Leadership Forum
2003 Forum Summary
On June 20, 2003 The Dan Hanley Trust convened a group of 33 Maine Healthcare leaders to help develop recommendations for value driven leadership and improved health and healthcare in Maine by addressing three key questions:
- What is our vision of good health and healthcare in Maine in 2008?
- How will we measure success?
- What activities will be needed to achieve measurable success?
The Trust Advisory committee wishes to thank participants for their commitment to participate and their patience in this startup effort. Linking with existing efforts as well as building and improving on the first forum will help us realize a better vision of Healthy Maine 2008, support development of a cadre of value driven healthcare leaders in Maine, and improve health and healthcare in Maine.
Below is a summary of what was said. For the most part the actual words of participants are used. In some cases suggestions are combined for conciseness. The discussion and this summary are intended to support existing efforts (see initial list below), inspire further critical conversations and, where needed, catalyze additional collaboration and suggest priorities for young value driven leaders to analyze, discuss and perhaps present their suggestions at future forums.
The fourth column “Existing Initiatives/Critical Questions” is intended to be a working document which could support ongoing identification of existing programs and efforts in key areas.
The original intent was to select priority issues which young leaders and leading Maine heath organizations would address and present for discussion at the next annual forum. Because of time limitations the final consensus discussion did not occur. However certain themes did emerge in the process of reviewing the minutes and are presented below for discussion. The final selection awaits your input and advice.
Put prevention at the center. Make prevention an organizing principle of Maine's healthcare system, including promoting healthy behaviors and communities.
Align medical care and public health efforts. Integrate/ leverage medical care strategies aimed at improving the health of individuals with public health strategies aimed at improving the health of populations and communities.
Address financial barriers to providing and receiving good care, including disparities in reimbursement and “cost shifting”
Make collaborative care the standard by active partnerships between primary and specialty care, physicians and nursing; and patients and providers. Develop the communications skills, processes and medical record strategies that will support collaborative care and improved patient and provider satisfaction
Achieve greater "equality in the quality of care." Improve access, health professions training and information in ways that allow us to better identify and address undeserved areas and populations and gaps between current and optimal care.
2008 Health & Healthcare in Maine
| Vision | Measures of Success | Activities |
>Existing Initiatives/ Critical Questions |
|
Health Care System |
-Higher Patient satisfaction -Higher Provider satisfaction |
-Promote models of best practices to improve satisfaction and outcomes -Find and support existing initiatives** |
|
| The system will: Eliminate disparities: Have equity of access & quality for
|
-% of the population covered with an appropriate health insurance product. -Readily available published safety & quality data |
-Continue to bring together comprehensive data to monitor quality -Expand efforts to publish quality data -Engage medical community to improve quality. -Continue to work in area of quality & bring this proposal to the Maine Medical Assoc. |
|
| Maine will be the safest place to receive care | -Support Physician investment in information technology -% of Maine MD’s using EMR |
||
| Maine physicians will practice Evidence based Medicine (EBM) in partnership with patients |
-% of benefits packages which promote EBM | ||
| Maine will have improved provider communication. Maine will move away from the old paradigm of primary care as “gate keepers” to a new paradigm of “gate opener” or collaborative care, with support for collaboration between primary care and specialists Maine providers will have a culture of caring |
-% of physicians who are linked electronically -Patient & Provider satisfaction |
-Support communication skills & leadership training as part of Healthcare training at all levels. | |
| Maine will be a more affordable place to receive care. Maine will have improved efficiency of its healthcare system which will result in cost saving. Maine will have elimination of current cost shifting. Maine will have equitable reimbursement |
-Healthcare costs within 1% of CPI -↓ $ spent on administrative costs -↓ $ spent on end of life medical care |
[This measure is a budget regulation. What if future people decided to purchase more health care, how can they do it in a system like this?] | |
| Prevention will be at the center of Maine’s healthcare system |
-↑ % of resources spent on prevention. -100% of tobacco settlement $ will be spent on personal & community prevention. |
-Continue to bring people together to develop infrastructure for prevention | |
| Maine will have a healthcare planning process and structure in place which addresses professional education and regionalization. |
-Maine State Health plan exists. |
-Develop a collaborative, comprehensive State Health Plan (SHP) -Support a State Health Plan which blends public heath & medical care system |
|
| Maine will have an adequate high quality workforce |
-100% of providers & health educators will be involved in the Health Education Plan. -Maine education system will have the capacity to fill 90% of the projected workforce needs |
-Develop a comprehensive K-16th year Health Education System. -Incorporate what was learned today into USM Health Management Course. -Continue to work for public/ private healthcare workforce development & embrace principles of precautionary health. -Explore establishing a student Health policy internship -Support the Dan Hanley Trust efforts to build value driven leadership. -Support growing new young healthcare leadership in Maine. |
|
| Maine will have a useful population health data system. Maine will have a statewide human research program. |
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| Public health will be integrated into the healthcare system through a two way communication system | -Provide leadership for 2010 efforts to integrate Public Health & Healthcare System -Expand my efforts to work with clinical colleagues to expand tools for improving individual & population health -Work in my professional capacity to redirect health curriculum to reflect need to integrate public health & medical care -Fund a program which integrates public health & heath care |
||
| Health of Maine’s People/Communities Ordinary families will be engaged in their own heath promotion. The public will understand the drivers of cost & quality and their role in both. People will understand the value of supporting their neighbors health Maine will engage average citizens by working with local municipalities |
-Maine will be recognized as a national leader in health literacy. -Maine will go from the bottom 25% Healthy Lifestyles to the top 25%. -No child in Maine will smoke before 18. -Life expectancy is still going up. -The 5 leading health indicators will be improved. -↑ Disability adjusted years (DALY) -Maine Health index (sick/well) will be improved |
-Develop a written personal health report card to give to patients. -Understand better ways to facilitate healthy behaviors -Teach better communication skills to nurses & healthcare providers to support healthier families -Advocate for adequate tobacco treatment facilities in the community -Discuss healthy lifestyles with every patient. -Help consumers be active participants in their own care. -Test the Maine health index for brain injured patients. -Pursue my own personal health goals including exercise & weight loss -Establish a trail building committee in my community |
|
| Maine Environment Maine will achieve better health by supporting: A healthy physical environment:
Healthy social environments where people can overcome their social circumstances A healthy educational environment Especially supporting 0-5 entering school ready to learn: Healthy economic environments & jobs |
-100% of public water is fluoridated. High rates of communities involved in conservation. -Reduce % of population living in poverty -75% of the workforce earns a livable income -75% of school children are prepared for school. -% high school seniors going on to 13th year of school -66% of students from Maine entering college will graduate |
-Don’t give up in addressing the issue of family violence -Work to encourage college attendance by youth in my town. |
Maine Development Foundation |
**Existing Initiatives:
Maine Health Management
Maine Data Public Reporting (Dirigo)
Quality Forum (Dirigo)
Non Governmental initiative on environment
Dirigo Health
Healthy People 2010
MHDO/MHIC: Maine Health Data Processing Center
Disease Management Systems
Funds for Healthy Maine
Biomedical Research Initiative
Maine Development Foundation
Other?
Lessons Learned
“Leadership is based on strength wisdom and hope.”
“Effectiveness of collaboration- each person is important. Take a vision and make it happen.”
“There is a lot of commonality in vision in this room.”
“One person can make a difference.”
“Courage to act on conviction and values—without courage, you can’t act on your convictions.”
“Dan Hanley wasn’t an MPH or biomedical researcher, but he let the problem be the catalyst for his innovation. One doesn’t need to always be an expert.”
“Leadership of Dan Hanley was not driven by ego. He wanted people to accomplish things without worrying about the credit.”
“We can be more effective as change agents if we subordinate individual benefits to the greater good.
“Dan had a unique ability to recognize unique opportunity—to match people & resources. For example he saw a way to assuage my anger at the system by sending me to the AMA.”
“T he value of ‘time travel’& imagining & visualizing what can happen—“
“One person can make a difference.”
“The importance of Dan’s approach—he saw me: he smiled and recognized me.”
“In 30+ lifetimes you can accomplish a lot.”
“The importance of Dan Hanley in my own life and the need to grow similar leadership.”
“I didn’t realize ways in which we were touched by Dan and we probably don’t realize the potential we now have to shape the future of Maine health.”
“I recognize the opportunity created by bringing people together and inspiring people to do what they might not have otherwise done.”
“I have a sense of the things that allowed Dan Hanley to accomplish so much.”
“Lessons of kindness—being kind will help.”
“The complexity of issues and the need to look at the bigger issues.”
“We all want the same thing.”
“I will continue to work to make this forum a success and challenge you to send us what you will do, what you have learned, and how we can improve. We’d like you to make a commitment to take some actions big and small and we will try to build on existing initiatives by inviting more organizations that are already working on many of these issues.
We hope you will go back to your own organizations for suggestions and ways to achieve the vision that we’ve talked about today.”