Learn more about Kathleen Merkley, DNP, APRN, FNP

Author Bio

Kathleen Merkley, DNP, APRN, FNP

Kathleen Merkley, DNP, APRN joined Health Catalyst in March 2013, as an Engagement Executive. Prior to coming to HC, she worked for Intermountain Healthcare as the corporate clinical IT implementation manager. Kathleen is a registered nurse/nurse practitioner and just received her doctorate in nursing practice from the University of Utah in May 2013.

Read articles by Kathleen Merkley, DNP, APRN, FNP


Kathleen Merkley, DNP, APRN, FNP

A More Accurate Sepsis Identification Method: Leveraging Physiological Data

The traditional sepsis identification method—based on a combination of physician notes, coding, and billing—is often varied and too subjective, leading to inaccurate data. Because margins are tight and health systems can’t afford to waste any resources, clinical teams need to start with the most effective sepsis identification method. Using physiological data, such as vital signs, to identify sepsis is proving to be highly effective.
With the physiological data approach, providers rely on the body’s response—rather than being steered by biases, anecdotal information, or reimbursement rates—to more accurately identify patients with sepsis. With a more effective approach to sepsis identification, providers can implement interventions sooner, leading to better outcomes.

Anne Marie Bickmore
Kathleen Merkley, DNP, APRN, FNP

The Top Five Recommendations for Improving the Patient Experience

Improving patient satisfaction scores and the overall patient experience of care is a top priority for health systems. It’s a key quality domain in the CMS Hospital Value-Based Purchasing (VBP) Program (25 percent) and it’s an integral part of the IHI Triple Aim.
But, despite the fact that health systems realize the importance of improving the patient experience of care, they often use patient satisfaction as a driver for outcomes. This article challenges this notion, instead recommending that they use patient satisfaction as a balance measure; one of five key recommendations for improving the patient experience:

Use patient satisfaction as a balance measure—not a driver for outcomes.
Evaluate entire care teams—not individual providers.
Use healthcare analytics to understand and act on data.
Leverage innovative technology.
Improve employee engagement.

This article also explains why patient experience is so closely tied to quality of care, and why it’s a prime indicator of a healthcare organization’s overall health.

Kathleen Merkley, DNP, APRN, FNP

Sepsis Treatment: Target Five Key Areas to Improve Sepsis Outcomes

More people in the U.S. die from sepsis than from prostate cancer, breast cancer, and AIDS…combined. Although health systems continue working to improve outcomes for septic patients, there is tremendous room for improvement.
Preparing health systems to most effectively tackle sepsis starts with an awareness of consensus definitions of sepsis and continues with following evidence-based recommendations from credible organizations, such as the Surviving Sepsis Campaign and the Sepsis Alliance.
Distilling ever-evolving recommendations and best practices for sepsis is time intensive. This article facilitates healthcare’s distillation effort by highlighting the five key areas health systems can target to improve sepsis outcomes (based on evidence-based guidelines and Health Catalyst’s first-hand experience with healthcare partners):

Early ED recognition
Three-hour sepsis bundle compliance
Six-hour sepsis bundle compliance
In-house recognition of sepsis
Sepsis readmissions: prioritize risk stratification

Kathleen Merkley, DNP, APRN, FNP
Michael Barton
Tracy Vayo

Improving Healthcare Outcomes: Keep the Triple Aim in Mind

The battle cry for healthcare organizations throughout the United States? Improve outcomes! However, as organizations begin to measure outcomes they realize not all outcomes are created equal and the question of what constitutes an improvement becomes more challenging. Healthcare leaders would be wise to keep the Triple Aim in mind when creating a strategy for optimizing outcomes. Achieving the appropriate balance among the three dimensions of the Triple Aim is critical to driving real, long-term change in healthcare delivery outcomes.

Kathleen Merkley, DNP, APRN, FNP

How Patient-Centered Care Turns Patients Into Leaders

Patient engagement is the cornerstone of effective patient-centered care teams. But what if care teams could do more than engage patients? What if they could turn these patients into care team leaders?
Patient-centered care teams can transform patients into proactive leaders who have the knowledge and motivation to take ownership of their health by following four key recommendations:

Make decisions using data.
Make it personal.
Make it easy to share information.
Leverage new technology when appropriate.

In what often feels like a fragmented system, patient-centered care teams provide a personalized environment and care continuity. And while patient engagement is a top priority, leveraging predictive analytics to move beyond engagement to empowerment will lead to better health outcomes for individuals and entire patient populations.

Holly Rimmasch
Kathleen Merkley, DNP, APRN, FNP
Kirstin Scott
Susan Easton
Tracy Vayo

What Do You Get With a Clinical Improvement Application from Health Catalyst?

Transforming healthcare takes more than just dashboards and data. It takes an entirely new approach combining best practices, analytics, and adoption of the improvement program throughout the entire organization. Which is why Health Catalyst Clinical Improvement Applications offer tools to help organizations with all three of those systems. The applications contain starter content (best practices), which includes a knowledge brief, a care process improvement map, and an outcomes improvement packet. Of course, analytics is also part of the applications in the form of precise patient registries, outcomes and process metrics, and visualizations. And finally, Health Catalyst includes deployment services to drive adoption of improvement work. This includes engagement with health system teams and sharing of insights based on work from a variety of healthcare organizations across the country and the world. Armed with a Clinical Improvement Application, a health system is in a better position to make real, meaning changes resulting in outcomes improvement for patients and itself.

Kathleen Merkley, DNP, APRN, FNP
Kirstin Scott
Susan Easton
Tracy Vayo

The 4 Clinical Teams Needed to Drive Sustainable Improvement

As the healthcare industry shifts from a fee-for-service to pay-for-performance and accountable care organizations are under greater pressure to make improvements to their clinical, financial and operational outcomes. As clinical quality improvement efforts grow systematically improving and sustaining care across the organization becomes more challenging. In order to ensure sustainable, long-term change a cross-functional, team-based approach that accelerates the implementation of change throughout the organization is necessary. This is the adoption system. Without an adoption system, improvement initiatives become a series of one off projects that may have a temporary positive impact, but soon return to the baseline level.

Kathleen Merkley, DNP, APRN, FNP

Using Clinical Metrics the Right Way: 5 Considerations Every Hospital Should Know

The ability to analyze data is more important than ever as the healthcare industry shifts from fee-for-service to a pay-for-performance model. And the wealth of clinical data now available is larger than ever. But just having that data isn’t enough. The data, clinical, financial, operational, etc., must be combined to form the powerful foundation that will drive quality improvement. The destination is higher quality care for improved patient outcomes. The route is having the right clinical metrics.

Kathleen Merkley, DNP, APRN, FNP
Ann Tinker, MSN, RN

How to Determine the Best Interventions for Clinical Quality Improvement Projects

Health systems use clinical quality improvement projects as a means to improve patient care, but the real improvement in care can only result from deliberate action by your teams. This action is called an intervention and becomes the solution that addresses your clinical quality improvement goal. The secret to selecting the right intervention is this: choose something that offers “gain” or improvement and then provides a means to “sustain that gain.” Finding efficient, effective interventions can be a challenge without knowing where to start, but by using an Aim statement, your teams will have a working template for each of their clinical quality improvement projects.

Kathleen Merkley, DNP, APRN, FNP

Leveraging Healthcare Analytics to Reduce Heart Failure Readmission Rates

Heart failure patients are adding an enormous strain to the US healthcare system. In addition, readmission rates for these diseases are adding to the burden.  Healthcare analytics can play a key role.  By following these 4 steps, all of which include data analytics, health systems can begin to reduce readmission rates: 1) Understand your true admission rates. 2) Establish reliable baseline measures. 3) Be aware of balance measures. 4) Establish an EDW.

Anne Marie Bickmore
Kathleen Merkley, DNP, APRN, FNP

Practice Management Solutions: The Key to Efficient Primary Care Delivery

Primary care practices are being asked to treat more and more patients—while reimbursement levels shrink. One of the best ways to tackle this challenge is to make sure that every member of a clinic’s staff is empowered to operate at the maximum level of his or her qualifications. For this to succeed, a system for coordinating care across the patient panel is necessary. And a solution built on the foundation of a healthcare EDW can do that, including:
i. Generate near real-time lists of patients who aren’t compliant with recommended, evidence-based care guidelines.
ii. Show clinicians and staff a patient’s health status at a glance.
iii. Increase efficiency and accuracy of working with healthcare data.
iv. View clinical, operational, and regulatory information about your patients all in one place.
v. Track and manage patient volume.
vi. Analyze performance of your patient panel as a whole—and your performance on various regulatory measures.
vii. Drill down into data for further insights into practice performance

Kathleen Merkley, DNP, APRN, FNP
Ann Tinker, MSN, RN

Overcoming Clinical Data Problems in Quality Improvement Projects

Starting your clinical quality improvement projects with access to data you’ve never seen before is exciting! But as analysis starts, you notice missing and incomplete data. Data quality problems are one of the most common but unexpected initial challenges of any substantive clinical quality improvement. project. Anny and Kathy both share keys to success learned from years of experience to overcome that trough of despair.

Kathleen Merkley, DNP, APRN, FNP

Defining Patient Populations Using Analytical Tools

Defining patient populations is an important first step when identifying opportunities for clinical improvement, but it can be a daunting one. How can a clinician easily find a specific patient population? Then, once found, how does that list turn into actionable steps that improve outcomes? In this Insight, Kathy describes how Health Catalyst helps clients define patient populations by using the Cohort Builder application and then using risk stratification, an exciting methodology that assists in identifying outcomes for specific patient populations.

Kathleen Merkley, DNP, APRN, FNP

Population Health Management: One Example That Shows Why It Really Matters

One of our clients recently launched a Population Health Management initiative in just eight weeks to ten percent of their clinics, potentially improving care delivery for approximately 2,300 patients. When the initiative is completed it will impact nearly 50,000 patients. The interdisciplinary team of clinicians, IT, care coordinators, and business analysts now have a single source of truth and near-real time results to proactively engage and work with their patients to manage care. According to their Director of Clinical Business Analytics, “What we’ve accomplished with Population Health is something we’ve been trying to do for over 20 years with our various clinics. We used to manually pull together reports, all with varying data, and we had no way to proactively monitor our populations. Now, we have near real-time data that enables our care coordinators to drive preventive care and ultimately lower our population health costs.”

Kathleen Merkley, DNP, APRN, FNP

A Key to Measuring Healthcare Quality Improvement: Use AIM Statements

Don Berwick’s now-famous quote about making quality improvement measureable says, “Some is not a number; soon is not a time.” As I work with clients looking to improve prioritized a clinical or organizational process, I wonder how I can help them operationalize the wisdom of Dr. Berwick’s quote. The answer comes in focusing on something called an AIM statement. An AIM statement provides the template for an improvement initiative. It is a written, measurable, and time-sensitive description of the goal(s) a quality improvement team expects to make from its improvement efforts. It represents an important quality topic that can stimulate enthusiastic team support. An AIM Statement includes the following six components…