Quality Improvement & Data Systems for Performance Excellence Board and Executive Learning Series...
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![Page 1: Quality Improvement & Data Systems for Performance Excellence Board and Executive Learning Series June 2, 2012 Lucy A. Savitz, Ph.D., MBA Director of Research.](https://reader030.fdocuments.us/reader030/viewer/2022032604/56649e6a5503460f94b67169/html5/thumbnails/1.jpg)
Quality Improvement & Data Systems for Performance
ExcellenceBoard and Executive Learning Series
June 2, 2012
Lucy A. Savitz, Ph.D., MBADirector of Research and
Education
Institute for Health Care Delivery Research
![Page 2: Quality Improvement & Data Systems for Performance Excellence Board and Executive Learning Series June 2, 2012 Lucy A. Savitz, Ph.D., MBA Director of Research.](https://reader030.fdocuments.us/reader030/viewer/2022032604/56649e6a5503460f94b67169/html5/thumbnails/2.jpg)
The Quality Challenge“the difference between the care we deliver and the care
we could deliver”
The Right Care
For The Right Person
At The Right Time
![Page 3: Quality Improvement & Data Systems for Performance Excellence Board and Executive Learning Series June 2, 2012 Lucy A. Savitz, Ph.D., MBA Director of Research.](https://reader030.fdocuments.us/reader030/viewer/2022032604/56649e6a5503460f94b67169/html5/thumbnails/3.jpg)
Care Delivery Falls Short of Potential
• Well-documented, massive variation in practices
• High rates of inappropriate care
• Unacceptable rates of preventable care-associated patient injury & death
• A striking inability to do what we know works
• Huge amounts of waste (>44%), spiraling prices, and limited access
![Page 4: Quality Improvement & Data Systems for Performance Excellence Board and Executive Learning Series June 2, 2012 Lucy A. Savitz, Ph.D., MBA Director of Research.](https://reader030.fdocuments.us/reader030/viewer/2022032604/56649e6a5503460f94b67169/html5/thumbnails/4.jpg)
Need for a Healthcare System that Learns
We require a sustainable system
• That gets the right care to the right person at the right time
and then
• Captures the results for making improvements.
![Page 5: Quality Improvement & Data Systems for Performance Excellence Board and Executive Learning Series June 2, 2012 Lucy A. Savitz, Ph.D., MBA Director of Research.](https://reader030.fdocuments.us/reader030/viewer/2022032604/56649e6a5503460f94b67169/html5/thumbnails/5.jpg)
Mission Critical Support for Performance Excellence
Training Clinical Integration
Foundation for Robust QI &
Delivery Science Research
Data Systems
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Driving Change
• We combined our QUE “research” experience with Deming’s quality theory to create a series of training programs.
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ATP Training, 1992-present
• 500+ Intermountain Staff
• 1,800+ External Participants
Training used to drive culture change.
Brent James, MD, M.Stat. , Chief Quality OfficerDirector and Founder; Institute for Health Care Delivery Research
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Clinical Integration
• Clinical work process-based organizational structure
• A fundamental idea of QI theory is to identify key work processes then organize around them.
• A limited number of these key processes make up the majority of services you provide to patients.
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Integrated Reporting and Analysis
EDWEDWFinancial
Data
FinancialData
Clinical Data
Clinical Data
Claims&Eligibility
Claims&Eligibility
Data Systems
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HELP
Pharmacy Pharmacy
Radiology Radiology
Data Entry(CW)
& Results Review
EventMonitor
Billing &Financial
MedicalLogic
Modules
Medical Dictionaries
Database
Research& Analysis
(EDW)Patient Care
Database(CDR)
DatabaseInterface
LaboratoryLaboratory
2
InsurancePlans
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Case for Continuous Improvement
Incorporating
• Innovation
• Disciplined QI
• Research & Evaluation
Critical to finding new designs/solutions for optimizing:
• Patient experience
• Health of the population
• Controlling cost/reducing waste.
![Page 12: Quality Improvement & Data Systems for Performance Excellence Board and Executive Learning Series June 2, 2012 Lucy A. Savitz, Ph.D., MBA Director of Research.](https://reader030.fdocuments.us/reader030/viewer/2022032604/56649e6a5503460f94b67169/html5/thumbnails/12.jpg)
The Problem
Reducing variation in compliance with evidence-based guidelines.
• Care Process Models (CPMs) are narrative documents that aim at representing state-of-the-art medical knowledge.
• Clinical Decision Support Tools can include all ways in which health care knowledge is represented in health information systems.
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Key steps in our approach…
• Identify problem• Establish evidence base• Develop, test, & implement using QI
concepts and tools (define, measure, analyze, improve, control)
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Institute for Health Care Delivery Research: Staffing
Leadership: 3.0 FTEs
Brent James, MD, M.Stat.; Executive Director
Lucy Savitz, Ph.D., MBA; Director, Research & Education
Todd Allen, MD; Assistant Quality Officer
Support Staff:
• Clinical Program Analysts: 13.25 FTEs
• Education Program Staff: 4.25 FTEs
• Program Support Staff: 4.5 FTEs
• Interns/Fellows: 3.0 FTEs
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Core Functions of the Institute—supporting a Learning Commons
1. QI Training
2. Clinical Program Support, data examination to create the learning organization
3. Delivery System Transformation Support
4. Operationally Meaningful Research
5. Collaborations
6. Dissemination & Shared Learning
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Scientific Approach to QIIOM: Selker, H et al., 10/11.
• Clear, measurable process & outcomes goals
• Basis in evidence
• Iterative testing
• Appropriate analytic methods
• Documented results
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QI: Role in Driving Evidence Base
QI
ImplementationScience
ProgramEvaluation
Qausi-experimental
InterventionStudies(Trials)
Clinical Effectiveness
Outcomes
Driving the science of change/innovation…
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Selected References
• Wallace, J, LA Savitz: Estimating Waste in Frontline Health Care Workers, Journal of Evaluation in Clinical Practice, 14:178-180, 2008.
• Clark, DD, LA Savitz, SB Pingree: “Cost Cutting in Health Systems Without Compromising Quality,” Frontiers of Health Services Management, 27(2):19-30, 2010.
• James, BC & LA Savitz: “How Intermountain Trimmed Health Care Costs Through Robust Quality Improvement Efforts,” Health Affairs, 30(6), 2011.
• Selker, H, C Grossman, A Adams, D Goldman, C Dexii, G Meyer, V Roger, L Savitz, R Platt: “The Common Rule and Continuous Improvement in health Care, A Learning System Perspective, IOM, October, 2011.
• Luther, K & LA Savitz: “Leaders Challenged to Reduce Cost, Deliver More,” Healthcare Executive, Jan/Feb, 2012.
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Thank you.