Outcomes Improvement

Insights

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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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

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

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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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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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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Taylor Larsen

Why Health Systems Must Use Data Science to Improve Outcomes

In today’s improvement-driven healthcare environment, organizations must ensure that improvement measures help them reach desired outcomes and focus on the opportunities with optimal ROI. With data science-based analysis, health systems leverage machine learning to determine if improvement measures align with specific outcomes and avoid the risk and cost of carrying out interventions that are unlikely to support their goals.
There are four essential reasons that insights from data science help health systems implement and sustain improvement:

Measures aligned with desired outcomes drive improvement.
Improvement teams focus on processes they can impact.
Outcome-specific interventions might impact other outcomes.
Identifies opportunities with optimal ROI.

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Dorian DiNardo
Aaron Neiderhiser

Prioritizing Healthcare Projects to Optimize ROI

Healthcare organizations have long relied on traditional benchmarking to compare their performance to others and determine where they can do better; however, to identify the highest ROI improvement opportunities and understand how to take action, organizations need more comprehensive data.
Next-generation opportunity analysis tools, such as Health Catalyst® Touchstone™, use machine learning to identify projects with the greatest need for improvement and the greatest potential ROI. Because Touchstone determines prioritization with data from across the continuum of care, users can drive improvement decisions with information appropriate to their patient population and the domains they’re addressing.

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Holly Rimmasch

Four Population Health Management Strategies that Help Organizations Improve Outcomes

Population health management (PHM) strategies help organizations achieve sustainable outcomes improvement by guiding transformation across the continuum of care, versus focusing improvement resources on limited populations and acute care. Because population health comprises the complete picture of individual and population health (health behaviors, clinical care social and economic factors, and the physical environment), health systems can use PHM strategies to ensure that improvement initiatives comprehensively impact healthcare delivery.
Organizations can leverage four PHM strategies to achieve sustainable improvement:

Data transformation
Analytic transformation
Payment transformation
Care transformation

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Kathleen Clary, BSN, MSN, DNP

Measuring the Value of Care Management: Five Tools to Show Impact

To earn legitimacy and resources within a healthcare organization, care management programs need objective, data-driven ways to demonstrate their success. The value of care management isn’t always obvious; while these programs may, in fact, be responsible for improvements in critical metrics, such as reducing readmissions, C-suite leaders need visibility into care management’s impact and processes to understand precisely how they’re improving care and lowering costs at their organizations.
Five analytics-driven technologies give healthcare leaders a comprehensive understanding of care management performance:

The Patient Stratification Application
The Patient Intake Tool
The Care Coordination Application
The Care Companion Application
The Care Team Insights Tool

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John Hansmann, MSIE, LFHIMSS, DSHS

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:

Communication
Trust Building
Coaching
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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Heather Schoonover

Health Equity: Why it Matters and How to Achieve it

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.

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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

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Heather Schoonover
Taylor Miller

Combatting the Opioid Epidemic with Next-Generation Risk Assessment Tools

The opioid-related death rate in the U.S. has quadrupled since 1999, making more effective ways to predict opioid misuse a healthcare priority. A new generation of machine learning-enabled risk assessment tools promises to deliver broader and more relevant insight into a patient’s risk.
With more comprehensive insight (including comorbidities, other substance abuse, the amount of medication prescribed, and the duration of opioid use), clinicians can make informed decisions when prescribing opioids and reduce the risk that patients will misuse, abuse, or overuse the pain killers. Clinicians will also be able to identify which patients might benefit from alternatives to opioid pain management (non-pharmacologic, multi-modal therapies, or care management programs).

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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 Andersen

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 APRN, ACNP, ANP-BC

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
Integration

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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