Healthcare Performance Improvement Readiness Assessment: The Key to Achieving the IHI Triple Aim

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Enhanced patient experience, clinical quality improvements, and the ability to provide cost-effective care — how will your healthcare organization assess its readiness to make these types of changes and truly impact outcomes?

The Triple Aim’s concepts are not new. But the work involved in making the changes necessary to realize improved outcomes is daunting. To prepare for this type of improvement, healthcare organizations need to assess their readiness by answering questions such as these: How will my organization assess its readiness to make these changes and truly impact outcomes? How engaged are our clinicians? How ready is our culture? Is the right data governance in place? Is there an analytics infrastructure in place to identify high-value improvement opportunities and measure the success of improvement efforts?

With so many priorities clamoring for healthcare executives’ attention, it can be extremely difficult to meet a growing number of external demands for change while also maintaining a positive bottom line. The ability to remain financially viable in this new era of accountability, value-based payments, and transformational change is an incredible challenge.

Given the pressures facing healthcare, change is inevitable. Yet, poorly managed change can lead to instability, uncertainty, and cultural chaos in an organization. The average profit margin for U.S. hospitals is currently only 2.2 percent. Despite increasingly thin profit margins, healthcare organizations will need to place a major emphasis on improving quality and safety, reducing costs wherever reasonable and safe, and improving the experience of patients, families, providers, and employees. This means healthcare leaders will need to effectively execute a complex change management plan. This raises a key question — how can an organization increase its likelihood of success?

Performance Improvement Readiness Assessment — A Key to Success

We’ve found that starting with a performance improvement readiness assessment is the first step to success.

A performance improvement readiness assessment is a systematic analysis of an organization’s ability to achieve and sustain performance improvement based on a three-system approach. By using a readiness assessment, the health system is able to take a deep look at three critical elements of their “readiness” to improve. Those three elements, or three systems as we like to call them, are an analytics system, a best practice system, and an adoption system.

  1. Healthcare Analytics System

A robust healthcare analytics solution enables a healthcare organization to unlock its data, automate the distribution of the data, and discover patterns in the data. By combining the analytics system with an integrated enterprise data warehouse (EDW), critical information can be delivered to the right people, at the right time, in the right way. This integrated approach to using data and analytics makes it possible for health systems to build knowledge over time that can then be analyzed to make decisions about both operational and clinical improvements.

  1. Best Practice System

A clinical content (best practice) system provides a standardized way to organize and assimilate new evidence-based clinical knowledge, such as value stream maps, patient safety protocols, intervention criteria, and order sets. Because clinicians don’t have the time to identify all of the medical advancements that come out, a best practice system pulls all the relevant knowledge related to each clinician’s area of expertise into one repository, making it easy for them to provide bedside care based on current, peer-reviewed best practices. This improves the speed at which new medical knowledge becomes every day practice. It also makes the right thing to do the easy thing to do, while allowing clinicians the freedom to adjust course if patient needs demand changes.

Three systems — analytics, best practice, adoption — are necessary for sustainable improvement initiatives.

  1. Healthcare Adoption System

An adoption system is an essential mechanism to govern, plan, prioritize, and affect change throughout an organization. With an effective adoption system in place, an organization can spread and sustain improvements across the enterprise. Then, organizations will be able to standardize work processes by organizing team structures, training team members on their roles, allowing teams to design their own solutions, and making sure improvements are implemented consistently. This method applies Agile principles to care improvement, making it possible to implement a dependable mechanism to affect change throughout an organization in a measurable and sustainable manner.

The Case for Three Systems, Not Just an Analytics System

Without all three of these systems in place, an organization may not be able to reach their goals related to improving healthcare. Often organizations purchase highly expensive “healthcare analytics” systems because they believe that their lack of useful data and information is keeping them from improving care. High-quality, useful, and timely information is critical for sustainable, measureable improvement. However, without an adoption or best practice system, organizations often find themselves with very expensive software, lots of reports and dashboards, and no one using them. Additionally, there is still no measureable improvement!

Another scenario we see often is organizations believing that the reason they cannot improve is the lack of a single, reliable methodology. So, they send staff to expensive, labor-intensive courses like Six Sigma or to get Lean certified. And again, still no measureable, sustainable change! Without a reliable, integrated analytics system and a way to organize and manage best practices and the decision-making related to the use of content, the chaos of countless different processes, workflows, and databases across the organization will remain a significant challenge.

Creating a Culture of Performance Improvement

And we can’t forget culture. So many organizations get their Black Belts lined up, their shiny new integrated data splashed out in beautiful dashboards, and a library of clinical content ready for use. But they have not done the work to get the organization ready culturally for the change. They haven’t engrained the “why” in the minds of the staff or engaged in the hearts of providers. And once again, sustainable, measureable change does not happen. It is critical that ongoing learning and quality improvement become a central tenet of an organization’s culture.

By assessing the three systems and having a roadmap that will guide an organization through the steps required, the chances of successful, long-term improvement is much higher and the course corrections needed along the way are more evident.

Readiness Assessment — A Roadmap for Change

At the end of the day, what we all want is to help the patients we serve enjoy the best quality of life possible. We want the healthcare we provide to ensure they have the best chance at living a full, functional, and meaningful life. The only way that is possible is if our healthcare caregivers (i.e., providers, healthcare leadership, and employees) are engaged, passionate, and supported for success. Last, but not least, healthcare organizations must have the funds to stay open and properly resource their organizations.

Be ready for the improvement that needs to happen in your organization so that it is sustainable, measureable, and reliable.

We want to hear from you: does your organization use a readiness assessment? If not, can you see the benefit it would provide?

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