Outcomes Improvement


Ann Tinker

The Top 7 Outcome Measures and 3 Measurement Essentials

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 blog adds much-needed clarity by reviewing the top seven outcome measures, including definitions, important nuances, and real-life examples:

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

CMS used these exact seven outcome measures to calculate overall hospital quality and arrive at its 2016 hospital star ratings.
This blog also reiterates the importance of outcomes measurement, clarifies how outcome measures are defined and prioritized, and recommends three essentials for successful outcomes measurement:

Integrated care

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Dr. John Haughom

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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James Bulger

Medical Libraries: An Essential Resource in Outcomes Improvement

In healthcare outcomes improvement work, where best-practice insight and evidence-based knowledge are critical, medical libraries are an essential resource. Medical libraries are more valuable than ever in today’s digital world, in which information is readily available, but accessing accurate, focused evidence requires specialized skill and means.
Organizations aiming to improve quality and move successfully toward value-based care need both data from the enterprise data warehouse (EDW) and evidence from the medical library. While data identifies opportunities for improvement, evidence furnished by the medical library shows whether proposed solutions are viable. Together, both knowledge bases drive pragmatic, sustainable improvement.

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Cessily Johnson
Michael Buck

Patient Registries Turn Knowledge into Outcomes Improvements

In today’s data-rich healthcare environment, patient registries put knowledge in front of the people who will use it to improve outcomes and population health. Non-IT professionals (e.g., clinicians and researchers) often don’t have direct, timely access to operational and clinical data. As a result, organizations miss out on important improvement opportunities and data-driven point-of-care decisions. Knowledge too often remains siloed in the enterprise data warehouse (EDW) or among specialized groups.
Patient registries remove these barriers. It allows clinicians and researchers to make informed choices and frees up data analysts to focus on their priority areas.

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Neil Anderson

The Healthcare Outcomes Improvement Engine: The Best Way to Ensure Sustainable, Scalable Change

How do healthcare organizations create a systemwide focus on outcomes improvement? They build a healthcare outcomes improvement engine—a mechanism designed to drive successful and sustainable change.
Creating this outcomes improvement engine requires four critical components:

Engaging executives around outcomes improvement.
Prioritizing opportunities most likely to succeed.
Adequately staffing initiatives.
Communicating success early and often.

Once up and running, multidisciplinary engagement and standardized improvement processes fuel the outcomes improvement engine in its mission to produce sustainable, scalable improvement.

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Josh Ferguson

Reducing Unwanted Variation in Healthcare Clears the Way for Outcomes Improvement

According to statistician W. Edwards Deming, “Uncontrolled variation is the enemy of quality.” The statement is particularly true of outcomes improvement in healthcare, where variation threatens quality across processes and outcomes. To improve outcomes, health systems must recognize where and how inconsistency impacts their outcomes and reduce unwanted variation.
There are three key steps to reducing unwanted variation:

Remove obstacles to success on a communitywide level.
Maintain open lines of communication and share lessons learned.
Decrease the magnitude of variation.

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Cherbon VanEtten
Sherry Martin

How to Create Change Agents Who Will Sustain those Hard-earned Healthcare Improvements

Establishing a healthcare improvement initiative is just the first step toward transformation. The real work of improvement lies in sustaining it, which is why qualified change agent are essential to meaningful progress.
Change agents are trained to lead organizations in:

Case for change
Data management
Change management concepts
Cost Benefit Analysis

Health Catalyst’s Accelerated Practices Program gives change agents adaptive leadership training to guide systemwide change within their organizations. They are prepared to meet technical adaptive challenges while keeping teams engaged and productive, and, importantly, to use data analysis to improve quality, cost, and patient satisfaction outcomes.

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Josh Ferguson

The Who, What, and How of Health Outcome Measures

Even though thousands of health outcome measures have the potential to impact the work we do every day, how well do we really understand them? In this article, we take a close look at the definitions, origins, and characteristics of health outcome measures. We break down the financial relevance of certain measures, the relationship between outcome measures and ACOs, and which measures impede, rather than enhance, a typical healthcare system. We review the role of an enterprise data warehouse and analytics, and we touch on the future of health outcome measures, all in an effort to provide deeper insight into some of the mechanics behind outcomes improvement.

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Brian Eliason

9 Ways Your Outcomes Improvement Program Could Be Delayed

A health system’s outcomes improvement program is an expensive undertaking. It’s worth the results, but there’s no need to make it even more expensive through unforeseen and unnecessary delays. We outline the three phases of managing outcomes improvement programs, from hardware and software acquisition and configuration to resource management to sustaining and scaling the gains. We also examine the nine potential pitfalls that can undermine success in each of these phases:

Hardware and software acquisition delays
Environment readiness
Source system access
Lack of resource capacity
Lack of analytic and technical skills
Data quality paralysis
Lack of clinical or operational engagement
Punitive culture: data used as a weapon
No CEO, no go

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Drew Cardon

From Installed to Stalled: Why Sustaining Outcomes Improvement Requires More than Technology

The big first step toward building an outcomes improvement program is installing the analytics platform. But it’s certainly not the only step. Sustaining healthcare outcomes improvement is a triathlon, and the three legs are:

Installing an analytics platform
Gaining adoption
Implementing best practices

The program requires buy-in, enthusiasm, even evangelizing of analytics and its tools throughout the organization. It also requires that learnings from analysis translate into best practices, otherwise the program fails to produce results and will eventually fade away. Equally important is that top-level leadership across the organization, not just IT, supports and promotes the program ongoing. We explore each of the elements and how they come together to create successful and sustainable outcomes improvement that defines leading healthcare organizations.

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Dr. Bill Knowles

Moving Healthcare Outcomes Improvement Projects to the Finish Line

There are many ways to approach outcomes improvement in healthcare. Health Catalyst advocates the three-systems methodology whose individual components remain firm: best practices, adoption, and analytics. There are also various ways to interpret the three systems and this article uncovers nuances in how they are defined. With this unique perspective, organizations may be better able to understand how to develop outcomes improvement projects that not only launch with enthusiasm, but sustain energy over the long-term. Furthermore, outcomes improvement done right is scalable so that small firms, those with fewer resources, can adapt the methodology to improve their performance.

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Ann Tinker
Leslie Falk

The Top Five Essentials for Outcomes Improvement

Outcomes improvement is complicated, but we’re beginning to understand what successful quality improvement programs have in common:

Adaptive leadership, culture, and governance
Evidence- and consensus-based best practices
Financial alignment

Although understanding the top five essentials for quality improvement in healthcare is key, it’s equally important to understand the most useful definitions and key considerations. For example, how different service delivery models (telemedicine, ACO, etc.) impact quality improvement programs and how quality improvement starts with an organization’s underlying systems of care.
This executive report takes an in-depth look at quality improvement with the goal of providing health systems with not only the top five essentials but also a more comprehensive understanding of the topic so they’re in a better position to improve quality and, ultimately, transform healthcare.

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Kirstin Scott
Tracy Vayo

The Top Six Early Detection and Action Must-Haves for Improving Outcomes

Given the industry’s shift toward value-based, outcomes-based healthcare, organizations are working to improve outcomes. One of their top outcomes improvement priorities should be early detection and action, which can significantly improve clinical, financial, and patient experience outcomes. Through early detection and action, systems embrace a proactive approach to healthcare that aims to prevent illness; the earlier a condition is detected, the better the outcome.
But, as with most things in healthcare, improving early detection is easier said than done. This executive report provides helpful, actionable guidance about overcoming common barriers (logistical, cultural, and technical) and improving early detection and action by integrating six must-haves:

Multidisciplinary teams
Leadership-driven culture change
Creative customization
Proof-of-concept pilot projects
Health Catalyst tools (knowledge briefs, outcomes improvement packets and worksheets, and care process improvement maps).

The report features a Thibodaux Regional Medical Center sepsis success story that demonstrates how creative customization, when paired with evidence-based standardization, can improve early detection and action efforts, as well as clinical, financial, and patient outcomes.

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Dr. Bryan Oshiro

The Top Success Factors for Making the Switch to Outcomes-Based Healthcare

Transitioning to outcomes-based healthcare is an industry wide goal. While some health systems, such as Texas Children’s Hospital, are in the process of making the switch (and doing it successfully), many systems don’t even know where to begin.
Despite the challenges of achieving outcomes-based healthcare, it is essential for surviving the transition from fee-for-service (FFS) to value-based care. Systems can overcome the top three challenges associated with making the switch (lack of analytics, lack of access to information, and inappropriate organizational structure) by focusing on the most important success factors:

Multidisciplinary Teams

Armed with an enterprise data warehouse (EDW) to make data-driven decisions about the best outcomes improvement goals to pursue, and permanent multidisciplinary teams responsible for continuously improving care, systems can start making the switch to outcomes-based healthcare.

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Brant Avondet

7 Features of Highly Effective Outcomes Improvement Projects

There’s a formula for success when putting together outcomes improvement projects and organizing the teams that make them prosper. Too often, critically strategic projects launch without the proper planning, structure, and people in place to ensure viability and long-term sustainability. They never achieve the critical mass required to realize substantial improvements, or they do, but then the project fades away and the former state returns. The formula for enduring success follows seven simple steps:

Take an Outcomes Versus Accountability Focus
Define Your Goal and Aim Statements Early and Stick to Them
Assign an Owner of the Analytics (Report or Application) Up Front
Get End Users Involved In the Process
Design to Make Doing the Right Thing Easy
Don’t Underestimate the Power of 1:1 Training
Get the Champion Involved

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Paul Horstmeier

The Top 100 Hospitals Improve Outcomes and Reduce Costs

Truven recently conducted its annual 100 Top Hospitals Study. Using objective and independent research, and publicly available information, Truven determines the top-performers based on a variety of performance measures, from mortality to readmissions.
For this first time in the study’s 23-year history, the top-performing hospitals were able to simultaneously improve outcomes and reduce costs. When interviewed about the reason behind this unprecedented trend, Truven’s Senior VP of Performance Improvement credited “uniformity and consistency.” But the report reveals other commonalities among the winners:

Data and Analytics
Evidence-Based Practices

This curation summarizes the study’s high-level findings, including specific achievements.

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John Hansmann

The Top 8 Skills Every Healthcare Process Improvement Leader Must Have

Healthcare process improvement leaders not only have to be a jack-of-all-trades, but they need to be a master, as well. This is one of the most important leadership roles in the healthcare system with responsibilities that can ultimately end up saving lives, improving the patient experience, improving caregiver job satisfaction, and reducing costs. Although there are many others, these eight skills are the most critical for the efficient, and ultimately, successful process improvement leader:

Trust Building
Understanding Process Management
Understanding Care Management Personnel
Constructive Accountability and Constructive Conflict
Resiliency and Persistency
Seeing the Big Picture

Along with the right training, education, and sponsorship, it’s easy to see why this role blends many elements of art and science.

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Josh Ferguson

How to Measure Health Outcomes that Matter to Everyone

To measure health outcomes that matter to everyone, it’s important to ask several questions before starting out:

How do regulatory requirements differ from outcomes improvement?
Do the measurements align with organizational goals and values?
Are the measurements worth the resources required to document them?
Will the metrics actually be applied to outcomes improvement?
Who are the beneficiaries of the outcomes improvement initiative?

The answers to these questions help save time and resources, sustain and expand the improvement effort, refine the list of measures to those that truly improve outcomes, and most of all, help avoid the outcomes measures graveyard.

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Tom Burton

Why Process Measures Are Often More Important Than Outcome Measures in Healthcare

The healthcare industry is currently obsessed with outcome measures — and for good reason. But tracking outcome measures alone is insufficient to reach the goals of better quality and reduced costs. Instead, health systems must get more granular with their data by tracking process measures. Process measures make it possible to identify the root cause of a health system’s failures. They’re the checklists of systematically guaranteeing that the right care will be delivered to every patient, every time. By using these checklists, organizations will be able to improve quality and cost by reducing the amount of variation in care delivery.

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Caleb Stowell
Sara Sprinkhuizen

Improving Outcomes That Matter Most to Patients

Patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs) have been used in healthcare since the 1970s. But the industry hasn’t had meaningful, consistent PROs and PROMs definitions until ICHOM developed one. ICHOM, a pioneer in outcomes measurement and improvement, demonstrates that healthcare organizations focused on improving patient outcomes that patients actually care about are the ones most likely to transform healthcare.

PROs and PROMs complement clinical indicators in understanding the quality of healthcare a team is delivering. For example, an improvement program for prostate cancer patients that only focuses on improving blood loss or length of stay in the hospital completely misses a patient’s biggest fears: will they need to wear pads for the rest of their life? Will their relationship with their partner be the same as it was?

By focusing on outcomes that matter most to patients, health systems will be more successful at improving outcomes. ICHOM describes five strategies for getting started with PROs and PROMs:

Find the Believers (Identify Clinician Champions)
Organize a Cross-Functional Team (with Appropriate Governance)
Invest Time and Resources
Celebrate Progress Along the Way
Use Early Successes to Scale and Spread

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Kathleen Merkley
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.

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Jeff Selander

Employee Wellness: A Combination of Personal Accountability and Corporate Responsibility

A strong employee wellness program is the first step to encouraging better health and creating meaningful, positive change in the lives of employees and their families. A well-designed healthcare insurance plan, a comprehensive wellness program, and creating a culture of personal accountability for wellness can optimize healthcare spending and improve employee health. It can also bolster the understanding and shared accountability for healthcare costs between the employees and the company.

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Anne Marie Bickmore

Prospective Analytics: The Next Thing in Healthcare Analytics

Retrospective and predictive analytics are familiar terms for practitioners of clinical outcomes improvement, but the new kid on the block is prospective analytics. This is the next level that uses findings from its predecessors to not only identify the best clinical routes, but also what the results might be of each choice. Prospective analytics gives bedside clinicians an expanded, branching view of operational and clinical options in a type of decision support that can lead to not only improving surgical and medical outcomes, but to making a positive financial contribution, as well. But, as expected with any new process or new way of thinking, prospective analytics requires careful introduction and stewardship to help drive its adoption within the organization.

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Paul Horstmeier

Michael Porter and Others Show How to Deliver Better Care in Value-based Healthcare Documentary

Healthcare organizations from Hamburg to Gothenburg to Boston are realizing the future of care delivery through a value-based approach, as portrayed in this video documentary featuring professor Michael Porter of the Harvard Business School. Measured Outcomes: A Future View of Value-Based Healthcare explains how value-based care is a methodology that involves standardizing outcome measurements, tracking them over the long term, and putting clinical teams in place with the longevity needed to build a sustainable program. More importantly, it is healthcare that matters most to patients because they report and track their own quality measurements, giving them a say in their own healthcare experience. Providers are winning, patients are winning, and the results for the organizations showcased in this video are remarkable, such as an 88 percent prostatectomy success rate for the Martini-Klinik in Hamburg, Germany, compared to a 32.8 percent rate for the rest of the country. And with just 10 surgeons on staff, they are doing more volume than any other facility in the world, by far, all attributable to their value-based approach.

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Steve Catmull

Patient Engagement And Outcomes Improvement from the Patient’s Perspective

Usually, when we think of the phrase “patient engagement,” we think of what providers and healthcare systems are doing to involve patients in their own care. Patient engagement is often defined as providing access to a patient portal or reaching out to patients through social media channels or via an organization’s website. But it’s also about patients proactively becoming involved in their own care, in partnership with their healthcare providers. Call it “DIY” or “personalized” medicine, but it can reduce preventable admissions and shorten lengths of stay. It can also significantly improve an individual’s outcomes and always creates better awareness of one’s symptoms and how they are changing. With proper tracking, patients can create a view of their personal data that enhances what’s conventionally available to their providers. This is one motivated patient’s account through an episode of personalized medicine.

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