A common managerial expression is, "You can't improve what you don't measure." This is particularly true in healthcare. The focus within healthcare on safety, quality, equity and cost leads to numerous measurements. A challenge that healthcare leaders face is using the data collected through measurement initiatives to drive improved reliability and care.
In a webinar hosted by Becker's Hospital Review and sponsored by Chartis, Andrew Resnick, MD, chief medical and quality officer at Chartis, moderated a discussion between Steve Mrozowski, senior director of patient safety and high reliability at Cleveland Clinic, and Michael Stadler, MD, chief medical officer of Froedtert Hospital in Wauwatosa, Wisc., and associate dean for clinical affairs at the Medical College of Wisconsin in Milwaukee. The panelists discussed how their organizations use measurements, ratings, and rankings to achieve greater reliability and higher-quality care.
Four key takeaways were:
- Healthcare leaders want to deliver high quality, reliable care despite challenges. The healthcare industry faces numerous challenges including burnt out staff and tight finances. These challenges were exacerbated by the pandemic, which disrupted nearly every aspect of healthcare at once.
Despite these challenge – or perhaps because of them - , it’s more important than ever to prioritize high reliability care, rather than putting it on the back-burner.. "We want to create high-performing organizations that are resilient to human and system failures that occur every day," Dr. Resnick said. - Now is the time to create high-reliability organizations. Some healthcare leaders argue that it is necessary to wait to focus on high reliability until current issues are resolved, such as staffing shortages, budget shortfalls, capacity constraints, and more. Dr. Resnick challenged this thinking. "High reliability is not separate," he said. "It is the way to solve these problems by fundamentally altering an organization and transforming it." He added, "The best way to decrease cost is by improving quality." Therefore, now is the right time to focus on high reliability.
Dr. Resnick said that creating high-reliability organizations has multiple benefits including improvements in efficiency, patient experience, performance on regulatory surveys, staff engagement, reputation, and ratings and rankings. - Ratings and ranking can be used to drive improvement. In a real-time poll of participants, 73 percent said their organization values ratings and rankings a lot. The panelists explained that performance in ratings and rankings is important because it shows an organization how it is performing versus peers and identifies areas and opportunities for improvement.
Dr. Stadler said Froedtert Hospital uses Vizient to help measure and improve its results. Vizient, with more than 100 objective measures, was appealing to Froedtert. "Not only is the data objective," Dr. Stadler said, "but we believe it's transparent in terms of the way the measures are analyzed." He continued, "We are measured against appropriate peer groups in academic medical centers." - Alignment from the board to the front lines is essential in leveraging ranking to achieve higher quality care. "We engage our board in all aspects of quality and safety work," Mr. Mrozowski said. Among webinar participants, 48 percent said their leadership and board were "very committed" to ratings and rankings.
However, educating the board and leadership about quality and ratings is not enough. Creating a high-reliability organization requires aligning the entire organization — including front-line employees — with the mission, vision, and values. This means cascading all measures that are part of ratings and ranking to all levels and departments and engaging everyone in the organization. This is best done through multidisciplinary teams, education, and communication. It is having "a system that connects everyone from the board down to the frontline," Dr. Resnick said.