tag:blogger.com,1999:blog-75300436522899091362024-02-19T02:54:45.194-05:00Stroke Pathways ProjectA comprehensive strategic design approach to health care solutionsMarco Steinberghttp://www.blogger.com/profile/14786788398940005839noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-7530043652289909136.post-62799531967698622972008-05-26T15:54:00.008-04:002008-05-30T08:45:18.187-04:00<p class="MsoNormal"><b><span style=";font-family:Arial;color:black;" >Stroke and Strategic Design</span></b><span style="font-family:Arial;"><o:p></o:p></span></p> <u1:p></u1:p> <p class="MsoNormal"><span style=";font-family:Arial;color:black;" >When we looked at the current system for stroke care, we identified two fundamental problems: It is set up to deliver a <b>standard</b> range of care for individual needs and it does so within a <b>fragmented</b> delivery system that varies by region, city, hospital and physician. All of these fragmented activities occur in separate realms driven by their own internal logics. Strategic design is a critical new perspective for stroke care. Current care improvement efforts focus on policy or on process improvement. Without a strategic component, even excellent tactical approaches may simply make poorly conceived care principles more efficient.</span><span style="font-family:Arial;"><o:p></o:p></span></p> <p class="MsoNormal"><b><span style="font-family:Arial;">Approach</span></b><span style="font-family:Arial;"><o:p></o:p><br /></span></p><ul><li><span style="font-family:Arial;">A full care cycle approach to care-innovations (prevention, acute therapy, long-term needs)<o:p></o:p></span></li><li><span style="font-family:Arial;">A systems approach to care delivery, focused on strategic improvements <o:p></o:p></span> <u1:p></u1:p> </li><li><span style="font-family:Arial;">A design-centric approach to problem solving<o:p></o:p></span><span style="font-family:Arial;"><o:p></o:p></span><br /></li></ul> <p class="MsoNormal"><b><span style="font-family:Arial;">Objectives</span></b><span style="font-family:Arial;"><br />Improved patient outcomes (mortality, morbidity, quality of life) at lower costs<b face="arial"><br /><u1:p></u1:p><br />Products</b> <span style="color:black;"><br />Our work delivered the following </span><o:p></o:p></span></p> <u1:p></u1:p> <p class="MsoNormal"><span style=";font-family:Arial;color:black;" >1. A <b>methodology</b> for looking at complex systems </span><span style="font-family:Arial;"><o:p></o:p></span><span style=";font-family:Arial;color:black;" ><br />2. A <b>strategic roadmap</b> to improving outcomes at lower costs</span><span style="font-family:Arial;"><o:p></o:p></span> <u1:p></u1:p><br /><span style=";font-family:Arial;color:black;" >3. </span><span style="font-family:Arial;">Defining the <b>“top 10” </b>areas of opportunity for improvement<br /><u1:p></u1:p><br />and we are currently developing<br /><u1:p></u1:p><br />4. <b>Pilots</b> to demonstrate effective improvement<br />5. A methodology defining the <b>science of implementation</b><o:p></o:p></span></p> <p class="MsoNormal"><o:p> </o:p></p> <div style="text-align: left;"><span style=";font-family:Arial;font-size:9;" ><b style=""><span style="font-family:arial;"></span><o:p></o:p></b></span></div>Marco Steinberghttp://www.blogger.com/profile/14786788398940005839noreply@blogger.comtag:blogger.com,1999:blog-7530043652289909136.post-19089519722585122082008-05-26T15:02:00.002-04:002008-05-30T08:58:17.909-04:00Our "TOP 10" System improvement opportunities<a style="font-weight: bold;" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUlAPPX-6_jpBl6zI0FmvfYk-JI_qctYSvz8FXcVUGzw4P4g29Izzz6oVuDLvC7rm1G2TYe7-xvlhCkvni9F7IhyG63WP2w8bcjDu_Kmaq1LR8oolnGfaIvczQL8wVCl70vZVoJRoYKQs/s1600-h/Presentation2.jpg"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUlAPPX-6_jpBl6zI0FmvfYk-JI_qctYSvz8FXcVUGzw4P4g29Izzz6oVuDLvC7rm1G2TYe7-xvlhCkvni9F7IhyG63WP2w8bcjDu_Kmaq1LR8oolnGfaIvczQL8wVCl70vZVoJRoYKQs/s320/Presentation2.jpg" alt="" id="BLOGGER_PHOTO_ID_5204764184237027810" border="0" /></a><span style="font-family:arial;">Our </span><span style="font-family:arial;">system design</span><span style="font-family:arial;"> approach looked at stroke from a </span><span style="font-family:arial;">full care cycle perspective</span><span style="font-family:arial;">. We defined this into three distinct but interrelated phases:</span><br /><br /><span style="font-weight: bold;font-family:arial;" >1. Before a stroke </span><span style="font-family:arial;">(includes prevention)</span><br /><span style="font-weight: bold;font-family:arial;" >2. Acute</span><br /><span style="font-weight: bold;font-family:arial;" >3. After a stroke </span><span style="font-family:arial;">(</span><span style="font-family:arial;">includes rehabilitation and long term needs)</span><br /><br /><span style="font-family:arial;">The diagram shows our framework overlaid with the opportunities.<br /><br /><span style="font-style: italic;">Click on image for closer look</span><br /></span>Marco Steinberghttp://www.blogger.com/profile/14786788398940005839noreply@blogger.comtag:blogger.com,1999:blog-7530043652289909136.post-4157899318742476722008-05-26T13:35:00.009-04:002010-03-10T15:10:35.340-05:00North Carolina Pilot<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiWHixrLfGD4apaDPl4dWoef6P8YhQzonmrhTPLz9os3e4uTeGQirfzImyl8kyvDSRYrLiLrVcJl0-r3vwLNSshO10MqHNR0lRgHdBj4Fe_XPTckJIgx_BuVoTF92rdE4d802eBsGVlEw/s1600-h/US+Stroke+Map.jpg"><img style="margin: 0pt 10px 10px 0pt; float: left; cursor: pointer;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiWHixrLfGD4apaDPl4dWoef6P8YhQzonmrhTPLz9os3e4uTeGQirfzImyl8kyvDSRYrLiLrVcJl0-r3vwLNSshO10MqHNR0lRgHdBj4Fe_XPTckJIgx_BuVoTF92rdE4d802eBsGVlEw/s320/US+Stroke+Map.jpg" alt="" id="BLOGGER_PHOTO_ID_5204744813934522738" border="0" /></a><span style="font-family:arial;">We are currently working to implement a unique care delivery system in the heart of America’s Stroke Belt that would improve stroke outcomes, reduce costs, and extend the reach of care to underserved communities in North Carolina while building a replicable model nationwide.</span><br /><br /><span style=";font-family:Arial;font-size:10px;" ><span style=""><span class="msoIns"><ins cite="mailto:Computer%20Resources" datetime="2007-12-03T12:33"><!--[if gte vml 1]><v:shapetype id="_x0000_t75" coordsize="21600,21600" spt="75" preferrelative="t" path="m@4@5l@4@11@9@11@9@5xe" filled="f" stroked="f"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:formulas> <v:path extrusionok="f" gradientshapeok="t" connecttype="rect"> <o:lock ext="edit" aspectratio="t"> </v:shapetype><v:shape id="_x0000_i1025" type="#_x0000_t75" style="'width:240pt;"> <v:imagedata src="file:///C:\DOCUME~1\steinber\LOCALS~1\Temp\msohtml1\01\clip_image001.jpg" title="US Stroke Map II" cropright="4228f"> </v:shape><![endif]--><!--[if !vml]--><!--[endif]--></ins></span></span></span><br /><span style="font-weight: bold;font-family:arial;" >A NEW STROKE DELIVERY MODEL</span><br /><br /><span style="font-family:arial;">North Carolina has the 4th highest stroke mortality rate in the nation (twice the national average) and while improvements have been made in stroke care, the overall system of care is far from where it can be.</span><br /><br /><span style="font-family:arial;">The idea is to extend the reach of care to underserved communities in Robeson County through Lumberton’s <a href="http://www.srmc.org/">Southeastern Regional Medical Center </a>(SRMC). This is made possible by an integrated knowledge, team, and service model between SRMC and the <a href="http://www.unchealthcare.org/site/aboutus/ncneuroscienceshospital">North Carolina Neurosciences Hospital</a> at UNC (NSH-UNC):</span><br /><br /><span style="font-family:arial;">1. Partner with the existing stroke services at the North Carolina Neurosciences Hospital at the University of North Carolina (NSH-UNC).</span><br /><span style="font-family:arial;">2. Implement a new stroke patient segmentation system to better match care needs with therapy options</span><br /><span style="font-family:arial;">3. Extend the reach of care to underserved communities in Robeson County through Lumberton’s Southeastern Regional Medical Center (SRMC).</span><br /><span style="font-family:arial;">4. Apply our System Design know-how to redesign and integrate a new comprehensive delivery system to better serve patient outcomes at lower costs.</span><br /><br /><span style="font-family:arial;">Our approach is unique in that it is based on:</span><br /><span style="font-family:arial;">1. Triaging stroke patients along an <span style="font-weight: bold;">integrated, </span><span style="font-weight: bold;">full care cycle</span><br />2. <span style="font-weight: bold;">Segmenting patients by imaging-based acuity</span> to match them with most effective care<br /></span><span style="font-family:arial;">3. A hub and spoke delivery model to <span style="font-weight: bold;">extend care to rural, underserved communities</span></span><br /><br /><span style="font-family:arial;">We believe we have the right strategic insights, stakeholder buy-in, decision making support, and team partnership to implement a successful and robust system.</span><br /><br /><span style="font-family:arial;">If you are interested in learning more, please contact us at:<br /><br />Marco Steinberg<br />Director of Strategic Design<br /><a href="http://www.sitra.fi/en/">SITRA, the Finnish Innovation Fund</a><br />marco.steinberg@sitra.fi</span><span style="font-family:arial;"><span style="font-weight: bold;"><br /></span></span><input id="gwProxy" type="hidden"><!--Session data--><input onclick="jsCall();" id="jsProxy" type="hidden"><div id="refHTML"></div><input id="gwProxy" type="hidden"><!--Session data--><input onclick="jsCall();" id="jsProxy" type="hidden"><div id="refHTML"></div><input id="gwProxy" type="hidden"><!--Session data--><input onclick="jsCall();" id="jsProxy" type="hidden"><div id="refHTML"></div><input id="gwProxy" type="hidden"><!--Session data--><input onclick="jsCall();" id="jsProxy" type="hidden"><div id="refHTML"></div><input id="gwProxy" type="hidden"><!--Session data--><input onclick="jsCall();" id="jsProxy" type="hidden"><div id="refHTML"></div>Marco Steinberghttp://www.blogger.com/profile/14786788398940005839noreply@blogger.com