As organizations confront a post-COVID-19 world, leaders must balance pandemic-driven practices and environments with team member eagerness to and uncertainty towards returning to business as usual. Even though ongoing fear and stress are inevitable, leaders and managers can use a positive workplace culture to support employees, engage their teams, and foster productivity. Safe, reliable access to health and wellness, remote mental health resources, and consistent communications will help organizations establish and maintain a positive culture that remains a steadfast source of support as the healthcare industry navigates the next phases of COVID-19.
Leadership, Culture, Governance, Diversity and Inclusion
From hospitals and clinics to data warehousing companies, overcoming implicit biases with the help of up-to-date data can improve patient care and team member equity. Allina Health and Health Catalyst used data to discover that implicit biases existed within their companies.
At Allina Health, these implicit biases proved to be a barrier to patient care. They negatively impacted patient access to important resources like hospice care. At Health Catalyst, the leadership team realized there was a lack of women in leadership positions and a general lack of diversity in the technology sector.
Leadership teams at both organizations invested in creating implicit bias trainings to equip team members with tools to overcome their biases.
Equity impacts the fabric of society down to the type and quality of healthcare different racial and ethnic patient populations receive. COVID-19 has underscored disparities in healthcare delivery in the United States, as the pandemic has disproportionately affected the nation’s black communities. To care for and recognize the value of all individuals, healthcare must leverage data and analytics to better understand patient populations by race and ethnicity and determine how to meet the needs of its underserved populations.
With no known end to the COVID-19 social distancing directives, many healthcare organizations are shifting some team members to remote work arrangements. Clinicians offering telehealth services, case managers, as well as administrative, financial, and IT teams and others contributing away from the frontlines of care are candidates to work from home while continuing to support their organization’s operations. Though a shift in normal processes, research has shown that remote workers can be as or more productive as they are in the office setting and often report high levels of job satisfaction. Following best practices for remote-first work will help team members, managers, and organizations transition to and thrive in a distributed setting.
Social distancing, effective hand-washing techniques, sneezing into elbows, and the like are critical means of mitigating the spread and impact of COVID-19, but the pandemic has also prompted another area of concern: cybersecurity. A growing remote workforce, more collective time online, and increasingly frequent social engineering attacks that take advantage of public curiosity about and fear of the novel coronavirus are exposing system and network vulnerabilities. Remote workers can increase their online safety by refreshing and ramping up cyber-hygiene best practices, including learning to recognize and report suspicious emails and protecting home internet connections.
While most consumer-oriented industries have turned to mobile-first, cloud-based platforms for consumer interaction, healthcare lags behind in digitization, particularly when it comes to self-service consumer engagement. As digital consumer interaction increasingly drives enterprise success, healthcare must join the modern digital playing field. To get there, organizations need to establish digital investment and enablement frameworks and can then follow five strategies for stable, scalable transformation:
Formally define “digital” for the organization.
Follow 10 guiding principles to support digital.
Divide technology into appropriate portfolios.
Develop an analogy to explain the integrated portfolio approach.
Strategically select vendor partners.
With leadership alignment, easy access to data, and a roadmap to reach their objectives, health systems can drastically increase revenue and grow market share by applying four principles:
Key 1. Alignment.
Key 2. Vehicles.
Key 3: Five tools: access to data, data acumen; finance, vision to execution, and prioritizing outcomes.
Key 4: Education.
Access to the right data can drive changes that generate $48M in revenue, surpassing the year three market share goals in year two.
Health system mergers can promise significant savings for participating organizations. Research, however, indicates as much as a tenfold gap between expectation and reality, with systems looking for a savings of 15 percent but more likely to realize savings around 1.5 percent.
Driving the merger expectation-reality disparity is a complex process that, without diligent preparation and strategy, makes it difficult for organizations to fully leverage cost synergies. With the right framework, however, health systems can achieve the process management, data sharing, and governance structure to align leadership, clinicians, and all stakeholders around merger goals.
A healthcare CIO’s role can demand such an intense focus on technology that IT leaders may struggle to find natural opportunities to engage with their C-suite peers in non-technical conversations. To bridge the gap, healthcare CIOs can answer five fundamental questions to better align their programs with organizational strategic goals and guide IT services to their full potential:
Whom do we serve?
What services do we provide?
How do we know we are doing a great job?
How do we provide the services?
How do we organize?
On July 25, 2019, our Health Catalyst CEO, Dan Burton, the rest of the executive leadership team, and dozens of fellow team members celebrated the Health Catalyst IPO in New York City. More than 700 team members and their families all over the world joined the celebration during events held locally—from Salt Lake City to Boston to Columbus to Singapore. This was a day long-in-the-making, starting with our prescient co-founders Tom Burton and Steve Barlow in 2008. From those early days onward, Health Catalyst has been a mission-driven company committed to being the catalyst for massive, measurable, data-informed healthcare improvement.
Utah HIMSS (UHIMSS) recognized Health Catalyst for its innovative leadership with the 2019 UHIMSS Healthcare IT Corporate Innovator award. Dale Sanders, Health Catalyst President of Technology, accepted the honor on behalf of his organization at the UHIMSS 2019 spring conference on May 17. He shared some key insights into what makes a great environment for ongoing innovation, including these valuable sources for invention and originality:
Pen and paper
The quality and patient safety movement of the early 21st century called for greater board of trustee involvement in improvement. However, too many health systems still don’t have the resources in place to effectively engage their boards around quality and safety measures.
Six guidelines describe how organizations can better leverage data to inform their boards:
Emphasize quality and patient safety goals.
Leverage National Quality Forum-endorsed measures.
Use benchmarking and risk adjustment to select targets.
Access data beyond the EHR.
Provide data and information for multiple organizational levels.
Develop a board-specific measurement and presentation strategy.
Employers are always looking for ways to reduce one of their biggest expenditures–the cost of providing health insurance to employees. Many employers have explored solutions such as adding wellness plans, reducing usage, and providing different provider access mechanisms, all with modest success.
Stemming the rising costs of health insurance requires management to understand and improve healthcare outcomes for their employee and dependent populations. Changing the future of employer health insurance will require a multi-faceted approach:
Driving additional value by reducing utilization of healthcare services within these employer populations.
Utilizing a wider lens through which to view performance of various providers, then making decisions based on those who are consistently providing low cost, high quality care.
Employer will need to combine their data with other companies across a geographic region to get a better picture of the provider landscape than has ever been possible before.
Bobbi Brown, MBA, and Stephen Grossbart, PhD have analyzed the biggest changes in the healthcare industry and 2018 and forecasted the trends to watch for in 2019. This report, based on their January 2019, covers the biggest 2019 healthcare trends, including the following:
The business of healthcare including new market entrants, business models and shifting strategies to stay competitive.
Increased consumer demand for more transparency
Continuous quality and cost control monitoring across populations.
CMS proposals to push ACOs into two-sided risk models.
Fewer process measures but more quality outcomes scrutiny for providers.
Overcrowding in the emergency department has been associated with increased inpatient mortality, increased length of stay, and increased costs for admitted patients. ED wait times and patients who leave without seeing a qualified medical provider are indicators of overcrowding. A data-driven system approach is needed to address these problems and redesign the delivery of emergency care.
This article explores common problems in emergency care and insights into embarking on a successful quality improvement journey to transform care delivery in the ED, including an exploration of the following topics:
A four-step approach to redesigning the delivery of emergency care.
Understanding ED performance.
Revising High-Impact Workflows.
Revising Staffing Patterns.
Setting Leadership Expectations.
Improving the Patient Experience.
Despite the complexity of healthcare analytics, one key strategy for effective, sustainable analytics stands out: designating an executive sponsor to oversee the program. This sponsor is a C-suite level leader who’s committed to championing analytics throughout the organization and has the influence and relationships to drive widespread outcomes improvement.
Healthcare executives can use four criteria to identify a great executive sponsor for their analytics programs:
Have a single accountable leader.
Find a sponsor with passion for and knowledge about data.
Choose organizational clout and a vision for analytics over a specific title.
Build a partnership with the CIO.
Healthcare generates an estimated $1 trillion in waste each year, including supply costs, unnecessary tests, and surgeries that aren’t clinically indicated by best practices. One effective way health systems can reduce waste is by centralizing duplicated services into one high-performing center for that service. For example, instead of having a few cardiac catheterization (cath) labs, a health system can consolidate its cath services into one facility, cutting equipment, staffing, and space requirements.
Despite its clinical and financial benefits, centralization can be challenging for health system leaders, who may face operational and political challenges when cutting services from certain locations. To navigate these challenges, leadership must use a data- and analytics-driven centralization strategy and a data and analytics system that can measure performance at the surgeon, facility, and program levels.
Drs. Allen Frankel and Michael Leonard have developed a framework for creating high-reliability organizations in healthcare. This report, based on their 2018 webinar, covers the components and factors of this frame work, including:
Improvement and Measurement
Teamwork and Communication
Employers that offer robust employee health plans at affordable costs are more likely to attract and retain a great workforce. Healthcare, however, is often a top expense for organizations, making balancing attractive benefits with attractive costs a complex undertaking. Employers need a deep understanding of employee populations and opportunities to manage health plan costs without sacrificing quality.
An analytics-driven approach to employee population health management gives employers insight into two key steps to lower healthcare costs and enhance benefits:
Manage easily fixed cost issues.
Use healthcare cost savings to fund expanded benefits.
By committing to transforming healthcare analytics, organizations can eventually save hundreds of millions of dollars (depending on their size) and achieve comprehensive outcomes improvement. The transformation helps organizations achieve the analytics efficiency needed to navigate the complex healthcare landscape of technology, regulatory, and financial challenges and the challenges of value-based care.
To achieve analytics transformation and ROI within a short timeframe, organizations can follow five phases to become data driven:
Establish a data-driven culture.
Acquire and access data.
Establish data stewardship.
Establish data quality.
Spread data use.
Historically technology and talent were primary assets used to weigh the value of M&A activity, but data is an equal pillar. Buyers (the acquiring organizations) face enormous responsibility and risk with M&A transactions. C-suite leaders have a lot to consider—enterprise-wide technology, finances, operations, facilities, talent, processes, workflows, etc.—during the due diligence process. But attention is often heavily weighted toward time-honored balance sheet and facility assets rather than next-generation assets with the long-term strategic value in the M&A process: data. The model for conducting due diligence around data involves four disciplines:
Establish the strategic objectives of the M&A with the leadership team.
Prioritize data along with the standardization of solutions and the design of a new IT organization (i.e., a co-equal effort for data, tools, and talent).
Identify the near-term data strategic priorities, stakeholders, and tools.
Assess the talent and consider creating an analytics center of excellence (ACOE) to harness organizational capabilities.
According to the Robert Wood Johnson Foundation, health equity is achieved when everyone can attain their full health potential and no one is disadvantaged from achieving this potential because of social position of any other socially defined circumstance.
Without health equity, there are endless social, health, and economic consequences that negatively impact patients, communities, and organizations. The U.S. ranks last on measures of health equity compared to other industrialized countries. Healthcare contributes to this problem in many ways, including ignoring clinician biases toward certain populations and overlooking the importance of social determinants of health.
Fortunately, there are effective, tested steps organizations can take to tackle their health inequities and disparities (e.g., incorporating nonmedical vital signs into their health assessment processes and partnering with community organizations to connect underserved populations with the services they need to be healthy). Some health systems, such as Allina Health, have achieved impressive results by making health equity a systemwide strategic priority.
Improving diversity and inclusivity in healthcare, and any industry, is more than just the right thing to do: it’s an intelligent business decision with impacts on productivity, sales, and innovation.
Organizations committed to addressing the lack of diversity and inclusivity in healthcare should start by thinking about the principles and values that underlie their cultures. At Health Catalyst, every diversity initiative is founded in one of the core principles that motivates our work and is embodied by every team member:
But turning the tide on monumental challenges, like closing the gender gap in technology (women hold less than 26 percent of U.S. technology jobs), requires more than a return to values; it requires initiatives, from equitable hiring practices to mentorship programs, that reflect an understanding of the diverse populations in the talent pool.
With an estimated 80 percent of medical errors resulting from miscommunication among healthcare teams, organizations can significantly improve outcomes with better communication. A communication methodology outlines the essential information clinicians need to share, giving care teams the knowledge they need, when they need it, to make informed treatment decisions.
One communication toolkit, SBAR (Situation, Background, Assessment, Recommendation), defines the essential information clinicians must share when they hand off patient care from the inpatient to the ambulatory setting:
S (situation): The patient’s current situation.
B (background): Information about the current situation.
A (assessment): Assessment of the situation and background and potential treatment options.
R (recommendation): Recommended action.
Healthcare leaders looking to establish and sustain a culture of large-scale outcomes improvement must communicate their health system’s values, beliefs, and norms throughout the entire organization. Effective communication spreads understanding of outcomes improvement, ensuring broad engagement and ongoing progress toward shared goals.
An eight-step strategy describes essential elements of organizational outcomes improvement communication plan:
Include a communications specialist on the outcomes improvement leadership team.
Analyze the stakeholders early and often.
Craft the central message around shared values.
Be a constant champion.
Commit to regular times and mechanisms for communication.
Make sure communication flows both ways.