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Top Five Lessons from VergeCon 2018: Taking a Systems Approach to Safety
“The Project Approach is not making patients safer!”
We had the opportunity recently to have a group of senior executives from health systems at our user group meeting a few weeks ago, and the progress our clients are making in keeping patients safer is incredibly encouraging. These executives came from great health systems around the country that are taking safety seriously, and they all were making progress on building better systems of care.
“We have 94 organizations that could do things in 94 different ways,” says one participant. That variability itself cascades, increasing cost of care, administrative costs, and increases risk of failure. Healthcare has been focused on reporting failure, but Verge clients are now focused on risk prevention through great systems.
“Nothing has changed since 1999. We adopted the LEAN approach, but that in itself became another project,” another leader stated. Today, his health system is rejecting the project approach to embrace technology that helps them think — and work — in a more holistic way.
As one panelist cautions: “Initially it was about rolling out HIS systems, but now that’s not good enough; we have to focus on getting better outcomes.” – Getting to better outcomes measurement in safety is hard when 6 out of seven events go unreported. Clients like Cleveland Clinic are finding those events in a new way with Verge Rounding, and our Risk Surveillance module is finding potential events in the EMR data for the first time.
Resist the complex; embrace simplicity for greater effectiveness.
Part of the fragmented approach to system integration is borne out of a tendency to do everything at once. “The issue is managing too many outcomes – say 60 – then watching them all go down and nothing going up,” a panelist said. Instead, it’s best to start small, do a few things really well, and move on to the next challenge.
The C-suite is in an uncomfortable place, straddling Fee for Service and Value Based Care contracts. Make it easy for them. Safety and Patient experience is the best bet in both worlds.
More health systems have arrived at a “tipping point” where failing either Value Based Care (VBC) or Fee For Service (FFS) contracts will kill a health system’s financials. Leadership is really challenged by this, as certain procedures that used to be highly valuable to provide are now a liability in some contracts. It is a complex problem to navigate, so now is the time to make it easy for healthcare leadership. Safety, Risk Management and Patient Experience activities have strong value in either model! Building executive dashboards to map operational successes and failures on an enterprise level help make data meaningful for harried C-suite executives.
There’s no significant change without physician buy-in, and there’s no buy-in without a data source they trust.
“We started doing multidisciplinary peer reviews, and we learned that what you might attribute to a doctor is really the system,” notes one participant. Combining peer review data, mortality data from payers and a credentialing solution into a data set that’s accessible, understandable, and reliable, helps build trust among physicians.
What is “patient safety”? And who is responsible for it?
Patient safety, and charting a course for its improvement, preoccupies every panelist. And the model is changing rapidly from a “report when safety fails” to “go find where safety might fail and fix the problem before someone gets hurt.” “Patient safety isn’t just about putting out the fire; it’s making sure the fire never happens again,” says Crockett. The fire analogy goes a long way here, removing the material that can burn, fireproof the area, and even if someone drops a match, there is no harm done. We need to fireproof our clinical areas! The panelists had a great discussion on how the prevention focus is present in every industry, and there is irony in providing preventative care to patients, while not focusing on a preventative approach to safety.
According to Crockett, the journey to improved patient safety begins the same way as improved patient experience and financial strength begins, with great operations. “Compliance is a by-product of reliable operations and rounding and safety audits are a critical part of that. Horizontally integrated organizations will ultimately prevail in all of these areas, while those that continue to take a piecemeal, “every silo for itself” approach will struggle and likely be acquired by organizations that do these critical activities well.
Speeding up Healthcare Transformation
Need help with your next phase of healthcare transformation? Verge Health can help you realize a high reliability culture where everyone — patients, clinicians, staff and executives – wins.
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- Mark Crockett – Chief Executive Officer, Verge Health
- Pat Fry – Executive Chairman of the Board, Verge Health
- Sherri Hess, Chief Nursing Informatics Officer, Banner Health
- Deborah Larkin – Carney, VP Quality and Safety, RWJBarnabas Health
- Istikram Qaderi, Chief Quality and Transformation Officer, Penn Highlands Healthcare
- Rita Stockman, Director Accreditation and Regulatory Services, Trinity Health
- Mark Williams, Chief Clinical Officer, Palmetto Health