How to Sustain Healthcare Quality Improvement in 3 Critical Steps

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How to Sustain Healthcare Quality Improvement in 3 Critical StepsBy Cherbon VanEtten


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


The Three-system Approach to Healthcare Transformation

All three of these systems work together, but the deployment system is essential to sustaining quality gains.


Driving Sustainable Healthcare TransformationWithout 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


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



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)



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



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



In practice, the deployment structure for sustaining clinical improvements looks like this:


The Clinical Implementation Team is Permanent and AccountableThese 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.


Sustaining Clinical Improvements is Difficult but PossibleThe 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.

© 2013 Health Catalystwww.healthcatalyst.com

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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.

http://www.healthcatalyst.com/

How to Sustain Healthcare Quality Improvement in 3 Critical Steps

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