Outcomes Improvement

Insights

Josh Ferguson APRN, ACNP, ANP-BC

When the Promise of Prehabilitation Meets the Power of Healthcare Analytics

Patients who undergo surgery frequently follow a rehabilitation program afterwards to promote recovery. However, starting this program before the procedure may help further accelerate recovery time. Prehabilitation is defined as physical or lifestyle preparation that happens before surgery and is designed to help patients regain function in less time.
Prehabilitation includes the following four main components:

Medical optimization of pre-existing medical conditions.
Physical fitness.
Nutritional status.
Psychological support.

Providing coordinated care from the pre-surgery period to post-operative recovery helps ensure the best patient outcomes. Additionally, health systems can glean important insights about best practices when they effectively follow the patient journey and capture relevant data throughout.

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Eric Denna, PhD
Ryan Smith

Improving Strategic Engagement for Healthcare CIOs with Five Key Questions

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?

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Steve Vance

How Healthcare Cost-Per-Case Improvements Deliver Big Bottom-Line Savings

As health systems face more pressure than ever to deliver cost savings, they’re turning their attention to cost-per-case improvement projects. These strategies can produce quick wins for improvement teams looking to gain momentum and buy-in. This article addresses the following topics:

How to identify areas of opportunity.
The importance of costing accuracy.
Four strategies for implementing cost-per-case improvement projects.
Example projects for new teams.
How to sustain results.

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Adam Bell
Kristen McRae

Continuity of Care Documents: Today’s Top Solution for Healthcare Interoperability Demands

While healthcare waits for the expanded data interoperability that FHIR promises, the industry needs an immediate solution for accessing and using disparate data from across the continuum of care. With FHIR potentially several years away, continuity of care documents (CCDs) are the best option for acquiring the ambulatory clinical care data health systems need to close quality gaps today. Because organizations that rely only on claims data to drive quality improvement risk missing out on more that 80 percent of patient information, CCDs are the current must-have answer to interoperability for successful quality improvement.

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Health Catalyst Editors

The Top Six Examples of Quality Improvement in Healthcare

In order to thrive in an increasingly challenging healthcare environment, undertaking quality improvement projects is more important than ever for healthcare systems’ continued survival. However, health systems need to tackle the right projects at the right time to maximize the impact to their organization.
This article shares both clinical and financial and operational examples of quality improvement in healthcare that may help others as they tackle improvement projects. Some examples shared include:

Pharmacist-led Medication Therapy Management (MTM) reduces total cost of care.
Optimizing sepsis care improves early recognition and outcomes.
Boosting readiness and change competencies successfully reduces clinical variation.
New generation Activity-Based Costing (ABC) accelerates timeliness of decision support.
Systematic, data-driven approach lowers length of stay (LOS) and improves care coordination.
Clinical and financial partnership reduces denials and write-offs by more than $3 million.

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Health Catalyst Editors

The Top Five 2019 Healthcare Trends

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.

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Kirstin Scott
Tracy Vayo

Is a Medical Writer the Missing Accelerant to Your Outcome Improvement Efforts?

Quality improvement efforts are more important than ever. However, even improvement efforts that have the right people, processes, and technology can struggle to make progress.  A medical writer with healthcare knowledge and strong information design skills may be the missing ingredient that can help speed time to adoption and value.
This article discusses the functions a medical writer can fulfill, and why they matter. You will also learn:

The four skills that a medical writer with strong information design skills brings to an improvement team.
Examples of output of medical writers in a healthcare setting.
The skills a medical writer needs.

Additionally, you will learn how to find this unique skill set and where you might find this key person.

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Health Catalyst Editors

Unlocking the Power of Patient-Reported Outcome Measures (PROMs)

Health systems attempt to measure an ever-increasing amount of clinical measures, these often miss the mark of what matters to patients. Patient-Reported Outcomes (PROs) are the missing link in empowering patients and helping to define good outcomes.  This article walks through how patient-reported outcome measures (PROMs) can help identify best practices and drive system-wide quality improvement. PROMs can help health systems do the following:

Serve as a guide for appropriateness and efficiency.
Lead to better shared decision-making.
Demonstrate value and transparency

This article also discusses the effect of PROMs on providers in a culture of “one more thing,” and tips for effective implementation.

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Health Catalyst Editors

ACOs: Four Ways Technology Contributes to Success

With an increasing emphasis on value-based care, Accountable Care Organizations (ACOs) are here to stay. In an ACO, healthcare providers and hospitals come together with the shared goals of reducing costs and increasing patient satisfaction by providing high-quality coordinated healthcare to Medicare patients.
However, many ACOs lack direction and experience difficulty understanding how to use data to improve care. Implementing a robust data analytics system to automate the process of data gathering and analysis as well as aligning data with ACO quality reporting measures.
The article walks through four keys to effectively implementing technology for ACO success:

Build a data repository with an analytics platform.
Bring data to the point of care.
Analyze claims data, identify outliers, including successes and failures.
Combine clinical claims, and quality data to identify opportunities for improvement.

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Dan LeSueur

How to Run Your Healthcare Analytics Operation Like a Business

A robust data analytics operation is necessary for healthcare systems’ survival. Just like any business, the analytics enterprise needs to be well managed using the principles of successful business operations.
This article walks through how to run an analytics operation like a business using the following five-question framework:

Who does the analytics team serve and what are those customers trying to do?
What services does the analytics team provide to help customers accomplish their goals?
How does the analytics team know they’re doing a great job and how do they communicate that effectively to the leadership team?
What is the most efficient way to provide analytics services?
What is the most effective way to organize?

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Health Catalyst Editors

The Four Keys to Increasing Hospital Capacity Without Construction

Many health systems have a hospital capacity problem as demand for patient beds rises. When the supply of usable patient beds can’t meet demand, the negative impact on patients and staff can be significant.
Hospitals can solve capacity problems with four key concepts:

Using data, start with the problem and the ideal solution.
Be sure the analytics team works with teams throughout the organization—including leadership.
Have leaders spend time with the operations team to understand workflow.
Focus on the impact, not the tool.

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Health Catalyst Editors

How to Evaluate Emerging Healthcare Technology With Innovative Analytics

As healthcare systems are pressured to cut costs and still provide high-quality care, they will need to look across the care continuum for answers, reduce variation in care, and look to emerging technologies. This article walks through how to evaluate the safety and effectiveness and of emerging healthcare technology and prioritize high-impact improvement projects using a robust data analytics platform. Topics covered include:

The importance of identifying variation in innovation.
Ways to improve outcomes and decrease costs.
The value of an analytics platform.
The reliable information that produce sparks for innovation.
Identifying and evaluating emerging healthcare technology.
Knowing what data to use.
The difference between efficacy and effectiveness in evaluation of emerging healthcare technology.

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Health Catalyst Editors

Reducing Hospital Readmissions: A Case for Integrated Analytics

Health systems continue to prioritize reducing hospital readmissions as part of their value-based payment and population health strategies. But organizations that aren’t fully integrating analytics into their readmission reduction workflows struggle to meet improvement goals. By embedding predictive models across the continuum of care, versus isolated them in episodes of care, health systems can leverage analytics for meaningful improvement.
Organizations that integrate predictive models into readmissions reduction workflows have achieved as much as a 40 percent reduction in risk-adjusted readmissions indexes. Effective analytics integration strategies use a multidisciplinary development approach to meet the needs of a patient’s entire care team and deliver common tools for all involved in the patient’s healthcare journey.

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Health Catalyst Editors

Emergency Department Quality Improvement: Transforming the Delivery of Care

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.

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Health Catalyst Editors

Improving Quality Measures Can Lead to Better Outcomes

Current quality measures are expensive and time consuming to report, and they don’t necessarily improve care. Many health systems are looking for better ways to measure the quality of their care, and they are using data analytics to achieve this goal. Data analytics can be helpful with quality improvement. There are four key considerations to evaluate quality measures:

Organizations must develop measures that are more clinically relevant and better represent the care provided.
Clinician buy-in is critical. Without it, quality improvement initiatives are less likely to succeed.
Investment in tools and effort surrounding improvement work must increase. Tools should include data analytics.
Measure improvement must translate to improvement in the care being measured.

When the right measures are in place to drive healthcare improvement, patient care and outcomes can and do improve.

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Curt Sellke

Healthcare Project Management Techniques: A Pragmatic Approach to Outcomes Improvement

Project management skills and good project managers are increasingly important to the healthcare industry because they can help control costs, manage risk, and speed improvement project outcomes. By applying project management techniques, from waterfall to agile methodologies, organizations can plan, organize, and execute a set of tasks efficiently in order to maximize resources and achieve specific goals.
This article explores project management techniques and offers considerations for healthcare leaders when adapting these techniques for clinical, financial, and operational process improvement. The author also shares a pragmatic application and practical tips for implementing these project management techniques in a healthcare environment.

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Dorian DiNardo

Effective Healthcare Decision Support for Executives: Three Problems that Leading Wisely® Solves

In the high-pressured world of value-based care, healthcare leadership is more important than ever. Leaders need to make data-driven decisions and respond to the increasing demands of patients while cutting costs.
The right tools–ones that support today’s outcome-focused healthcare environment–can help leaders break through the noise to make effective decisions. This article shares three common problems faced by healthcare leadership and how Leading Wisely, an executive decision support tool helps them make informed decisions and guide their organizations forward. Three effective strategies for healthcare leadership include:

How to prevent communication breakdown.
How to break through measure madness.
How to alleviate information overload and siloed reporting.

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David Grauer, MBA, MHSA

Addressing Healthcare Waste Through Centralization

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.

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Health Catalyst Editors

A Framework for High-Reliability Organizations in Healthcare

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:

Leadership
Transparency
Reliability
Improvement and Measurement
Continuous Learning
Negotiation
Teamwork and Communication
Accountability
Psychological Safety

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Elaine St. James, BSN, RN, CPHQ
Josh Ferguson APRN, ACNP, ANP-BC
Nancy Casazza, BSN, MMI, RN

How to Achieve Your Clinical Data Analytics Goals

Healthcare organizations know that they need to an effective clinical data analytics strategy to improve and survive in today’s challenging environment. In order to make these necessary improvements, healthcare leaders need to establish clear goals for their clinical data analytics initiatives.
Achieving these goals requires clinical teams to clearly identify problems and plan for how to achieve them. This article walks improvement teams through sometimes confusing process of identifying problems, setting clear, achievable goals, and common pitfalls along the way. Topics covered include:

Six categories of clinical data.
Three types of goals: outcome, process, and balance.
How to write an outcome goal.
Internal vs. External Benchmarks.
Mitigation strategies.
Getting clinical buy-in.

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Ann Tinker, MSN, RN

The Top Seven Healthcare Outcome Measures and Three Measurement Essentials

Healthcare outcomes improvement can’t happen without effective outcomes measurement. Given the healthcare industry’s administrative and regulatory complexities, and the fact that health systems measure and report on hundreds of outcomes annually, this article adds much-needed clarity by reviewing the top seven outcome measures, including definitions, important nuances, and real-life examples. The top seven categories of outcome measures are:

Mortality
Readmissions
Safety of care
Effectiveness of care
Patient experience
Timeliness of care
Efficient use of medical imaging

CMS used these seven outcome measures to calculate overall hospital quality and arrive at its 2018 hospital star ratings. This article also reiterates the importance of outcomes measurement, clarifies how outcome measures are defined and prioritized, and recommends three essentials for successful outcomes measurement.

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Health Catalyst

Lean Healthcare: 6 Methodologies for Improvement from Dr. Brent James

The survival of healthcare organizations depends on applying lean principles. Organizations that adopt lean principles can reduce waste while improving the quality of care. By applying stringent clinical data measurement approaches to routine care delivery, healthcare systems identify best practice protocols and incorporate those into the clinical workflow. Data from these best practices are applied through continuous-learning loop that enables teams across the organization to update and improve protocols–ultimately reducing waste, lowering costs, and improving access to care.
This executive report based on a presentation by Dr. Brent James at a regional medical center, covers the following:

How lean healthcare principles can help improve the quality of care.
The steps healthcare organizations need to take to create a continuous-learning loop.
How a lean approach creates financial leverage by eliminating waste and improving net operating margins and ROI.

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Lloyd Provost

Four Essential Ways Control Charts Guide Healthcare Improvement

Control charts are a critical asset to any health system seeking effective, sustainable improvement. With a simple three-line format, control charts show process change over time, including the average of the data, upper control limit, and lower control limit. This insight helps improvement teams monitor projects, understand opportunities and the impact of initiatives, and sustain improved processes.
Also known as Shewhart charts or statistical process control charts, control charts drive effective improvement by addressing three fundamental questions:

What is the goal of the improvement project?
How will the organization know that a change is an improvement?
What change can the organization make that will result in improvement?

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Kyle Salyers

How UPMC and Health Catalyst Improve Outcomes Using Innovation in Activity-based Costing

UPMC and Health Catalyst created a great business partnership focused on sharing risks and rewards to innovate how activity-based costing (ABC) is done in healthcare. The partners relied on complementary intellectual property, complementary talent, and complementary risks and rewards to drive benefits that extend beyond either organization’s borders. Health Catalyst licensed UPMC’s activity-based costing software, which served as the foundation for the Health Catalyst CORUS suite. Together, the partners will continue to work for innovations in ABC to drive outcomes improvements in healthcare.

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John Haughom, MD

Five Deming Principles That Help Healthcare Process Improvement

Dr. John Haughom explains 5 key Deming processes that can be applied to healthcare process improvement. These include 1) quality improvement as the science of process management, 2) if you cannot measure it, you cannot improve it, 3) managed care means managing the processes of care (not managing physicians and nurses), 4) the importance of the right data in the right format at the right time in the right hands, and 5) engaging the “smart cogs” of healthcare.

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