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How to Sustain Healthcare Quality Improvement in 3 Critical Steps

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Many healthcare organizations don’t hold quality and cost gains because they don’t make improvement the backbone of their organization. Rather, they approach improvement as a series of initiatives. Ronald D. Snee, a fellow with the American Society for Quality states, “Many organizations focus on sustaining the gains only after improvement has been achieved. Intuitively, that may seem the correct sequence, but it is in fact backwards. The time to focus on sustaining improvement gains is well before the initiative is launched.”

Here are 3 critical organizational steps that can help sustain those gains.

Published in: Health & Medicine
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How to Sustain Healthcare Quality Improvement in 3 Critical Steps

  1. 1. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. © 2014 Health Catalyst www.healthcatalyst.comProprietary. Feel free to share but we would appreciate a Health Catalyst citation. How to Sustain Healthcare Quality Improvement in 3 Critical Steps By Cherbon VanEtten
  2. 2. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Improving Care Quality Finding ways to improve care quality while reducing costs is essential in today’s healthcare environment. Many organizations focus on sustaining the gains only after improvement has been achieved. Intuitively, that may seem the correct sequence, but it is in fact backwards. The time to focus on sustaining improvement gains is well before the initiative is launched.” - RONALD D. SNEE, Ph.D. American Society for Quality Fellow
  3. 3. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. The Three-system Approach to Healthcare Transformation All three of these systems work together, but the deployment system is essential to sustaining quality gains.
  4. 4. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Driving Sustainable Healthcare Transformation Without structure and processes in place to sustain quality initiative, stakeholders tend to disengage. Many factors are involved in this loss of momentum and focus, but the most important are: Teams are temporarily assigned to the project A lack of clear accountability and decision pathways Limited or no access to analytic resources The inability to create broad buy-in for the change
  5. 5. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Aligning Organizational Resources Establishing permanent teams, clearly designating accountability, including analytic and clinical resources, and involving every level of the organization ensures broad understanding and support for the change. 1: The Clinical Implementation Team (CIT) 2: The Clinical Workgroup 3: Hospital Senior Executive Leadership
  6. 6. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Aligning Organizational Resources Once a clinical work process (for example, pregnancy) has been prioritized for improvement, the clinical implementation team is assembled. The team includes individuals who represent every major step in the care process (for example, fertility; prenatal; L&D; postpartum). Each CIT member represents a group of peers who fill the same role in the workflow. The Clinical Implementation Team (CIT)
  7. 7. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Aligning Organizational Resources The workgroup is comprised of the CIT leadership triad and content, analytic, and technical experts. This small, smart group does the legwork for the larger team by assembling and analyzing data and drafting tools like order sets, treatment protocols, and value stream maps. Additionally, the workgroup has primary accountability for studying the impact of the improvement effort and bringing forward that information to the CIT. The Clinical Workgroup
  8. 8. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Aligning Organizational Resources Understanding of a need for a different approach and being willing to make the necessary cultural changes must start at the top. It is difficult to surmount the challenge of involving clinicians on the frontlines of care in the process of improvement if executives aren’t completely on board with the approach. Hospital Senior Executive Leadership
  9. 9. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Aligning Organizational Resources In practice, the deployment structure for sustaining clinical improvements looks like this:
  10. 10. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. The Clinical Implementation Team is Permanent and Accountable These teams do not disband at the initiative launch, nor do they stop collaborating six months in; they are tasked with and accountable for continuing to monitor and maintain the improved process. Ongoing accountability lies with the clinical implementation team.
  11. 11. © 2014 Health Catalyst www.healthcatalyst.com Proprietary. Feel free to share but we would appreciate a Health Catalyst citation. Sustaining Clinical Improvements is Difficult but Possible The structure presented here is a straightforward, proven method for successfully rolling out and sustaining clinical improvement. All you need is executive support, the right analytics technology, and a single workgroup. An experienced analytics vendor can provide guidance and tools so you can learn how to structure yourself to become an improvement organization.
  12. 12. © 2013 Health Catalyst www.healthcatalyst.com Other Clinical Quality Improvement Resources Click to read additional information at www.healthcatalyst.com Cherbon VanEtten Director of Education, Health Catalyst Ms. VanEtten has 16 years of health care experience in information technology and healthcare analytics. Prior to joining Health Catalyst, she worked for MultiCare Health System as a Senior Project Manager Professional (PMP) where she led numerous enterprise wide strategic initiatives – including the implementation of a healthcare data warehouse and quality improvement programs. She developed tools and methodologies to calculate ROI and total cost of ownership for IT investments – including EHR and EDW systems. Ms. VanEtten was responsible for leading a multi- disciplinary clinical team in developing content for computerized physician order entry (CPOE), physician note templates and interdisciplinary plans of care. She earned her under graduate degree in Psychology from the University of Washington and graduate degree in Biomedical Informatics from Oregon Health and Science University.

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