Archive for the ‘Quality Improvement’ Category

Infographic: UW Medicine Healthcare Equity

March 15th, 2019 by Melanie Matthews

UW Medicine Healthcare has launched a number of initiatives to further its organizational goal of providing high-quality, culturally appropriate healthcare, regardless of age, race, ethnicity, gender, sexual orientation, religion or ability, according to a new infographic by UW Medicine.

The infographic examines UW Medicine’s programs supporting these goals.

When the prestigious Memorial Sloan Kettering Cancer Center (MSKCC) began to face tougher competition from hospitals with managed care contracts and limited networks, the state-of-the-art specialty hospital decided to implement a team-based care coordination approach to attract and retain healthcare payors focused on value-based care.

Integrated Case Management: Elevating Quality and Clinical Metrics with Multidisciplinary Team-Based Care details the framework and implementation of the service-based multidisciplinary program MSKCC adopted to demonstrate that the care it provides to more than 25,000 admitted patients each year is both cost-effective and cost-efficient.

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Guest Post: Americans Say Healthcare Isn’t the Consumer Experience Leader It Needs to Be

March 14th, 2019 by Nate Brogan

Healthcare consumer experiences are falling short of patients’ expectations, according to a West survey. West surveyed 1,036 adults and 317 healthcare providers in the United States to learn how Americans feel their healthcare experiences stack up against other consumer experiences. The survey revealed that, although patients want healthcare experiences to outshine other consumer experiences, 72 percent of patients feel healthcare is falling behind other industries in terms of delivering exceptional experiences. The solution? Patients suggest better communication is needed for healthcare to live up to consumer experience expectations.

More than half (56 percent) of providers agree that healthcare may be trailing other industries when it comes to delivering meaningful consumer experiences, the West survey revealed. Also, around one in three Americans believe healthcare organizations are not as focused on customer experiences as grocery stores (30 percent), travel companies (30 percent) and financial services companies (29 percent).

Lagging Healthcare Experiences

Patients who feel healthcare organizations need to raise the bar when it comes to delivering customer experiences point to billing and wait times as two of the areas where improved communication could make healthcare experiences better. Around one in three patients say healthcare bills are more confusing than other bills (30 percent) and doctors run late for appointments more frequently than service providers from other industries (35 percent). Both of those, patients say, detract from the overall healthcare consumer experience.

Transforming healthcare experiences—at least in regard to billing and wait times—may be as easy as making some simple communication adjustments. It doesn’t take much in terms of time or resources to send patients a text or email that notifies them when a doctor is running behind schedule. Most healthcare organizations already use patient engagement technology that enables teams to send patients automated messages to remind them about upcoming appointments. That same technology can be used to send other types of messages to patients—like a message to clarify a bill, for example.

Here is a closer look at two communication upgrades healthcare teams can make to deliver better experiences for patients:

Actively and clearly communicate about financial responsibilities.

Most patients agree that interpreting and paying medical bills is confusing. The financial stress of having to pay medical bills can be heavy enough. But add to it the confusion of trying to determine what amount is actually owed, what is covered by insurance, what services are included in billed costs, and the process of paying medical bills can become overwhelming. A majority of healthcare providers (61 percent) admit that they believe healthcare bills are more confusing than other bills. Unfortunately, healthcare’s lack of cost transparency and complicated billing can cause patients to feel negatively about their healthcare experiences. But some of that frustration can easily be avoided.

Sending messages to communicate about costs and payments can eliminate stress caused by medical bills and improve overall healthcare experiences for patients. Healthcare teams that use patient engagement technology to send appointment reminders can adapt their messages and use their existing technology to communicate about a variety of financial topics. This might mean sending patients messages following appointments to let them know when to expect a bill, what services will be included on their bill and what payment options are available to them. It could also mean following up with a message after a bill has been sent, to explain and clarify what costs are covered by insurance. According to West’s survey findings, only 15 percent of providers routinely send these types of messages. Making this type of increased communication a standard part of the billing process allows patients to better budget for healthcare expenses, and it lessens confusion and frustration—in other words, a big patient experience improvement.

Notify patients when there are delays or changes to scheduled appointments.

Another time when patients want increased communication is when doctors are running late. More than eight in ten patients (83 percent) think healthcare organizations are more likely than other companies to run behind schedule or keep them waiting. Because patients typically don’t find out about delays until after they arrive for an appointment, this causes a lot of waiting. Many providers don’t recognize quite how much of a problem waiting is, or that delays are a major frustration for patients. Less than half of providers (42 percent) think healthcare professionals actually run late more frequently than service providers in other industries. This explains why less than half (49 percent) of healthcare providers say that their patients receive notifications (text messages, voice calls or emails) when there are delays that impact their healthcare appointments.

It is unlikely that delays could be completely eliminated or that providers could maintain an on-time schedule 100 percent of the time. However, healthcare teams can certainly reduce waiting by leveraging their appointment reminder technology to communicate with patients when there are delays. Other industries send similar messages to alert consumers of delays. For example, airlines send messages to notify fliers of delayed and cancelled flights. By doing this, it allows consumers to adjust their arrival time and it helps minimize frustration. When healthcare teams send these types of communications to patients, they can show patients their time is valued and help them feel better about their healthcare experiences.

Patients hold healthcare to high standards; they want healthcare experiences to outshine other consumer experiences. Taking advantage of opportunities to use technology-enabled communications to better communicate with patients is an effective way to deliver better patient experiences. And doing so can help healthcare become the consumer experience leader patients expect it to be.

Nate Brogan

Nate Brogan

About the Author: Nate Brogan is an advocate for utilizing technology-enabled communications to engage and activate patients beyond the clinical setting, promoting the idea that engaging with patients between healthcare appointments in meaningful ways will encourage and inspire them to follow and embrace treatment plans—and that activating these positive behaviors ultimately leads to better outcomes for both healthcare organizations and patients. Brogan currently serves as President of Notification Services at West (, where the healthcare mission is to help organizations harness communications to expand the boundaries of where, when, and how healthcare is delivered.

Infographic: A Day in the Life of a Community Health Worker

March 11th, 2019 by Melanie Matthews

Community health workers are frontline public health outreach workers who have a strong connection to the communities they serve, with an in-depth understanding of their experiences, culture, language, or needs, according to a new infographic by the Connecticut Health Foundation.

The infographic examines the various roles of community health workers in today’s healthcare system.

Innovative Community Health Partnerships: Clinical Alliances to Reduce Health Disparities in Underserved PopulationsAs one of the poorest urban congressional districts in the country, the Bronx, a New York City borough, was also rated as the last county (#62) in New York for health outcomes and health factors by the Robert Wood Johnson Foundation. In reaction, the Bronx Health REACH initiative formed the “#Not62,” campaign to transform the health of the community.

Innovative Community Health Partnerships: Clinical Alliances to Reduce Health Disparities in Underserved Populations highlights the models of change and key initiatives developed through Bronx Health REACH’s community health transformation project.

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Infographic: Infections with the Highest Impact on Medicare HAC Penalties

August 24th, 2018 by Melanie Matthews

Attention to high-impact healthcare associated infections can help you get out of the bottom quartile penalty box, according to a new infographic by 3M.

The infographic examines the relative rate of impact on the 2018 penalties for six healthcare associated infections.

A Collaborative Blueprint for Reducing SNF Readmissions: Driving Results with Quality Reporting and Performance Metrics
Concerned about escalating hospital readmissions from skilled nursing facilities (SNFs) and the accompanying pinch of Medicare readmissions penalties, three Michigan healthcare organizations set competition aside to collaborate and reduce rehospitalizations from SNFs.

To solidify their coordinated approach, Henry Ford Health System (HFHS), the Detroit Medical Center and St. John’s Providence Health System formed the Tri-County SNF Collaborative with support from the Michigan Quality Improvement Organization (MPRO).

A Collaborative Blueprint for Reducing SNF Readmissions: Driving Results with Quality Reporting and Performance Metrics examines the evolution of the Tri-County SNF Collaborative, as well as the set of clinical and quality targets and metrics with which it operates.

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Guest Post: Increase HCAHPS Scores Through Healthcare Design

July 10th, 2018 by Rebecca Donner

Improving HCAHPS scores from an interior design perspective.

The Centers for Medicare & Medicaid Services’ (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was established as a way to measure patients’ perspectives on healthcare and make comparisons across hospitals based on the patient experience. Receiving a high score can boost hospitals’ Medicare/Medicaid reimbursement, while a low score can decrease funding by as much as 2 percent. Because HCAHPS scores can affect a hospital’s bottom line, it provides an incentive for them to place a greater focus on patient experience to receive a high score.

There a number of ways to increase a HCAHPS score, including patient communication and respect, speediness, cleanliness and even pain management procedures. But one way that may be overlooked is how to raise that score through interior design. There are a number of ways to approach HCAHPS scores from a design perspective.

Noise Reduction

With so much commotion in hospitals, it can be difficult for patients to rest, which is a key component to the healing process. Standard noise levels should be 35 dB(A) during the day and 30 d(B)A at night, but peak noise levels in hospitals often exceed 85 to 90 db(A), according to the Center for Health Design.

Aside from limiting overhead announcements and machine beeping, hospitals can reduce noise by focusing on the materials they use inside their facility. Carpet tiles or rubber flooring, as opposed to tile, can reduce the noise of foot traffic outside patient rooms. In addition, acoustic wall coverings and ceiling tiles act as giant sonic sponges, soaking up unwanted noise and echo. This can prevent any loud conversations or unwanted noises from traveling down hallways.


Privacy and comfort rank high in ways to improve patient experience. According to the 2016 Hospital Construction Survey, many hospitals are now converting semi-private rooms into private rooms to increase patient privacy. After all, no one wants to share a room with a stranger during what can be one of the scariest times in someone’s life. Plus, two patients in a room can increase the chance of infection.

Many hospitals are also increasing the square footage of patient rooms. This way, even if two patients are sharing a room, they each have plenty of private space.

Personal Controls

To make the hospital feel like home as much as possible, many facilities are now offering patients greater control over the lighting, temperature and window shades in their rooms. Everyone has different preferences when it comes to how warm or cool, or how dark or bright, they want a room to be. Personal dimming controls allow patients to adjust the lighting depending on their activity, whether they are trying to sleep or need extra light for reading or examinations. Giving patients control over these variables can lead to higher patient satisfaction.


Hospitals with high mobility and accessibility receive higher HCAHPS scores. Installing handrails makes it easier for patients to get to the bathroom, and wide bathrooms give patients the space they need when using the facilities.

About the Author:

Rebecca Donner

Rebecca Donner

Rebecca Donner is the owner and founder of Nashville-based healthcare interior design firm Inner Design Studio. For more information.

Infographic: Clinical Documentation to Optimize Value-Based Care in the Outpatient Setting

June 22nd, 2018 by Melanie Matthews

A strong commitment to clinical documentation improvement (CDI) can help healthcare organizations maximize claims reimbursement while improving quality of care, according to a new infographic by Galen Healthcare Solutions.

The infographic examines CDI goals and the impact of improved CDI on the healthcare bottom line.

Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS SuccessA laser focus on population health interventions and processes can generate immediate revenue streams for fledgling accountable care organizations that support the hard work of creating a sustainable ACO business model. This population health priority has proven a lucrative strategy for Caravan Health, whose 23 ACO clients saved more than $26 million across approximately 250,000 covered lives in 2016 under the Medicare Shared Savings Program (MSSP).

Profiting from Population Health Revenue in an ACO: Framework for Medicare Shared Savings and MIPS Success examines Caravan Health’s population health-focused approach for ACOs and its potential for positioning ACOs for success under MSSP and MACRA’s Merit-based Incentive Payment System (MIPS).

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Infographic: Impact of Diagnostics on Healthcare Outcomes

April 20th, 2018 by Melanie Matthews

Diagnostic testing plays a key role in reducing hospitalizations, preventing infections, and improving healthcare outcomes, according to a new infographic by Health Industry Distributors Association.

The infographic explores the impact of diagnostic testing on healthcare utilization, infections, adverse health events, patient satisfaction and healthcare costs.

Healthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare IndustryHealthcare Trends & Forecasts in 2018: Performance Expectations for the Healthcare Industry, HIN’s 14th annual business forecast, is designed to support healthcare C-suite planning as leaders react to presidential priorities and seek new strategies for engaging providers, patients and health plan members in value-based care.

HIN’s highly anticipated annual strategic playbook opens with perspectives from industry thought leader Brian Sanderson, managing principal, healthcare services, Crowe Horwath, who outlines a roadmap to healthcare provider success by examining the key issues, challenges and opportunities facing providers in the year to come. Following Sanderson’s outlook is guidance for healthcare payors from David Buchanan, president, Buchanan Strategies, on navigating seven hot button areas for insurers, from the future of Obamacare to the changing face of telehealth to the surprising role grocery stores might one day play in healthcare delivery. Click here for more information.

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Mounting Pressure from Value-Based Reimbursement Models Drives Clinical Improvement Strategy at Allina Health System

April 17th, 2018 by Melanie Matthews

Value-Based Reimbursement Models Drive Clinical Improvement Strategy

As a greater percentage of hospital payments are through value-based contracts, hospitals that reduce costs while maintaining quality will survive, predicts Pam Rush, cardiovascular clinical service line program director at Allina Health.

“How do we improve outcomes and decrease costs?” Rush asked participants in the March 2018 webinar, Predictive Healthcare Analytics: Four Pillars for Success. “We need to start to look at the world differently.”

How can we be more creative and do things differently? How can we use different members of the healthcare teams in new ways, such as nurse practitioners or advanced practice providers, she added. In addition, “we need to invest in data analytics and data resources and have data analysts who can pull the information for us so we can find the variation. We need to invest in physician and caregiver time to look at the data, to make changes in how they improve care, to monitor and see what is working and what doesn’t work.”

These four pillars…population health management, reducing clinical variation, testing new care processes and new models of payment, and leveraging cutting edge technologies…have been critical to the work at Allina Health System’s Minneapolis Heart Institute Center for Healthcare Delivery Innovation, said Rush.

In population health management, we’re looking at how can we focus on adherence to guidelines, identify where there are gaps in care and partner with people across the system, primary care and specialists, to improve consistency and adherence to guidelines, she explained.

Allina is reducing clinical variation by looking at unnecessary variations in care where there is inconsistent care without an influence on outcomes.

“We’re also looking at new ways of doing things. How can we use our nurse practitioners, how do we care for patients once they’re discharged from the hospital and bring them back in for clinic visits? It’s really looking at the care model and how we can do things differently to reduce total cost of care,” she said.

In cardiology, there are so many new devices, procedures and techniques to monitor, said Rush, but we need to figure out who are the right providers to do that monitoring, who are the right patients to do these expensive procedures on and who achieves the best outcomes, because we can’t afford to do all of this new technology to every single person.

Allina looks at these four pillars across the continuum. Starting in primary care to partner on prevention strategies, moving to who gets referred to cardiology, and when they’re referred to cardiology, what are the set of tests or treatments and guidelines to adhere to along the continuum to subspecialties, emergency services and all the way up through advanced therapies, such as transplant.

During the webinar, Rush along with Dr. Steven Bradley, cardiologist, MHI and associate director, MHI Healthcare Delivery Innovation Center, shared these four pillars of predictive analytics success along with details on creating a culture of quality and innovation, building performance improvement dashboards, as well as several case examples of quality improvement initiatives contributing to these savings and much more.

Listen to Ms. Rush describe how MHI leveraged an enterprise data warehouse to identify care gaps and clinical quality improvement opportunities.

Guest Post: Outcomes Drive the Evidence-Based Practice Journey

March 29th, 2018 by Michele Farrington and Cindy Dawson

The Institute of Medicine set a goal that 90 percent of all healthcare decisions will be evidence-based by 2020. Executives and nursing leaders, at all levels within organizations, have clear responsibility for making this goal a reality and ensuring consistent, standardized use of evidence-based practice (EBP) in care delivery that will meet patient, family, clinician, and organizational outcomes.

Promoting use of evidence, valuing questioning of clinical and administrative practice, and building organizational capacity, culture, and commitment are pivotal to building a supportive organizational culture related to EBP.

Organizations must meet regulatory requirements, from the Centers for Medicare and Medicaid Services and The Joint Commission, that incorporate EBPs and the need for increasing public accountability and transparency (e.g., use of national benchmarks) for quality and safety. Financial incentives associated with pay-for-performance are also directly linked to EBP. Despite these outside forces in today’s healthcare environment, clinicians and executives cannot forget about the need to provide individualized patient care, which includes patient engagement strategies aimed at improving the overall patient experience.

EBP is a continuous journey for individual clinicians and organizations alike and starts with building organizational capacity.

Organizational Capacity

EBP capacity is built using a strategic, systematic approach to create a solid foundation and infrastructure to support the work. Before EBP work can be successful at the unit or clinic level, EBP must be integrated at the organizational level and a culture for change must exist.

The organization’s mission, vision, and strategic plan must include EBP language to ensure evidence-based healthcare is clearly portrayed as the organizational norm. Creating a culture valuing inquiry and innovation must start during orientation for new hires and continue during competency review for current employees and through ongoing training and professional development opportunities for both clinicians and executive leaders.

An infrastructure that directly integrates EBP work into the organizational governance structure is needed to support the mission, vision, and strategic plan. A crucial organizational decision is determining what group will hold primary accountability or functional responsibility for EBP to ensure it is integrated into practice processes, policies, and documentation.

Recruiting and hiring clinicians and executives with experience and/or interest in EBP will help build the desired culture and capacity. EBP mentors are developed from successful projects and are used to nurture the next generation.

A well-defined path for EBP includes adoption of an EBP-process model to guide implementation and sustained organizational change across disciplines. There are a number of EBP process models: The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care; Johns Hopkins Nursing Evidence-Based Practice Model; Stetler Model of Evidence-Based Practice; and Advancing Research and Clinical Practice Through Close Collaboration (ARCC) Model. Each model follows a step-by-step problem-solving process suitable for concurrent use with the organization’s quality improvement processes.


The governance structure must clearly outline the process and channels for communicating EBP work and obtaining necessary approvals from applicable committees. EBP discussions should be a regular agenda item for all shared governance committees.

Project results should be reported internally through the organization’s shared governance and quality improvement structures to promote practice change adoption, share learning, garner continued support (e.g., time, resources), and as a platform to recognize success for the institution’s EBP program.

Successful EBP work takes time and effort, so successes should be celebrated and rewarded throughout the process. Celebrations are an opportunity to spotlight clinicians for doing this work and helps build a pervasive culture that supports and expects use of evidence in practice. These strategies promote organizational buy-in and commitment for the EBP process and set higher standards as a foundation for future efforts.

Expected behaviors from clinicians across all job classifications at every level must clearly demonstrate the value of EBP. Behavioral expectations regarding EBP are easily set if they are built into every job description and can be quickly reviewed annually during the performance appraisal process. Utilizing documents and mechanisms that already occur is an easy and efficient way to promote positive reinforcement and priority setting in busy work environments with many ongoing and competing demands for clinicians’ and leaders’ time and attention.


EBP is value-added with a strong return on investment and responds to current priorities. A single project may improve patient and clinician safety, improve clinical outcomes, improve patient/family satisfaction, promote innovate care, and/or reduce costs.

Clinicians, nurses, and leaders all influence an organization’s capacity for EBP. Leaders who demonstrate and expect EBP will promote its use in clinical and operational decision-making at the unit or clinic and organizational levels. Building on the organization’s mission, vision, capacity, and value for delivery of reliable, safe, high quality care provides a foundation for success.

About the Authors:

Michele Farrington, BSN, RN, CPHON, is a clinical healthcare research associate at the University of Iowa Hospitals and Clinics. She is certified in pediatric hematology/oncology nursing and received her BSN from the University of Iowa. She has been leading, co-leading, or mentoring EBP initiatives since 2003, and her work has been awarded extramural funding, validating the strength of the projects and impact on nursing care. She is widely published and has given multiple local, regional, national, and international presentations.

Cindy Dawson, MSN, RN, CORLN, is the chief nurse executive and associate director of the University of Iowa Hospitals and Clinics. She received her BSN from the University of Iowa, MSN from the University of Phoenix, and is a Certified Otorhinolaryngology Nurse. Over the course of her career, she has published extensively on EBP, nurse triage, nursing management/leadership, and clinical practice guidelines and has given numerous local, regional, national, and international presentations on these topics.

HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remains with them. The company accepts no liability for any errors, omissions or representations.

Infographic: 5 Factors Driving Healthcare Digital Transformation

November 8th, 2017 by Melanie Matthews

Increases in life expectancy, changing consumer behavior, political uncertainties, inflation and rising number of chronic diseases are helping to drive the digital health transformation demand, according to a new infographic by InsightRush.

The infographic examines how each of these factors is contributing to the digital health transformation.

2016 Healthcare Benchmarks: Digital HealthDigital health, also referred to as ‘connected health,’ leverages technology to help identify, track and manage health problems and challenges faced by patients. Person-centric health management is slowly acknowledging the device-driven lives of patients and health plan members and incorporating these tools into care delivery and management efforts.

2016 Healthcare Benchmarks: Digital Health examines program goals, platforms, components, development strategies, target populations and health conditions, patient engagement metrics, results and challenges reported by more than 100 healthcare organizations responding to the February 2016 Digital Health survey by the Healthcare Intelligence Network.

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