Clinically Meaningful Quality Metrics Improve the Provider Experience

Nearly half (46 percent) of all physicians report that they suffer from burnout, citing too many bureaucratic tasks as one reason. Providers want to find meaning in their work, and improvement on many current quality metrics do not predict better patient outcomes or experience of care. They are looking for tools to reduce their workload and improve their ability to provide excellent care, including having metrics and registries that are meaningful and informative.

Faced with the challenge of making quality measures meaningful, Partners HealthCare worked to redefine measures to be more relevant, create point-of-care registries to manage an all-payer population, created teams of Population Health Coordinators to support front-line teams in managing the registries, and used its analytics platform to monitor change and explore provider variation in order to improve quality. This resulted in:

  • 85 percent of clinicians surveyed felt that the new metrics helped them take better care of their patients.
  • Quality improved at an unprecedented rate on an all-payer population 5 times bigger than the standard P4P population.
  • Near real-time measurement using clinical data eliminated months-long delays, while run charts and provider and clinic-comparison views turbo charged quality improvement.
  • 125 percent increase in user adoption of the analytic tool (99 unique users, 674 unique sessions, and rising).
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Data-Driven Approach to Improving Cardiovascular Care and Operations Leads to $75M in Improvements

Health spending in the United States is greater than the gross domestic product of most nations, and the costs for cardiovascular disease (CVD) and stroke care alone total $193.1 billion. CVD accounts for approximately one out of every three deaths in the U.S. and contributes to the shorter life expectancy of Americans. Thirty-five percent of CVD related deaths occur before the age of 75 years, and 19 percent before the age of 65.

Allina Health is a large integrated healthcare delivery network operating in Minnesota and western Wisconsin that includes three large cardiac centers. Due to the prevalence and mortality rate of CVD, leaders at Allina Health recognized that they needed to focus on cardiovascular health in order to truly impact the population health and patient outcomes of the communities they serve.

By leveraging real-time data from its enterprise data warehouse (EDW), Allina Health effectively identified and addressed clinical practice variation and operational issues affecting cardiovascular care and costs. In doing so, the health system realized more than $75 million in performance enhancement savings and revenue increase over a four-year period by focusing on supply chain, lab test and blood utilization, clinical practice changes and clinical documentation improvement.

 

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Other Content in Quality & Process Improvement

Posts

6 Proven Strategies for Engaging Physicians—and 4 Ways to Fail

For healthcare organizations to be successful with their quality and cost improvement initiatives, physicians must be engaged with the proposed changes. But many physicians are not engaged because their morale is suffering. While some strategies to encourage buy-in for improvement initiatives don’t work, there are six strategies that have proven to be effective: (1) discover a common purpose, (2) adopt an engaging style, (3) turn physicians into partners, not customers, (4) segment the engagement plan, (5) use “engaging” improvement methods, and (6) provide them with backup—all the way to the board. Once the organization has their trust, physicians will gain enthusiasm to move forward with improvement efforts that will benefit everyone.

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Outcomes Improvement Governance: A Handbook for Success and Achieving More with Less

For healthcare organizations looking to achieve outcomes improvement goals, effective governance is the most essential must-have. This leadership culture ensures success by enabling health systems to invest in outcomes improvement and allocate resources appropriately toward these goals.

This executive report is an outcomes improvement governance handbook centered on four guiding principles (and associated helpful steps) health systems can follow to achieve effective governance and start achieving more with less:

  1. Stakeholder engagement
  2. Shared understanding
  3. Alignment
  4. Focus

With these four principles, organizations can build a foundation of engagement and focus around the work, where they maximize strengths, and discover and address weaknesses. They establish an improvement methodology, define their goals, and sustain and standardize improvement work.

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Why Clinicians Are the Missing Link in Healthcare Quality Improvement and Three Principles to Solve the Problem

When it comes to successful quality improvement (QI) in healthcare, clinicians tend to be the missing link. Fortunately, the disconnect between QI initiatives and the day-to-day work of clinicians can be explained and resolved if health systems adopt and embrace three clinician-focused principles:

  • Principle #1: QI starts at the front line (initiatives should be identified and driven by clinicians).
  • Principle #2: QI makes it easy for clinicians to do the right thing (removes barriers to good work rather than increasing the amount of work clinicians do).
  • Principle #3: QI empowers clinicians to adapt care (even if it’s not QI protocol).

Although some clinicians are enthusiastic advocates of their systems’ QI efforts, most are suspicious because they’re frequently cut out of the decision-making process or forced to ignore their best clinical judgement. Health systems that work to close the gap between leaders and clinicians by embracing these three principles will add the missing link—clinicians—back into successful healthcare QI.

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Data for Improving Healthcare vs. Data for Exasperating Healthcare Workers

For better or worse, hospitals are obligated to collect and report data for regulatory purposes. Or they feel compelled to meet some reputational metric. The problem is, an inordinate amount of time can be spent on what is considered data for accountability or punishment, when the real focus should be on data for learning and improvement. When time, effort, and resources are dedicated to the latter, it leads to real outcomes improvement.

Deming has three views of focusing on a process and this article applies them to healthcare:

  1. Sub-optimization, over-emphasizing a single part at the expense of the whole.
  2. Extreme over-emphasis, also called gaming the system.
  3. The right amount of focus, the only path to improvement.

With data for learning as the primary goal, improving clinical, operational, and financial processes becomes an internal strategy that lifts the entire healthcare system.

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The Top Seven Analytics-Driven Approaches for Reducing Diagnostic Error and Improving Patient Safety

From a wrong diagnosis to a delayed one, diagnostic error is a growing concern in the industry. Diagnostic error consequences are severe—they are responsible for 17 percent of preventable deaths (according to a Harvard Medical Practice study) and account for the highest portion of total payments (32.5 percent), according to a 1986-2010 analysis of malpractice claims. Patient safety depends heavily on getting the diagnosis right the first time.

Health systems know reducing diagnostic error to improve patient safety is a top priority, but knowing where to start is a challenge. Systems can start by implementing the top seven analytics-driven approaches for reducing diagnostic error:

  1. Use KPA to Target Improvement Areas
  2. Always Consider Delayed Diagnosis
  3. Diagnose Earlier Using Data
  4. Use the Choosing Wisely Initiative as a Guide
  5. Understand Patient Populations Using Data
  6. Collaborate with Improvement Teams
  7. Include Patients and Their Families
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Analyst Reviews & Awards

Webinars

How to Establish an Evidence-Based Care Delivery Structure like Allina Health

Clinicians have to make difficult decisions on a regular basis. And when different clinicians within the same health system make markedly different decisions about medical treatment, significant waste and inconsistent outcomes arise.

What will be discussed?:

  1. Establishing peer-reviewed and approved CPGs
  2. Prioritizing improvements
  3. Developing the CPG checklist
  4. Engaging and collaborating with clinicians

Don’t miss hearing firsthand how Allina established a systemwide EBDM model and realized a five percent decrease in Stage 1 lung cancer treatment variation as well as a 20 percent decrease in the number of heparin protocols.

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A CEO’s Keys to Continuous Quality Improvement

Healthcare organizations will not survive this unstable environment without a vision and a plan. Even with rapidly declining reimbursement that makes resource allocation tight, a CEO must address what it will cost to sustain a commitment to quality and then move forward in building capacity into the organization to provide that quality.

Join Greg Stock, chief executive officer of Thibodaux Regional Medical Center, as he shares how Thibodaux strives for the Triple Aim using the following keys to successful continuous quality improvement:

  • Engaging physicians and other influencers to bring together the right people for effective collaboration
  • Leveraging a data warehouse to identify opportunities for improvement, have a single source of truth to support decisions, and rapidly implement change
  • Spreading expertise across the organization, or ensuring individuals take the knowledge and skills they have acquired and apply them to other problem areas throughout the organization

Don’t miss hearing this CEO’s experiences with a methodology that The Joint Commission calls “best practice in how to use data and get physicians engaged.”

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Discovering a Common Purpose: Creating Physician Engagement (Webinar)

Join Dr. Bryan Oshiro, MD Chief Medical Officer, Health Catalyst , as he shares key best practices in getting physician engagement including identifying and empowering physician leaders in key functional teams, compensating for leadership roles, educating and developing a common purpose, triad teamwork approaches, giving quick, easy, and responsive access to the right data to identify problems and make recommendations, and supporting and empowering physician-led recommendations.

Attendees will learn:

  • The importance of physician engagement in quality improvement (the “why”)
  • To describe the challenges and barriers to truly have physicians lead quality improvement (“the what”)
  • To identify strategies to enhance physician engagement (the “how”)

Creating Physician engagement is a journey. It is a partnership that requires putting the patient first to provide the best care possible.

Please join Dr. Oshiro as he shares his experiences spanning three decades of quality improvement and clinical practice, from Loma Linda University Medical School to Intermountain Healthcare, for what will be an engaging and enlightening session.

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Transforming Healthcare: Data Alone Is Not Sufficient (Webinar)

In volume-driven healthcare, provider organizations attempt to gain mass, often by acquisition and centralization, and manage profit or efficiency through cost reduction initiatives and economies of scale.The report card for the current model is clear: A for the technology of healthcare, and F for value. This data-driven management-by-optimization model isn’t working.  Innovation, not optimization is the key to survival and success.

Data and analytics are necessary but alone are insufficient to produce innovation. We propose a fundamentally different approach, coupling practices modeled on the science of adaptation and successful, highly innovative companies with new healthcare metrics and analytics. Adaptation is the cumulative result of many small changes over time. The higher the velocity of adaptation, the better organisms deal with rapid environmental change. Healthcare organizations can and must learn to safely increase their velocity of adaptation.

Current Healthcare Key Performance Indicators (KPIs) assess the effect of organizational behaviors in the past but don’t tell us which behaviors contributed positively and negatively. In order to drive future KPIs, we need to identify and measure the adaptive behaviors that are influencing performance today and link those measures to interventions that will improve performance tomorrow.

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Breakthrough Analysis: New Insights into Reducing Healthcare Waste (Webinar)

Join Dr. Burton, a nationally renowned physician executive, in an advanced analysis of healthcare waste. With nearly three decades practicing medicine and architecting clinical processes as an executive at Intermountain Healthcare, Dr. Burton has spent the greater part of his career focused on developing a systematic process and tools to eliminate waste from US Healthcare.

Attend and learn:

  1. How to dissect waste into coherent “chunks”
  2. What data and tools are needed to quantify the different forms of waste and implement improvement initiatives to reduce waste
  3. How to organize clinical teams to use the data and tools to reduce waste
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