Driving Clinical Optimization

In today's era of healthcare reform, organizations face many unique financial and strategic challenges. Healthcare reform requires leaders to improve access to care and increase the quality and safety of care, while decreasing the cost associated with delivery of care. The vessel that will guide organizations down this path is an effective and efficient electronic health record (EHR) system that end users have bought into and used productively to deliver safe care across the continuum.

No matter where a healthcare organization is in its EHR implementation process, its leaders must find ways to improve efficiencies and solve problems before they slow productivity and reduce clinical optimization. One solution, clinical business analytics, enables organizations to identify and solve previously unknown challenges, driving clinical optimization.

Defining Optimization
For any organization's clinical optimization process, leaders must first determine their definition of “optimization” as a guiding principle going forward. Working with an outside resource can help with setting guiding principles, best practices and expectations. Make sure well-defined key performance indicators (KPIs) are in place, and from there set specific benchmarks for future performance and measurement expectations. For example, who will complete the measurement? For which departments does each KPI apply? How often do you measure?

Clinical Assessment
Next, focus on the set area in clinical delivery to assess. Current state mapping will allow your team to see steps, processes, workflows and potential delays in delivering a service to patients to ensure the organization truly offers value-added care. Coordinating with this step, utilize root-cause analysis for problem solving of any current or potential service delays or issues, knowing that more than one root cause can be a hindrance. Arrange identified root causes with higher priority on those causing more issues or delays in patient care.

For the prioritized root cause, focus on optimizing for achieved solutions. Consider industry best practices, including feedback from vendors, EHR user groups, strategic advisors or professional management organizations. With industry best practices in mind, from here map the future state value stream by eliminating any non-value-adding steps from the previous current state value stream. Design and test new workflow pilots to ensure true effectiveness.

Return to KPIs
Even post optimization, continuous monitoring is imperative. Consistently monitor KPI dashboards for emerging patterns indicating improvement interference. If initial value stream changes don't align with target results, make adjustments and re-measure.

Lasting Results
After testing is complete, take the optimized new future-state value stream across the organization. Not everything goes as smoothly as the pilot. Cross-organizational implementation elicits new challenges, so continue thorough monitoring.

Successful clinical optimization can't occur (and last) without diligent behavioral change. Provide training and reinforce continued proper practice with champions throughout the organization backing, personally demonstrating and enforcing new workflows. Make sure to transition new process ownership to direct operational leadership, so they can apply and monitor new successful workflow daily.

Bringing in Data Analytics
Clinical healthcare analytics works to bring the optimization process into inherent practice. In a full-circle effort, a smart healthcare data analytics process examines clinical data for conclusions and patterns in efficient care delivery, improves KPIs and works to support an organization's infrastructure to drive cultural change. This is when you begin to observe change not only in clinical process areas but also organizational change – when you see the culture of the organization shift and clinical analytics begins to drive change or optimization within the clinical setting. You start to see clinical areas using their KPIs and trending data to move processes to a more efficient state, or you see clinical analytics driving clinical optimization.

As you begin to realize the benefits of clinical data analytics, cultural and behavioral changes within the organization happen without resistance, and performance measures trend upward as you see the process begin to repeat itself as it becomes part of the organization's environment. Clinical data analytics becomes the glue between process improvement and optimization, and is now the driving force to consistently improving your KPIs in areas such as value based purchasing, patient satisfaction and National Database of Nursing Quality Indicator scores. Both clinical data analytics and clinical optimization will now become a mechanism that generates revenue back to the organization through improving and maintaining high levels and standards within your performance measures. These are areas that that are increasingly being shifted to incentive-based payment structures. By adopting a clinical data analytic program that drives optimization, organizations will be hard-wiring a strategy for success moving forward.