The 4 Clinical Teams Needed to Drive Sustainable Improvement

The 4 Clinical Teams Needed to
Drive Sustainable Improvement

© 2014 Health Catalyst
www.healthcatalyst.com
Proprietary. Feel free to share but we would appreciate a Health Catalyst citation.
Best Practices for Clinical Teams
Most healthcare organiz-
ations and clinical teams
understand the ongoing
need to improve to their
clinical, financial, and
operational outcomes.
As the industry shifts from
fee-for-service to pay-for-
performance and account-
able care, there are now
financial viability drivers.

One of the methods used to
improve quality and influence
outcomes is to acquire an
extensive library of evidence-
based protocols, best practices,
order sets, guidelines, and
other literature.
The goal of the content system
isn’t just to collect and store
information, but to make it easy
for clinicians to get the
information they need.

Making sense of all the data an
organization accumulates about
patient populations is also
important.
To achieve a deeper level of
insight regarding the stored
data, a healthcare analytics
system is needed.
Today most organizations have
made initial forays into analytics.
Some have committed to a full-
on data warehouse analytics
initiative.

A great content and analytics
system may be sufficient for a
series of one-off initiatives.
However, as improvement
efforts expand, sustaining care
across the organization will
become increasingly difficult.
To make quality improvement
sustainable a cross-functional,
team-based approach will be
needed to accelerate change
organization-wide.

Clinical Teams Drive Improvement
When building any sort of team
structure all the team members
must be integrated from across
the organization.
The team must be permanent.
If a team is thrown together to
perform an analytics-based
process improvement, and then
disbanded once improvement
begins, gains made will not be
sustainable.

Team members must be
engaged and understand the
long-term commitment required.
Attending meetings, analyzing
data, offering evidence-based
recommendations, and providing
workflow understanding may feel
like a full-time job.
Participation on an improvement
initiative team is usually on top of
other duties.

Building a successful deployment system requires a
commitment from at least four teams:
This team is accountable for and
prioritizes all quality initiatives
across the organization. Team
members generally include C-level
executives such as the CEO, CMO,
CNO, CIO, and CMIO.
Leadership team
These teams are accountable for
clinical quality across the continuum
of care in a specific domain (e.g.,
Women and Children’s or Cardio-
vascular) and consist primarily of
clinicians and administration leaders.
Guidance team
Usually a physician and nurse who
are well respected within their
specialty and can influence other
clinicians within specific areas of
the organization who lead these
teams.
Outcome Improvement teams
Led by a physician and nurse
subject matter experts, this team
does the heavy lifting of quality
improvement. These small teams
also include analytics and technical
experts.
Workgroups

Effective leaders are selected
based on their knowledge of
the clinical or organizational
process, as well as their
leadership, facilitation and
communication skills.
Clinical team members should
be prepared to lead their co-
workers through the improve-
ment processes that have
been developed and help
drive the change in practice.

Clinical Teams Taking Action
Once the teams are established,
the Outcomes Improvement
team develops goal statements
and the workgroups identify aim
statements.
To gain buy-in clinicians need to
have a sense of ownership in
developing clinical improvements
and ensure the teams are rowing
in the same direction.

For example:
The Cardiovascular
group may agree heart
failure issues need to be
addressed but team
members may disagree
on improvement targets.
“Improve compliance
on CMS metrics.”
“Focus on risk
stratification.”
“We should look at
transitions of care.”

Implementation of a Key
Performance Analysis (KPA) tool
will enable the team to analyze
the data and determine which
areas will deliver the best ROI.
The Guidance team presents
the recommendations for
approval to the Executive team.
Once approved, the Outcomes
Improvement team establishes
a workgroup to address them.

Agile Development Key to Success
Clinical quality improvement
does not have a beginning,
middle, or end. As such,
employing Agile development
methods is important.
Agile development lends itself
to a continuous, iterative
approach that allows ongoing
improvement over time.

All Three Systems are Critical
Having all three systems in
place – content, analytics and
deployment –is critical for
creating sustainable clinical
process improvements.
The deployment system is often
the most difficult to implement
as it can’t be purchased in the
same way as order sets or
analytics technologies.

All Three Systems are Critical
The deployment system
requires real, ongoing
commitment from leadership
and the cross-functional
team to ensure success.
Without investing in a
deployment system it is
impossible to drive and
sustain true clinical process
improvement.

More about this topic
3 Steps to Prioritize Clinical Quality Improvement in Healthcare
Bobbi Brown, Vice President of Financial Engagement
Quality Improvement in Healthcare: Where is the Best Place to Start?
Eric Just, Vice President of Technology
Overcoming Clinical Data Problems in Quality Improvement Projects
Kathleen Merkley, Vice President, Executive Engagement
Ann Tinker, Vice President, Customer Engagement
Quality Improvement in Healthcare: An ACO Palliative Care Case Study
Case Study
6 Steps for Implementing Successful Performance Improvement Initiatives in Healthcare
Bobbi Brown, Vice President of Financial Engagement
Leslie Falk, Vice President, Executive Engagement
Link to original article for a more in-depth discussion.
The 4 Clinical Teams Needed to Drive Sustainable Improvement

For more information:

Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Susan Easton joined Health Catalyst in May 2013 as an Engagement Executive. Susan
brings over 30 years of healthcare experience, starting with direct patient care and
spending the majority of her career in leadership roles in the areas of quality, safety and
healthcare analytics. Susan spent 19 years dedicated to improving clinical care including
the implementation of analytic systems to support performance improvement across the
continuum of care. Prior to joining Health Catalyst, Susan was an Executive Director at PeaceHealth
where she was responsible for enterprise wide data warehousing, business intelligence analytics,
clinical quality and Patient Experience. During her 26 years at PeaceHealth, Susan had a variety of
duties and responsibilities outside her primary director role including overseeing a variety of technical
teams: application development team, interface team and database administration team. Additionally
she held operational leadership roles managing the peer review process, serving in a variety of roles
related to health information management and including administrating several clinics and opening a
walk in clinic in a rural setting. Ms. Easton has an educational background that is both clinical and
business related with undergraduate work in nursing and a Masters Degree in Business.
Kathleen Merkley, DNP, APRN joined Health Catalyst in March 2013, as an Engagement
Executive. Prior to coming to HC, she worked for Intermountain Healthcare as the
corporate clinical IT implementation manager. Kathleen is a registered nurse/nurse
practitioner and just received her doctorate in nursing practice from the University of Utah
in May 2013.

Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Tracy Vayo joined Health Catalyst in 2014. Before coming to Catalyst Tracy spent the last
12+ years as Director of Patient and Provider Publications for Intermountain Healthcare –
creating care process models, patient education, and implementation tools for clinical best
practice. She was the Director of Pediatric Education Services for 5 years at Primary
Children’s Hospital, with oversight of staff and patient/family education for, 9 years in
Cardiac Rehab and Wellness, including 4 years as Manager of Cardiac Rehab and Wellness at Ogden
Regional Medical Center, a year as Manager of Cardiac Rehab at Holy Cross Hospital, and 4 years as
a Clinical Exercise Therapist at LDS Hospital. She was over 5 years as a Technical and/or Medical
Writer – including at Unisys, Iomega, and Evans & Sutherland.
Kirstin Scott has a background in instructional design. She began work at Health
Catalyst in 2014 after 12 years as a medical writer at Intermountain Healthcare. There she
worked primarily with Women and Newborns and Pediatric Specialty Clinical Programs.

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The 4 Clinical Teams Needed to Drive Sustainable Improvement