The shift to value-based care may be occurring more slowly than advocates would like. In a climate of escalating costs and lingering disruption from the pandemic, 然而, organizations that embrace alternative payment models stand to make significant financial gains in the short term—and set themselves up to be providers of choice as value-based payment models proliferate.
想想看:截至2020年, 48.5%的商业医疗费用 were directly tied to clinical quality metrics aimed at reducing costs, 增进人民健康, 提高病人的体验. Healthcare organizations are being increasingly incentivized through value-based payment arrangement, and there’s little doubt this will continue.
合作改善质素
Organizations that underestimate the scope of the transition to value do so at their peril. Improving and sustaining quality performance is a substantial organizational effort that hospitals frequently struggle to achieve independently.
在一个这样的例子中, 心电图 partnered with an academic health system (AHS) to implement technology-supported, evidence-based practices and processes to improve outcomes in the most challenging quality measures. 心电图’s subject matter experts (SMEs) facilitated clinician/IT collaboration to design new, streamlined EHR documentation workflows that:
- Incorporated evidence-based clinical care practices.
- 加速结果改善.
- Enab领导 real-time performance monitoring.
情况概述
The AHS wanted to reexamine its approach to achieving specific performance targets in one of its commercial insurer’s 绩效工资 (P4P)程序. Despite having numerous initiatives in place, the organization was still leaving millions of dollars on the table each year in P4P payments.
In 2020, 心电图 partnered with the AHS to rapidly assess its approach to achieving those targets, with a focus on improving measures related to:
- 耐甲氧西林金黄色葡萄球菌感染.
- 手术部位感染(ssi).
- Appropriate use of emergency department (ED) and outpatient cardiac imaging.
- 计划外的再入院.
我们确定了几个障碍 impeded the AHS’s ability to implement significant and sustainable improvements:
成功的关键因素
Taking a collaborative approach with our client 领导 to the successful implementation of quality improvement (QI) initiatives.
结果
通过这次合作, 我们的客户取得了有意义的临床成果, 操作, and financial outcomes across the MRSA screening and intervention, SSIs, and imaging quality measures and will implement workflows to reduce unplanned readmissions later this year.
持续改善, we worked with the AHS to improve its reporting infrastructure to manage real-time measure performance.
MRSA筛查和干预
设计 and implemented an inpatient MRSA screening and treatment interventions bundle, identifying patients with community-acquired MRSA (thereby reducing hospital-acquired attribution) and treating infected patients to reduce the in-hospital spread of MRSA.
SSI减少
设计 and implemented a pre-operative patient triage tool to identify patients at high risk for SSIs and provide evidence-based interventions to reduce patients’ risk of infection prior to surgery, while simultaneously ensuring appropriate antibiotic stewardship. The health system realized a 40% reduction in SSIs from July 2021 to June 2022.
ED影像管理
Developed and implemented best practice guidelines for adult imaging in the ED through detai领导 process maps, 教育材料, and socialization with providers to decrease unnecessary patient imaging.
减少计划外再入院
设计, 领导, and implemented interventions to reduce unplanned readmissions, including integrating discharge planning and care coordination, enhancing discharge planning processes for patients with medium and high risk of readmission, addressing social determinants of health that impact readmissions, and increasing outpatient clinic availability to ensure timely postdischarge appointments for patients at risk of readmission.
实时报告
开发耐甲氧西林金黄色葡萄球菌, SSI, and imaging quality measure reports to provide 操作 and clinical leadership with real-time performance data to ensure the health system had the tools and processes to sustain, 继续改进, 随着时间的推移衡量绩效.
变革的模型
As a result of this work, the AHS is projected to earn approximately $11.6 million in financial incentives over three years while simultaneously improving clinical outcomes and patient safety. 心电图’s partnership model was essential in overcoming barriers to acheive these results.
医院 and health systems that similarly engage in QI efforts should implement the critical success factors above and, 如果需要, collaborate with an external partner to overcome barriers to improvement. These organizations will be well positioned to develop strong QI capabilities and realize sustained improvements across value-based care arrangements.
Here’s how 心电图 partnered with a health system to develop a telehealth strategy.
编辑: 马特杂粮面包
出版于2022年8月17日