Leading Reliable Healthcare

Leading Reliable Healthcare describes ?state of the art? healthcare management systems. The key focus of the publication is ?reliable?; describing how leadership can ensure never less than reliable standards of care for patients and how excellence can be achieved. The focus throughout is on ensuring that patients and their families can depend on a reliable healthcare system for their needs, fulfilling their expectations that hospitals are trustworthy, stable and capable of dealing with their health, from the simplest to the most complex illnesses.

Each of the chapters focuses on a different aspect of building a reliable healthcare system, concentrating on the leadership necessary to deliver and manage the different component elements of the healthcare system. The nominated contributors for this book are recognized leaders from various healthcare systems around the globe, including the UK, USA, Canada and South Korea/Singapore. The contributors have been selected to ensure a wide perspective of healthcare management, building on diverse approaches, practices and experiences, and are currently practicing healthcare management in their respective systems. The book aims to focus on the pragmatic rather than theoretical and will provide a series of practical methodologies and case studies to help improve decision making in healthcare management.

With contributions by:

• Sallie J. Weaver, PhD, MHS, Associate Professor, Armstrong Institute for Patient Safety and Quality and Dept. of Anesthesiology & Critical Care Medicine, John Hopkins University School of Medicine



• Susan Mascitelli, Senior Vice President, Patient Services & Liaison to the Board of Trustees, New York-Presbyterian Hospital





• Dr. Sandra Fenwick, Chief Executive Officer, Boston Children?s Hospital





• Martin A. Makary, MD, MPH, Professor of Surgery, Johns Hopkins University School of Medicine; Professor of Health Policy and Management, John Hopkins Bloomberg School of Public Health





• Frank Federico, RPh, Vice President, Institute for Healthcare Improvement





• Dr. Hanan Edrees, Manager, Quality Management, KAMC-Riyadh





• Dr. Hee Hwang, CIO and Associate Professor; Seoul National University Bundang Hospital, Department of Pediatrics, Division of pediatric Neurology, Center of Medical Informatics





• Dr. M. Andrew Padmos, Chief Executive Officer, The Royal College of Physicians and Surgeons of Canada





• Professor Richard Hobbs, Professor of Primary Care Health Sciences, Director, NIHR English School for Primary Care Research, Nuffield Department of Primary Care Health Sciences, University of Oxford





• Ms. Jules Martin, Managing Director, Central London Clinical Commissioning Group





• Dr. Bruno Holthof, Chief Executive Officer, Oxford University Hospitals





• Tara Donnelly, Chief Executive, Health Innovation Network, South London





• Göran Henriks, Chief Executive of Learning and Innovation, Qulturum, County Council of Jönköping, Sweden

Chapter 1: Developing the Organizational Culture

• How to develop a governance strategy which orients the organization towards achievement, competency, outcome and innovation.
• Methods on how to get staff to embrace the vision and mission of the organization and achieve a commitment to quality patient-centered care.
• How to involve patients and care givers in setting institutional goals.
• Preparation and implementation of codes of conduct in all levels of clinical and non-clinical staff.

Chapter 2: Leading Operational Effectiveness

• Effective implementation of policies and procedures
• Choice of measures of productivity and their delivery
• Devolution of responsibility, eg., by establishment of Departmental Performance Management Programs
• How to incentive staff engagement and empowerment
• Introduction to lean management techniques
• How to recruit and retain talent

Chapter 3: Leading Effective Clinical Practice

• Physician and healthcare worker engagement to establish clinical outcomes agenda
• Description and delivery of best clinical practice (adoption of guidelines and clinical pathways)
• Understanding patient flow and delivering timely healthcare
• Monitoring clinical outcomes for efficacy and safety
• International benchmarking of clinical outcomes

Chapter 4: Ensuring Patient Safety

• Introducing a Safety-First Culture

• Clarify accountability at every level of the organization
• How to strengthen safety reporting system
• A system for identifying and eliminating unsafe condition
• Introducing incentives to support a safety first culture

Chapter 5: Leading a High Reliability Organization

• How to adapt and apply the lessons of high-reliability science to enable hospitals to reach levels of quality and safety that are comparable to those of the best high-reliability organizations, such as the aviation and nuclear industries.
• Introduce a practical framework for assessing the hospitals’ readiness for and progress toward high reliability.
• Implementation of an incremental process to move the hospital to an appropriate level of reliability.

Chapter 6: Introducing Information Technology: a neural network for reliable healthcare

• Digital healthcare
• Value adding EMR
• Clinical decision support system
• Stability of the digital system
• Security of information
• Administrative, financial and logistic technology
• Digital disaster preparedness plan

Chapter 7: Ensuring Healthcare Education and Training to support organizational effectiveness

• Learning organization concept
• Talent management
• Skills maintenance and upgrade
• Staff development (physicians, nurses, allied health, managers, etc.)
• Targeted scholarship
• Career professional development
• Gap replacement
• Leadership education

Chapter 8: Leading Integration of Primary Healthcare and Hospitals

• Integrating preventative medicine and screening across the interface
• Clinical pathways and primary healthcare as a filter to prevent hospital overload
• How to shift elements of women and child health to the community
• Shifting the balance of chronic disease management to primary care

Chapter 9: The Introduction of Performance Parameters

• How to shift clinical quality indicators from process driven to clinical outcomes
• How to develop patient reported outcome measures
• Introducing business intelligence indicators

Chapter 10: Delivering better value in healthcare

• Using programmatic funding to support the introduction of value as a clinical concept
• Introducing rationing methodologies based on the incremental cost-effectiveness of new technologies
• Exploring the concept that investment in some new service development should be mirrored by disinvestment in services which add little clinical value

Chapter 11: Leadership Through Crisis

• The role of the leader and board of directors
• Preparing a disaster preparedness and risk management plan
• Description of the emergency response, encompassing; communication (both internal and external); staff engagement, staff and patient protection
• Using recovery from the crisis to leverage wider cultural change within the organization

Chapter 12: How to Deal with Innovation

• Robotic surgery
• Immunotherapy
• PET CT scanning linked to cyclotron production of radio-isotopes
• Generation of hospital based intellectual property and its commercialization

Dr. Bandar Al Knawy holds the position of Chief Executive Officer (CEO) at National Guard Health Affairs (NGHA), an organization which comprises three medical cities in the three major regions of Saudi Arabia as well as holding the position of President, King Saud bin Abdulaziz University for Health Sciences.

Dr. Al Knawy obtained his MBBS from King Abdulaziz University, Jeddah, Faculty of Medicine in June 1985. He completed his residency training in Internal Medicine in 1990 and obtained his Gastroenterology Fellowship in 1992 from Dalhousie University, Halifax, Nova Scotia, Canada. He holds a fellowship in Internal Medicine from the American and Canadian Boards, as well as the American Board Certification in Gastroenterology. In addition, Dr. Al Knawy has been a Fellow of the Royal College of Physicians and Surgeons of Canada since 1991.

Dr. Al Knawy is a strong advocate of Quality and Patient Safety and pioneered the development of the Medication Safety Programme in Saudi Arabia in addition to many Patient Safety initiatives at NGHA.

Dr. Al Knawy has had numerous scientific and medical articles published in international journals. He is the guest editor of the February 2010 issue of Clinics in Liver Disease – Healthcare Associated Transmission of Hepatitis B & C Viruses. Dr Al Knawy is the authorship of the book entitled "Hepatology: A Practical Approach" published in December 2004 and also a textbook entitled Hepatocellular Carcinoma: A Practical Approach" released in September 2009.

Dr. Al Knawy is a highly skilled and qualified medical professional who is committed to provide, with all sincerity and dedication, the highest quality patient care for the betterment and the development, of National Guard Health Affairs.