Quality Matters: 5 Steps to Jump-Start Your Hospital's Quality Transformation
What is your #1 challenge in clinical quality improvement?
If your hospital is like its peers, it’s changing physician behavior. And changing physician behavior doesn’t happen on its own. It happens by focusing on physician engagement. And who better to know about engaging physicians to achieve quality improvement than physicians themselves. Here is a five step process recommended by CPM Healthgrades’ ACE (Accelerated Clinical Excellence) physician consultants.
No matter where your hospital is on its quality trajectory, a comprehensive physician engagement plan will help you reach the next level:
- Measure: You already collect a universe of quality measurements. To decide which ones to focus on, ask yourself: What are your quality goals? Do you want to focus on process measures to meet the priorities of some ratings organizations, or on risk-adjusted outcomes, which matter most to patients, physicians and payers? If the latter, decide which benchmark(s) matter most to your organization and your physicians. Do you want to compare your outcomes with Medicare MedPAR data, all-payer data, your competition or all of the above? For example, if all hospitals performed at the level of Healthgrades’ 2013 Distinguished Hospital Award for Clinical Excellence recipients, 164,406 lives could have been saved.
- Turn Data Into Information: Next, further hone your focus by deciding what you want to improve first. Is it your cardiac or orthopedic service lines, or your readiness for health reform priorities like chronic disease management and bundled payments? Then make it personal for your physicians. Familiarize them with the personal information about them available online, and use in-depth clinical chart review to have a peer discussion about what happened – and could have happened – to their patients.
- Turn Information Into Action: Are your physicians and executives aligned around your quality goals? Take the next step by leveraging physician champions to engage with your medical staff one-on-one and as a group. Create pain (a necessity for change) by using sophisticated data analytics to guide discussions about each physician’s patient outcomes. Then introduce evidence-based medicine and best clinical practices as a way to improve those outcomes and lessen the pain. Get executives on board by showing them the money – for example, a potential $7.9 million Medicare readmissions penalty (see figure).
- Build Structure and Sustainable Process Change: As the ghosts of New Year’s resolutions past remind us, meaningful change is a challenge to maintain. Do you have the data and resources to both create and sustain change? That means high-visibility monthly or quarterly benchmark reports, dedicated physician champions, and hard-wired clinical process change including structured order sets, clinical guidelines and checklists. You may also want to include physician documentation training to support data analysis integrity. One client, a 600-bed Midwestern hospital, leveraged these transformations to reduce orthopedic complication rates by 67% in one year, from 17.19% to 5.64%.
- Receive the Recognition You Deserve: Outcomes matter. You should get credit for your clinical quality transformation from consumers, your board of directors and community physicians. If you aren’t, do you need help figuring out why? Many organizations are unsure how to prepare for consumerism and internet-based provider searches. With a newly insured population under health reform only a year away, ACE physician consultants can show you how to transform clinical quality into a competitive advantage.
To paraphrase Neil Armstrong, that’s five quality engagement steps for physicians, and a giant sustainable leap in quality transformation for your organization.
Webinar: Listen to senior physician consultant Divya Cantor, MD, explain the steps to quality transformation using real-life examples.