Catalysis News http://feed.informer.com/digests/KLQN7YPJZV/feeder Catalysis News Respective post owners and feed distributors Tue, 22 Nov 2016 12:42:09 -0600 Feed Informer http://feed.informer.com/ Podcast, The Lens – 33. Discussion with Process Improvement Leaders https://createvalue.org/articles_and_news/podcast-lens-33-discussion-process-improvement-leaders/ ThedaCare Center for Healthcare Value » Articles & News urn:uuid:40aa539d-1601-dbff-372a-8f928d2345aa Mon, 12 Jul 2021 08:20:55 -0500 <p>            Today we have a special treat for our listeners. We will be sharing a segment of the PI leader discussion panel from our Summit in June. The panel features Penny Iannelli from UMass Memorial Health Care, Carlos Scholz from The Permanente Medical Group, and Yvett Sena from UNM Health [&#8230;]</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/podcast-lens-33-discussion-process-improvement-leaders/">Podcast, The Lens &#8211; 33. Discussion with Process Improvement Leaders</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> <p><iframe src="https://anchor.fm/the-lens-by-catalysis/embed/episodes/33--Insights-from-Process-Improvement-Leaders-e146h98" width="400px" height="102px" frameborder="0" scrolling="no"></iframe></p> <div><a href="https://podcasts.apple.com/us/podcast/the-lens/id1498519918?uo=4"><img loading="lazy" class=" wp-image-15447 alignnone" src="https://createvalue.org/wp-content/uploads/apple-podcasts-300x90.jpg" alt="" width="253" height="76" srcset="https://createvalue.org/wp-content/uploads/apple-podcasts-300x90.jpg 300w, https://createvalue.org/wp-content/uploads/apple-podcasts-1024x308.jpg 1024w, https://createvalue.org/wp-content/uploads/apple-podcasts-768x231.jpg 768w, https://createvalue.org/wp-content/uploads/apple-podcasts-90x27.jpg 90w, https://createvalue.org/wp-content/uploads/apple-podcasts-150x45.jpg 150w, https://createvalue.org/wp-content/uploads/apple-podcasts-250x75.jpg 250w, https://createvalue.org/wp-content/uploads/apple-podcasts.jpg 1129w" sizes="(max-width: 253px) 100vw, 253px" /></a>             <a href="https://open.spotify.com/show/5X3IctwRvIYFKgHCPzGB6f" target="_blank" rel="noopener noreferrer"><img loading="lazy" class=" wp-image-15448 alignnone" src="https://createvalue.org/wp-content/uploads/images-300x83.png" alt="" width="246" height="68" srcset="https://createvalue.org/wp-content/uploads/images-300x83.png 300w, https://createvalue.org/wp-content/uploads/images-90x25.png 90w, https://createvalue.org/wp-content/uploads/images-150x41.png 150w, https://createvalue.org/wp-content/uploads/images-250x69.png 250w, https://createvalue.org/wp-content/uploads/images.png 428w" sizes="(max-width: 246px) 100vw, 246px" /></a></div> <p>Today we have a special treat for our listeners. We will be sharing a segment of the PI leader discussion panel from our Summit in June. The panel features Penny Iannelli from UMass Memorial Health Care, Carlos Scholz from The Permanente Medical Group, and Yvett Sena from UNM Health System. The session is moderated by my colleague, Chris Weisbrod. These improvement leaders share insights about their lean journey.</p> <h3><strong>Related Items</strong></h3> <p><a href="https://createvalue.org/summit-usa/" target="_blank" rel="noopener">Lean Healthcare Transformation Summit</a></p> <p>Catalysis <a href="https://createvalue.org/networks/healthcare-value-network/" target="_blank" rel="noopener">Healthcare Value Network</a></p> <p><a href="https://createvalue.org/transformation-roadmap/" target="_blank" rel="noopener">Transformation Roadmap</a> Services</p> <p>Catalysis Academy <a href="https://createvalue.org/catalysis-academy-organizational-subscriptions/" target="_blank" rel="noopener">Organizational Subscriptions</a></p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/podcast-lens-33-discussion-process-improvement-leaders/">Podcast, The Lens &#8211; 33. Discussion with Process Improvement Leaders</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> Electronic Health Records: A Radical Shift Beginning to Realize a Much Broader Promise https://createvalue.org/articles_and_news/electronic-health-records-a-radical-shift-beginning-to-realize-a-much-broader-promise/ ThedaCare Center for Healthcare Value » Articles & News urn:uuid:bff75eef-d551-ccd5-0469-91b46a2e1fed Thu, 08 Jul 2021 11:08:26 -0500 <p>The conversion of paper medical charts to digital has been a massive effort over the past 10 to 15 years. The energy has led to the creation of an integrated patient record with every bit of information needed to provide diagnosis treatment and prevention while allowing full access of information to the patient. In this [&#8230;]</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/electronic-health-records-a-radical-shift-beginning-to-realize-a-much-broader-promise/">Electronic Health Records: A Radical Shift Beginning to Realize a Much Broader Promise</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> <p>The conversion of paper medical charts to digital has been a massive effort over the past 10 to 15 years. The energy has led to the creation of an integrated patient record with every bit of information needed to provide diagnosis treatment and prevention while allowing full access of information to the patient. In this process EHR companies have been criticized for not being on the fore front of innovation. But this is far from the truth. Many radical shifts in technology have led to unforeseen downstream effects. Examples include the internet which enabled ecommerce, electric cars enabling self-automation, and the iPhone allowing complex computations with apps. The electronic health record (EHR) is a radical shift that is beginning to realize it’s promise, particularly in four key areas: data supporting care improvement, data supporting diagnostics, treatment, and discovery, usability, and interoperability.  </p> <h3><strong>Data that Supports Care</strong></h3> <p>EHR companies, which had been focused on making sure EHR systems were populated with all the clinical data needed for patient care, now can build systems that allow the data to be extracted in ways to improve care at the point it is delivered. But for the companies to assist managers of provider organizations in building real-time information flow systems, managers must first define their organization&#8217;s data needs. </p> <p>The EHR contains a lot of point-of-care-data, but this must be organized in a fashion that allows caregivers to make fast, accurate decisions in real time to improve care processes quickly.  For instance, Morningside Mount Sinai (MMS) in New York City built a data command center in spring 2020 that transformed how staff saw Covid-19 patients. MMS managers worked with EHR programmers to create a digital display in a large meeting room so that managers could see, minute by minute, information on the status and location of Covid-19-positive patients as well as those under investigation for possible infection. (Reference <a href="https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0020" target="_blank" rel="noopener">NEJM Catalyst article</a>)</p> <p>This information provided immediate insight into the need for additional beds, locations of possible infectious outbreaks, and areas where staff might be overly stressed. Other information included deaths, discharges, and movement of patients with Covid-19. The immediate availability of this information was vital for planning the many patient movements that were required for safety and was core to the decision to add 60 critical-care beds at MMS within a very tight time frame.</p> <h3><strong>Data Supporting Diagnostics, Treatment and Discovery</strong></h3> <p>EHR innovations are changing the face of medical diagnostics, treatment, and discovery. Large databases of information have been created by merging millions of de-identified patient records with the goal to improve care for all. With the eventual full participation of all EHR customers, these databases will include more than 200 million patient charts. But even now, with about 100 million records, doctors can compare a group of similar patients and determine the best treatment for their individual patient based on similar comorbidities, age, sex, and so on. Rare diseases can be diagnosed, and treatment begun more swiftly as providers who treat these patients can connect with each other.  </p> <p>This vast observational database is creating immense opportunities to conduct research that takes days, not years, to complete. A common data source is also leading to ways to share information quickly such as the <a href="https://ehrn.org/" target="_blank" rel="noopener">Epic Health Research Network</a> (EHRN), an open-access journal designed for rapidly sharing knowledge to help solve medical problems. Any organization can submit articles, which are peer reviewed by EHRN staff and then immediately shared. Studies that have emerged on EHRN include the <a href="https://ehrn.org/articles/delayed-cancer-screenings-a-second-look" target="_blank" rel="noopener">first evidence</a> that COVID-19 had resulted in delayed cancer screenings  and that <a href="https://www.fiercehealthcare.com/tech/industry-voices-epic-s-judy-faulkner-and-john-toussaint-observational-ehr-data-powering-fight" target="_blank" rel="noopener">anticoagulation is an important early treatment</a> for severely ill patients with COVID-19.</p> <p>Another emerging area of discovery has been the EHR impact on Covid-19 vaccinations. EHRs have been used to identify priority populations based on age, risk factors, and occupation. Health systems can then use patient portals to send targeted notifications and communications to patients. This same data can be used in mobile apps by patients or by caregivers working with underserved communities to match patients with vaccine availability and make appointments. And finally, healthcare organizations can share the vaccine data in real time with state and local immunization information systems, public health agencies, and tribal departments. Some states such as <a href="https://www.epic.com/epic/post/unlikely-pairing-uncommon-times-governor-recruits-healthcare-software-company-epic-covid-19-response" target="_blank" rel="noopener">Wisconsin</a> have already enlisted the help of an EHR vendor to manage all vaccine information for the state.</p> <h3><strong>Usability</strong></h3> <p>The real breakthrough here is the emerging use of artificial intelligence (AI) and interfaces such as voice recognition to relieve the EHR burden on clinicians. Systems now exist that allow caregivers to call up specific records – lab reports, medication lists, x-ray results – by voice command to review with patient’s mid-exam. Likewise, providers can call out examination data during the patient visit and software allows for the entire visit to be recorded, transcribed, and documented. Very soon, physicians will be able to compare patient symptoms easily and quickly against the observational data base to fine-tune therapies based on the patient’s age, comorbidities, weight, and so on.</p> <p>While most health care systems have yet to adopt these technologies, many have taken steps to make their EHRs more user-friendly or to reduce the amount of time that clinicians must devote to them. For instance, some have had their physician “super users” of EHRs (those who are experts in using them) design simplified EHR templates of the best ways to document the care that is delivered in the exam room. And some vendors have also developed efficient processes for providers to follow.</p> <p>Separately, many health care systems have moved to having less-skilled staff enter much of the data. Medical assistants, for example, do medication reconciliation and take and input information such as the initial vitals and chief complaint. Then the provider can simply focus on the patient and then document key parts of his or her history on templates that are easy to use.</p> <h3><strong>Interoperability</strong></h3> <p>For years, the inability of the EHR system of one vendor to easily exchange information with those of other vendors has posed a problem. But much work has been done to break down these walls. Surveys conducted by the independent research firm <a href="https://klasresearch.com/" target="_blank" rel="noopener">KLAS</a> in 2020 <a href="https://www.hcinnovationgroup.com/interoperability-hie/interoperability/article/21203913/klas-epic-outpaces-competition-in-achieving-deep-interoperability" target="_blank" rel="noopener">found</a> that 66% of Epic customers were able to achieve “deep interoperability” – a stage where providers have consistent access to outside data, can easily locate patient records, can view outside data inside their EHR workflow, and experience EHRs having a frequent, positive impact on patient care. The vendor who scored the next highest in this area was Cerner, with 28% of provider organizations reporting that they had achieved deep interoperability — four times the number in 2017.</p> <p>What this means is that if you show up in an emergency room 500 miles from your home tonight, chances are much greater than eight years ago that caregivers working to save your life will know exactly what medications you are taking even if you cannot say. The interoperability of some vendors’ EHRs is better than those of others, but research organizations such as KLAS are shining a light on such disparities, and customers (i.e., health care systems) are pushing the laggards to move faster to improve.</p> <p>The transition to digital records has been bumpy but now we are beginning to see how the practice of medicine can be enormously improved with the use of digital records.</p> <p>Imagine a practitioner being able to determine the most appropriate treatment within seconds and put a full explanation of condition and treatment on a big screen to review with the patient. Vitals such as EKG and oxygen levels will be downloaded from wearable biotechnology – either the patient’s own or a bracelet slipped onto the patient’s wrist when he or she enters the clinic – and entered into the electronic record automatically. Clinicians will not have to search for reports or wait for information. The doctor-patient relationship will be front and center and all the technology and care processes will be behind the scenes, running smoothly. Thanks to what we have learned from EHR, we are on the cusp of revolutionary change.</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/electronic-health-records-a-radical-shift-beginning-to-realize-a-much-broader-promise/">Electronic Health Records: A Radical Shift Beginning to Realize a Much Broader Promise</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> How Do Healthcare CEOs View the Transformative Future? https://createvalue.org/articles_and_news/healthcare-ceos-view-transformative-future/ ThedaCare Center for Healthcare Value » Articles & News urn:uuid:9e14a3a1-f3e9-c723-de9a-9aec6e78ef15 Thu, 08 Jul 2021 10:48:19 -0500 <p>A survey of 200 healthcare executives from around the globe, conducted by KPMG, reveals that while the pandemic has quickened transformation in healthcare systems, obstacles including workforce stability, provider incentivization and innovation barriers could slow progress. Chief executives from some of the world’s leading public and private healthcare providers in eight geographies were interviewed for KPMG’s [&#8230;]</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/healthcare-ceos-view-transformative-future/">How Do Healthcare CEOs View the Transformative Future?</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> <p>A survey of 200 healthcare executives from around the globe, conducted by KPMG, reveals that while the pandemic has quickened transformation in healthcare systems, obstacles including workforce stability, provider incentivization and innovation barriers could slow progress.</p> <p>Chief executives from some of the world’s leading public and private healthcare providers in eight geographies were interviewed for <a href="https://home.kpmg/xx/en/home/media/press-releases/2021/06/covid-19-accelerating-transformation-in-healthcare-but-workforce-challenges-and-digital-innovation-implementation.html" target="_blank" rel="noopener">KPMG’s first-ever Global Healthcare CEO Future Pulse</a>. The report offers insights into how healthcare leaders overseeing hospitals, health systems and care provider networks are preparing for the future.</p> <p>For the research, an online survey of 200 healthcare CEOs in the eight jurisdictions was commissioned by KPMG and conducted by Forbes Insights in March to April 2021.</p> <p><a href="https://www.hcinnovationgroup.com/policy-value-based-care/health-it-leadership/news/21228759/how-do-healthcare-ceos-view-the-transformative-future" target="_blank" rel="noopener">Read more</a></p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/healthcare-ceos-view-transformative-future/">How Do Healthcare CEOs View the Transformative Future?</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> Podcast, The Lens – 32. Developing and Deploying a Strategic Plan at Nemours https://createvalue.org/articles_and_news/podcast-lens-32-developing-deploying-strategic-plan-nemours/ ThedaCare Center for Healthcare Value » Articles & News urn:uuid:5a26df6f-f117-1f78-fe12-3f91fe70e5b6 Mon, 14 Jun 2021 08:27:34 -0500 <p>            Kellie Olmstead, Vice President and Chief Transformation Officer at Nemours shares about how they utilized multiple aspects of the management system in defining as well as deploying their strategic plan. Related Items Creating a Lean Management System virtual workshop The Lean Management System Modular Implementation Program Transformation Roadmap Catalysis Healthcare [&#8230;]</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/podcast-lens-32-developing-deploying-strategic-plan-nemours/">Podcast, The Lens &#8211; 32. Developing and Deploying a Strategic Plan at Nemours</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> <p><iframe src="https://anchor.fm/the-lens-by-catalysis/embed/episodes/32--Developing-and-Deploying-a-Strategic-Plan-at-Nemours-e1226d6" width="400px" height="102px" frameborder="0" scrolling="no"></iframe></p> <div><a href="https://podcasts.apple.com/us/podcast/the-lens/id1498519918?uo=4"><img loading="lazy" class=" wp-image-15447 alignnone" src="https://createvalue.org/wp-content/uploads/apple-podcasts-300x90.jpg" alt="" width="253" height="76" srcset="https://createvalue.org/wp-content/uploads/apple-podcasts-300x90.jpg 300w, https://createvalue.org/wp-content/uploads/apple-podcasts-1024x308.jpg 1024w, https://createvalue.org/wp-content/uploads/apple-podcasts-768x231.jpg 768w, https://createvalue.org/wp-content/uploads/apple-podcasts-90x27.jpg 90w, https://createvalue.org/wp-content/uploads/apple-podcasts-150x45.jpg 150w, https://createvalue.org/wp-content/uploads/apple-podcasts-250x75.jpg 250w, https://createvalue.org/wp-content/uploads/apple-podcasts.jpg 1129w" sizes="(max-width: 253px) 100vw, 253px" /></a>             <a href="https://open.spotify.com/show/5X3IctwRvIYFKgHCPzGB6f" target="_blank" rel="noopener noreferrer"><img loading="lazy" class=" wp-image-15448 alignnone" src="https://createvalue.org/wp-content/uploads/images-300x83.png" alt="" width="246" height="68" srcset="https://createvalue.org/wp-content/uploads/images-300x83.png 300w, https://createvalue.org/wp-content/uploads/images-90x25.png 90w, https://createvalue.org/wp-content/uploads/images-150x41.png 150w, https://createvalue.org/wp-content/uploads/images-250x69.png 250w, https://createvalue.org/wp-content/uploads/images.png 428w" sizes="(max-width: 246px) 100vw, 246px" /></a></div> <p>Kellie Olmstead, Vice President and Chief Transformation Officer at Nemours shares about how they utilized multiple aspects of the management system in defining as well as deploying their strategic plan.</p> <h3><strong>Related Items</strong></h3> <p><a href="https://createvalue.org/workshops/" target="_blank" rel="noopener">Creating a Lean Management System</a> virtual workshop</p> <p><a href="https://createvalue.org/customized-services/lean-management-system-modular-implementation-program/" target="_blank" rel="noopener noreferrer">The Lean Management System Modular Implementation Program</a></p> <p><a href="https://createvalue.org/transformation-roadmap/" target="_blank" rel="noopener noreferrer">Transformation Roadmap</a></p> <p><a href="https://createvalue.org/networks/healthcare-value-network/" target="_blank" rel="noopener">Catalysis Healthcare Value Network</a></p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/podcast-lens-32-developing-deploying-strategic-plan-nemours/">Podcast, The Lens &#8211; 32. Developing and Deploying a Strategic Plan at Nemours</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> John Toussaint’s Monthly Reflections – What’s Next? https://createvalue.org/articles_and_news/john-toussaints-monthly-reflections-whats-next/ ThedaCare Center for Healthcare Value » Articles & News urn:uuid:ddfaff57-dcfd-2c13-3480-b84598604c88 Tue, 08 Jun 2021 10:35:49 -0500 <p>I was talking to a colleague this week who is the lean transformation leader at a large multispecialty physician group in California. He has a great deal of lean transformation experience. He asked me, “So what’s next? We have taken the transformation journey as outlined by Catalysis and we want to know what’s next.” It [&#8230;]</p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/john-toussaints-monthly-reflections-whats-next/">John Toussaint&#8217;s Monthly Reflections &#8211; What&#8217;s Next?</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p> <p>I was talking to a colleague this week who is the lean transformation leader at a large multispecialty physician group in California. He has a great deal of lean transformation experience. He asked me, “So what’s next? We have taken the <a href="https://createvalue.org/transformation-roadmap/">transformation journey as outlined by Catalysis</a> and we want to know what’s next.” It was clear that they had done a great job on many of the key areas of transformation, including setting behavioral expectations, training leaders as coaches, developing model cells, deploying strategy, etc. but there were some gaps in learning. Let us review the transformation framework he was talking about.</p> <p>At Catalysis we have identified five swim lanes of change guiding the organizational excellence journey. The first swim lane is the board. The board must be supportive. In addition, they need to practice the principles of organizational excellence to understand the work and the culture change going on within the organization. It is the executive teams’ job to make sure the board is exposed and that there is a plan for them to be engaged in the work.</p> <p>The second swim lane is the executive team. Executives must have a coach and be willing to be coached. They need to learn how to go to the gemba and ask open-ended questions. They need to learn leader standard work. They need to practice A3 thinking. The personal journey may be the hardest part of the change. For this work executives create a personal development plan <a href="https://createvalue.org/articles_and_news/podcast-lens-30-personal-a3/">using a personal A3</a>. This is as opposed to a problem solving A3. Self-reflection is the most powerful way to change ourselves. Understanding the background and current state of our leadership style and then analyzing why we act the way we do leads us to the right side of the A3. Answering these two questions can help guide experiments leaders can try. What did I do this week that unleashed the creativity of my team? And what did I do that shut them down?</p> <p>The executives, as a team, are also responsible for developing True North, Key Behavioral Indicators, Strategy Development, Strategy Deployment, and Visual Management. These systems and behaviors are created over time and require a knowledgeable facilitator.</p> <p>The third swim lane is the performance improvement (PI) team. The PI team members should be coaching both up and down. Yes, coaching rather than doing is the core function of the PI team. When I was CEO, we hired facilitators to run kaizen events and value streams. These tools are important, but the PI team needs to be teaching managers and front-line workers the tools, not doing the work themselves. Capability will not be left behind if the PI team members do all the work.</p> <p>The fourth swim lane is the model cell. There are two types of model cells. Those that emerge from breakthrough value stream improvement led by the PI team and those that emerge from a different process led by a Research and Development (R&amp;D) team that we describe as <a href="https://createvalue.org/wp-content/uploads/Designing-the-Future-of-Healthcare-Whitepaper.pdf">New Care Model Development</a> (NCMD). The measure of success for model cells designed using breakthrough value stream improvement is 50-100% improvement from the baseline performance. Front line staff are deeply involved in the value stream work that leads to the new design and eventually the execution of the model cell.</p> <p>If breakthrough value stream improvement is not achieving the level of improvement required, it may be that the existing process has reached its limit of performance, which means the process should be obsoleted and a new way of delivering care created. This requires a different system. This system is the development value stream, <a href="https://createvalue.org/articles_and_news/podcast-lens-29-increasing-patient-value-developing-new-care-models/">better known as R&amp;D</a>. Most health systems do not have an R&amp;D function. Today we need to obsolete many of the processes in health care delivery that do not work and replace them with patient-centered care that delivers greater value. That will not happen unless we build a system to deeply understand customers’ needs, develop radical new concepts from this knowledge, and rapidly test the concepts in patient environments.</p> <p>In both breakthrough value stream improvement and NCMD an executive sponsor is required. Leaders must be patient. The work may take six-nine months before the new standard work can be spread to other areas.</p> <p>The final swim lane is the support functions. HR, IT and finance leaders can make or break the transformation. For example, all three play a crucial role in model cell development. Staff jobs change, and that is real work for HR because new roles may not fit neatly into previous job titles. IT must support new processes by turning on different EHR functions and finance needs to look at the new design results systemically rather than by line item.</p> <p>Back to my discussion with my colleague. With the above transformation journey guidepost in mind, we found that very little work had been done at the level of the board swim lane. Some board members were deeply engaged but some were not engaged at all. We also found there may need to be consideration for creating a development value stream and obsolete some existing care processes that were functioning poorly. Finally, he felt it was time for his leaders to learn from other leaders by joining <a href="https://createvalue.org/ceo-forum/">executive forums</a> and interacting with leaders on the same journey.</p> <p>All organizations have gaps on the transformation journey. What are the gaps at your organization? I am keen to know <u>what’s next for you</u>.</p> <p>&nbsp;</p> <p><a href="https://lp.constantcontactpages.com/su/dSydUhk" target="_blank" rel="noopener">Sign up to have John&#8217;s monthly reflections sent to your inbox.</a></p> <p>&nbsp;</p> <h3>Related Items</h3> <p><a href="https://createvalue.org/transformation-roadmap/" target="_blank" rel="noopener">Transformation Roadmap Services</a></p> <p><a href="https://createvalue.org/catalysis-academy-organizational-subscriptions/" target="_blank" rel="noopener">Organizational Subscription</a> to Catalysis Academy</p> <p>Principle-Based <a href="https://createvalue.org/customized-services/principle-based-executive-coaching/" target="_blank" rel="noopener">Executive Coaching</a> </p> <p><a href="https://createvalue.org/networks/healthcare-value-network/" target="_blank" rel="noopener">Catalysis Healthcare Value Network</a></p> <p><em><a href="https://createvalue.org/product/becoming-the-change/" target="_blank" rel="noopener">Becoming the Change</a>, </em>by John Toussait, MD, and Kim Barnas </p> <p>The post <a rel="nofollow" href="https://createvalue.org/articles_and_news/john-toussaints-monthly-reflections-whats-next/">John Toussaint&#8217;s Monthly Reflections &#8211; What&#8217;s Next?</a> appeared first on <a rel="nofollow" href="https://createvalue.org">Catalysis</a>.</p>