Driving Clinical Excellence at NHRMC

November 05, 2018

When you think of whether a product or service is a good value, you consider more than the cost.  You consider whether the cost reflects the quality of the product or service you received.  Similarly, when we talk about driving value in the care we provide, we look to the relationship between quality and costs.  This is referred to as the “Value Equation,” and can be stated as:

                                                            Health Outcomes that Matter to Patients

                                                Value = ------------------------------------------------------------

                                                                Total Costs across the Episode of Care

We can increase the value of the care we deliver by a combination of quality improvement and cost reduction.  We know there is a lot of waste in healthcare, and as we’ve learned from our Lean journeys, reduction of waste leads to more efficiency and less overall costs to provide care.  One means of reducing waste is to identify and reduce unwarranted clinical variation.

Unwarranted care variation can be defined as differences in care that cannot be explained by type or severity of patient illness or patient preference, and is often unintentionally built in to our systems of care.  By identifying best practices we can begin to develop standards of care. Once care standards are identified, we can identify and address processes that drive us toward meeting the standards or inadvertently lead the providers away from best practice.

Led by Vice President of Clinical Excellence Dr. Clyde Harris, and Director of Clinical Excellence Claire Corbett, the Clinical Excellence team has already begun their mission of identifying and reducing unwarranted care variation, identifying best-evidence care, and redesigning and implementing care pathways where possible.

“The department is being organized by the Clinical Excellence team, but it is being driven by physicians, providers and subject matter experts,” said Corbett. “We already have three physician led teams that are hard at work reviewing analytical information and implementing plans to reduce unwarranted care variation ensuring evidence based outcomes for patients.”

These teams, and future Clinical Excellence teams, will identify evidence based guidelines, and in the absence of specific guidelines, consensus based best practices that will be implemented to optimize care delivery and patient experience. Through the use of robust analytics, process engineering tools and multidisciplinary clinical and operational leadership, teams will identify areas of opportunity and implement improvement strategies.

“The concept of clinical excellence has been done in pockets, but there has never been a structure for physicians to collaborate and discuss optimization,” said Harris. “Physicians coming together to develop standards of optimal care is fantastic. We are encouraged to work with additional teams to identify areas of opportunity and work to determine care standards.”  The Clinical Excellence Department will also assist and accelerate teams that may be working on projects that promote best care practices.

All of this is being done to positively impact quality of care, reduce system costs and produce high reliability outcomes. These concepts and strategies will help to develop a system-wide culture of minimizing unwarranted clinical variation, ensuring evidence based standard outcomes for patients, and helping secure the organization in rapidly changing healthcare environment.

Ultimately, Clinical Excellence strives to make it easier to provide the right care for the right patient at the right time.