Grappling with the evolving guidelines and regulations surrounding opioid prescribing is a significant challenge for health systems across the country. Over-prescription of opioids, such as morphine, oxycodone and hydrocodone, happens in a variety of ways, according to a report authored by a panel of clinical executives at a leading U.S. health system and described in an article in the Sept. 8, 2017 issue of Health Affairs. As the article states, overtreatment and opioid misuse has “driven an epidemic of opioid addiction and drug overdoses, now the leading cause of accidental death in the United States.”
Improving appropriate utilization is a priority for every health system – and it’s the focus of this post, which is Part 4 in a series focused on how high-performing healthcare systems are using clinical process improvement to tackle the common priorities in healthcare often referred to as the “triple aim + 1” or the “quadruple aim.” Part 1 took a high-level look at increasing clinician engagement, delivering quality patient care and containing costs. Part 2 targeted clinician engagement and satisfaction. Part 3 delved deeper into solutions for improving patient safety and quality of care delivery. This piece wraps up the series by focusing on how healthcare systems are effectively reducing costs through appropriate utilization.
Welcome to part 3 of a blog series focused on how high-performing healthcare systems are using clinical process improvement to tackle the common priorities often referred to as the “triple aim + 1” or the “quadruple aim.” The first blog in this series took a high-level look at increasing clinician engagement, delivering quality patient care and containing costs. The second blog focused on clinician engagement and satisfaction. This piece dives deeper into solutions for improving patient quality & safety of care delivery.
A couple weeks ago, I shared insights about addressing common priorities in healthcare, often referred to as the “triple aim + 1” or the “quadruple aim.” Meeting those four objectives – improving patient satisfaction, delivering quality patient care, containing costs and increasing clinician engagement – can be challenging without the proper insight and processes in place.
You may know of it as the “Triple Aim Plus One.” It’s a shortcut reference to four key objectives pursued across healthcare today:
- Improve patient satisfaction
- Deliver quality patient care
- Contain costs
- Increase clinician engagement
The era of modern medicine has produced groundbreaking discoveries that have helped save countless lives. But despite their value to patient care, these discoveries also place a heavy burden on providers and their organizations. A study published in 2011 estimated that as of 2010, medical knowledge began doubling every 3.5 years. By 2020, the doubling rate is expected to drop to approximately 73 days. This rapid rate of change has a significant influence on clinical processes. Today’s best practices may be outdated tomorrow. This, in turn, creates unnecessary variation in clinical processes and increases morbidity and mortality risks that can be avoided.
We want to pick-up from where we left off a couple weeks ago, which called attention to healthcare’s “Quiet Crisis” – a scenario in which clinical processes vary widely; are difficult to see into in near-real time; and, next to impossible to control and improve with EHR systems alone. One C-level clinician described the current state as ‘whack-a-mole’ healthcare. This environment is not conducive to clinical process control and improvement.
The serious health threat of sepsis and the accompanying financial impact is a problem well known in healthcare. It causes half of hospital deaths. Measuring the effectiveness of a hospital’s response to sepsis is much more difficult. Despite significant investment in early detection, health systems lack insight they need to understand, control and ultimately improve the clinical processes guiding treatment of sepsis.
Not achieving hoped-for outcomes often stems from not having the capability for instant insight, improvement and control of vital clinical processes that will produce desired results. Clinical process control is critical to changing the current state.
I’ve seen this during my career as a physician and as Chief Health Information Officer at Hennepin County Medical Center in Minneapolis, and now as Chief Medical Officer at LogicStream Health. For health systems to achieve reliable, high quality, evidence-based care, ongoing improvement, control and automation of clinical processes is must-have capability.
There are a number of forces behind what I call healthcare’s “Quiet Crisis.” The first and most critical issue being lack of clinical process control leading to far too much unnecessary care variation. We have very limited ability to see into the clinical processes in near-real-time to observe this variation and where it can be intervened upon. Therefore, as clinical leaders we can’t find the variation, making it next to impossible to control and actually improve our care delivery.
Topics: Quality & Safety