on a counter or on a fax machine or in a "shred" bucket under their desk, all for easy "view" by the after-hours cleaning staff, or otherwise. .
In April, you may make rounds with the medical records staff to query them about how they work through their checklist for subpoenas and other third party requests for records. In August, you may meet with the CFO's contract manager to review a sample of vendor agreements that should include a fully executed Business Associate Agreement. In June, you may seat yourself in a public waiting area with one of the admissions staff and listen for any "incidental" disclosures that could be overheard by other customers and their family members who are seated nearby.
During September, you may request a current copy of your organization's "workstation" inventory and confirm whether its up-to-date by conducting an assessment of all computing devices - whether owned by the organization or workforce, including desktops, laptops, tablets, smartphones and "any other devices that perform similar functions" and which are used on (or off) premises. According to a May 2018 OCR Cyber Security Newsletter (link is https://www.hhs.gov/sites/d
Of course, HIPAA assessment worksheets can be used to score and report your observations to create a paper trail and to keep your leadership apprised, but it is the "eyeball" connection with your workforce that is truly the bottom line here.
Raise the bar, raise the awareness and show up. It only takes an hour once a month to get this done. Here's looking at you -- in your hallways and offices -- very soon!
No, this is not the annual HIPAA security risk assessment. No, this is not a surprise, mock survey in preparation for some third party visit. Instead, you are simply showing up and letting your personnel know, first hand, that you really are interested in what they are actually doing to safeguard your customers' protected health information or "PHI." Nothing more.
In working with our HIPAA clients, we always recommend an annual HIPAA assessment calendar that sets out a series of compliance "questions" that will be reviewed -- one for each of the 12 months -- as part of an ongoing assessment process. The calendar can always be updated (or supplemented) as new questions or issues arise through the year.
For example, if this is January, then you may be in the HR department with the education coordinator reviewing a sample of personnel files to confirm that documentation exists to confirm completion of all new hire and annual HIPAA training. In March, you may join a supervisor and walk through their department work space at the end of the business day to look for any printed copies of PHI that may have been left on a counter or on a fax machine or in a "shred" bucket under their desk, all for easy "view" by the after-hours cleaning staff, or otherwise. .
In April, you may make rounds with the medical records staff to query them about how they work through their checklist for subpoenas and other third party requests for records. In August, you may meet with the CFO's contract manager to review a sample of vendor agreements that should include a fully executed Business Associate Agreement. In June, you may seat yourself in a public waiting area with one of the admissions staff and listen for any "incidental" disclosures that could be overheard by other customers and their family members who are seated nearby.
During September, you may request a current copy of your organization's "workstation" inventory and confirm whether its up-to-date by conducting an assessment of all computing devices - whether owned by the organization or workforce, including desktops, laptops, tablets, smartphones and "any other devices that perform similar functions" and which are used on (or off) premises. According to a May 2018 OCR Cyber Security Newsletter (link is https://www.hhs.gov/sites/d
Of course, HIPAA assessment worksheets can be used to score and report your observations to create a paper trail and to keep your leadership apprised, but it is the "eyeball" connection with your workforce that is truly the bottom line here.
Raise the bar, raise the awareness and show up. It only takes an hour once a month to get this done. Here's looking at you -- in your hallways and offices -- very soon!
Susan E. Ziel, Consultant
Integrity Health Strategies
sziel@ihsconsultinggroup.com
Tuesday, March 6, 2018
Wicked Problems
They are called "wicked" problems. In our world, there are many examples. Inequality, illiteracy, terrorism, poverty, homelessness, famine and disease.
The literature is filled with discussions, definitions, models and frameworks, of course, but in an effort to dissect this literature, I recently used an online tool to test my ability to explain "wicked" problems in a new way. The tool only allows you to use the Ten Hundred most commonly used words in the Oxford English Dictionary (Note: the word "Thousand" isn't on the list.) The process was developed by scientists who wanted to help people in better describing and understanding hard ideas.
The links to some of the relevant literature, in addition to the online editor tool itself, are set out at the conclusion of this, my "top ten" wicked problem list, which still makes me smile today. Enjoy.
How good are you in explaining the many "hard ideas" in health care or otherwise? Give this tool your best shot next time you're working on a fresh message that just might reach your audience.
Links:
Gawande, Atul (2012). "Something Wicked This Way Comes," The New Yorker (June 28, 2012).
Hirschman, Albert O. The Rhetoric of Reaction: Perversity, Futility and Jeopardy. Belknap Press (2004).
Kolko, Jon, Wicked Problems, Problems Worth Solving. Austin Center for Design (2012).
https://www.wickedproblems.com/
RIttel, Horst W. J.; Webber, Melvin, M. (1973). "Dilemmas in a General Theory of Planning", Policy Sciences 4: 155-169.
Up-Goer Five Text Editor: http://splasho.com/upgoer5/
The literature is filled with discussions, definitions, models and frameworks, of course, but in an effort to dissect this literature, I recently used an online tool to test my ability to explain "wicked" problems in a new way. The tool only allows you to use the Ten Hundred most commonly used words in the Oxford English Dictionary (Note: the word "Thousand" isn't on the list.) The process was developed by scientists who wanted to help people in better describing and understanding hard ideas.
The links to some of the relevant literature, in addition to the online editor tool itself, are set out at the conclusion of this, my "top ten" wicked problem list, which still makes me smile today. Enjoy.
- A hard problem is a very large human problem.
- A hard problem can't be fixed for many reasons. First, a hard problem has deep and dark corners. Second, a hard problem is not easily understood because there are missing words and ever-changing meanings. Third, there are too many people who can't come together and agree on how to fix it.
- A type of hard problem is a world that can't grow food or find clean water. Another type is people who can't read or who always fight. Another type is people who have no money, no job or no home. Another type is people who are scared or sick.
- Every hard problem happens because of another hard problem.
- Different from hard problems, an easy problem can be understood and fixed. Even if not simple, an easy problem is like putting a human in a new place in the world or making children able to stop being sick.
- Trying to fix an easy problem either works or it doesn't. Trying to fix a hard problem is not the same -- things either get better or they get worse -- which is not always easy to see or like.
- Fixing a hard problem doesn't always last and it may cause or add to other hard problems, which makes most fixes hard to trust or accept, and easy to fight, for three reasons. First, humans often believe that the fix will only make the problem worse. Second, humans often believe that the fix is hard to do and it won't matter anyway. Third, humans often believe that the fix needs too much money and that we will lose more than we get in return.
- The real world of trying to fix hard problems is just that - hard. The problems always continue, change and grow, and the fixes never completely work, and the humans do not agree on anything.
- However, any human idea not to act or to try to fix a hard problem is also a big problem.
- All we can do is work together, and to try as best we can to try the fix the hard problems and to make our way forward in this crazy, yet amazing, world.
How good are you in explaining the many "hard ideas" in health care or otherwise? Give this tool your best shot next time you're working on a fresh message that just might reach your audience.
Links:
Gawande, Atul (2012). "Something Wicked This Way Comes," The New Yorker (June 28, 2012).
Hirschman, Albert O. The Rhetoric of Reaction: Perversity, Futility and Jeopardy. Belknap Press (2004).
Kolko, Jon, Wicked Problems, Problems Worth Solving. Austin Center for Design (2012).
https://www.wickedproblems.com/
RIttel, Horst W. J.; Webber, Melvin, M. (1973). "Dilemmas in a General Theory of Planning", Policy Sciences 4: 155-169.
Up-Goer Five Text Editor: http://splasho.com/upgoer5/
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