WINNIPEG REGIONAL
HEALTH AUTHORITY
2012 Supply Chain Forum
Innovation in Health Care
Dan Skwarchuk, Executive Director,
Health Services Integration and Innovation
Winnipeg Regional Health Authority
November 21, 2012
Health Innovation as a Literary “Trend”
University of Manitoba Library search…
Found over 268,000 published articles on file
Total Published Articles (Annual), 2003-2009
40,000
35,000
30,000
25,000
20,000
15,000
10,000
5,000
0
2003
2005
2007
2009
Literary “Trend” Cont’d…
Generally, across the literature, health innovation usually
falls into the following broad categories:
•
Research
•
New products and technologies
•
New processes and approaches
•
New ways of thinking
•
New ways to use people
•
Doing more with similar or fewer resources
(productivity and efficiency)
WRHA Strategic Plan - Innovation
• Maximize benefits from
research, development &
innovation including the
increased use of evidence
informed decision making.
• Improve productivity through
process improvement, service
reconfiguration and
benchmarking
The WRHA Views of Innovation
Innovation refers to a process
through which economic or
social value is extracted from
knowledge through the
generation, development, and
implementation of ideas to
produce new or significantly
improved products,
processes, and services.
Model of sustaining innovation
Christensen et al. (2009)
The Innovator’s Prescription
Christensen et al. (2009)
The Innovator’s Prescription
Innovation within the WRHA
Some (selective) examples include:
•
Bell Hotel Redevelopment Project (new thinking)
•
Use of evidence in contracting (processes)
•
Nurse Practitioners and Physician Assistants (people)
•
Manitoba Renal Program’s new Nurse-Led Telehealth
Service (technology)
•
Business Process Solution Project (processes)
•
Home-based specialty services (new thinking)
•
Unit-level inventory process improvement (processes)
Workplan for Innovation in the WRHA
• Overall need to develop a culture of innovation with
supports to go outside of normal boundaries.
• Committee with focus on fostering and incubating
innovative ideas within the WHR.
• Inventory of innovation in the WHR.
• Provision of seed funding for innovative ideas.
• Tolerance for failure and not punitive when innovative
ideas fail. Learn from mistakes.
• Better understanding of tolerable risks.
Draft - Enterprise Risk Management Risk Universe
Strategic
Governance &
Leadership
 Governance
• Board Structure &
Performance
•Culture and Ethics
•Control/Risk Environment
•Social Responsibility
 Planning and
Resource Allocation
•Organizational Structure
•Strategic Planning
•HR Strategy
•IT Strategy
•Partnership Development
& Management
 External
Environment
•Demographics
•Lifestyle Trends
•Socio-Political
•Economic Factors
•Hazards (Pandemic,
terrorism, natural disasters,
etc)
•Business Continuity
Major Initiatives
•Vision and Direction
•Planning and Execution
•Measurement and
Monitoring
•Business Acceptance
Corporate
Reputation
Stakeholder
Relations
Operational
Patient Care
Human
Resources
Communication Service Delivery  Recruitment,
•Admission, Transfer and Selection &
and Relations
Discharge
• Public and Media
Retention
•Assessment &
Relations
•Patient Relations
•Government Relations
•Employee
Communication
•Vendor Relations
•Union Relations
•Crisis Communication
Diagnostics
•Care & Service
Accessibility
•Care Plan/ Service Plan
•Treatment
•Coordination of Services
•Patient Rights
•Medication Management
Support
Services
•Supply Chain
•Food and Laundry
Services
•Facilities Management
•Health Information
Management
Patient Safety
•Infection Prevention
Control
•Incident Reporting
•Education & Training
•Security
•Credentialing
•Medical staff
•Support staff
•Contractual staff
•Employment Equity
 Development
& Performance
•Training and Education
•Succession Planning
• Performance
Management
Labor
Relations
•Labor Agreements
•Contingency Planning
Information
Technology
Compliance
Financial
Compliance
Financial
Physical
Assets
IT Management Asset
• E-Health
Management
Access &
•Replacement Management
Security
Capital/
Construction
System
Acquisition &
Reliability &
Disposal
Continuity
•Asset Acquisition
•Back up and recovery
•Disaster Recovery
System
Integrity
•Commitment Tracking &
Processing
• Contract/Project
Management
• Asset Disposal
End User
Support &
Education
Equipment
Acquisition,
Maintenance &
Disposal
•Equipment Acquisition
•Commitment Tracking &
Processing
deployment and
• Contract Management
retirement
•Maintenance
•Inventory Management •Equipment Obsolescence
& Disposal
Compensation Infrastructure
& Benefits
•Asset replacement,
•Salary Administration
and Compensation
Management
Employee
Safety
• Health and Safety
Site/Asset
Security
• Asset storage & handling
• Facilities
•Security and Access
 Inventory
Management
• Contract Management
•Distribution
•Inventory Shrinkage and
Obsolescence
•Valuation
•Product Recalls
Standards of
Business Conduct
•Ethics
•Fraud
•Conflict of Interest
•Industry Relations
Legal &
Regulatory
• Governing Legislation,
Bylaws & Regulations
•Contractual Agreements
•Professional Regulatory
Bodies
•Prescribed Standards of
Practice
•Data Protection
• Privacy
•Environmental, Health &
Safety
•Research
•Facility Standards
•Procurement Practices
•Patient Safety
•Intellectual Property
Funding
•Capital
•Operating
•Debt
•Foundation
Market
•Interest Rates
•Foreign Exchange
•Financial Instruments
•Investments
Liquidity and
Credit
•Cash Management
•Credit and Collections
•Insurance
Accounting and
Reporting
• Accounting, Reporting &
Disclosure
•Internal Control
Requirements
•Trust Accounts/Special
Purpose Accounts
Pension Funding
Budgeting and
Forecasting
Taxes (Property,
Commodity)
“If you're not failing every now and again,
it's a sign you're not doing anything very
innovative.”
- Woody Allen
Enablers of Innovation
• Need for improved knowledge translation:
-
Improved spread and adoption of new and best practices
Innovation rounds and storytelling
Increased public and provider engagement
Enhanced supports for publications
Awards – but celebrating the successes as well as failures
Development of Innovation Community of Practice
• Health Sciences Centre Foundation
• Innovation Council of Manitoba
• St. Boniface Hospital Research Centre
• Manitoba Health Innovation Branch
• Professional Associations
• Manitoba Centre for Health Policy
• University of Manitoba Centre for Health
• Business Community
Innovation (Faculty of Medicine)
• University of Manitoba – Other Faculties
(mechanic, computer, and biosystem
engineering)
• University of Winnipeg
• Red River College
• Business Council of Manitoba
How Can We Collaborate
More Effectively with the
Business Community in
Health Innovation?
First some context…
Understanding the WRHA Structure
Primary Care
Community Health
Centres
Family Physicians
Home Care
Mental Health
Neighbourhood
Networks
Secondary and
Tertiary Care
Long Term Care
Concordia
Grace
Health Sciences
St. Boniface
Seven Oaks
Victoria
Chronic Care
Central Assessment and
Placement
Deer Lodge Centre
Misericordia
Personal Care Homes
Respite Care
Palliative Care
Rehab/Geriatrics
Riverview
Services to Seniors
Public Health
Childhood  Youth  Young Families 
Prevention
Promotion Protection
Primary Treatment
Acute Intervention
Middle Age 
Seniors
Supportive and
Restorative
Services
21
Community Areas in
Winnipeg
West St. Paul
East
St. Paul
8
1) St. James
2) Assiniboine South
9
3) Fort Garry
10
4) St. Vital
5) St.Boniface
6) Transcona
6
11
1
12
7) River East
8) Seven Oaks
7
5
2
9) Inkster
10) Point Douglas
11) Downtown
3
4
12) River Heights
22
The WRHA Matrix Structure
Regional Programs
River East /
Transcona
Downtown /
Point Douglas
Primary Care
X
X
Home Care
X
X
Mental Health
X
X
Internal Medicine
Health Science
Centre
Seven Oaks
Hospital
X
X
X
Family Medicine
X
Renal Health
Personal Care Home
X
X
X
X
Note: This is just a excerpt
The WRHA Matrix Structure
(What this Means to Contracting)
Regional Clinical Programs
• Strategic Planning
• Quality and Standards
(including clinical contracting)
• Centralized Operations
Hospitals & Community Areas
• Day-to-Day Operations
• Managing to Quality
• Managing to Budget
(volume and price)
Contracting Groups
(PRES Groups)
n=147 Groups
Members = 1,100
Employees
WRHA and Product Innovations
Current Processes – Challenging!
Innovative
Idea or Product
Business
Community
WRHA
Logistics
Services
PRES Group (n=147)
Regional Program (n=30)
Hospital or Area (n=15)
How Can We Collaborate More
Effectively with the Business
Community in Health Innovation?
Improved knowledge sharing
• Our priorities and your interests?
• Push AND pull innovations?
Contracting flexibility for innovation
• Less stringent RFP criteria?
• More focus on problem versus solution?
Improved access
• PRES Groups?
• Regional Programs?
• Hospitals and Community Area?
• Help in system navigation?
Contract clarity on innovation
• Proof of concept costs?
• Key risks and mitigation?
• Knowledge translation responsibility?
Thank-you
Questions?
Breakout Session
1:30 pm to 2:45 pm
Followed by 30 min Break &
Networking Opportunity
Breakout Sessions
•
•
•
•
•
Group 1- Mapleleaf room A
Group 2- Mapleleaf room B
Group 3- Evergreen Room (main room)
Group 4- Spruce Room (through the restaurant)
Group 5- Elm Room