A Toolkit for Redesign in Health Care: Final Report
The broader and deeper the scope of the redesign effort of a hospital, the more likely redesign produces system-wide transformation. For the purposes of this project, "redesign" and "system transformation" will both be used to describe the desired process outcomes.
In October 2003, Denver Health began a major effort to redesign/transform the process of care in the hospital in a comprehensive manner. This project was supported by the Agency for Healthcare Research and Quality through Contract No. 290-00-0014.
This document presents the following information:
- A brief description of Denver Health gives context for the redesign process. It enables others to identify the attributes of their system that are similar to or different from those of Denver Health and to assess how these attributes may influence their application of the approach to redesign described below.
- Forces that compel health care systems to embark on redesign or system transformation.
- Steps to be taken in planning for redesign/system transformation. In general, the steps are listed and discussed in the temporal sequence in which they occurred. Following these steps in this sequence will provide a robust approach for planning redesign.
- Strategies for translating information gathered into proposed projects for implementation.This is presented to show the depth and breadth of activities which can emerge from the planning process.Some of the proposed projects which emerged from Denver Health's planning process may be different from those that would emerge from another institution's planning, depending in part on the forces that affect the institution and the information arising from its external and internal data gathering. However, delineating the projects provides examples for consideration.
- Potential metrics for use in the implementation phase.The metrics would vary to some extent, depending on the nature of the projects to be undertaken. However, the system metrics that suggested here should be useful capturing meaningful change at the system level.
The information detailed in this report provides an approach to redesign utilized by Denver Health. It is presented here with the intent to help others who wish to undertake the process of redesign or system transformation.
The implementation phase has just begun, so this document does not provide information on the actual implementation of the redesign process or data on outcomes of redesign.