Better health outcomes are the goal across any healthcare system, whether in a hospital corporation or a specialist doctor's office. Furthermore, the industry is moving increasingly toward a “value-based” care model. Technology will play a pivotal role in supporting that transition, allowing the industry to begin optimizing towards better workflows and eventually, more positive health and business outcomes.
And yet there remain numerous challenges and impediments.
There continues to be massive consolidation, with a 50% uptick in M&A activity in the last two years. Which has the potential of creating efficiencies and scale, but often results in siloed operations, fragmented systems, and impaired performance visibility.
Patient records are now largely digitized. But few organizations have managed to fully unlock the potential EMR systems and other technology platforms could provide to improve outcomes and create a superior patient and clinician experience.
Change management is an issue, with already overburdened staff struggling to do their jobs well without having to adopt new technologies. This issue has only been exacerbated by the pandemic.
So how do organizations successfully overcome these challenges to create a “gold standard” for delivering high quality care to their patients?
The Benefits of a Digital Approach
To identify a gold standard, it’s helpful to remind the organization of the benefits digitization will provide, if fully utilized.
Standardization of Evidence-based Care Practices
Standardization of evidence based care pathways enables more consistent care and improves outcomes. It also facilitates effective and timely communication across the organization, providing a more consistent care experience for patients and clinicians.
The Importance of Having the Right Technology
Technology is the only way in which a gold standard can be rolled out to multiple facilities efficiently. Change management without the right tech can be extremely expensive, so simply defining the gold standard is not enough. Furthermore, technology provides the flexibility and agility to roll out changes to the gold standard.
More Informed Decision-making
Fully embracing a digital value-based care strategy can unlock powerful data to improve decision-making. By identifying which interventions and approaches are most correlated with improved outcomes, conversion to admission rates, and length of stay metrics you can create a platform that helps identify the actions needed to hit your business goals systematically. You can also pinpoint team members and facilities that seem to consistently operate at a high level, and hone in on why.
Digital strategies allow teams that are stretched thin to stay in sync, reducing cognitive overhead and stress for your staff, minimizing miscommunication between interdisciplinary team members, reducing repetitive intake processes for patients and double entry for clinicians, as well as ensuring critical decisions don’t slip through the cracks.
Defining a Gold Standard
What does a process for creating a gold standard look like?
First, it needs to be top down. We have yet to see a successful transformation initiative succeed from the bottom up. Change initiatives are incredibly hard. Without executive support they fade.
It’s useful to start with what’s working internally. Find the overachieving programs, facilities, and team members. To the degree you have quantitative data to inform why, leverage it. But in most cases you’ll need to rely on more qualitative data.
Gathering these data from the inside not only informs what you’re already doing well, it helps you identify internal champions who can be models you can point to and who can enthusiastically advocate for chance. In the process, you’ll also learn what opportunities there are for improvement.
The organization shouldn’t just speak with the team. It should also speak with the patients and their support systems. There is no greater source of feedback than directly from your customers. This can be done in a myriad of ways: observation of the clinical setting, surveys, chatting with patients and family members, etc. The most important thing coming out of this exercise is to learn what they are missing from the current experience, rather than what is going well. This informs your greatest areas of opportunity.
Using this qualitative feedback from your stakeholders, it can often be helpful to engage in some form of a user-centered design process, creating personas for each informed by the data and going through a user journey exercise. The idea here is to identify what intersection points the various stakeholders have with each other and the various activities they must complete during the care journey. This process can surface points of friction and uncover further opportunities for improvement.
Finally, inward examination should be coupled with external research. Identifying specifically what new and cutting-edge literature research is available to raise the standard of care in their organizations can be eye-opening and enlightening for the internal team. We’ve found uncovering the sorts of insights that are legitimately actionable typically requires reaching out and trying to have detailed conversations with their team members responsible for driving the change.
Making it Happen
With all these inputs, one can begin to craft a vision of what the desired change should look like. There are numerous approaches to crafting this vision, some of which we outlined in this article on change management. It’s critical that such a vision be compelling, rational, and seem achievable to the team.
Using internal and external proof points can be helpful in this regard ––if other organizations are capable of driving this change, we should be able to as well.
The project team should be multidisciplinary, with enough executive buy-in and air cover to be effective. Making sure at least one team member is strong in change management initiatives (or partnering with a firm like Manifold to help) is critical as well, to address the myriad roadblocks and challenges that will inevitably arise during the process.
Finally, having a solid data infrastructure in place is critical to ensure you can monitor the effectiveness of the initiatives as you roll them out, from pilot to broad adoption. Specifically you’re looking at three sets of metrics:
- Process Metrics. Metrics that specifically have to do with the process itself - things like timely intervention completion, patient participation in setting goals, therapy hours compliance, etc.
- Outcome Metrics. Metrics are associated with health outcomes. But they may also include average hospital stay, bed or room turnover, medical equipment utilization rate, average patient wait time, average treatment charge, average cost per discharge, etc. It’s critical that you have baseline data for any of these metrics to ensure you can track the improvement over time.
- Key drivers. How do process metrics correlate to outcome metrics? Can we update or refine the gold standard on a continual basis?
Operational complexity in healthcare is here to stay. Embracing a process to progressively bake in technology in the service of increasing outcome metrics and patient satisfaction will be imperative in the coming years. Organizations that are willing to adapt and embrace a transformation effort, informed by stakeholders and adhering to a solid change management process, are likely to reap the benefits of this tectonic shift.